01 mayo 2011

JACC: CARDIOVASCULAR INTERVENTIONS. Radial Artery Graft String Sign Due to Lumen Obliteration by Neointima. Insight From Optical Coherence Tomography

David Adlam, BM, DPhil, Keith M. Channon, MD

The radial artery is a commonly used conduit for coronary artery bypass grafting. Long-term patency rates are at least as good and in some series are better than for saphenous vein grafts (1,2). However, radial artery graft failure remains a significant problem (3), in particular in cases where radial conduits are used on smaller target vessels or where there is significant competitive flow from a native coronary with a relatively low grade stenosis (4). The string sign, where the radial graft conduit is patent but with only a thread of antegrade flow, is a well-recognized angiographic presentation of radial graft failure (3). We describe for the first time optical coherence tomography (OCT) images of a radial conduit presenting with the string sign. JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 5, 2011. Copyright © 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00. PUBLISHED BY ELSEVIER INC. DOI: 10.1016/j.jcin.2010.10.017.

01 octubre 2011

INTERVENTIONAL CARDIOLOGY, Volume 6, Issue 2, Autumn 2011

Revista completa publicada libre por sus editores.

21 abril 2011

The role of advanced imaging in Transcatheter Aortic Valve Implantation

Apostolos Tzikas. Promotor: Prof.dr. P.W.J.C. Serruys. Overige leden: Prof.dr. P.J. de Feyter, Prof.dr. F. Zijlstra, Dr. F.J. ten Cate. Copromotoren: Dr. P.P.T. de Jaegere Dr. M.L. Geleijnse

© 2011 Copyright of the published articles is with the correspond- ing journal or otherwise with the author. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means without the permission of the author or the corresponding journal. ISBN 978-960-93-2840-1. Produced in Thessaloniki, Greece by Ziti Publications. Financial support by the Netherlands Heart Foundation for the publication of this thesis is gratefully acknowledged.

01 mayo 2011

JACC: CARDIOVASCULAR INTERVENTIONS. Explantation of Patent Foramen Ovale Closure Devices. A Multicenter Survey

Swarnendra K. Verma, MD, Jonathan M. Tobis, MD

Objectives: The aim of this study was to examine the frequency and causes of surgical explantation of patent foramen ovale (PFO) closure devices. Background: PFO has been linked with cryptogenic strokes, recurrent transient neurologic deficits, sleep apnea, decompression illness, and migraines. Several randomized trials are in progress to determine whether PFO closure is preferable to medical management in the treatment of patients with cryptogenic strokes or migraine. The majority of PFO closures are performed off-label, because there is no U.S. Food and Drug Administration approval for use of any device to close a PFO. As data are accumulating on the benefits of implanting PFO closure devices, it is also important to examine complications that might occur. JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 5, 2011. Copyright © 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00. PUBLISHED BY ELSEVIER INC. DOI: 10.1016/j.jcin.2011.01.009.

01 mayo 2012

FUTURE CARDIOLOGY. Percutaneous interventions of the aorta

Marc Gewillig, Werner Budts, Derize Boshoff & Geert Maleux

Coarctat i on of t he aor ta i ncl udes a wi de ar ray of anatomi cal and pathophysiological variations that may cause important long-term morbidity and mortality. Percutaneous techniques, such as balloon dilation and stenting, allow clinicians to safely decrease or aboli sh most gradients along the aorta, albeit wi th l i mi tati ons. Proper pati ent sel ecti on and i nter venti onal techni que al l ow clinicians to obtain an adequate stretch or therapeutic tear of the vessel wall, but should avoid complications, such as an excessive tear, di ssection, aneurysm formati on or rupture. The i nter venti onal techni que i s tai l ored by pati ent characteri stics such as age, size and growth potential, by characteri stics of the lesion such as degree of narrowing, length, angulation(s) and by local regulations. Future Cardiol. (2012) 8(2), 251–269. ISSN 1479-6678. 10.2217/FCA.12.10. Copyright © 2012 Marc Gewillig.

01 mayo 2011

JACC: CARDIOVASCULAR INTERVENTIONS. Optical Coherence Tomography or Intravascular Ultrasound?

Ik-Kyung Jang, MD, PhD

Intravascular ultrasound (IVUS) has been an important modality in understanding the in vivo pathophysiology of coronary artery disease and in predicting outcome of percutaneous coronary intervention (PCI). The IVUS features associated with acute coronary syndromes include positive remodeling, large plaque burden, ruptured plaque, and intracoronary thrombus. Plaque burden, lesion site calcium, and positive remodeling have been reported to be associated with no-reflow phenomenon and periprocedural myocardial necrosis after PCI (1,2). Attempts to characterize coronary plaques using IVUS were less successful. Although some studies showed that lipid pool-like hypoechoic plaques on IVUS may be associated with periprocedural myocardial infarction, conflicting studies have been reported. It was generally accepted that IVUS is not an ideal tool to detect lipid-rich plaque. However, recent studies reported that echo-attenuated plaque on gray scale IVUS was associated with no-reflow and/or elevated creatine kinase-myocardial band (CK-MB) after PCI, which indicates that this type of plaque contains vasoactive substances, thrombogenic substrates, or rigid material including cholesterol crystal that does not go through the capillary system, causing distal embolization with resultant myocardial necrosis. JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 5, 2011. Copyright © 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00. PUBLISHED BY ELSEVIER INC. DOI: 10.1016/j.jcin.2011.02.004.

