CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Spontaneous Coronary Artery Dissection : Utility of Intravascular Ultrasound and Optical Coherence Tomography During Percutaneous Coronary Intervention

Karl Poon, MBBS, FRACP; Brendan Bell, MBBS, FRACP; Owen Christopher Raffel, MBBS, FRACP; Darren L. Walters, MBBS, MPhil, FRACP, FCSANZ, FSCAI; Ik-Kyung Jang, MD, PhD

Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndromes but is represented disproportionately in young female patients. No specific guidelines exist concerning the appropriate treatment (medical therapy, intracoronary stents, coronary bypass surgery) or the optimal type of stents in otherwise atheroma-free vessels. Copyright © 2011 American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632.

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Paclitaxel-Eluting Stents Compared With Bare Metal Stents in Diabetic Patients With Acute Myocardial Infarction : HORIZONS-AMI Trial

Bernhard Witzenbichler, MD; Jochen Wo¨hrle, MD; Giulio Guagliumi, MD; Jan Z. Peruga, MD; Bruce R. Brodie, MD; Dariusz Dudek, MD; Ran Kornowski, MD; Franz Hartmann, MD; Kristin L. Hood, PhD; Helen Parise, ScD; Alexandra J. Lansky, MD; Eugenia Nikolsky, MD, PhD; Roxana Mehran, MD; Gregg W. Stone, MD

In the prospective, randomized Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial, implantation of paclitaxel-eluting stents (PES) safely reduced the rates of ischemic target lesion revascularization (TLR) compared with bare metal stents (BMS) in patients with ST-segment–elevation myocardial infarction (STEMI) undergoing primary percutaneous intervention. Diabetes mellitus is a known predictor of adverse outcomes after percutaneous intervention in STEMI. We therefore sought to assess the impact of PES in diabetic patients with STEMI from the HORIZONS-AMI trial. Copyright © 2011 American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Comparison of Zotarolimus-Eluting Stents With Sirolimus-Eluting and Paclitaxel-Eluting Stents : Intimal Hyperplasia and Vascular Changes Assessed by Volumetric Intravascular Ultrasound Analysis

Soo-Jin Kang, MD; Gary S. Mintz, MD; Duk-Woo Park, MD; Seung-Whan Lee, MD; Young-Hak Kim, MD; Cheol Whan Lee, MD; Ki-Hoon Han, MD; Jae-Joong Kim, MD; Seong-Wook Park, MD; Seung-Jung Park, MD

As a substudy of the large, randomized ZEST (Comparison of the Efficacy and Safety of Zotarolimus- Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) trial comparing first- and second-generation drug-eluting stents, we evaluated intimal hyperplasia (IH) and vascular changes using volumetric intravascular ultrasound analysis. Copyright © 2011 American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632

JAMA. Clinical, Angiographic, and Genetic Factors Associated With Early Coronary Stent Thrombosis

Guillaume Cayla, MD, PhD Jean-Se´ bastien Hulot, MD, PhD Stephen A. O’Connor, MD Atul Pathak, MD, PhD Stuart A. Scott, PhD Yves Gruel, MD, PHD Johanne Silvain, MD, PhD Jean-Baptiste Vignalou, MD Yves Huerre, MD Axel de la Briolle, MD, PHD Fre´de´ rick Allanic Farzin Beygui, MD, PhD Olivier Barthe´le´ my, MD Gilles Montalescot, MD, PhD Jean-Philippe Collet, MD, PhD

Context: Despite dual antiplatelet therapy, stent thrombosis remains a devastating and unpredictable complication of percutaneous coronary intervention (PCI). Objective: To perform a sequential analysis of clinical and genetic factors associated with definite early stent thrombosis. Copyright ©2011 American Medical Association. All rights reserved. JAMA, October 26, 2011—Vol 306, No. 16

JAMA. Standard vs High Dose Clopidogrel Based on Platelet Function Testing After Percutaneous Coronary Intervention. The GRAVITAS Randomized Trial

Matthew J. Price, MD Peter B. Berger, MD Paul S. Teirstein, MD Jean-Franc¸ ois Tanguay, MD Dominick J. Angiolillo, MD Douglas Spriggs, MD Sanjeev Puri, MD Mark Robbins, MD Kirk N. Garratt, MD Olivier F. Bertrand, MD Michael E. Stillabower, MD Joseph R. Aragon, MD David E. Kandzari, MD Curtiss T. Stinis, MD Michael S. Lee, MD Steven V. Manoukian, MD Christopher P. Cannon, MD Nicholas J. Schork, PhD Eric J. Topol, MD for the GRAVITAS Investigators

