Heart failure is becoming increasingly prevalent, and currently coronary artery disease (CAD) is the primary cause of left ventricular (LV) systolic dysfunction. A potential therapeutic option for patients with severe CAD and LV dysfunction is a strategy of revascularization. In this review, we summarize the available literature regarding revascularization for these patients. The literature suggests that patients with severe CAD and LV dysfunction may benefit from revascularization and those patients with viable myocardium may derive the most benefit.
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http://dx.doi.org/10.1007/s11886-006-0055-5 | DOI Listing |
The broad spectrum of clinical manifestations caused by peripheral arterial disease [PAD] and the morphologic heterogeneity of associated atherosclerotic lesions present a considerable management challenge. Endovascular interventions are recognized an effective treatment for PAD. Within this revascularization strategy the role of atherectomy debulking modalities continue to evolve.
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
December 2024
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA.
Cardiogenic shock (CS) in acute myocardial infarction (AMI) is a life-threatening syndrome characterized by systemic hypoperfusion that can quickly progress to multiorgan failure and death. Various devices and configurations of mechanical circulatory support (MCS) exist to support patients, each with unique pathophysiological characteristics. The Intra-aortic balloon pump can improve coronary perfusion, decrease afterload, and indirectly augment cardiac output.
View Article and Find Full Text PDFInt J Cardiol
December 2024
Cardiothoracic and Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Background: The results of randomized clinical trials comparing the outcomes of different strategies for driving PCI are mixed, and it remains unclear which technique for driving PCI offers the greatest benefit. The aim of the study was to compare the clinical efficacy of different techniques to guide percutaneous coronary intervention (PCI).
Methods: We search major electronic databases for randomized clinical trials evaluating clinical outcomes of PCI with stent implantation guided by coronary angiography (CA), fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), intravascular ultrasound (IVUS) and optical coherence tomography (OCT).
Prog Cardiovasc Dis
December 2024
Department of Cardiology, Columbia University Irving Medical Center/New York Presbyterian Hospital and the Cardiovascular Research Foundation, 161 Fort Washington Avenue, New York, NY 10032, United States of America.
Ischemic cardiomyopathy (ICM) is characterized by myocardial dysfunction due to myocardial ischemia, associated with the presence of significant coronary artery disease (CAD). We provide a comprehensive review of the current evidence for coronary revascularization in ICM, including consideration of the different modalities of coronary artery bypass grafting and percutaneous coronary intervention . In addition to a contemporary assessment of the literature, we aim to provide real-world insights and perspectives to guide clinical decision-making in this heterogeneous and complex patient population.
View Article and Find Full Text PDFAm Heart J
December 2024
Department of cardiology, Guy's and St Thomas' NHS Foundation Trust, Harefield Hospital, London, UK; King's College London, London, UK.
Background: ST-segment elevation myocardial infarction (STEMI) is treated with immediate primary percutaneous coronary intervention (pPCI) to restore coronary blood flow in the acutely ischaemic territory, but is associated with reperfusion injury limiting the benefit of the therapy. No treatment has proven effective in reducing reperfusion injury. Transcoronary hypothermia has been tested in clinical studies and is well tolerated, but is generally established after crossing the occlusion with a guidewire therefore after initial reperfusion, which might have contributed to the neutral outcomes.
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