[How to avoid and manage a vascular complication during TAVI procedure].

Transcatheter aortic valve implantation (TAVI) has established as a gold standard in the treatment of elderly patients with severe aortic stenosis. Vascular access marks the first step in a TAVI procedure where the transfemoral access is preferred. Therefore, vascular complications are one of the main concerns of operators.

Evaluation of the safety and efficacy of the Axiostat® dressing device to achieve radial artery access hemostasis: The R3A study.

Background: Radial access is the default approach in interventional cardiology. The Axiostat® surgical hemostatic dressing, using chitosan as its active component, has demonstrated potential in accelerating blood clotting. This study aims to assess the efficacy and the safety of the Axiostat® dressing in achieving hemostasis in patients undergoing transradial coronary angioplasty (TRCA).

The everolimus eluting Synergy Megatron drug-eluting stent platform: Early outcomes from the European Synergy Megatron Implanters' Registry.

Background: The Synergy Megatron is an everolimus-drug eluting stent that may offer advantages in the treatment of aorto-ostial disease and large proximal vessels.

Aims: To report the short- to medium-term clinical outcomes from the European Synergy Megatron Implanters' Registry.

Methods: This registry was an investigator-initiated study conducted at 14 European centers.

Case report: takotsubo cardiomyopathy after transcatheter aortic valve-in-valve replacement.

Background: Transcatheter aortic valve implantation (TAVI) has become a first-line therapeutic option in patients with severe, symptomatic aortic stenosis at increased surgical risk. Despite its success, the TAVI procedure has been associated with acute life-threatening complications as myocardial infarction secondary to periprocedural coronary occlusion, annular rupture, or vascular injury.

Case Summary: A 79-year-old woman with a dysfunctional bioprosthetic valve following previous surgical valve replacement was hospitalized in our institution to perform a Valve-in-Valve Transcatheter Aortic Valve Replacement (ViV TAVR).

Chimney Stenting for Coronary Occlusion During TAVR: Insights From the Chimney Registry.

Objectives: The aim of this study was to determine the safety and efficacy of chimney stenting, a bailout technique to treat coronary artery occlusion (CAO).

Background: CAO during transcatheter aortic valve replacement (TAVR) is a rare but often fatal complication.

Methods: In the international Chimney Registry, patient and procedural characteristics and data on outcomes are retrospectively collected from patients who underwent chimney stenting during TAVR.

Outcomes of transfemoral balloon expandable transcatheter aortic valve implantation: Comparison of two subsequent valve generations.

Background: The SAPIEN 3 (S3) addresses several limitations of the SAPIEN XT (SXT) for the performance of transfemoral (TF-) balloon expandable transcatheter aortic valve implantation (TAVI).

Objectives: We aimed to determine whether their altered features translate into improved outcomes in a real-world TF-TAVI patient population.

Methods: Data for 3,314 patients were extracted from the European registries SOURCE-XT and SOURCE-3.

[Management of non-rhythmic complications of TAVI procedures].

Transcatheter aortic valve (TAVI) is the treatment of choice in patients with severe symptomatic aortic stenosis at high surgical risk. Recent data have also shown favorable results in patients considered to have an intermediate operative risk, which broadens the application of this new technology. Despite its success, the TAVI procedure has been associated with life-threatening complications.

Treatment with a dedicated bifurcation sirolimus-eluting cobalt-chromium stent for distal left main coronary artery disease: rationale and design of the POLBOS LM study.

Aims: The aim of this study is to demonstrate the non-inferiority of the BiOSS LIM C sirolimus-eluting cobalt-chromium bifurcation dedicated stent against the XIENCE stent regarding the patient-oriented composite endpoint (POCE) at 12 months among patients with left main coronary artery disease (LMCA).

Methods And Results: The POLBOS LM study is a single-arm, prospective, multicentre study enrolling 260 patients (SYNTAX score ≤32) with a pre-specified performance goal based on the results of the EXCEL trial with contemporary percutaneous coronary intervention (PCI) for LMCA disease. Patient enrolment will comply with objective inclusion criteria of diameter stenosis ≥50% in the LMCA based on off-line quantitative coronary angiography (QCA) analysed by an independent core laboratory using dedicated bifurcation QCA software.

[Optimization of systolic heart failure treatment by general practitioners after hospital discharge: Are guidelines applied?].

Unlabelled: Heart failure is a common and serious disease, with constantly increasing incidence. General practitioners have an essential role in its management.

Aim Of The Study: Describe general practitioner's practice in optimizing heart failure treatment after hospital discharge.

Characteristics and outcomes of patients ≤ 75 years who underwent transcatheter aortic valve implantation: insights from the SOURCE 3 Registry.