01 octubre 2010

CIRCULATION. Intravascular Ultrasound–Documented Healing of Spontaneous Coronary Artery Dissection

Italo Porto, MD, PhD, Cristina Aurigemma, MD, Faustino Pennestrì, MD and Antonio G. Rebuzzi, MD

A 46-year-old woman without a history of cardiovascular disease and no coronary risk factor was urgently admitted to our hospital with rest crushing chest pain, which had started 3 hours before. The ECG demonstrated minimal anterior ST-segment elevation in leads V1 to V4 (Figure 1). In the first sample cardiac troponin T was 0.08 ng/mL. Coronary angiography was urgently performed and demonstrated a 50% smooth stenosis in the proximal left anterior descending (LAD) coronary (Figure 2) with a faint dye staining just proximal to the first diagonal branch. Because initial differential diagnosis included variant angina, intracoronary ergonovine (32 μg) was given. Diffuse LAD coronary vasoconstriction, more severe on the LAD coronary ostium, was seen. Because there was still no clear indication of a culprit lesion, intravascular ultrasound (IVUS) examination was performed, which surprisingly showed an intramural hematoma starting from the mid-LAD up to its ostium, with mild lumen compromise, and the presence of nonobstructive atheroma. Copyright © 2010 American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632

01 mayo 2011

JACC: CARDIOVASCULAR INTERVENTIONS. Assessment of Echo-Attenuated Plaque by Optical Coherence Tomography and its Impact on Post-Procedural Creatine Kinase-Myocardial Band Elevation in Elective Stent Implantation

Tetsumin Lee, MD, Tsunekazu Kakuta, MD, Taishi Yonetsu, MD, Kentaro Takahashi, MD, Ginga Yamamoto, MD, Yoshito Iesaka, MD, Hideomi Fujiwara, MD, Mitsuaki Isobe, MD

Objectives: This study examined morphological characteristics of echo-attenuated plaques by optical coherence tomography (OCT) and evaluated their influence on creatine kinase-myocardial band (CK-MB) elevation after percutaneous coronary intervention (PCI) in patients with elective stent implantation. JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 5, 2011. Copyright © 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00. PUBLISHED BY ELSEVIER INC. DOI: 10.1016/j.jcin.2010.12.013.

01 mayo 2011

JACC: CARDIOVASCULAR INTERVENTIONS. The Relationship Between Volumetric Plaque Components and Classical Cardiovascular Risk Factors and the Metabolic Syndrome

Mingri Zheng, MD, So-Yeon Choi, MD, PhD*, Seung-Jea Tahk, MD, PhD, Hong-Seok Lim, MD, PhD, Hyoung-Mo Yang, MD, Byoung-Joo Choi, MD, Myeong-Ho Yoon, MD, PhD, Jin-Sun Park, MD, Gyo-Seung Hwang, MD, PhD, Joon-Han Shin, MD

Objectives: The aim of this study was to analyze volumetric plaque composition of the coronary arterial tree according to the classical cardiovascular risk factors and metabolic syndrome (MS) using virtual histology–intravascular ultrasound (VH-IVUS). Background: It remains unclear how the cardiovascular risk factors correlate with the histological components of coronary plaques. JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 5, 2011. Copyright © 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00. PUBLISHED BY ELSEVIER INC. DOI: 10.1016/j.jcin.2010.12.015.

26 julio 2011

CIRCULATION. Percutaneous Repair of Paravalvular Prosthetic Regurgitation Acute and 30-Day Outcomes in 115 Patients

Paul Sorajja, MD, Allison K. Cabalka, MD, Donald J. Hagler, MD and Charanjit S. Rihal, MD

Background —Percutaneous repair has emerged as a potential therapy for patients with prosthetic paravalvular regurgitation. However, there is a relative paucity of data on the feasibility and outcome of this procedure. Copyright © 2011. American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632.

27 septiembre 2011

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Transarterial Medtronic CoreValve System Implantation for Degenerated Surgically Implanted Aortic Prostheses

Fleur Descoutures, MD, Dominique Himbert, MD, Costin Radu, MD, Bernard Iung, MD, Caroline Cueff, MD, David Messika-Zeitoun, MD, PhD, Gregory Ducrocq, MD, Eric Brochet, MD, Patrick Nataf, MD and Alec Vahanian, MD

Background —To assess the results of transcatheter aortic valve implantation (TAVI) using the Medtronic CoreValve System (MCS), through the transarterial approach, in high-risk patients with degenerated surgically implanted aortic bioprostheses (SP). Copyright © 2011. American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632

01 julio 2011

JACC. Transcatheter Aortic Valve Implantation for Failing Surgical Aortic Bioprosthetic Valve

