Optimizing the Approach and Clinical Outcomes of Women Undergoing Chronic Total Occlusion-Percutaneous Coronary Intervention.

Coronary artery disease remains a leading cause of morbidity and mortality globally, with chronic total occlusions (CTOs) representing a particularly challenging subset. Percutaneous coronary intervention (PCI) for CTOs has evolved significantly over the years, driven by advancements in equipment, techniques, and operator expertise. However, women have historically been underrepresented in clinical trials and guidelines, leading to a gap in an evidence-based management tailored to their specific needs, including in CTO-PCI.

Radiation Exposure Using Rampart vs Standard Lead Aprons and Shields During Invasive Cardiovascular Procedures.

Background: Radiation exposure during invasive cardiovascular procedures remains an important health care issue. Lead aprons and shields (LAS) are used to decrease radiation exposure but leave large portions of the body unshielded. The Rampart IC M1128 is a portable radiation shielding system that may significantly attenuate radiation exposure.

Percutaneous axillary extracorporeal membrane oxygenation supported complex left main bifurcation percutaneous coronary intervention.

A 66-year-old man with multiple comorbidities including severe peripheral artery disease and heart failure with reduced ejection fraction presented with complex coronary artery disease with an elevated Society of Thoracic Surgeons Predicted Risk of Mortality for coronary artery bypass grafting and a Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery score of 18. With a multidisciplinary heart team approach, the patient successfully underwent percutaneous axillary venoarterial extracorporeal membrane oxygenation (VA-ECMO) supported high-risk percutaneous coronary intervention of a heavily calcified left main bifurcation lesion. Given the patient's peripheral artery disease, alternative arterial access for ECMO cannulation was performed percutaneously via the right axillary artery.

Acute Coronary Syndrome in Women: An Update.

Purpose Of Review: The goal of this manuscript is to provide a concise summary of recent developments in the approach to and treatment of women with acute coronary syndrome (ACS).

Recent Findings: This review covers terminology updates relating to ACS and myocardial injury and infarction. Updates on disparities in recognition, treatments, and outcomes of women with ACS due to atherosclerotic coronary artery disease are covered.

Intravascular lithotripsy in chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS-CTO registry.

Background: The use of intravascular lithotripsy (IVL) in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study.

Methods: We analyzed the baseline clinical and angiographic characteristics and procedural outcomes of 82 CTO PCIs that required IVL at 14 centers between 2020 and 2022.

Results: During the study period, IVL was used in 82 of 3301 (2.

Factors Associated With the Use of Bare Metal Stents in Patients With ST Elevation Myocardial Infarction.

Background: Drug eluting stents (DES) are used in the majority of patients undergoing percutaneous coronary intervention (PCI). Factors associated with the use of bare metal stents (BMS) for patients undergoing primary PCI for ST elevation myocardial infarction (STEMI) have not been adequately explored. The objective of this study was to evaluate factors associated with BMS use in STEMI patients undergoing primary PCI.

Inpatient management of acute decompensated heart failure.

Acute decompensated heart failure (ADHF) is the leading cause of hospital admissions in patients older than 65 years. These hospitalisations are highly risky and are associated with poor outcomes, including rehospitalisation and death. The management of ADHF is drastically different from that of chronic heart failure as inpatient treatment consists primarily of haemodynamic stabilisation, symptom relief and prevention of short-term morbidity and mortality.

Mixed aortic valve disease treated with transcatheter aortic valve replacement in a high risk patient presenting with acute decompensated heart failure.

Mixed aortic valve disease refers to the combination of aortic regurgitation (AR) and aortic stenosis (AS). Commonly etiologies include a bicuspid aortic valve, rheumatic heart disease, and endocarditis superimposed upon a stenotic aortic valve. Treatment depends upon the severity of disease, the presence of symptoms and the size and function of the left ventricle.

An evidence-based review of recent advances in therapy for heart failure with reduced ejection fraction (HFrEF).

An estimated 5.1 million Americans have chronic heart failure and this is expected to increase 25% by 2030. Heart failure is a clinical syndrome that evolves from either functional or structural changes to the ventricles that lead to filling or ejection abnormalities.

Long-term response of the left ventricle to cardiac resynchronization therapy: insights from standard and strain echocardiography.

Left ventricular (LV) response to cardiac resynchronization therapy (CRT) has typically been studied over 3- to 12-month periods. Longer-term data are unclear and response of strain parameters has not been reported. The authors evaluated long-term response with standard and strain echocardiography in 57 patients (52±15 years; 40 male; 30 white; 15 with ischemic etiology) who received a CRT-defibrillator between January 2004 and December 2005.