Context High platelet reactivity while receiving clopidogrel has been linked to cardiovascular events after percutaneous coronary intervention (PCI), but a treatment strategy for this issue is not well defined. Objective To evaluate the effect of high-dose compared with standard-dose clopidogrel in patients with high on-treatment platelet reactivity after PCI. Copyright © 2011 American Medical Association. All rights reserved. JAMA, March 16, 2011—Vol 305, No. 11

CATH LAB DIGEST. Overcoming the Final Challenge in STEMI PCI: Reducing Infarct Size with Super-Selective ClearWay Catheter-Directed Delivery of Abciximab with Aspiration Thrombectomy

Rajesh M. Dave, MD, FACC, FSCAI, Chief Medical Executive, Holy Spirit Cardiovascular Institute, Director, Cardiac Catheterization Laboratories, The Ortenzio Heart Center, Holy Spirit Hospital Camp Hill, Pennsylvania

A 49-year-old gentleman with history of hyperlipidemia presented to the emergency room with two hours of chest pain. His EKG demonstrated anterior wall ST-elevation myocardial infarction (STEMI). He was given aspirin 325 mg, prasugrel 60 mg and was taken emergently to the cardiac catheterization laboratory for primary percutaneous coronary intervention (PCI). Upon diagnostic angiography, the patient was found to have a total occlusion of the left anterior descending coronary artery (LAD) (Figure 1). The remainder of coronary arteries, the left main, circumflex and right coronary arteries, were without significant stenosis. The patient was given 60 units/kg unfractionated heparin. Published on CathLab Digest (http://www.cathlabdigest.com) Issue Number: Volume 20 - Issue 5 - May 2012

JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE. Towards real-time cardiovascular magnetic resonance guided transarterial CoreValve implantation: in vivo evaluation in swine

Philipp Kahlert , Nina Parohl , Juliane Albert , Lena Schäfer , Renate Reinhardt 3 , Gernot M Kaiser , Brad Decker Abstract 4 , Björn Plicht 1 , Raimund Erbel , Holger Eggebrecht , Mark E Ladd and Harald H Quick

Real-time cardiovascular magnetic resonance (rtCMR) is considered attractive for guiding TAVI. Owing to an unlimited scan plane orientation and an unsurpassed soft-tissue contrast with simultaneous device visualization, rtCMR is presumed to allow safe device navigation and to offer optimal orientation for precise axial positioning. We sought to evaluate the preclinical feasibility of rtCMR-guided transarterial aortic valve implatation (TAVI) using the nitinol-based Medtronic CoreValve bioprosthesis. Journal of Cardiovascular Magnetic Resonance 2012, 14:21. Copyright © 2012 Kahlert et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

JACC: CARDIOVASCULAR IMAGING. Multidetector Computed Tomography in Transcatheter Aortic Valve Implantation

Jonathon Leipsic, Ronen Gurvitch, Troy M. LaBounty, James K. Min, David Wood, Mark Johnson, Amr M. Ajlan, Namal Wijesinghe, and John G. Webb

Aortic stenosis is a common disorder. Aortic valve replacement is indicated in symptomatic patients with severe aortic stenosis, as the prognosis of untreated patients is poor. Nevertheless, many patients pose a prohibitively high surgical risk and are not candidates for surgical valve replacement. Transcatheter aortic valve implantation (TAVI) is a novel method to treat selected high-risk patients with aortic stenosis. Patient screening and anatomic measurements of the aortic root are of great importance to ensure procedural success and appropriate patient selection. Multidetector computed tomography (CT) is playing an increasingly important role in patient screening protocols before TAVI, provides detailed anatomic assessment of the aortic root and valve annulus, assesses the suitability of iliofemoral access, and determines appropriate coaxial angles to optimize the valve implantation procedure. Additionally, CT is providing a greater understanding of mediumterm valve durability and integrity. This review outlines an evolving role for CT angiography in support of a TAVI program and describe step by step howCT can be used to enhance the procedure and provide a practical guide for the utilization of CT angiography in support of a transcatheter aortic valve program. JACC: CARDIOVASCULAR IMAGING VOL. 4, NO. 4, 2011 Copyright © 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-878X. PUBLISHED BY ELSEVIER INC.

