Publications by authors named "Antonios Kouparanis"

Degeneration of the surgical bioprosthetic valves remains one of the most common complications of surgical valve replacement. Redo surgery is the gold standard, but unfortunately, most of these patients are deemed inoperable because of the high perioperative mortality. Transcatheter implantation of a new valve inside the degenerated bioprosthesis (valve-in-valve (ViV)) has emerged as an alternative solution.

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Article Synopsis
  • The study examined the incidence of radial artery occlusion (RAO) in patients undergoing transradial coronary catheterization, involving 1357 participants across multiple centers.
  • The overall incidence of RAO was found to be 9.5%, with higher occurrences in the angiography-only group compared to the PCI group (10.6% vs. 6.2%).
  • Several independent risk factors for RAO were identified, including female gender, access site cross-over, radial artery spasms, and post-catheterization use of dabigatran, while factors like performing PCI and higher doses of intravenous heparin were associated with lower odds of RAO.
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A 58-year-old male with a medical history of arterial hypertension, dyslipidemia, and psoriasis was admitted for a scheduled surgical removal of the thyroid gland. During the surgery, the patient suffered severe blood loss caused by vascular complications. After the operation, his electrocardiogram showed diffuse ST segment elevation along with high-sensitivity cardiac troponin T elevation and severe left ventricular systolic dysfunction.

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An emergency transradial coronary angiography in a 68-year-old woman demonstrated sub-total occlusion of the proximal left anterior descending artery.

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Advances in the diagnosis and treatment of pulmonary hypertension (PH) have gradually improved the disease course. This retrospective cohort study aims to explore the diagnostic hemodynamic profile and survival of PH patients and their temporal changes, as well as investigate potential prognostic factors. Overall, 257 adult patients were diagnosed with PH following right heart catheterization (RHC) from January 2008 to June 2023 according to the hemodynamic cut-off values proposed by the corresponding ESC/ERS guidelines at the time RHC was performed.

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Introduction: The self-expanding, resheathable, repositionable transcatheter aortic heart valve Portico is being used successfully for transcatheter aortic valve implantation procedures (TAVI) in patients with severe aortic stenosis. The aim of this study was to evaluate outcomes at 2 years after TAVI with the Portico valve.

Methods: Multicenter registry of clinical, echocardiographic and survival data from consecutive patients treated with the Portico TAVI system (Abbott, Chicago, IL, USA) in three cath labs in Northern Greece and Epirus during 2017-2020.

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In this difficult case of an 80-year-old woman with an acute coronary syndrome and extremely calcified and tortuous left anterior descending artery, the operators were unable to insert the stent into the distal cylinder of the Telescope after encountering strong resistance. Assuming the stent was stuck at the level of the distal cylinder entry pot, they decided to remove both the guide catheter extension (GCE) and the stent as a single unit to prevent complications. Since the first GCE was introduced in 2009, many other GCE systems have been developed and there is accumulating experience with their use.

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Article Synopsis
  • Radial artery occlusion (RAO) is the most common issue arising from transradial catheterization, with no established treatment from randomized studies.
  • The LOW-RAO study aims to determine if low-molecular-weight heparin effectively treats RAO after procedures like angiography and stenting.
  • This randomized controlled trial will involve 60 patients and compare outcomes between those receiving heparin and those receiving no treatment, focusing on artery patency after 4 weeks.
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Article Synopsis
  • A significant decline in hospital admissions for acute stroke (AS) and acute coronary syndrome (ACS) was noted during the second wave of the COVID-19 pandemic in Greece, showing a 34% and 33% reduction respectively compared to 2019.
  • Researchers analyzed hospitalization rates from three hospitals over two months in late 2020, finding results consistent with the first wave of the pandemic.
  • The ongoing reduction in admissions suggests that lockdowns may negatively affect the management of cerebro/cardiovascular diseases, underscoring the importance of public health campaigns to address these findings.
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Distal transradial access, through puncture of the radial artery at its course in the anatomical snuffbox, has emerged recently as an alternative approach for coronary catheterization. Several advantages of this approach seem promising and several studies are trying to elucidate its features. This review provides an overview of the snuffbox approach for coronary catheterization and summarizes the key results of the research conducted so far.

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A 72-year-old male patient, with first degree atrioventricular block and LBBB on his baseline ECG, developed persistent complete atrioventricular block after recanalization of a chronic total occlusion of his left anterior descending artery (LAD) and ultimately underwent permanent pacemaker implantation. Occlusion of the second septal branch, probably supplying the right branch of the His bundle is speculated to have led to this complication. During elective intervention to the LAD territory in patients with prior conduction abnormalities on the ECG, care should be taken to preserve normal blood flow to the septal perforators.

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