June 2020 Table of Contents

Chronic Total Occlusions 

Planned Robotic Chronic Total Occlusion Percutaneous Coronary Intervention: Feasibility Report 

Daniel Walters, MD; Mitul Patel, MD; Ryan Reeves, MD; Lawrence Ang, MD; Belal Al Khiami, MD; Ehtisham Mahmud, MD

Complex robotic percutaneous coronary intervention (PCI) is technically possible and leads to clinically comparable outcomes compared with the manual approach. However, there are limited data on the feasibility of chronic total occlusion revascularization via the robotic PCI approach. Ten consecutive patients undergoing robotic PCI for a coronary chronic total occlusion at a single tertiary academic center were analyzed. The PRECISION, PRECISION GRX, and PROGRESS CTO registries were utilized for data collection with regard to procedural/clinical details and results. 

J INVASIVE CARDIOL 2020;32(6):201-205. Epub 2020 April 24.

Mitral Valve Disease

Evaluation of Effectiveness and Safety of Transcatheter Mitral Valve Repair Under Moderate Conscious Sedation

Ismail Ates, MD; Sercan Okutucu, MD; Gulcan Kose, MD; Drew Hinson, MD; Konstantinos Marmagkiolis, MD; Cezar Iliescu, MD; Mehmet Cilingiroglu, MD

Transcatheter mitral valve repair (TMVR) using the MitraClip system (Abbott Vascular) has become a world-wide, well-established therapeutic alternative to symptomatic patients with severe mitral regurgitation and prohibitive surgical risk. Currently, TMVRs are performed under general anesthesia; which increases the overall procedure complexity, time, costs, and possible major complications. Herein, we aimed to present the effectiveness and safety of TMVR under moderate conscious sedation. 

J INVASIVE CARDIOL 2020;32(6):206-210.

Coronary Artery Disease 

Novel Prognostic Score for Immediate and Late Success After Percutaneous Mitral Balloon Commissurotomy in Patients With Mitral Stenosis

Luiz Eugenio B. Prota-Filho, MD; Rafael A. Meneguz-Moreno, MD; Caio C. V. Queiroz, MD; Fabricio C. Wohnrath, MD; Felipe A.C. Carboni, MD; Gisele R.C. Silva, MD; Joselyn I.P. Castro, MD; Wandemberg S. Silva, MD; Auristela I.O. Ramos, MD, PhD; Nisia L. Gomes, MD; J. Italo Franca, BS, MSc; Cesar Esteves, MD, PhD; Sergio L.N. Braga, MD, PhD; Alexandre Abizaid, MD, PhD; J. Ribamar Costa Jr, MD, PhD

Percutaneous mitral balloon commissurotomy (PMBC) remains the preferred treatment for patients with severe symptomatic rheumatic mitral stenosis and suitable anatomy. The Wilkins score, introduced in 1988, remains the most widely used tool to select suitable candidates for PMBC; it is based on only four preprocedure echocardiographic morphological features. The objective of this study was therefore to propose a new score for the prediction of immediate and late success that integrates clinical and hemodynamic parameters. This is a single-center, retrospective analysis of all 1582 patients with severe mitral stenosis who underwent PMBC from August 1987 to July 2010. The composite outcome was cardiovascular death, new PMBC, or mitral valve repair surgery up to 24 years of follow-up. 

J INVASIVE CARDIOL 2020;32(6):211-217. Epub 2020 April 9.

Radiation Safety 

The Impact of Novel X-Ray Systems and X-Ray System Optimization on Patient Radiation Dose Administered During Cardiac Catheterization

Evangelia Vemmou, MD; Ilias Nikolakopoulos, MD; Iosif Xenogiannis, MD; Michael Megaly, MD, MS; Mohamed A. Omer, MD; Larissa Stanberry, PhD; Ross Garberich, MS, MBA; Bavana V. Rangan, BDS, MPH; Kenneth W. Baran, MD; Mario Gössl, MD, PhD; Paul Sorajja, MD; Ivan Chavez, MD; Michael Mooney, MD; Jay Traverse, MD; Yale Wang, MD; Santiago Garcia, MD; Anil Poulose, MD; M. Nicholas Burke, MD; Emmanouil S. Brilakis, MD, PhD

The effect of x-ray system optimization on patient radiation dose has received limited study. We analyzed patient radiation dose in 1786 cardiac catheterization procedures (diagnostic coronary angiography and/or PCI) performed at a single tertiary-care center before and after x-ray system optimization. 

