Percutaneous management of RetroFlex 3 balloon rupture and separation of the Edwards Sapien delivery system.

We report the case of an 85-year-old woman with severe aortic stenosis who underwent transcatheter aortic valve replacement with use of the Edwards Sapien(®) valve system. The procedure was complicated by rupture of the valve-deployment balloon, with separation and retention of the nose cone of the RetroFlex 3(®) delivery system in the iliac artery. Our endovascular retrieval of the equipment was successful, and we achieved access-site hemostasis by deploying a covered stent.

Racial differences in the prevalence of severe aortic stenosis.

Background: In an era of expanded treatment options for severe aortic stenosis, it is important to understand risk factors for the condition. It has been suggested that severe aortic stenosis is less common in African Americans, but there are limited data from large studies.

Methods And Results: The Synthetic Derivative at Vanderbilt University Medical Center, a database of over 2.

Transcatheter aortic valve replacement for aortic bioprosthetic valve failure with cardiogenic shock.

Acutely failing bioprosthetic valves represent a clinical emergency and are exceedingly challenging given the paucity of therapeutic options. Oftentimes, these patients are not re-operative candidates due to clinical instability. We present 2 cases of acute degenerative aortic bioprosthetic valve failure with cardiogenic shock treated with transcatheter aortic valve replacement (TAVR).

Peripheral vascular complications during transcatheter aortic valve replacement: management and potential role of chronic steroid use.

Purpose: To report a case of a major vascular complication during transcatheter aortic valve replacement (TAVR) and the endovascular management thereof. Additionally, we discuss a possible correlation with long-term steroid use.

Case Report: A 79-year-old woman with a history of critical aortic stenosis underwent elective TAVR.

Altered social interaction in adult rats following neonatal treatment with domoic acid.

Schizophrenia is a debilitating neurological disorder characterized by positive, negative, cognitive and/or emotional symptoms. Decreased social interaction is a common negative symptom. Social interaction can be readily observed in rats and is therefore an ideal target behaviour when evaluating an animal model of schizophrenia.

Routine intraoperative completion angiography after coronary artery bypass grafting and 1-stop hybrid revascularization results from a fully integrated hybrid catheterization laboratory/operating room.

Objectives: This study sought to report our experience with a routine completion angiogram after coronary artery bypass surgery (CABG) and simultaneous (1-stop) percutaneous coronary intervention (PCI) at the time of CABG performed in the hybrid catheterization laboratory/operating room.

Background: The value of a routine completion angiogram after CABG and 1-stop hybrid CABG/PCI remains unresolved.

Methods: Between April 2005 and July 2007, 366 consecutive patients underwent CABG surgery, with (n = 112) or without (n = 254) concomitant 1-stop PCI (hybrid), all with completion angiography before chest closure.

Current perspectives on coronary revascularization in the diabetic patient.

In the last few decades, the increase in the prevalence of type 2 diabetes mellitus has reached epidemic proportions in the Western world. A similar, though delayed, pattern is seen in developing countries. Chronic hyperglycemia, dyslipidemia, and insulin resistance have been associated with an accelerated form of atherogenesis, characterized by a prothrombotic state, enhanced inflammation, and endothelial dysfunction.

Lack of benefit from intravenous platelet glycoprotein IIb/IIIa receptor inhibition as adjunctive treatment for percutaneous interventions of aortocoronary bypass grafts: a pooled analysis of five randomized clinical trials.

Background: Despite widespread use of platelet glycoprotein (GP) IIb/IIIa receptor inhibitors for percutaneous coronary interventions (PCI) of bypass grafts, data supporting this strategy are lacking.

Methods And Results: A pooled analysis of 5 randomized intravenous GP IIb/IIIa inhibitor trials (EPIC, EPILOG, EPISTENT, IMPACT II, and PURSUIT) was performed, and outcomes of graft interventions were assessed at 30 days and 6 months. Compared with PCI of native circulation (n=13 158), graft interventions (n=627) were associated with worse outcomes and in particular with a doubling of mortality at 30 days (2.