ARCHIVES OF CARDIOVASCULAR DISEASE. The development of transcatheter aortic valve replacement in the USA

Danny Dvir , Israel M. Barbash, Itsik Ben-Dor, Petros Okubagzi, Lowell F. Satler, Ron Waksman and Augusto D. Pichard

Summary: The penetration rate of devices in general, and in transcatheter aortic valve replacement (TAVR) specifically, is significantly delayed in the United States of America (USA) compared with in Europe. This is mostly due to the mission statement of the regulatory agencies in the USA, which requires very rigorous clinical testing of a device prior to its approval. The USA had a major role in the development and evaluation of this technology and USA research has enabled clinicians inside and outside of the USA to conduct a concise scientifically based assessment of the performance of TAVR devices in terms of safety and efficacy. In the following review, we provide data on the development of TAVR in the USA, revealing the critical role the USA has played in this extraordinary process. Archives of Cardiovascular Disease (2012) 105, 160—164. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

JACC: CARDIOVASCULAR INTERVENTIONS. The Global Experience With Percutaneous Aortic Valve Replacement

Martyn Thomas, MD London, United Kingdom

Transcatheter aortic valve replacement is now a viable option in the treatment of high-risk severe symptomatic aortic stenosis. This review describes the current data with this technology and also the potential for the future role of the technology, including potential ways to yet further improve the short- and longer-term results. JACC: CARDIOVASCULAR INTERVENTIONS VOL. 3, NO. 11, 2010. Copyright © 2010 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798. PUBLISHED BY ELSEVIER INC.

ARCHIVES OF CARDIOVASCULAR DISEASE. Transcatheter aortic valve implantation: The evolution of prostheses, delivery systems and approaches

John G. Webb and Ronald K. Binder

Summary It is two decades since the first report of transcatheter implantation of a stented aortic valve in an animal. The first implantation of a transcatheter aortic valve in a human was accomplished just one decade ago dramatically demonstrating the promise of this new therapy. Over the past 10 years, there have been rapid developments in valves, delivery systems and technical approaches. Today, transcatheter valve implantation is a technical possibility for the great majority of patients with aortic stenosis. The next 10 years may well see this become the dominant therapy for aortic stenosis. Archives of Cardiovascular Disease (2012) 105, 153—159. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

HEART. Acute haemodynamic changes after percutaneous mitral valve repair: relation to mid-term outcomes

Oliver Gaemperli, Marco Moccetti, Daniel Surder, et al.

Background: Percutaneous mitral valve repair (MVR) using the Evalve MitraClip has been recently introduced as a potential alternative to surgical MVR. Objective: To assess immediate haemodynamic changes after percutaneous MVR using right heart catheterisation. Heart 2012;98:126-132. doi:10.1136/heartjnl-2011-300705

HEART. Cost-effectiveness of transcatheter aortic valve replacement in patients ineligible for conventional aortic valve replacement

Maureen Watt, Stuart Mealing, James Eaton, et al.

Objective To assess the cost-effectiveness of transcatheter aortic valve implantation (TAVI) compared with medical management in patients with severe aortic stenosis who are ineligible for conventional aortic valve replacement (SAVR) from the perspective of the UK National Health Service. Heart 2012;98:370e376. doi:10.1136/heartjnl-2011-300444

HEART. Cost-effectiveness of dabigatran etexilate for the prevention of stroke and systemic embolism in UK patients with atrial fibrillation

Anuraag R Kansal, Sonja V Sorensen, Ray Gani, et al.

Objective To assess the cost-effectiveness of dabigatran etexilate, a new oral anticoagulant, versus warfarin and other alternatives for the prevention of stroke and systemic embolism in UK patients with atrial fibrillation (AF). Heart 2012;98:573e578. doi:10.1136/heartjnl-2011-300646

“Pressure Pressing Down on Me”: Importance of Intracoronary Physiology and Inotropic Challenge for Myocardial Bridge

Paolo Boretto, Alessandro Depaoli, Federico Conrotto, Pierluigi Omedè, Ovidio De Filippo, Alessandro Serafini, Giulio Antonino Strazzarino, Paolo Fonio, Gaetano Maria De Ferrari, and Fabrizio D’Ascenzo

A 66-year-old otherwise healthy woman was admitted to the cardiology department for exercise-induced dyspnea and positive stress electrocardiogram with anterior ST-segment depression. A coronary computed tomography showed an 18-mm-long myocardial bridge (MB) in mid left anterior descending artery with deep encasement (3.9 mm) (Figure 1) (1), without other significant stenosis. At coronary angiography MB was confirmed, although hard to be seen (Figure 2). Functional assessment with instantaneous wave-free ratio (iFR) was obtained showing baseline diastolic flow limitation (iFR 0.86) (Figure 3). After infusion of nitrates, a dobutamine challenge was performed to further assess hemodynamic relevance. During a 5 μg/kg/min dobutamine infusion, iFR further reduced to 0.72 (Figure 4). Because no significant coronary stenosis was detected, the patient was discharged with calcium-channel blocker with complete resolution of symptoms at 3-month follow-up visit.