J INVASIVE CARDIOL 2020;32(6):218-221. Epub 2020 May 9.

Atrial Fibrillation

Left Atrial Appendage Occlusion in Patients With Thrombus in Left Atrial Appendage

Levent Sahiner, MD; Cem Coteli, MD; Ergun Baris Kaya, MD; Ahmet Ates, MD; Gul Sinem Kilic, MD; Hikmet Yorgun, MD; Kudret Aytemir, MD

Atrial appendage (LAA) occlusion is a therapeutic option for thromboembolic prevention in atrial fibrillation patients who have contraindications to oral anticoagulation or high risk of bleeding. Traditionally, thrombus in the LAA has been considered a contraindication for LAA occlusion. Recently, resistant thrombus formation in patients using oral anticoagulation was suggested as an indication for LAA occlusion. we evaluated the safety and efficacy of LAA occlusion in 12 patients with LAA thrombus.

J INVASIVE CARDIOL 2020;32(6):222-227. Epub 2020 April 24.

Mitral Valve Disease 

Percutaneous Mitral Valve Repair With MitraClip in Inoperable Patients With Severe Mitral Regurgitation Complicated by Cardiogenic Shock

Santiago Garcia, MD; Said Alsidawi, MD; Richard Bae, MD; Joao Cavalcante, MD; Peter Eckman, MD; Mario Gössl, MD, PhD; Robert Steffen, MD; Benjamin Sun, MD; Christian W. Schmidt, MS; Paul Sorajja, MD

Severe mitral regurgitation (MR) complicated by cardiogenic shock has high operative mortality. Percutaneous leaflet repair with MitraClip (Abbott Vascular) is a less invasive alternative to surgery. The effectiveness and safety of this approach is unknown. We retrospectively analyzed procedural characteristics of shock patients with severe MR treated with MitraClip in a tertiary, high-volume program (Abbott Northwestern Hospital, Minneapolis, Minnesota) during 2010-2019. The primary outcome of the study was 30-day survival free of significant MR (grade ≤2). One-year mortality was a secondary outcome.

J INVASIVE CARDIOL 2020;32(6):228-231. Epub 2020 May 9. 

Coronary Artery Disease 

Utility of Radiopaque Bypass Graft Markers During Coronary Angiography Following Coronary Artery Bypass Graft Surgery

Zachary Oman, DO, MBA; Julien Feghaly, MD; Lucas Gu, DO; Ammar Nasir, MD; Michael Forsberg, MD

Radiopaque bypass graft markers allow easy visualization of the location of the graft and can minimize contrast use and radiation exposure during follow-up coronary angiography. This retrospective study analyzed coronary artery bypass graft patients who underwent subsequent coronary angiography in the John Cochrane Veterans Affairs Medical Center from January 2009 until September 2017. 

J INVASIVE CARDIOL 2020;32(6):232-234. Epub 2020 May 9.

Transcatheter Aortic Valve Replacement 

Interaction Between Balloon-Expandable Valves and Coronary Ostia: Angiographic Analysis and Impact on Coronary Access

Laurent Faroux, MD, MSc*; Thomas Couture, MS*; Camila Guimaraes, MD; Lucia Junquera, MD; David del Val, MD; Guillem Muntané-Carol, MD; Jerôme Wintzer-Wehekind, MD; Siamak Mohammadi, MD; Jean-Michel Paradis, MD; Robert Delarochellière, MD; Dimitri Kalavrouziotis, MD; Eric Dumont, MD; Sergio Pasian, MD; Josep Rodés-Cabau, MD         *Joint first authors

We sought to evaluate the position of balloon-expandable valves in relation to the coronary ostia using an angiographic- and computed-tomography based analysis, and to determine the impact of valve position on coronary angiography/percutaneous coronary intervention feasibility and results. 

J INVASIVE CARDIOL 2020;32(6):235-242. Epub 2020 May 20.

Clinical Outcomes

Differential Longitudinal Outcomes Following Percutaneous Coronary Intervention to the Left Internal Mammary Artery and Other Bypass Grafts of the LAD: Findings From the NCDR

Keong Keong Yeo, MBBS; Farnaz Azarbal, MD; Pearl Zakroysky, MPH; David Dai, MPH; Matthew Roe, MD, MHS; Daniel Wojdyla, MS; Reginald Low, MD; Kendrick Shunk, MD, PhD 

J INVASIVE CARDIOL 2020;32(6):E143-E150.