Background: Current trials and registries of transcatheter valve implantation (TAVI) mostly include patients older than 75 years. Little is known about younger patients who undergo this treatment. We investigated comorbidities among patients < 75 years old who underwent TAVI in the SAPIEN 3™ European post-approval SOURCE 3 Registry, and analysed outcomes at 30 days and 1 year.

Comparative assessment of "plaque/media" change on three modalities of IVUS immediately after implantation of either everolimus-eluting bioresorbable vascular scaffold or everolimus-eluting metallic stent in Absorb II study.

The purpose of the study to assess the comparability of immediate changes in plaque/media volume (PV) on three modalities of intravascular ultrasound (IVUS) after implantation of either bioresorbable vascular scaffold (BVS) or everolimus-eluting metallic stent (EES) in Absorb II Study. The two devices have different device volume and ultrasound backscattering that may interfere with the "plaque/media" assessed by three modalities on IVUS: grayscale, backscattering of radiofrequency and brightness function. In a multicenter randomized controlled trial, 501 patients with stable or unstable angina underwent documentary IVUS pre- and post- implantation.

Prevalence of coronary artery spasm during dobutamine stress echocardiography.

The aim of this study was to assess the prevalence of coronary artery spasm during dobutamine stress echocardiography (DSE). Over a 9-year period (from November 2001 to October 2010) we reviewed all patients (n = 2,224) referred for DSE. Criteria for selection included patients > 18 years old who underwent DSE.

Acute hyperkalemia and failure of pacemaker stimulus.

Acute hyperkalemia may induce well-known serious cardiac arrhythmia. However, ventricular aberration including concealed conduction may also occur. We report the case of a 35-year-old woman who had a previous history of late-operated ventricular septal defect communication and DDD pacemaker was admitted for dyspnea.

Home diagnosis of obstructive sleep apnoea in coronary patients: validity of a simplified device automated analysis.

Introduction: Our aim was to evaluate a type 3 portable simplified device as a screening tool for obstructive sleep apnoea (OSA) in coronary patients.

Materials And Methods: In 50 patients selected independently from sleep complaints, we compared the number of respiratory events per hour of valid recording time counted automatically by the device and the number counted manually per hour of sleep on polysomnography performed at home during the same night.

Results: Five patients were excluded because of technical failures.

Prevalence and characteristics of left ventricular outflow tract obstruction in Tako-Tsubo syndrome.

Background And Objective: Tako-Tsubo syndrome is a clinical entity mimicking acute coronary syndrome (ACS). Left ventricular outflow tract (LVOT) obstruction may occur in Tako-Tsubo syndrome. The aim of this study was to determine the prevalence and features of LVOT obstruction in Tako-Tsubo syndrome in a population presenting with ACS.

Maternal complication of pregnancy in Marfan syndrome.

Objectives: Evaluate the risk of aortic complications (aortic dissection or prophylactic aortic surgical replacement) associated with pregnancy in Marfan syndrome in the absence of specific care.

Background: Data are scarce on aortic complications during pregnancy in Marfan syndrome.

Methods: Retrospective study on a large population (415 patients) followed up in our multidisciplinary out-patient clinic devoted to Marfan syndrome.

Reliability of echocardiography for hemodynamic assessment of end-stage heart failure.

The management of patients with end-stage heart failure is difficult and may require the monitoring of intracardiac pressures. The aim of this prospective study was to assess the reliability of echocardiography in patients with end-stage HF. Twenty consecutive patients presenting with severe left ventricular dysfunction in end-stage heart failure were prospectively studied.

Tako-Tsubo syndrome after an exercise echocardiography.

The Tako-Tsubo syndrome is a clinical entity recently described that associate a chest pain occurring during a stress, an abnormal ECG and/or an increase in the troponin blood level and a transient left ventricular dysfunction with an akinesis involving generally the midsection and the apex of the heart. It has also been reported that left ventricle (LV) dysfunction may involve only the midventricle, although it seems less common. We report the case of a 66 year old woman that developed a stress-induced cardiomyopathy (Tako-Tsubo syndrome) involving the midventricle when performing an exercise echocardiography.

[Very late intrastent thrombosis--at 27 months!].

Interrupting platelet antiaggregant therapy in coronary patients treated by stenting exposes them to the risk of cardiac complications. The risk of acute thrombosis of the stent is well known but late intrastent thrombosis is less common and mainly observed with drug eluting stents. The authors report the case of a 54 year old man who had thrombosis of an ordinary stent implanted 27 months previously which occurred in the immediate post-operative period after repair of an inguinal hernia.

Prevalence of tako-tsubo syndrome in a large urban agglomeration.

Among 4,551 patients referred to the investigators' catheterization laboratory, 1,613 presented with acute coronary syndrome, and 12 had confirmed Tako-Tsubo syndrome (prevalence 0.7%). In conclusion, the present study emphasizes the underestimation of this new heart disease.