Routine Protamine Administration for Bleeding in Transcatheter Aortic Valve Implantation: The ACE-PROTAVI Randomized Clinical Trial.

Importance: Vascular complications after transfemoral transcatheter aortic valve implantation (TAVI) remain an important cause of procedure-related morbidity. Routine reversal of anticoagulation with protamine at the conclusion of transfemoral TAVI could reduce complications, but data remain scarce.

Objective: To evaluate the efficacy and safety of routine protamine administration after transfemoral TAVI.

The Role of Comorbidities in Predicting Functional Improvement After Transcatheter Aortic Valve Implantation.

Background: Patients undergoing transcatheter aortic valve implantation (TAVI) have a high comorbidity burden. We sought to stratify patients into functional outcomes using the Kansas City Cardiomyopathy Questionnaire (KCCQ-12), a patient-reported outcome with benefits over both the New York Heart Association (NYHA) classification and the original 23-item KCCQ, and to evaluate the importance of comorbidities in predicting failure of functional improvement post-TAVI in a contemporary cohort.

Methods: In total, 366 patients with severe aortic stenosis undergoing TAVI with baseline KCCQ-12 were retrospectively analysed and divided into two groups.

Clinical Outcomes Associated With Balloon Aortic Valvuloplasty in the Contemporary Era.

Background: Severe aortic stenosis is the most common acquired valvular disorder. Balloon aortic valvuloplasty (BAV) is considered for patients who are not suitable for surgical aortic valve replacement (SAVR) and transcatheter aortic valve insertion (TAVI). The American Heart Association and European Society of Cardiology recommend BAV as a bridging procedure for SAVR and TAVI due to the significant morbidity and mortality associated with it.

Combined spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS): a case series.

Background: Spontaneous Coronary Artery Dissection (SCAD) and Takotsubo Syndrome (TTS) are two different entities with several shared risk factors, but their management is different. They can co-exist in patients with chest pain which affects their management. We present two cases of combined SCAD and TTS in patients presented with chest pain.

Acute vestibular neuritis may provoke atrial fibrillation.

Background: Exclusion of stroke is the focus of guidelines in the emergency department assessment of acute vertigo, especially with new-onset atrial fibrillation (AF). Early diagnosis of vestibular neuritis (VN) is also important but may be deferred awaiting brain magnetic resonance imaging (MRI) for exclusion of stroke. This may delay potentially beneficial corticosteroid therapy.

Short- and Long-Term Outcomes After Transcatheter Aortic Valve Implantation in Public and Private Hospital Settings: A Propensity-Matched Analysis.

Objectives: To compare short- and long-term outcomes after transcatheter aortic valve implantation (TAVI) in the public and private hospital setting.

Design: Propensity-matched, retrospective analysis of a prospective registry.

Setting And Participants: Patients with severe aortic stenosis who underwent TAVI at a tertiary public hospital (n=507) and an experienced private hospital (n=436).

Case report of amiodarone-associated allergic pneumonitis amidst the COVID-19 pandemic.

Amiodarone is a common antiarrhythmic drug that is utilised in clinical practice and is associated with pulmonary toxicity. The most common form of pulmonary complication is interstitial pneumonitis which is treated with discontinuation of amiodarone and initiation of corticosteroids. Amiodarone-induced pulmonary eosinophilia is a rare complication of amiodarone therapy, with blood and pulmonary eosinophilia the predominant features.

Impact of Gender on Transcatheter Aortic Valve Implantation Outcomes.

Previous studies indicate that women who underwentwho underwent transcatheter aortic valve implantation (TAVI) have poorer 30-day outcomes compared with men. However, the effect of gender as a prognostic factor for long-term outcomes following TAVI remains unclear. Between 2008 and 2018, all patients (n = 683) who underwent TAVI in 2 centres in Melbourne, Australia were prospectively included in a registry.

Medium-Term Bioresorbable Scaffold Outcomes Utilising Data From an Australian Clinical Quality Registry.

Background: Bioresorbable scaffolds (BRS) are a novel technology in coronary intervention. However, recent trials demonstrate higher rates of device failure compared to contemporary drug-eluting stents. This study sought to utilise a clinical quality registry to assess the medium-term safety of the Abbott Absorb BRS (Abbott Vascular, Santa Clara, CA, USA), in an Australian context.

Clopidogrel Resistance: case reports of CYP2C19 gene variants in suspected coronary stent thrombosis.

