Beyond Stenosis With Fractional Flow Reserve Via Computed Tomography and Advanced Plaque Analyses for the Diagnosis of Lesion-Specific Ischemia.

In the treatment of stable coronary artery disease (CAD), the determination of stenosis severity by invasive coronary angiography (ICA) is a critical procedure, and for borderline lesions, the detection of ischemia through invasive fractional flow reserve (FFR) is the gold standard. With advances in computational fluid dynamics, FFR can now be calculated noninvasively using anatomic data from coronary computed tomographic angiography (CCTA). This technique is known as FFR.

Long-Term Prognostic Utility of Coronary CT Angiography in Stable Patients With Diabetes Mellitus.

Objectives: The goal of this study was to determine the long-term prognostic value of coronary computed tomography angiography (CTA) among patients with diabetes mellitus (DM) compared with nondiabetic subjects.

Background: The long-term prognostic value of coronary CTA in patients with DM is not well established.

Methods: Patients enrolled in the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter) registry with 5-year follow-up data were identified.

A systematic review and meta-analysis of multidetector computed tomography in the assessment of coronary artery bypass grafts.

Purpose: The present meta-analysis aimed to compare the diagnostic accuracy of more recent computed tomography coronary angiography (CTCA) with invasive coronary angiography (ICA) in the assessment of graft patency after coronary artery bypass graft surgery (CABG).

Material And Methods: A systematic review was performed using nine electronic databases from their dates of inception to July 2015. Predefined inclusion criteria included studies reporting on comparative outcomes using ≥64 slice multidetector computed tomography (MDCT) and ICA.

Long term prognostic utility of coronary CT angiography in patients with no modifiable coronary artery disease risk factors: Results from the 5 year follow-up of the CONFIRM International Multicenter Registry.

Background: Coronary computed tomography angiography (coronary CTA) can prognosticate outcomes in patients without modifiable risk factors over medium term follow-up. This ability was driven by major adverse cardiovascular events (MACE).

Objective: Determine if coronary CTA could discriminate risk of mortality with longer term follow-up.

An Unusual Case of Cannula Obstruction Resulting from Venous Thromboembolism.

Cerebral strokes of unknown origin frequently present with a patent foramen ovale (PFO), a common atrial septal defect occurring in approximately 25% of the adult population. Deep vein thrombosis (DVT) or pulmonary embolism (PE) in the presence of a PFO can produce paradoxical systemic embolization subsequent to an increase in pulmonary pressure, permitting entry of thrombi into the arterial circulation. Diagnosis of an impending paradoxical embolism (IPDE) involves the detection of DVT or PE in the presence of an abnormal communication between left and right circulations and may include a right-to-left shunt.

Imaging the Aortic Annulus with Multi-Detector Computed Tomography and 3-Dimensional Transesophageal Echocardiography.

Degenerative aortic stenosis is the most common cause of valvular heart disease in Western nations. Transcatheter aortic valve replacement (TAVR) is an alternative therapy for inoperable or high-risk patients with symptomatic severe aortic stenosis. Three-dimensional imaging techniques provide multiplanar imaging, allowing precise measurements of the noncircular aortic annulus and complex anatomy of the aortic root.

Isolated hypertrophy of the basal ventricular septum: characteristics of patients with and without outflow tract obstruction.

Background: Isolated basal septal hypertrophy (IBSH) of the left ventricle (LV) is not a well understood phenomenon, particularly in the presence of concomitant left ventricular outflow tract obstruction (LVOTO). We evaluated the prevalence of IBSH and compared those with and without LVOTO.

Methods: Retrospective observational study of 4104 consecutive patients undergoing echocardiography at a community cardiology practice and a hospital without specialized Hypertrophic Cardiomyopathy (HCM) service to determine prevalence of IBSH, defined as isolated hypertrophy (>15 mm) of the basal LV septum (BS) without hypertrophy elsewhere.

Successful ablation of incessant AV reentrant tachycardia in a patient on extracorporeal membrane oxygenation.

We present the first described case of an accessory pathway ablation, requiring a transseptal puncture, performed on ECMO for tachycardia-induced cardiomyopathy in the context of cardiogenic shock. The performance of a transseptal puncture in such a scenario is a feasible option and should be considered if the clinical situation dictates, despite the inherent risks. After ablation of the left lateral pathway the patient was successfully weaned off ECMO and made a complete recovery.