Volume 20 - Issue 2 - February, 2008

Use of Radiofrequency Energy and Covered Stents in Patients with an Occluded Superior Vena Cava and Requiring Endocardial Pace

Obstructions of the caval veins may develop in various clinical settings in subjects with tumoral lesions, after surgery on the caval veins — as in the Mustard/Senning operation, after radiation therapy, or due to central lines, dialysis catheters and pacing wires.1–4 In particular, patients with a history of multiple cardiac surgical procedures or with a history of infections of the pacemaker site and electrodes may easily develop an iatrogenic occlusion of the venous access.2 Various kinds of interventions have been performed in these subjects, including



Ductal Stent and Cavo-Atrial Sac Occlusion in an Adult with Profound Cyanosis after Palliated Cyanotic Congenital Heart Disease

Interventional catheterizations are an increasingly important component in the management of the growing population of adults with congenital heart disease (CHD). The experience of interventions on adults with CHD from some centers has been reported and the types of procedures resemble those that are common in the pediatric population.1,2
We report a unique case of a 35-year-old female with palliated complex who underwent two unusual interventions during the same catheterization procedure. The first, patent ductus arteriosus (PDA) stent placement, is an uncommon procedure t



Retrieval of a Detached Partially Expanded Stent Using the SpideRX and EnSnare Devices — A First Report

Case Report. A 66-year-old male with previous two-vessel coronary artery bypass graft surgery (CABG) presented with an acute coronary syndrome. Angiography demonstrated a critical 95% stenosis in the ostium of the saphenous vein graft (SVG) to the obtuse marginal (OM) of a dominant circumflex vessel, and another 70% thrombotic lesion in the mid portion of the same graft (Figure 1). The left internal thoracic artery (was widely patent, supplying a diffusely diseased distal left anterior descending artery not amenable to percutaneous intervention. Intervention was p



Double Inferior Vena Cava Filter Implantation in a Patient with a Duplicate Inferior Vena Cava

Case Presentation. A 79-year-old female presented with pain and swelling of the left lower extremity. Physical examination revealed a swollen left calf and 1+ pitting edema over both ankles. There was no evidence of calf tenderness and Homan’s sign was negative bilaterally. A venous duplex Doppler study revealed the presence of occluding thrombi in the left popliteal, as well as the right popliteal and posterior tibial veins. She was also found to have microcytic hypochromic anemia. Upper gastrointestinal endoscopy revealed the presence of erosive esophagitis and ant



Editor's Message

Double Right Coronary Artery with Acute Inferior Wall Myocardial Infarction

The incidence of primary congenital coronary anomalies varies from 0.95–2% in the adult population undergoing coronary angiography (CAG).1–4 The majority of these are reported to be anomalies of origin or distribution, with separate ostia of the left anterior descending artery and left circumflex artery being the most common. Coronary artery anomalies are divided into those that cause and those that do not cause myocardial ischemia.5,6 We describe a rare benign anomaly, a double right coronary artery (RCA) presenting as acute inferior wall myocardial infarctio



Bifurcation Coronary Artery Disease: Current Techniques and Future Directions (Part 1)

Published randomized trials of drug-eluting stents (DES) have shown reduced rates of restenosis and target lesion revascularization (TLR) in noncomplex lesions compared to bare-metal stents (BMS).1 Given this documented success of the antiproliferative therapies in relatively simple lesions, interventional cardiologists have developed techniques and devices hoping to demonstrate similarly durable results in more complex lesion subsets.2–6 Bifurcation coronary artery disease (CAD) comprises an important subset of lesions inadequately studied and thus far unapproved f



Clinical Application of Prophylactic Percutaneous Left Ventricular Assist Device (Tandem Heart™) in High-Risk Percutaneous Cor

Introduction of novel devices for cardiac support during complex percutaneous coronary intervention (PCI) has revolutionized the treatment of coronary artery disease (CAD) and has led to an increasing number of high-risk PCI procedures. Traditionally, the intra-aortic balloon pump (IABP) has been used to provide hemodynamic stability during coronary interventions in high-risk patients. However, the mortality rate continues to be high (30–75%) despite the use of IABPs in the setting of acute myocardial infarction complicated by cardiogenic shock; insertion of a percutaneous transseptal



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