Top Ten 2017 • Journal of Invasive Cardiology • Vol. 29
Dr. Bhatt’s Top Ten List
Percutaneous Transcatheter Therapies for the Management of Left Ventricular Assist Device Complications
Rohan J. Kalathiya, MD; Jonathan Grinstein, MD; Nir Uriel, MD; Atman P. Shah, MD
The utilization of continuous-flow left ventricular assist devices (LVADs) has greatly increased over the last decade. This increased use of LVAD therapy has led to the observation of mechanical complications such as device thrombosis, de novo aortic insufficiency, and outflow graft stenosis. Surgical repair for these complications remains the therapy of choice; however, surgery may be associated with high operative risk in some patients. The purpose of this article is to discuss mechanical complications associated with LVAD therapy and interventional transcatheter therapies that have been used to solve these increasingly complex problems.
Root Cause Analysis of Deaths in ST-Segment Elevation Myocardial Infarctions Treated With Primary PCI: What Can We Do Better?
Fredy El Sakr, MD; Mohamad Kenaan, MD; Daniel Menees, MD; Milan Seth, BS, MS; Hitinder S. Gurm, MD
Recent data demonstrate that mortality of patients with ST-elevation myocardial infarction has not changed despite dramatic reduction in door-to-balloon times. Identifying potential areas in care that can be further optimized to decrease mortality remains a priority. We performed a root-cause analysis of all patients who died following primary percutaneous coronary intervention (PCI) during index hospitalization from 2008 to 2013 at the University of Michigan. Mortality following primary PCI was deemed mostly unpreventable. However, improvement in symptom-onset to medical care was identified as one potential target that might be of value in further reducing the mortality associated with ST-elevation myocardial infarction.
Antecubital Fossa Venous Access For Right Heart Catheterization
Omar Waheed; Abhinav Sharma, MD; Maninder Singh, MD; Edo Kaluski, MD
With the advance of radial access and ulnar access, there has been an increased interest in performing right heart catheterization and right-heart based procedures via antecubital venous access. Our purpose is to describe the venous anatomy of the upper extremities, technique, equipment, and cost for employing this approach. Reported also is the international experience based on publications assessing procedural success, complications, fluoroscopy time and radiation dose, access-site compression time, and time to ambulation. Antecubital-venous-access based right heart catheterization carries satisfactory success rates, requires a short learning curve, and is exceptionally safe even when performed with full anticoagulation.
Transcatheter Aortic Valve Replacement Versus Surgical Valve Replacement in Low-Intermediate Surgical Risk Patients: A Systematic Review and Meta-Analysis
Aakash Garg, MD; Sunil V. Rao, MD; Gautam Visveswaran, MD; Sahil Agrawal, MD; Abhishek Sharma, MD; Lohit Garg, MD; Indrajeet Mahata, MD; Jalaj Garg, MD; Dinesh Singal, MD; Marc Cohen, MD; John B. Kostis, MD, PhD
Novel Method for Exchange of Impella Circulatory Assist Catheter: The “Trojan Horse” Technique
Colin T. Phillips, MD; Hector Tamez, MD; Thomas M. Tu, MD; Robert W. Yeh, MD; Duane S. Pinto, MD, MPH
Patients with an indwelling Impella device may require escalation of hemodynamic support or exchange to another circulatory assistance platform. Challenges exist in avoiding bleeding and loss of wire access in these patients. We describe a single-access “Trojan Horse” technique that minimizes bleeding while maintaining arterial access for rapid exchange of this percutaneous ventricular assist device.
Percutaneous Mechanical Circulatory Support for Cardiac Disease: Temporal Trends in Use and Complications Between 2009 and 2015
Bradley W. Ternus, MD; Jacob C. Jentzer, MD; Abdallah El Sabbagh, MD; Mackram F. Eleid, MD; Malcolm R. Bell, MD; Joseph G. Murphy, MD; Charanjit S. Rihal, MD; Gregory W. Barsness, MD
We present the indications for use, temporal trends, complications, and 1-year clinical outcomes after single-access percutaneous mechanical circulatory support device placement from years 2009-2015 at our institution. We included 778 patients with an intraaortic balloon pump or Impella device placed in the catheterization suite between January 1, 2009 and December 31, 2015.
Contemporary Trends and Outcomes Associated With the Preprocedural Use of Oral P2Y12 Inhibitors in Patients Undergoing Percutaneous Coronary Intervention: Insights From the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2)
Devraj Sukul, MD; Milan Seth, MS; Simon R. Dixon, MBChB; Akshay Khandelwal, MD; Thomas A. LaLonde, MD; Hitinder S. Gurm, MD
Outcomes After Successful Percutaneous Coronary Intervention of Calcified Lesions Using Rotational Atherectomy, Cutting Balloon Angioplasty, or Balloon-Only Angioplasty Before Drug-Eluting Stent Implantation
Björn Redfors, MD, PhD; Akiko Maehara, MD; Bernhard Witzenbichler, MD; Giora Weisz, MD; Thomas D. Stuckey, MD; Timothy D. Henry, MD; Thomas McAndrew, PhD; Roxana Mehran, MD; Ajay J. Kirtane, MD, SM; Gregg W. Stone, MD; Philippe Généreux, MD
Percutaneous coronary intervention (PCI) of calcified lesions is increasingly common and is associated with a high risk of adverse events. Our objective was to report adverse event rates after rotational atherectomy (RA) with contemporary drugeluting stent (DES) implantation and compare RA to cutting balloon angioplasty and balloon-only angioplasty in the allcomers ADAPT-DES trial.
Classification for Assessing the Quality of Diagnostic Coronary Angiography
Philippe Généreux, MD; Roxana Mehran, MD; Martin B. Leon, MD; Nicolas Bettinger, MD; Gregg W. Stone, MD
Coronary angiography remains the gold standard for diagnosing obstructive coronary artery disease. However, no standardized, objective, and quantitative classification to assess the quality of coronary angiography exists. In the present report, we sought to establish a novel standardized quantitative classification for the quality of coronary angiography, taking into consideration two main parameters: coronary contrast filling and coronary sinus contrast reflux.
Transpedal Access for the Management of Complex Peripheral Artery Disease
Konstantinos Marmagkiolis, MD; Partha Sardar, MD; Jihad A. Mustapha, MD; Miguel Montero-Baker, MD; Konstantinos Charitakis, MD; Cezar Iliescu, MD; Dmitriy N. Feldman, MD
Critical limb ischemia is associated with high risk of limb loss, as well as cardiovascular and all-cause mortality. Transpedal access is a novel, increasingly utilized technique for the management of complex peripheral artery disease (PAD). In order to evaluate the safety and efficacy of transpedal access for PAD, we performed a literature search using PubMed from January 2003 to December 2016 and evaluated patient sample demographics, procedure indications, access and target vessel, procedural characteristics, outcomes, and complications.