Volume 24 - Issue 2 - February 2012

Successful Use of Glycoprotein IIb/IIIa Inhibitor, Heparin, and IABP During PCI in a Post-Neurosurgical Patient with STEMI and Cardiogenic Shock Due to Very Late Bare-Metal Stent Thrombosis

Nuri I. Akkus, MD1, Saurabh Rajpal, MBBS, MD2, Sujata Agnani, MD1

Abstract: Stent thrombosis is not unusual in a post-operative setting. Use of heparin, aspirin, clopidogrel, and glycoprotein (GP)  IIb/IIIa inhibitors in this setting needs to be balanced because of the increased risk of perioperative bleeding. This is of special concern in neurosurgery, where postoperative mass effect from bleeding in a closed space is a serious risk....

Coronary Imaging and Intervention During Cardiovascular Collapse: Use of the LUCAS Mechanical CPR Device in the Cardiac Catheterization Laboratory

Nazanin Azadi, MD1, James T. Niemann, MD2, Joseph L. Thomas, MD1

Abstract: The management of cardiac arrest during coronary angiography and intervention presents substantial challenges. Patients presenting with ST-segment elevation myocardial infarction or following resuscitation from cardiac arrest are at greatest risk and may represent a significant portion of patients in some centers. Timely and effective cardiopulmonary resuscitation (CPR), with manual chest compressions is the primary mode of support though novel circulatory assist devices may have some role....

An Unusual Complication After Coronary Catheterization

Dominique Grisoli, MD1, Vlad Gariboldi, MD1, Jacques Quilici, MD2

ABSTRACT: Valvular complications after coronary catheterization are extremely rare and are seldom reported in the literature. We report a patient who experienced acute traumatic aortic regurgitation after repeated coronary transcatheter procedures. Despite clinical stabilization under medical treatment, his clinical course led to an aortic-valve replacement.

J INVASIVE CARDIOL 2012;24(2):E22-E23...

Transcatheter Closure of a Large Aortopulmonary Window with Severe Pulmonary Arterial Hypertension Beyond Infancy

Anurakti Srivastava, MD and Anil Sivadasan Radha, MD, DNB

ABSTRACT: A patient presented with a large aortopulmonary window and significant pulmonary hypertension, and underwent successful closure with muscular ventricular septal occluder (ShenZhen Lifetech Scientific Inc.) without complications in short-term follow-up.

J INVASIVE CARDIOL 2012;24(2):E24-E26...

Deferring Coronary Stenting for Myocardial Bridging by Fractional Flow Reserve and Optical Coherence Tomography

Atsushi Mizuno, MD, Yutaro Nishi, MD, Koichiro Niwa, MD

ABSTRACT: Deciding how to treat acute myocardial infarction (MI) with myocardial bridge is difficult because stent fracture and early restenosis are frequently reported. We present a 50-year-old female patient with acute MI and myocardial bridge. Optical coherence tomography (OCT) and fractional flow reserve were used to reach a decision on treatment.  

J INVASIVE CARDIOL 2012;24(2):E27-E29...

Novel Use of a GuideLiner Catheter to Visualize Distal LAD After LIMA Anastomosis in Selective Coronary Angiography

Asif Serajian, DO

ABSTRACT: We report a case of GuideLiner catheter use during transradial intervention for selective coronary angiography of the distal left anterior descending artery (LAD), beyond the left internal mammary artery (LIMA) anastomosis. The lesion within the LAD was located distal to the anastomosis of a very tortuous LIMA, otherwise unable to be visualized due to competitive flow from the LIMA. Stenting by way of the LIMA could not be performed due to this severe tortuosity as well....

Transcatheter Repair of Fontan Baffle Stenosis and Fenestration in Two Patients Using Cook Zenith Aortic Endografts

Nitin Madan, MD1, Sharif Ellozy, MD2, Barry Love, MD1

ABSTRACT: Patients with Fontan baffles for single ventricle may have cyanosis from right-to-left shunt through leaks in the baffle or due to intentionally created fenestrations. Typically this right-to-left shunt may be addressed with catheter-based occlusion devices. However, in narrowing of the Fontan baffle, placement of occluders within the Fontan baffle may additionally narrow the pathway and is therefore undesirable....

Usefulness of the Corsair Microcatheter for Treatment of Complex Chronic Total Occlusion

Yoritaka Otsuka, MD, Keita Nakamura, MD, Taro Saito, MD

ABSTRACT: Percutaneous coronary intervention (PCI) for the treatment of chronic total occlusion (CTO) is one of the most technically challenging areas of interventional cardiology. When CTO is combined with angulation and tortuosity of the coronary artery, the technical complexity of PCI for CTO is magnified....

Application of Optical Coherence Tomography in the Treatment of Coronary Bifurcation Lesions

Victorio Pidlaoan, MD, Subhash Banerjee, MD, Emmanouil S. Brilakis, MD, PhD

ABSTRACT: Optical coherence tomography (OCT) is a novel intravascular imaging modality with excellent resolution. We report the application of OCT in 3 coronary bifurcation interventions, in which OCT allowed optimization of the final procedural result, by detecting a dissection, intracoronary thrombus and by confirming complete ostial coverage by a stent.

J INVASIVE CARDIOL 2012;24(2):E39-E42...

Editor's Message

Richard E. Shaw, PhD, FACC, FACA Editor-in-Chief

Dear Readers,

In this issue of the Journal of Invasive Cardiology, we are introducing two new special sections. The first new section is dedicated to covering advances in Transcatheter Aortic Valve Replacement (TAVR) and the section editor is Dr. Howard Herrmann, Professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania and Director of the Interventional Cardiology Program and Cardiac Catheterization Laboratories at the Hospital of the University of Pennsylvania in Philadelphia, Pennsylvania....

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