The clinical utility of bivalirudin in patients with coronary artery disease.

Bivalirudin, a direct thrombin inhibitor, is an anticoagulant commonly used in invasive cardiology procedures. It has evolved from relative obscurity, as an anticoagulation option only utilized in rare instances of allergy or resistance to heparin products, to the now preferred antithrombotic anticoagulant in the cardiac catheterization laboratory. On the way to displacing unfractionated heparin as the preferred anticoagulant for percutaneous coronary intervention, multiple studies comparing bivalirudin with heparin have consistently shown equivalent ischemic efficacy endpoints (i.

Percutaneous coronary artery stenting of unprotected left main coronary artery disease using drug-eluting stents: the initial Baylor University Medical Center experience.

Significant narrowing of the left main coronary artery is a high-risk condition with significant mortality risk. Bypass surgery is the current gold-standard treatment for unprotected left main (ULM) disease. Stenting utilizing drug-eluting stents (DES) is another therapeutic option for patients with ULM disease considered too high risk for bypass surgery or for patients who simply refuse bypass surgery.

Valve structure and survival in octogenarians having aortic valve replacement for aortic stenosis (+/- aortic regurgitation) with versus without coronary artery bypass grafting at a single US medical center (1993 to 2005).

The purpose of this study was to determine the effect of simultaneous coronary artery bypass grafting (CABG) and valve structure on both early and late survival in octogenarians having aortic valve replacement (AVR) for aortic stenosis (AS) (with or without aortic regurgitation). Although a number of reports are available in octogenarians having AVR for AS, none have described aortic valve structure. Most have limited numbers of patients and few have described late results.