Off-site primary percutaneous coronary intervention in a new centre is safe: comparing clinical outcomes with a hospital with surgical backup.

Objectives: To evaluate the procedural and clinical outcomes of a new primary percutaneous coronary intervention (PPCI) centre without surgical back-up (off-site PCI) and to investigate whether these results are comparable with a high volume on-site PCI centre in the Netherlands.

Background: Controversy remains about the safety and efficacy of PPCI in off-site PCI centres.

Methods: We retrospectively analysed clinical and procedural data as well as 6‑month follow-up of 226 patients diagnosed with ST-elevated myocardial infarction (STEMI) who underwent PPCI at VieCuri Medical Centre Venlo and 115 STEMI patients who underwent PPCI at Catharina Hospital Eindhoven.

Clinical pacing post-conditioning during revascularization after AMI.

Intermittent dyssynchrony, induced by ventricular pacing, during early reperfusion reduces infarct size in pre-clinical studies. We evaluated cardioprotection by pacing post-conditioning (PPC) in ST-segment elevation myocardial infarction in a randomized, controlled, single-center, single-blinded, first-in-man study. Patients with first ST-segment elevation myocardial infarction received either PPC plus percutaneous coronary intervention (PCI) (n = 30) or PCI (n = 30).

Coronary artery-bronchial artery fistulas: report of two Dutch cases with a review of the literature.

Background: Coronary bronchial artery fistulas (CBFs) are rare anomalies, which may be isolated or associated with other disorders.

Materials And Methods: Two adult patients with CBFs are described and a PubMed search was performed using the keywords "coronary bronchial artery fistulas" in the period from 2008 to 2013.

Results: Twenty-seven reviewed subjects resulting in a total of 31 fistulas were collected.

The first year of the Venlo percutaneous coronary intervention program: procedural and 6-month clinical outcomes.

Objectives: Analysis of the first results of off-site percutaneous coronary interventions (PCI) and fractional flow reserve (FFR) measurements at VieCuri Medical Centre for Northern Limburg in Venlo.

Background: Off-site PCI is accepted in the European and American Cardiac Guidelines as the need for PCI increases and it has been proven to be a safe treatment option for acute coronary syndrome.

Methods: Retrospective cohort study reporting characteristics, PCI and FFR specifications, complications and 6-month follow-up for all consecutive patients from the beginning of off-site PCI in Venlo until July 2012.

Heart failure admissions in adults with congenital heart disease; risk factors and prognosis.

Background: Heart failure (HF) is a serious complication and often the cause of death in adults with congenital heart disease (CHD). Therefore, our aims were to determine the frequency of HF-admissions, and to assess risk factors of first HF-admission and of mortality after first HF-admission in adults with CHD.

Methods: The Dutch CONCOR registry was linked to the Hospital Discharge Registry and National Mortality Registry to obtain data on HF-admissions and mortality.

Venous graft perforation leading to cardiac tamponade.

We describe a cardiac tamponade after venous graft perforation due to stent inflation. The complications and therapeutic options are discussed.

Left ventricular viability in a patient with heart failure due to left main stem stenosis, predicted by SPECT and gadolinium-enhanced magnetic resonance but not by dobutamine stress echocardiography.

A 54-year-old woman with occlusive disease of the distal abdominal aorta was referred for pre-operative risk assessment, and was diagnosed with severe impairment of the left ventricular function due to left main stem coronary artery stenosis. Low-dose dobutamine stress echocardiography did not demonstrate contractile reserve, while gadoliniumenhanced cardiac magnetic resonance (CMR) suggested viability of the left ventricle. The patient underwent coronary bypass grafting, and had an uncomplicated post-operative course, with improvement of the left ventricular ejection fraction from the initial 20% to 44% after four months.

Protein-losing enteropathy in association with constrictive pericarditis.

Although acute pericarditis is a common and usual benign disorder, sometimes evolution to constrictive pericarditis may occur. We present a case of constrictive pericarditis late after coronary bypass grafting, complicated by right sided heart failure. Edema formation was aggravated due to protein-losing enteropathy, resulting in hypoalbuminemia.

A probable primary HIV infection associated with acute non-specific myocarditis causing severe dilated cardiomyopathy.

A patient with a probable primary HIV infection and a biopsy proven non-specific myocarditis is reported. The patient developed a severe dilated cardiomyopathy and initially presented with global heartfailure and fever. The left ventricular function partially recovered.