Predicting Periprocedural Complications in Chronic Total Occlusion Percutaneous Coronary Intervention: The PROGRESS-CTO Complication Scores.

Background: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is associated with increased risk of periprocedural complications. Estimating the risk of complications facilitates risk-benefit assessment and procedural planning.

Objectives: This study sought to develop risk scores for in-hospital major adverse cardiovascular events (MACE), mortality, pericardiocentesis, and acute myocardial infarction (MI) in patients undergoing CTO PCI.

Long-Term Survival After Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy: A 16-Year Experience.

Background: Alcohol septal ablation (ASA) is an accepted treatment for medically refractory hypertrophic obstructive cardiomyopathy (HOCM). The procedural and medium-term outcomes have been reassuring. The iatrogenic targeted septal infarction has raised theoretical concerns about risk of arrhythmia and long-term survival.

Predicting complete heart block after alcohol septal ablation for hypertrophic cardiomyopathy using a risk stratification model and clinical tool.

Background: Alcohol septal ablation (ASA) is a proven method of septal reduction for patients with drug refractory, symptomatic hypertrophic obstructive cardiomyopathy (HOCM). This procedure is associated with a 6.5-11% risk of complete heart block (CHB).

Patient and Device Selection for Hemodynamic Support in High-Risk Percutaneous Coronary Intervention.

Coronary artery disease continues to advance resulting in the development of high-risk percutaneous interventions. This includes treatment of patients with multivessel disease, unprotected left main, acute myocardial infarction complicated by cardiogenic shock, and depressed left ventricular ejection fraction. As a result, mechanical circulatory support devices have evolved but require an understanding of patient hemodynamics, device mechanics, and access management.

Gender Disparities in CAD: Women and Ischemic Heart Disease.

Purpose Of Review: The goal of this article is to review the disparities that exist for women who present for treatment of ischemic heart disease.

Recent Findings: It is well known that women are more likely to present with ischemic heart disease at an advanced age with more comorbidities when compared to male counterparts. Despite correction of risk factors, women experience worse outcomes, even in the absence of obstructive coronary artery disease.

Comparison of quantitative stenosis characteristics at routine coronary computed tomography angiography with invasive fractional flow reserve for assessing lesion-specific ischemia.

Objective: To comprehensively evaluate quantitative parameters derived from routine coronary CT angiography (cCTA) for predicting lesion-specific ischemia in comparison to invasive fractional flow reserve (FFR).

Background: The ability of cCTA to gauge lesion-specific ischemia is limited. Several quantitative parameters have been proposed to enhance the specificity of cCTA, such as morphologic indices (lesion length/minimal lumen diameter(4) [LL/MLD(4)]; percentage aggregate plaque volume [%APV]) and a measure of intracoronary contrast gradients (corrected coronary opacification [CCO]).

A non-contrast self-navigated 3-dimensional MR technique for aortic root and vascular access route assessment in the context of transcatheter aortic valve replacement: proof of concept.

Objectives: Due to the high prevalence of renal failure in transcatheter aortic valve replacement (TAVR) candidates, a non-contrast MR technique is desirable for pre-procedural planning. We sought to evaluate the feasibility of a novel, non-contrast, free-breathing, self-navigated three-dimensional (SN3D) MR sequence for imaging the aorta from its root to the iliofemoral run-off in comparison to non-contrast two-dimensional-balanced steady-state free-precession (2D-bSSFP) imaging.

Methods: SN3D [field of view (FOV), 220-370 mm(3); slice thickness, 1.

Diagnostic value of quantitative stenosis predictors with coronary CT angiography compared to invasive fractional flow reserve.

Objective: To evaluate the diagnostic performance of CCTA-derived stenosis predictors including CT-FFR for the detection of ischemia-inducing stenosis compared to invasive FFR.

Materials And Methods: Stenosis parameters were assessed using dual-source CT (DSCT). All patients underwent both CCTA and invasive FFR within 3 months and were retrospectively analyzed.

Imaging coronary artery disease and the myocardial ischemic cascade: clinical principles and scope.

On a subcellular level, atherogenesis is characterized by the translocation of proatherogenic lipoproteins into the arterial wall. An inflammatory response involving complex repair mechanisms subsequently causes maladaptive vascular changes resulting in coronary stenosis or occlusion. The chronology of the underlying processes occurring from atherosclerosis to myocardial ischemia affect the selection and interpretation of diagnostic testing.

Comparison of diagnostic value of a novel noninvasive coronary computed tomography angiography method versus standard coronary angiography for assessing fractional flow reserve.

Noninvasive fractional flow reserve (FFR) from coronary computed tomography angiography (cCTA) correlates well with invasive FFR and substantially improves the detection of obstructive coronary artery disease. However, with current algorithms, computed tomography (CT)-based FFR is derived off-site in an involved time-consuming manner. We sought to investigate the diagnostic performance of a novel CT-based FFR algorithm, developed for time-efficient in-hospital evaluation of hemodynamically indeterminate coronary lesions.

High numbers of false-positive stress tests are the result of inappropriate testing.

Patients who underwent coronary angiography preceded by stress testing during the period January 2009 through March 2012 were evaluated using the CathPCI database. The predictive accuracy of stress echocardiography (SE) and single-photon emission computed tomography (SPECT) were determined and used to back calculate the pretest probability of the population being tested. In total, 2662 catheterizations were performed, 866 (33%) of which were preceded by stress imaging.