Transhepatic approach of patent foramen ovale closure in the setting of congenital inferior vena cava anomaly.

Patent foramen ovale (PFO) is the most common interatrial septal abnormality. The indications for PFO device closure are still being evaluated, with the most common reason being to prevent cerebrovascular accidents (CVA) caused by paradoxical embolism of deep vein thrombosis (DVT) in the lower extremities. This procedure is usually performed through percutaneous intervention using femoral vein access.

Outcomes of Hemodynamic Support With Impella for Acute Myocardial Infarction Complicated by Cardiogenic Shock at a Rural Community Hospital Without On-Site Surgical Back-up.

Aims: Impella 2.5 and Impella CP (Abiomed) are percutaneous left ventricular assist devices that can be easily deployed in the cardiac catheterization laboratory without need for surgery and provide effective hemodynamic support. The utility of Impella devices for management of acute myocardial infarction complicated by cardiogenic shock (AMI-CS) at a rural community hospital without on-site surgical back-up has not been reported.

The evanescent right atrial mass.

An unusual cause of pulmonary emboli from an evanescent right atrial mass is described in this case report. The systematic approach from initial presentation to a definite diagnosis of a rare condition is described.

TEE-guided transcatheter aortic valve implantation with "zero contrast" - a viable alternative for patients with chronic kidney disease.

Acute kidney injury (AKI) stage II-III has been associated with a higher short-term and long-term mortality after transcatheter aortic valve replacement (TAVR). We present a patient with AKI where fluoroscopic landmarks and TEE imaging were used exclusively, sparing the patient a contrast load, and describe patient-tailored modifications.

Validation and incremental value of the hybrid algorithm for CTO PCI.

Objectives: To evaluate the outcomes and benefits of using the hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI).

Background: The hybrid algorithm harmonizes antegrade and retrograde techniques for performing CTO PCI. It has the potential to increase success rates and improve efficiency for CTO PCI.

Rationale for Percutaneous Intervention of CTO.

Chronic total occlusion accounts for 15% of cases during diagnostic angiography with higher referral rate to surgical revascularization. With contemporary strategies and techniques, the success rate with experienced operators can exceed 90%. Currently available observational studies in carefully selected patient populations show evidence of a trend toward symptom relief; improvement in quality of life, left ventricular function, and mortality; and improved tolerance toward future ischemic events.