Feasibility of Coronary Access Following Redo-TAVR for Evolut Failure: A Computed Tomography Simulation Study.

Background: Coronary accessibility following redo-transcatheter aortic valve replacement (redo-TAVR) is increasingly important, particularly in younger low-risk patients. This study aimed to predict coronary accessibility after simulated Sapien-3 balloon-expandable valve implantation within an Evolut supra-annular, self-expanding valve using pre-TAVR computed tomography (CT) imaging.

Methods: A total of 219 pre-TAVR CT scans from the Evolut Low-Risk CT substudy were analyzed.

Mechanical Circulatory Support in Patients With COVID-19 Presenting With Myocardial Infarction.

ST-segment elevation myocardial infarction (STEMI) complicating COVID-19 is associated with an increased risk of cardiogenic shock and mortality. However, little is known about the frequency of use and clinical impact of mechanical circulatory support (MCS) in these patients. We sought to define patterns of MCS utilization, patient characteristics, and outcomes in patients with COVID-19 with STEMI.

North American COVID-19 Myocardial Infarction (NACMI) Risk Score for Prediction of In-Hospital Mortality.

Background: In-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) is higher in those with COVID-19 than in those without COVID-19. The factors that predispose to this mortality rate and their relative contribution are poorly understood. This study developed a risk score inclusive of clinical variables to predict in-hospital mortality in patients with COVID-19 and STEMI.

Sex Differences in Clinical Characteristics, Management Strategies, and Outcomes of STEMI With COVID-19: NACMI Registry.

Background: Women with ST-segment elevation myocardial infarction (STEMI) had worse outcomes than men prior to the COVID-19 pandemic. Although concomitant COVID-19 infection increases mortality risk in STEMI patients, no studies have evaluated sex differences in this context.

Methods: The North American COVID-19 STEMI registry is a prospective, multicenter registry of hospitalized STEMI patients with COVID-19 infection.

Trends in Clinical Presentation, Management, and Outcomes of STEMI in Patients With COVID-19.

Background: We previously reported high in-hospital mortality for ST-segment elevation myocardial infarction (STEMI) patients with COVID-19 treated in the early phase of the pandemic.

Objectives: The purpose of this study was to describe trends of COVID-19 patients with STEMI during the course of the pandemic.

Methods: The NACMI (North American COVID-19 STEMI) registry is a prospective, investigator-initiated, multicenter, observational registry of hospitalized STEMI patients with confirmed or suspected COVID-19 infection in North America.

Approach to Tibiopedal Retrograde Revascularization of Below-The-Knee Peripheral Arterial Diseases With or Without Transradial Guidance Peripheral Angiography.

Objective: We sought to compare the use of transradial peripheral angiography to guide retrograde revascularization of below-the-knee (BTK) lesions using tibiopedal access (TPA).

Background: Tibiopedal retrograde revascularization of BTK lesions is an emerging technique in peripheral interventions.

Methods: We performed an observational cohort study of 194 consecutive adult patients with critical limb ischemia (CLI) who underwent endovascular intervention for BTK diseases using peripheral angiography and primary TPA access with vs without transradial (TR) guidance at 2 centers (New York, USA and Budapest, Hungary).

Primary Retrograde Tibio-Pedal Approach for Endovascular Intervention of Femoropopliteal Disease with Chronic Total Occlusion.

Objectives: This study investigated the feasibility, safety, and the acute outcome of primary retrograde tibio pedal approach (TPA) in the treatment of peripheral arterial disease (PAD) with femoropopliteal (FP) chronic total occlusion (CTO).

Background: With maturing in endovascular technology and further development in new devices, endovascular therapy has become a comparable and preferred treatment for patients with PAD. The retrograde TPA has not been studied to treat FP CTO extensively.

Sex-related difference in the use of percutaneous left ventricular assist device in patients undergoing complex high-risk percutaneous coronary intervention: Insight from the cVAD registry.

Objective: To assess the in-hospital and short-term outcome differences between males and females who underwent high-risk PCI with mechanical circulatory support (MCS).

Background: Sex differences have been noted in several percutaneous coronary intervention (PCI) series with females less likely to be referred for PCI due increased risk of adverse events. However, data on sex differences in utilization and outcomes of high-risk PCI with MCS is scarce.

Functional hemodynamics assessment during endovascular Tibio-pedal retrograde intervention of peripheral arterial disease.

Objective: We sought to use a novel technique to measure the functional hemodynamics of peripheral arterial lesions during endovascular interventions.

Background: Functional hemodynamics has not been thoroughly evaluated during endovascular interventions. The aim of our study is to evaluate the feasibility and the potential benefits of pedal pressures measurements from tibio-pedal access.

Transpedal vs. femoral access for peripheral arterial interventions-A single center experience.

