Usefulness of N-acetylcysteine or ascorbic acid versus placebo to prevent contrast-induced acute kidney injury in patients undergoing elective cardiac catheterization: a single-center, prospective, randomized, double-blind, placebo-controlled trial.

Background: Contrast-induced acute kidney injury (CI-AKI) is a serious complication of procedures requiring contrast media associated with rising costs, prolonged hospitalization, and increased mortality. The aim of this study was to assess whether prophylactic administration of standard dosages of intravenous N-acetylcysteine or ascorbic acid reduce the incidence of CI-AKI in patients with chronic renal insufficiency undergoing elective cardiac catheterization.

Methods: In a single-center, prospective, randomized, double-blind, placebo-controlled trial, the preventive effects of N-acetylcysteine and ascorbic acid were evaluated in 520 patients with chronically impaired renal function (serum creatinine ≥1.

Does the number of simultaneously activated electrodes during phased RF multielectrode ablation of atrial fibrillation influence the incidence of silent cerebral microembolism?

Background: Asymptomatic cerebral embolus (ACE) detected by diffusion-weighted magnetic resonance imaging (DW-MRI) following atrial fibrillation (AF) ablation has been reported at varying rates with different ablation techniques.

Objective: To evaluate the incidence of ACE after phased radiofrequency ablation for AF with procedural modifications that potentially reduce the embolic load.

Methods: One hundred twenty consecutive patients with AF underwent MRI before ablation, 24 hours after ablation, and at 4-6 weeks.

Contemporary success and complication rates of percutaneous coronary intervention for chronic total coronary occlusions: results from the ALKK quality control registry of 2006.

Aims: Despite successful prevention of lesion recurrence by drug-eluting stents (DES), and the advancement in procedural techniques in the treatment of chronic total coronary occlusions (CTO), the number of CTOs treated by percutaneous coronary intervention (PCI) is still low as compared to their prevalence. This study aims to assess the outcome of PCI for CTOs in a contemporary survey of PCI in interventional centres in Germany.

Methods And Results: The basis of this analysis is the 2006 quality assessment database of PCI conducted by the ALKK (working group of cardiology centres).

Percutaneous transluminal dilatation of inadvertent partial or complete occlusion of the femoral artery caused by Angio-Seal deployment for puncture site closure after cardiac catheterization.

The use of access-site closure devices in interventional cardiology has expanded rapidly in the past several years. Initial reports indicated remarkable safety with these devices but there are a small number of major complications. This single-center, retrospective study was carried out to investigate the efficacy of percutaneous transluminal angioplasty (PTA) of inadvertent occlusion or severe stenosis of the femoral artery after deployment of the Angio-Seal closure device.

Pulmonary vein isolation by duty-cycled bipolar and unipolar antrum ablation using a novel multielectrode ablation catheter system: first clinical results.

Background: The electrical disconnection of the pulmonary veins (PV) plays an important role in the ablation strategy of paroxysmal atrial fibrillation (PAF). Circumferential antral ablation with a conventional ablation technique using a steerable ablation catheter is sometimes difficult to perform and does not always result in isolation of the targeted PV.

Methods: Patients with symptomatic PAF were treated with a novel circular mapping/ablation catheter (PVAC).

A randomized comparison of transradial versus transfemoral approach for coronary angiography and angioplasty.

Objectives: The aim of the study was to evaluate the safety, feasibility, and procedural variables by the transradial approach compared with the transfemoral access in a standard population of patients undergoing coronary catheterization.

Background: Coronary catheterization is usually performed via the transfemoral approach. Transradial access may offer some advantages in comparison with transfemoral access especially under conditions of aggressive anticoagulation and antiplatelet treatment.

[Superior vena cava syndrome by cardiac tumor].

Case Report: A 59-year-old man with a 4-week history of dyspnea, coughing, and chest discomfort was referred to hospital for further evaluation. Moreover, he reported fever and fatigue. There were neither cardiovascular risk factors nor drug medication.

Incidence of coronary artery disease and necessity of revascularization in symptomatic patients requiring permanent pacemaker implantation.

