Antegrade Dissection Re-entry for Management of Retained Microcatheter Tips During PCI for Chronic Total Occlusion: A Case Series.

Application of the hybrid algorithm for the treatment of coronary chronic total occlusions requires the operator to readily deploy complex techniques and advanced technologies to achieve successful revascularization. Patient-specific factors and limitations in torquability and material strength of low-profile equipment such as microcatheters can result in procedural complications due to device fracture. Using a mini-series of 2 cases to demonstrate the successful application of antegrade dissection re-entry techniques to overcome such challenges, we highlight procedural complexities and risk, and review prior approaches and literature.

Ten Years of Percutaneous Pulmonary Valve Implantation in Australia and New Zealand.

Objective: This study sought to investigate the characteristics, morbidity (including the rate of infective endocarditis and valve replacement) and mortality of individuals undergoing percutaneous pulmonary valve implantation in Australia and New Zealand since the procedure has been performed.

Background: The outcomes of percutaneous pulmonary valve implantation in Australia and New Zealand have not been evaluated. Recent international data, including patients from New Zealand, suggests the rate of infective endocarditis is not insignificant.

Clinical outcomes following single access transfemoral transcatheter aortic valve implantation.

Objectives: We describe the first experience using calcification of anatomical landmarks to obviate the need for transcatheter aortic valve implantation (TAVI) alignment aortography and secondary TAVI access.

Background: TAVI alignment conventionally involves secondary femoral access for contrast aortography using a second catheter. Secondary femoral access accounts for up to 25% of all vascular complications.

Impact of Patient BMI on Patient and Operator Radiation Dose During Percutaneous Coronary Intervention.

Aims: This study sought to investigate patient and operator radiation dose in patients undergoing percutaneous coronary intervention (PCI) and the impact of body mass index (BMI) on patient and operator dose.

Methods: In patients undergoing PCI, radiation dose parameters, baseline characteristics and procedural data were collected in a tertiary centre for 3.5 years.

"Gazing Into the Abyss": Transcatheter Mitral Valve-in-Valve Implantation Through a Cavernous Left Atrium.

We describe the case of a 73-year-old woman presenting with heart failure, a degenerating bioprosthetic mitral valve, and severely dilated left atrium, and highlight the role of multimodality imaging in planning transseptal transcatheter mitral valve-in-valve implantation. ().

Coagulation derangement and risk factors for valve thrombosis following transcatheter aortic valve implantation.

Aims: Durability of transcatheter aortic valve implantation (TAVI) is key to its expansion. We sought to identify incidence of valve thrombosis and predictors of valve thrombosis in our single centre with associated coagulation testing pre-TAVI and post-TAVI.

Methods And Results: This single-centre observational study comprised patients undergoing transfemoral TAVI discussed in the Heart Team meeting .

Neurocognitive Status after Aortic Valve Replacement: Differences between TAVI and Surgery.

Over the past decade, indications for transcatheter aortic valve implantation (TAVI) have progressed rapidly-procedural numbers now exceed those of surgical aortic valve replacement (SAVR) in many countries, and TAVI is now a realistic and attractive alternative to SAVR in low-risk patients. Neurocognitive outcomes after TAVI and SAVR remain an issue and sit firmly under the spotlight as TAVI moves into low-risk cohorts. Cognitive decline and stroke carry a significant burden and predict future functional decline, reduced mobility, poor quality of life and increased mortality.

Primary operator radiation dose in the cardiac catheter laboratory.

Objectives: Radiation from cardiac angiography procedures is harmful to patients and the staff performing them. This study sought to investigate operator radiation dose for a range of procedures and different operators in order to investigate trends and optimise dose.

Methods: Real-time dosemeters (RTDs) were worn by operators for angiography procedures for 3 years.

Three-dimensional printed cardiac fistulae: a case series.

Background: Three-dimensional (3D) printing of cardiac fistulae allows for immediate understanding of their complex courses and anatomical relations. Models can be used to improve patient understanding, enhance the consenting process, facilitate communication between multidisciplinary staff at heart team meetings, and help plan surgical or percutaneous interventions.

Case Summary: We report four cases where 3D printed models were used as an adjunct with traditional measures in treating patients with complex cardiac fistulae.

3D printed cardiac fistula: Guiding percutaneous structural intervention.

We present the case of a 21-year-old female with a complex right coronary sinus of valsalva to right atrial fistulae. 3D printing of the fistulae and surrounding anatomy was beneficial in assessment of the anatomy and perioperative planning. Successful percutaneous closure was achieved.

Transcatheter mitral valve intervention: an emerging treatment for mitral regurgitation.

Mitral regurgitation (MR) is a valvular heart disease associated with significant morbidity and mortality. Transcatheter mitral valve intervention (TMVI) repairs or replaces the mitral valve through small arterial and venous entry sites and so avoids risks associated with open heart surgery. Transcatheter devices targeting components of the mitral apparatus are being developed to repair or replace it.

Recurrent undifferentiated shock: Idiopathic Systemic Capillary Leak Syndrome.

Idiopathic Systemic Capillary Leak Syndrome is a potentially fatal disorder that is under diagnosed. It commonly presents as recurrent undifferentiated shock with hypotension, hypoalbuminemia and hemoconcentration. There are three distinct phases that define the syndrome; Prodromal, Extravasation and Recovery.