VersaCross Transseptal System for Mitral Transcatheter Edge-To-Edge Repair With the PASCAL Repair Platform.

Background: VersaCross is a novel radiofrequency transseptal solution that may improve the efficiency and workflow of transseptal puncture (TSP). The aim of this study was to compare the VersaCross transseptal system with mechanical needle systems during mitral transcatheter edge-to-edge repair (M-TEER) with the PASCAL device.

Methods: This is a single-center retrospective study of consecutive patients who underwent M-TEER with the PASCAL.

Routine postaccess-closure angiography to detect vascular complications following transfemoral TAVR.

Background: Vascular complications following transfemoral TAVR are associated with increased morbidity and mortality. Measures that may mitigate this risk are important.

Aim: To evaluate the utility of routine, access-vessel angiography post sheath-removal in the detection and management of complications in patients undergoing transcatheter aortic valve replacement (TAVR).

A very rare vascular complication of the Edwards expandable eSheath during transcatheter aortic valve replacement.

Transcatheter aortic valve replacement (TAVR) has revolutionized the management of severe symptomatic aortic valve stenosis. TAVR is now indicated as an alternative to surgical replacement in a wide risk profile ranging from high to low surgical risk. Although vascular complications have decreased in frequency over time, with the introduction of lower profile delivery systems and sheaths, they remain one of the most frequently encountered and serious complications of TAVR.

A Modified Buddy-Wire Technique for Crossing of the Interatrial Septum With the Sapien 3 Valve During Transseptal Mitral Valve-in-Valve/Ring Procedures.

Background: Crossing of the interatrial septum (IAS) with the Edwards Sapien-3 transcatheter heart valve (THV) may fail, despite preparatory balloon septostomy. A planned buddy guidewire placed in the left ventricle may help facilitate crossing of the IAS and mitral bioprosthesis with the THV.

Methods: A retrospective study of 12 consecutive patients undergoing transseptal, mitral valve-in-valve or valve-in-ring procedures using the Edwards Sapien-3 THV since 2018 with a planned buddy-wire technique.

Comparison of left ventricular with right ventricular rapid pacing on tamponade during TAVI.

Background: Small studies have suggested left ventricular (LV) rapid pacing has similar safety and efficacy to conventional right ventricular (RV) rapid pacing in transcatheter aortic valve implantation (TAVI). However, there are limited data on the comparative rates of tamponade. The study compared the rate of cardiac tamponade between LV and RV-pacing during TAVI.

ST-segment elevation myocardial infarction with plaque erosion, to stent or not to stent: utility of intracoronary optical coherence tomography (OCT) imaging-a case report.

Background: Treating acute myocardial infarction in the setting of insignificant coronary obstruction is an emerging challenge especially with the application of intracoronary imaging like intravascular ultrasound and optical coherence tomography (OCT). The cardiologists dealing with such patients may consider not to stent if there is intracoronary imaging evidence of minimal thrombus without plaque rupture and the vessel appears patent with settling of chest pain and electrocardiogram (ECG) changes.

Case Summary: A 47-year-old gentleman presented direct to the emergency department after experiencing retrosternal chest pain with an ECG showing hyperacute anterior T waves.

Successful rotational atherectomy of left main stem with double kiss crush stenting using double guiding catheter: a case report.

Background: Coronary artery bypass grafting is the preferred revascularization procedure for patients with multivessel disease, and those with complex left main disease, as it is associated with a survival advantage in this group of patients. Sometimes however surgical management is not the treatment of choice due to many factors including ongoing chest pain, haemodynamic instability, or patient preference. In these situations, percutaneous coronary intervention (PCI) offers an alternative revascularization strategy.

A feasibility study of transaxillary TAVI with the lotus valve.

Objectives: To assess the feasibility of axillary transcatheter aortic valve implantation (TAVI) using the Lotus valve.

Background: TAVI is used to treat patients with severe aortic stenosis, with transfemoral (TF) access being the safest and most widely used route. In patients unsuitable for this, there are reports that the axillary artery may be safest alternative access route.

Retrieval of a stuck Rotablator burr ("Kokeshi phenomenon") and successful percutaneous coronary intervention.

We report the case of a 74-year-old man having angioplasty following admission with a troponin positive acute coronary syndrome. Due to heavy coronary artery calcification, rotablation was used. The procedure was complicated by a stuck burr ("Kokeshi phenomenon").

Cost implications of implementing NICE guideline on chest pain in rapid access chest pain clinics: an audit and cost analysis.

Background: Implementing the recently published National Institute for Health and Clinical Excellence (NICE) clinical guideline on chest pain (CG95) in rapid access chest pain clinics (RACPCs) could significantly impact on overall cost, while introducing new technology like cardiac computed tomography (CT) scanning. With the National Health Service (NHS) under pressure to make £20 billion savings, applying CG95 in RACPCs could be challenging. An audit enabled us to assess the cost implications.