Assessment of chronical total occlusions management in France: The ENCOCHE Registry, a prospective, multicentric study.

Background: Coronary chronic total occlusions (CTO) are frequent, and coronary angioplasty has been increasingly used in recent years for lesion revascularisation. However, to date, no dedicated multicentric prospective study is available in France.

Aim: To describe the characteristics of CTO patients and to assess current treatment strategies in French catheterisation laboratory practice.

Transcatheter aortic valve implantation using the SAPIEN 3 valve to treat aortic regurgitation: The French multicentre S3AR study.

Background: Transcatheter aortic valve implantation now has a major role in the treatment of patients with severe aortic stenosis. However, evidence is scarce on its feasibility and safety to treat patients with pure aortic regurgitation.

Aims: We sought to evaluate the results of transcatheter aortic valve implantation using the balloon-expandable SAPIEN 3 transcatheter heart valve (Edwards Lifesciences, Irvine, CA, USA) in patients with pure aortic regurgitation on native non-calcified valves.

Left Ventricular Rapid Pacing Via the Valve Delivery Guidewire in Transcatheter Aortic Valve Replacement.

Objectives: This study investigated whether left ventricular (LV) stimulation via a guidewire-reduced procedure duration while maintaining efficacy and safety compared with standard right ventricular (RV) stimulation.

Background: Rapid ventricular pacing is necessary to ensure cardiac standstill during transcatheter aortic valve replacement (TAVR).

Methods: This is a prospective, multicenter, single-blinded, superiority, randomized controlled trial.

Rapid pacing using the left ventricular guidewire: Reviving an old technique to simplify BAV and TAVI procedures.

Objectives: We sought to demonstrate the safety and efficacy of rapid left ventricular (LV) pacing through the guidewire during balloon aortic valvuloplasty (BAV) and Transaortic valve implantation (TAVI).

Background: Right ventricular temporary pacing during TAVI and BAV is time-consuming and associated with vascular and pericardial complications.

Methods: Rapid left ventricular pacing was provided via the back-up 0.

Cyclosporine before PCI in Patients with Acute Myocardial Infarction.

Background: Experimental and clinical evidence suggests that cyclosporine may attenuate reperfusion injury and reduce myocardial infarct size. We aimed to test whether cyclosporine would improve clinical outcomes and prevent adverse left ventricular remodeling.

Methods: In a multicenter, double-blind, randomized trial, we assigned 970 patients with an acute anterior ST-segment elevation myocardial infarction (STEMI) who were undergoing percutaneous coronary intervention (PCI) within 12 hours after symptom onset and who had complete occlusion of the culprit coronary artery to receive a bolus injection of cyclosporine (administered intravenously at a dose of 2.

Rationale and design of the Cyclosporine to ImpRove Clinical oUtcome in ST-elevation myocardial infarction patients (the CIRCUS trial).

Background: Both acute myocardial ischemia and reperfusion contribute to cardiomyocyte death in ST-elevation myocardial infarction (STEMI). The final infarct size is the principal determinant of subsequent clinical outcome in STEMI patients. In a proof-of-concept phase II trial, the administration of cyclosporine prior to primary percutaneous coronary intervention (PPCI) has been associated with a reduction of infarct size in STEMI patients.

Effect of cyclosporine on reperfusion injury in acute myocardial infarction.

Background: Experimental evidence suggests that cyclosporine, which inhibits the opening of mitochondrial permeability-transition pores, attenuates lethal myocardial injury that occurs at the time of reperfusion. In this pilot trial, we sought to determine whether the administration of cyclosporine at the time of percutaneous coronary intervention (PCI) would limit the size of the infarct during acute myocardial infarction.

Methods: We randomly assigned 58 patients who presented with acute ST-elevation myocardial infarction to receive either an intravenous bolus of 2.

Assessment of acute myocardial infarction using MDCT after percutaneous coronary intervention: comparison with MRI.

Objective: Imaging to determine myocardial infarct size is difficult in the emergency setting because the current gold standards, MRI and nuclear medicine techniques, are difficult to perform in unstable patients. Delayed enhanced MDCT has recently been proposed as a technique to study contrast uptake in infarcted myocardium. In this study, we compared the extent of acute myocardial infarction as measured by delayed enhanced MDCT performed immediately after percutaneous coronary intervention (PCI) without an additional iodine injection with that measured by delayed gadolinium-enhanced MRI.

Acute chest pain with normal coronary angiogram: role of contrast-enhanced multidetector computed tomography in the differential diagnosis between myocarditis and myocardial infarction.

Objective: To evaluate the accuracy of delayed-enhanced multidetector computed tomography (MSCT) for differentiating between myocarditis and myocardial infarction in patients with normal x-ray coronary angiography.

Methods: Twelve consecutive patients referred for acute chest pain and normal coronary arteries on x-ray coronary angiography were involved in this study. Delayed-enhanced MSCT and postgadolinium delayed-enhanced magnetic resonance imaging (MRI) examinations were performed within 36 hours and 4 days, respectively, after patient admission.

Long-term benefit of postconditioning.

Background: We previously demonstrated that ischemic postconditioning decreases creatine kinase release, a surrogate marker for infarct size, in patients with acute myocardial infarction. Our objective was to determine whether ischemic postconditioning could afford (1) a persistent infarct size limitation and (2) an improved recovery of myocardial contractile function several months after infarction.

Methods And Results: Patients presenting within 6 hours of the onset of chest pain, with suspicion for a first ST-segment-elevation myocardial infarction, and for whom the clinical decision was made to treat with percutaneous coronary intervention, were eligible for enrollment.

Postconditioning the human heart.

Background: In animal models, brief periods of ischemia performed just at the time of reperfusion can reduce infarct size, a phenomenon called postconditioning. In this prospective, randomized, controlled, multicenter study, we investigated whether postconditioning may protect the human heart during coronary angioplasty for acute myocardial infarction.

Methods And Results: Thirty patients, submitted to coronary angioplasty for ongoing acute myocardial infarction, contributed to the study.

150 microgram intracoronary adenosine bolus for accurate fractional flow reserve assessment of angiographically intermediate coronary stenosis.

Aims: Fractional flow reserve measurement is based upon achieving maximum hyperemia. A 40 microg intracoronary (IC) adenosine bolus sometimes seems insufficient, and we therefore sought to assess the possible role of 100-150 microg boli in routine.

Methods And Results: 108 intermediate (49+/-16%) stenoses were consecutively studied with 6F catheters.

Ginkgo biloba extract EGb 761 attenuates myocardial stunning in the pig heart.

Myocardial stunning, a transient contractile dysfunction that appears following a brief period of ischemia, is at least partly due to the production of oxygen-derived free radicals. The objective of the present study was to determine whether the Ginkgo biloba extract EGb761, which has antioxidant properties in vitro, can attenuate myocardial stunning in vivo. Forty-seven anesthetized open-chest farm pigs underwent 10 min of occlusion of the left anterior descending coronary artery (LAD), followed by 3 hours of reperfusion.