Chronic total occlusion in non-ST elevation myocardial infarction - A multi-centre observational study.

Objectives: To evaluate the characteristics and outcomes of patients with a chronic total occlusion (CTO) in a Non-ST Elevation Myocardial Infarction (NSTEMI) cohort.

Background: There is limited data on the clinical characteristics, revascularisation strategies and outcomes of patients presenting with a NSTEMI and a CTO.

Methods: Retrospective analysis of a six-centre percutaneous coronary intervention (PCI) registry in the UK between January 2015 and December 2020 was performed.

Iatrogenic Dissection of the Left Internal Mammary Artery During Percutaneous Coronary Intervention of Jump Radial Artery Graft Bifurcation Disease: A Case Report.

Guide-catheter-induced ostial coronary artery dissection is a feared complication of percutaneous coronary intervention, but thankfully the incidence is low. We describe a case of catheter-induced ostial dissection of the left internal mammary artery (LIMA) with multiple radial jump grafts during percutaneous coronary intervention of radial graft bifurcation disease via the LIMA. The dissection led to loss of flow and profound haemodynamic compromise and cardiac arrest as the LIMA supplied the majority of the myocardium in this patient.

Feasibility of 5 Fr Contralateral Radial Access for Hybrid Chronic Total Occlusion Percutaneous Coronary Intervention: Experience From a Single Tertiary Center in the United Kingdom.

Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using the hybrid algorithm has traditionally been performed femorally using 8 Fr sheaths. Antegrade dissection and re-entry (ADR) has facilitated procedures using 6 and 7 Fr guides via the radial artery. Radial artery dysfunction and occlusion is a recognized complication preventing future radial procedures, but is significantly less common with 5 Fr sheaths.

Daily remote ischaemic conditioning following acute myocardial infarction: a randomised controlled trial.

Background: Remote ischaemic conditioning (rIC) is a cardioprotective tool which has shown promise in preclinical and clinical trials in the context of acute ischaemia. Repeated rIC post myocardial infarction may provide additional benefits which have not previously been tested clinically.

Methods: The trial assessed the role of daily rIC in enhancing left ventricular ejection fraction (LVEF) recovery in patients with impaired LVEF (<45%) after ST segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (P-PCI).

Pacemaker leads and cardiac perforation.

This case series highlights the rare but potentially life threatening complication of ventricular perforation caused by pacemaker leads and discusses appropriate investigations and management strategies.

Remote ischemic conditioning: from experimental observation to clinical application: report from the 8th Biennial Hatter Cardiovascular Institute Workshop.

In 1993, Przyklenk and colleagues made the intriguing experimental observation that 'brief ischemia in one vascular bed also protects remote, virgin myocardium from subsequent sustained coronary artery occlusion' and that this effect'...

The time-of-day variation in vascular smooth muscle contractility depends on a nitric oxide signalling pathway.

The dip in blood pressure during the resting-period is paradoxically associated with an increase in total peripheral resistance and occurs at a time when the vascular response to vasoconstrictor compounds is heightened, and to vasodilators reduced. However, the cellular mechanisms responsible for this time-of-day variation are not well defined. We have investigated the role of nitric oxide synthase (NOS) signalling in the control of contraction in mesenteric resistance arteries using wire myography, combined with quantitative PCR analysis of gene transcription and western blot analysis of protein.

Pseudoaneurysm of the left ventricle following apical approach TAVI.

Symptomatic severe aortic stenosis carries a two year survival of only 50%. However many patients are unsuitable for conventional aortic valve replacement as they are considered too high risk due to significant co-morbidities. Transcatheter Aortic Valve Implantation (TAVI) offers a viable alternative for this high risk patient group, either by the femoral or apical route.

The cost of postgraduate training.

The Modernising Medical Careers and European Working Time Directive have led to significant changes in the working patterns and training of junior doctors. This article seeks to explore the hidden costs incurred by trainees of various specialties and grades for postgraduate training.

Spontaneous bowel perforation due to norovirus: a case report.

Norovirus is the leading cause of epidemic gastroenteritis worldwide but the disease is usually self-limiting and generally only causes serious health problems in the young, elderly and immunocompromised. The authors report a case of bowel perforation in an elderly Caucasian lady with confirmed infection with Norovirus genogroup II and no other presumptive cause. To the authors' knowledge this is the first such case of bowel perforation due to Norovirus.

Validity of electrocardiographic classification of left ventricular hypertrophy across adult ethnic groups with echocardiography as a standard.

Aims: To assess the validity of the electrocardiogram (ECG) as a diagnostic tool for left ventricular hypertrophy (LVH) for different ethnic groups with echocardiography as a standard.

Methods: Systematic review of the literature using the Cornell and Sokolow-Lyon voltage criteria for LVH.

Results: Five studies were identified.