Clopidogrel is a widely used anti-platelet agent for the prevention of arterial thrombosis. Clopidogrel is administered as a pro-drug and metabolised to its active metabolite by the hepatic cytochrome P450 2C19 (CYP2C19) enzyme. The active metabolite is responsible for the anti-platelet activity of clopidogrel.

[Effect of previous statins on prognosis of octogenarian patients with coronary heart disease with percutaneous coronary stenting].

Objective: To evaluate the effect of statin pretreatment on prognosis of octogenarian patients with coronary heart disease with percutaneous coronary intervention (PCI).

Methods: A total of 90 patients aged at 85 years old and over with coronary heart disease (CAD) undergoing stenting were enrolled. The duration of statin, hospitalization and one-year clinical follow-up outcome including all-cause mortality, major adverse cardiac event (MACE), stroke and other major hemorrhages were collected and analyzed.

Percutaneous coronary intervention in women: in-hospital clinical outcome: experience from a single private institution in Melbourne.

Background: Differences in outcome between women and men treated with percutaneous coronary intervention (PCI) have decreased. This study was aimed at assessing the demographic, clinical, and angiographic features, procedural characteristics and in-hospital results of women undergoing PCI and comparing their results with those of a group of men undergoing PCI throughout the same period of time.

Methods And Results: All consecutive PCI procedures performed at Epworth Hospital from November 2004 to January 2007 were analysed.

Very late drug-eluting stent thrombosis post exercise stress echocardiogram.

Stent thrombosis, although a rare event, has been the object of considerable interest because of its attendant morbidity and mortality and has come into focus with the advent of drug-eluting stents. We report a case of very late drug-eluting stent thrombosis occurring immediately after an exercise stress echocardiogram, in a patient who, 2 years earlier, had undergone primary percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI). Similar cases reported in the literature and the possible mechanisms of stent thrombosis associated with exercise testing are reviewed.

Long-term outcome of patients of over 85 years old with acute coronary syndrome undergoing percutaneous coronary stenting: a comparison of bare metal stent and drug eluting stent.

Background: Patients aged over 85 years have been under-represented in percutaneous coronary intervention (PCI) trials despite an increase in referrals for PCI. The long-term safety and efficacy of percutaneous coronary stenting in patients aged over 85 years with acute coronary syndrome (ACS) remain unclear. Moreover it is unknown whether there are differences between bare metal stent (BMS) and drug eluting stent (DES) in this special population.

Parental responses to involvement in rounds on a pediatric inpatient unit at a teaching hospital: a qualitative study.

Purpose: In pediatric teaching hospitals, medical decisions are traditionally made by the attending and resident physicians during rounds that do not include parents. This structure limits the ability of the medical team to provide "family-centered care" and the attending physician to model communication skills. The authors thus set out to identify how parents responded to participation in interdisciplinary teaching rounds conducted in a large tertiary care children's teaching hospital.

Anomalous origin of left coronary artery from the pulmonary artery does the management in the adult differ from that of the infant? Four cases of the Bland-White-Garland Syndrome.

We report four adult patients with anomalous origin of left main coronary artery from the pulmonary artery that presented to us from 1995 to 2006. One died suddenly at the age of 21 years before undergoing surgery, two patients had ligation and left internal mammary artery (LIMA) grafting to the left anterior descending artery, and one had aortic implantation of the left main coronary artery. All three patients who had surgical treatment are doing well.

Clopidogrel resistance.

Clopidogrel resistance has been used as one of the terms employed in the literature to describe different degrees of ex vivo low platelet inhibition after clopidogrel administration. In addition to the diverse nomenclature, the characterisation of clopidogrel resistance has also been problematic because different authors have given different definitions. The mechanisms responsible for this decreased platelet response are not yet clearly defined, some hypotheses have been put forward but not yet demonstrated.

Post-infarct left ventricular free wall rupture-not always a lethal complication of acute myocardial infarction.

Post-myocardial infarction cardiac rupture is an important complication and cause of death in the period following myocardial infarction. It is rarely diagnosed before death. However, early diagnosis is crucial as successful treatment is possible with surgery.

Epworth hospital interventional cardiology report, 2002.

In March 2001, the Victorian Heart Centre at Epworth Hospital implemented a database management system to improve the standard of data collection and analysis of procedures performed in our catheter laboratory. A retrospective analysis of procedures undertaken during 2000, together with prospective data collected during 2001/2002, has enabled us to achieve our goals of benchmarking performance and undertaking research on the outcomes of interventional cardiology procedures at Epworth. The figures reported in this year's cardiac catheterisation laboratory audit report confirm a continued high standard performance in our laboratory.