Objective: To compare the transpedal approach to established femoral approach for endovascular treatment of infrainguinal peripheral arterial disease.

Background: Endovascular treatment of infrainguinal peripheral arterial disease is on the rise. Femoral approach is widely used but has significant complications.

Distal transradial artery access in the anatomical snuffbox for coronary angiography as an alternative access site for faster hemostasis.

Objectives: This study investigated the feasibility, safety, and the potential benefit of faster hemostasis with the distal transradial artery access (TRA).

Background: TRA has been shown to be associated with lower bleeding and vascular complications. Limited data are available regarding the new technique of accessing the distal radial artery in the anatomical snuffbox.

Access and closure management of large bore femoral arterial access.

Femoral and radial artery access continue to be the standard of care for percutaneous coronary interventions. Cardiac catheterization has progressed to encompass a wide range of diagnostic and interventional procedures including coronary, peripheral, endovascular, and structural heart disease interventions. Despite advanced technology to make these procedures safe, bleeding, and vascular complications continue to be a substantial source of morbidity, especially in patients undergoing large-bore access procedures.

Transcatheter bicuspid aortic valve replacement in Turner syndrome: A unique experience of interventional cardiologist.

A 69-year-old short-statured Turner syndrome (TS) patient with a history of poliomyelitis in childhood and moderate bicuspid aortic stenosis (BAS) reported worsening dyspnea and fatigue over six months. A repeat transthoracic echocardiogram revealed progression to severe aortic stenosis with dilated ascending aorta (AA). As part of the work-up for aortic valve replacement, the patient underwent cardiac catheterization, which revealed a severely calcified AV with an area of 0.

Feasibility of coronary angiography and percutaneous coronary intervention after transcatheter aortic valve replacement using a Medtronic™ self-expandable bioprosthetic valve.

Background And Objective: With aging, the progression of atherosclerosis in the coronary arteries is expected. The Medtronic™ self-expandable aortic bioprosthetic valve is deployed in the supra-annular position, and it has been challenging to selectively engage coronary arteries post-transcatheter aortic valve replacement (TAVR) even though there are diamond-shaped spaces in the mesh frame within the valve. Given the scarcity of data, we analyzed angiographic and clinical data from all patients requiring coronary angiography (CA) or intervention post-TAVR.

A novel approach in the management of right-sided endocarditis: percutaneous vegectomy using the AngioVac cannula.

The AngioVac is a vacuum-based device introduced in 2012 to percutaneously remove undesirable material from the intravascular system. In scattered reports, the AngioVac has been used for removal of device-led vegetations and right-sided thrombi. In this article, we describe three cases of right-sided endocarditis treated with AngioVac: a mobile mass extending from the vena cava into the right atrium, large native tricuspid vegetations, and bioprosthetic tricuspid vegetations.

Safety of coronary angiography and percutaneous coronary intervention via the radial versus femoral route in patients on uninterrupted oral anticoagulation with warfarin.

Objective: To evaluate access site and other bleeding complications associated with radial versus femoral access in patients receiving oral anticoagulation (OAC) with warfarin.

Background: Patients receiving OAC with warfarin undergoing coronary angiography and percutaneous coronary intervention (PCI) may have OAC continued despite the risk of bleeding. To what extent arterial access site impacts bleeding in such patients is not well studied.

Coronary Collateral Circulation and Cardiovascular Risk Factors: Is There a Paradox?

We sought to determine the association of major cardiovascular risk factors and other comorbidities with the presence or absence of coronary collateral (CC) circulation. All electronic medical records from 2010 to 2011 were retrospectively reviewed. A total of 563 patients were divided into 2 groups: CC present (180) and CC absent (383).

Ticagrelor: the first novel reversible P2Y(12) inhibitor.

Introduction: Dual antiplatelet therapy is a standard of care for treating patients with acute coronary syndrome (ACS). Combination therapy with aspirin and one of the P2Y(12) inhibitors (clopidogrel, prasugrel, or most recently, ticagrelor ) has been recommended by both ACC/AHA and ESC guidelines for ACS patients.

Areas Covered: Ticagrelor is the first generation of a new class of reversible P2Y(12) inhibitors, recently added to updated ACC and ESC guidelines for use in patients with ACS.

Effect of proton pump inhibitors on platelet inhibition activity of clopidogrel in Chinese patients with percutaneous coronary intervention.

Background: The purpose of this study was to examine the effect of proton pump inhibitors (PPI) on the antiplatelet activity of clopidogrel in a consecutive series of Chinese patients after they had received coronary stents.

Methods: A sample of 51 consecutive Chinese patients treated with coronary stents and taking PPI and clopidogrel for more than 30 days were enrolled in this study. Mean values for platelet residual units and percentage inhibition before PPI (+PPI) and 14 days after discontinuation of PPI (-PPI) were compared using the paired t-test.