Nicolo Piazza, MD, Sabine Bleiziffer, MD, Gernot Brockmann, MD, Ruge Hendrick, MD, Marcus-André Deutsch, MD, Anke Opitz, MD, Domenico Mazzitelli, MD, Peter Tassani-Prell, MD, PHD, Christian Schreiber, MD, Rüdiger Lange, MD, PHD

With an aging population, improvement in life expectancy, and significant increase in the use of bioprosthetic valves, structural valve deterioration will become more and more prevalent. The operative mortality for an elective redo aortic valve surgery is reported to range from 2% to 7%, but this percentage can increase to more than 30% in high-risk and nonelective patients. Because transcatheter aortic valve (TAV)-in-surgical aortic valve (SAV) implantation represents a minimally invasive alternative to conventional redo surgery, it may prove to be safer and just as effective as redo surgery. Of course, prospective comparisons with a large number of patients and long-term follow-up are required to confirm these potential advantages. It is axiomatic that knowledge of the basic construction and dimensions, radiographic identification, and potential failure modes of SAV bioprostheses is fundamental in understanding key principles involved in TAV-in-SAV implantation. The goals of this paper are: 1) to review the classification, physical characteristics, and potential failure modes of surgical bioprosthetic aortic valves; and 2) to discuss patient selection and procedural techniques relevant to TAV-in-SAV implantation. JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 7, 2011 Copyright © 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00 PUBLISHED BY ELSEVIER INC.

01 enero 2011

JACC. Transcatheter Aortic Valve Implantation Lessons From the PARTNER (Placement of Aortic Transcatheter Valves) Trial

Jon C. George, MD, Vincent Varghese, DO, George Dangas, MD, Jeffrey J. Popma, MD

The PARTNER (Placement of Aortic Transcatheter Valves) trial, recently published (1) and presented at the 2010 Transcatheter Cardiovascular Therapeutics conference, investigated the safety and efficacy of transcatheter aortic-valve implantation (TAVI) in patients deemed unsuitable for surgical aortic valve replacement. Severe calcific aortic stenosis (AS) is an increasingly prevalent disease in elderly persons, with a high and rapid rate of mortality in untreated patients, approaching 50% mortality over the first 2 years (2). Aortic valve replacement is the current gold standard of treatment and has been proven to prolong and improve quality of life in good operative candidates; however, in patients with multiple or severe comorbidities and high operative risk, surgery is often prohibitive (3,4). Transcatheter aortic-valve implantation is a newer and less invasive alternative approach that has demonstrated favorable results and low mortality in these highsurgical-risk patients in the PARTNER trial. JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 1, 2011 Copyright © 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00 PUBLISHED BY ELSEVIER INC.

01 marzo 2011

EHJ. Intraplaque haemorrhages as the trigger of plaque vulnerability

Jean-Baptiste Michel, Renu Virmani, Eloïsa Arbustini and Gerard Pasterkamp

Atherothrombosis remains one of the main causes of morbidity and mortality in the western countries. Human atherothrombotic disease begins early in life in relation to circulating lipid retention in the inner vascular wall. Risk factors enhance the progression towards clinical expression: dyslipidaemia, diabetes, smoking, hypertension, ageing, etc. The evolution from the initial lipid retention in the arterial wall to clinical events is a continuum of increasingly complex biological processes. Current strategies to fight the consequences of atherothrombosis are orientated either towards the promotion of a healthy life style 1 and preventive treatment of risk factors, or towards late interventional strategies. 2 Despite this therapeutic arsenal, the incidence of clinical events remains dramatically high, 3 dependent, at least in part, on the increasing frequency of type 2 diabetes and ageing. But some medical treatments, focusing only on prevention of the metabolic risk, have failed to reduce cardiovascular mortality, thus illustrating that our understanding of the pathophysiology of human atherothrombosis leading to clinical events remain incomplete. New paradigms are now emerging which may give rise to novel experimental strategies to improve therapeutic efficacy and prediction of disease progression. Recent studies strengthen the concept that the intraplaque neovascularization and bleeding (Figure 1, upper panel) are events that could play a major role in plaque progression and leucocyte infiltration, and may also serve as a measure of risk for the development of future events. The recent advances in our understanding of IntraPlaque Hemorrhage as a critical event in triggering acute clinical events have important implications for clinical research and possibly future clinical practice. European Heart Journal (2011) 32, 1977–1985. Published on behalf of the European Society of Cardiology. All rights reserved. Copyright © The Author 2011.

01 abril 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Nobori Stent Shows Less Vascular Inflammation and Early Recovery of Endothelial Function Compared With Cypher Stent FREE

Lakshmana K. Pendyala, MD; Daisuke Matsumoto, MD, PhD; Toshiro Shinke, MD, PhD; Taizo Iwasaki, PhD; Ryota Sugimoto, MEng; Dongming Hou, MD, PhD; Jack P. Chen, MD; Jaipal Singh, PhD; Spencer B. King, III, MD; Nicolas Chronos, MD; Jinsheng Li, MD, PhD

Objectives: The current study sought to examine inflammation at the stented segments of Nobori (Terumo Corporation, Tokyo, Japan) and Cypher (Cordis, Miami, Florida) drug-eluting stents (DES), as well as free radical production and endothelial function of the adjacent nonstented segments in a pig coronary model.