Team Approach

Characteristics and Outcomes of Patients Who Are Denied From a Percutaneous Edge-to-Edge Mitral Valve Repair After Being Referred to a Transcatheter Mitral Valve Program: Impact of a Dedicated Multidisciplinary Mitral Heart Team Approach 

Anthony Poulin, MD*; Frédéric Beaupré, MD*; Caroline Gravel, RN; Sandra Hadjadj, MSc; Mathieu Bernier, MD; Jonathan Beaudoin, MD; Kim O’Connor, MD; Alfredo Nunes Ferreira-Neto, MD; Jérôme Wintzer, MD; Eric Dumont, MD; François Dagenais, MD; Josep Rodés-Cabau, MD; Jean-Michel Paradis, MD  *Joint first authors

J INVASIVE CARDIOL 2020;32(6):E151-E157.

Peripheral Vascular Disease

The Efficacy of Percutaneous Transluminal Angioplasty on the Limb Salvage and Recovery of Symptoms in Patients With Buerger’s Disease With Critical Limb Ischemia

Orhan Rodoplu, MD; Cenk Eray Yildiz, MD; Didem Melis Oztas, MD; Cenk Conkbayir, MD; Orcun Unal, MD; Mustafa Ozer Ulukan, MD; Mert Meric, MD; Murat Ugurlucan, MD; Ahmet Kirbas, MD

J INVASIVE CARDIOL 2020;32(6):E158-E167. 

Clinical Images

Endovascular Treatment of a Migrated Superior Vena Cava Stent in the Right Atrium   

Rajesh Vijayvergiya, MD; Kewal Kanabar, MD; Sanjeev Kaushal, MD; Anupam Lal, MD; Sabari Krishnan, MD

J INVASIVE CARDIOL 2020;32(6):E168-E169.

Clinical Images

Critical Left Main Coronary Stenosis After Sutureless Aortic Valve Replacement   

Wai Kin Chi, MBChB; Chak-Yu So, MBChB; Ka-Lung Chui, MBChB; Joseph Y.S. Chan, MBBS; Chi-Yuen Chan, MBChB

J INVASIVE CARDIOL 2020;32(6):E170-E171.

Clinical Images

Triple-Access Retrograde Chronic Total Occlusion Intervention Through Vein Graft and Epicardial Collaterals   

Ioannis Tsiafoutis, MD; Catherine Liontou, MD; Athanasios Antonakopoulos, MD; Konstantina Katsanou, MD; Michael Koutouzis, MD; Apostolos Katsivas, MD

J INVASIVE CARDIOL 2020;32(6):E172-173.

Clinical Images

Technical Considerations for TAVR in the Treatment of Stentless Bioprosthetic Aortic Valve Insufficiency in LVAD Patients   

Jonathan Yap, MBBS, MRCP, MPH; Benjamin R. Stripe, MD; Garrett B. Wong, MD; Thomas W. Smith, MD; Jeffrey A. Southard, MD

J INVASIVE CARDIOL 2020;32(6):E174.

Clinical Images

Rotatripsy: A Hybrid “Drill and Disrupt” Approach for Treating Heavily Calcified Coronary Lesions   

Konstantinos Aznaouridis, MD, PhD; Maria Bonou, MD, PhD; Constantina Masoura, MD, PhD; Chris Kapelios, MD, PhD; Dimitris Tousoulis, MD, PhD; John Barbetseas, MD, PhD

J INVASIVE CARDIOL 2020;32(6):E175.

Clinical Images

Acute Anterior STEMI in Multivessel Spontaneous Coronary Dissections   

Daniela Trabattoni, MD; Giulia Santagostino Baldi, MD; Giovanni Teruzzi, MD; Edoardo Conte, MD; Antonio Bartorelli, MD

J INVASIVE CARDIOL 2020;32(6):E176.

Clinical Images

Spontaneous Device Detachment After Its Partial Deployment During Left Atrial Appendage Occlusion: A Nightmare in the Cath Lab

Giuseppe Talanas, MD; Eleonora Moccia, MD; Giuseppe D. Sanna, MD, PhD; Guido Parodi, MD, PhD

J INVASIVE CARDIOL 2020;32(6):E177.