Background And Purpose: The cause of severe cardiac conduction disturbances or sinus node dysfunction is often unknown. The objective of this study was to assess the incidence of coronary artery disease (CAD) and the necessity of revascularization in patients with symptomatic bradycardia requiring permanent pacemaker implantation and to try to find a causal association between the need for a pacemaker and the presence of CAD.

Patients And Methods: From January 2002 to December 2005, 507 pacemakers were implanted due to symptomatic bradycardia.

Aortic valve stenosis due to alkaptonuria.

Cardiovascular disease is a less-well appreciated aspect of alkaptonuria. A 69-year-old man presented with shortness of breath and exertional chest pain. He had a previous diagnosis of alkaptonuria (endogenous ochronosis), confirmed on the basis of urine coloration, skin pigmentation and ochronotic arthropathy in the knees.

The late open infarct-related artery hypothesis: evidence-based medicine or not?

Randomized clinical trials have clearly shown that early reperfusion of coronary arteries is the established treatment of myocardial infarction preserving left ventricular function and reducing mortality. However, late patency of the infarct-related artery is an independent predictor of survival leading to the late open-artery hypothesis. This concept implies restoration of antegrade blood flow of the infarct-related artery in patients with myocardial infarction to improve survival by mechanisms less time-dependent or even time-independent.

Inferior vena cava approach to permanent pacemaker implantation.

A 89-year-old woman required permanent pacemaker implantation because of symptomatic bradyarrhythmia with multiple falls and repeated fractures. Because of the obstruction of the thoracic veins and infection of both groins, an alternative approach via directly punctured inferior vena cava was performed. At follow-up, the patient remained well with an excellent symptomatic response to pacing.

Antiplatelet therapy early after bioprosthetic aortic valve replacement is unnecessary in patients without thromboembolic risk factors.

Background: The use of antithrombotic therapy during the postoperative period after biological aortic valve replacement (AVR) in patients without thromboembolic risk factors remains controversial. Treatment with warfarin is recommended for the first 3 months after biological AVR. The use of antiplatelet therapy - mainly aspirin (ASA) - is suggested as an alternative treatment but its efficacy is still unsettled.

Hybrid treatment for complex aortic problems combining surgery and stenting in the integrated operating theater.

Objectives: Conventional surgical treatment of complex aortic pathologies involving several thoracoabdominal aortic segments necessitates extended incisions or subsequent surgeries, resulting in significant mortality and morbidity rates. The combination of surgery and simultaneous stenting in the operating theater may reduce the surgical trauma.

Methods: A total of nine patients (62 +/- 10 years, range 44-70) underwent a combined surgical and endovascular treatment of thoracic or thoracoabdominal aortic aneurysms or chronic dissection.

Comparison of interventional versus conservative treatment of isolated ostial lesions of coronary diagonal branch arteries.

This study compares percutaneous coronary intervention of isolated ostial stenosis of diagonal branches with a luminal diameter >/=2.0 mm with medical treatment with regard to cardiac events during hospitalization and follow-up. Medical treatment is an alternative to percutaneous intervention without a greater incidence of death or myocardial infarction at 12-month follow-up.

Patency rates of three arterial grafting patterns to the left anterior descending and diagonal coronary arteries in symptomatic patients.

Background: The use of internal thoracic arteries is an established method for treating coronary artery disease because of their excellent long-term patency rates. However, these results mainly referred to the left internal thoracic artery (LITA) grafted to the left anterior descending coronary artery (LAD). The aim of this study was to compare the patency rate of the LITA after its placement to the diagonal branch.

Infective tricuspid valve endocarditis with septic pulmonary emboli due to puncture of an endogenous arteriovenous fistula in a chronic hemodialysis patient.

Background: Patients on chronic hemodialysis are at high risk for infectious endocarditis due to prosthetic access devices such as cuffed venous catheters and polytetrafluoroethylene grafts. Right-sided endocarditis without any predisposing factors is rare in dialysed patients.

Case Report: A 42-year-old man with chronic renal failure was referred to hospital due to febrile temperatures.