Use of a percutaneous left ventricular assist device for high-risk cardiac interventions and cardiogenic shock.

Objective: We sought to describe the use of the TandemHeart percutaneous left ventricular assist device (PVAD) in a group of high-risk patients undergoing complex cardiovascular procedures.

Background: There is a substantial risk of acute decompensation and death in patients with cardiogenic shock or a reduced cardiac reserve undergoing high-risk cardiovascular interventions. The TandemHeart PVAD provides near-total hemodynamic support in this setting.

The role of cardiovascular computed tomographic angiography for coronary sinus mitral annuloplasty.

Background: The coronary sinus (CS) travels in close proximity to the left circumflex (LCX) artery. Percutaneously placed CS devices used to treat mitral regurgitation (MR) therefore have the potential to impinge upon the LCX arterial distribution and compromise coronary flow.

Objectives: In this study, we sought to analyze the anatomic relationship between the CS, LCX and mitral annulus (MA) in patients with right dominant (RCD), left dominant (LCD) and codominant (CCD) arterial systems using a novel systematic approach.

Diagnostic accuracy of 64 multidetector computed tomographic angiography in peripheral vascular disease.

Background: Previous studies of multidetector CT (MDCT) of the lower extremities for the detection of peripheral vascular disease showed high diagnostic accuracy but were performed with older generation systems.

Objective: The purpose of this study was to evaluate the diagnostic accuracy of 64 MDCT for the detection of hemodynamically significant disease within the lower extremity peripheral vasculature as compared to digital subtraction angiography (DSA).

Methods: Twenty-eight consecutive patients with symptomatic lower extremity intermittent claudication and an abnormal ankle-brachial index (ABI; less than 0.

Prognostic significance of zero coronary calcium scores on cardiac computed tomography.

Background: Most unexpected cardiovascular events occur in persons at intermediate risk of coronary artery disease (10%-20% 10-year risk). Coronary artery calcium (CAC) has been shown to be highly specific for atherosclerosis, occurring only in the intima of the coronary arteries. Evidence shows that elevated coronary calcium scores (CCSs) are predictive of future cardiovascular events, both independently of and incrementally to conventional cardiovascular risk factors.

Current results of balloon aortic valvuloplasty in high-risk patients.

In this report, we describe our experience with a contemporary series of patients with severe aortic stenosis (AS) undergoing balloon aortic valvuloplasty (BAV) who were not deemed to be surgical candidates. Demographic, hemodynamic and procedural data, operative risk (EuroSCORE) and long-term follow up were collected. Eighty consecutive patients with severe symptomatic AS underwent 104 BAV procedures as a single center and were followed for a mean of 3+/-2 years.