Cardiovascular revascularization medicine : including molecular interventions
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Cardiovasc Revasc Med · Mar 2011
Contemporary approaches to perioperative management of coronary stents and to preoperative coronary revascularization: a survey of 374 interventional cardiologists.
We sought to assess contemporary approaches of interventional cardiologists to preoperative evaluation and perioperative management of coronary stents. ⋯ Interventional cardiologists frequently treat patients who require surgery after stent implantation. Although agreement exists on the optimum delay for surgery after stenting, on the need for bare metal stents or balloon angioplasty alone if early noncardiac surgery is needed, and on the treatment of perioperative stent thrombosis, there is divergence of opinion on the need for preoperative stress testing and on the "bridging" therapy for patients who need surgery early after stent implantation.
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Cardiovasc Revasc Med · Mar 2011
Case ReportsEmbolized Amplatzer septal occluder device presenting with ventricular fibrillation.
The Amplatzer septal occluder device is used with high success and low-complication rate. Device embolization occurs in around 0.3-0.55% of cases. We report the case of a 44-year-old man with ventricular fibrillation (VF) due to embolization of Amplatzer septal occluder into the right ventricle, 1 h after the successful closure of secundum ASD with a 26-mm Amplatzer septal occluder device. ⋯ Percutaneous retrieval attempt was unsuccessful. He was referred to surgery immediately. To our knowledge, VF has not been reported yet.
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Cardiovasc Revasc Med · Mar 2011
Cardiovascular magnetic resonance imaging in delivering and evaluating the efficacy of hepatocyte growth factor gene in chronic infarct scar.
In an open-chest model of acute infarct, epicardial delivery of hepatocyte growth factor (pCK-HGF-X7) gene improved left ventricle (LV) function. This study was designed to test (a) the efficacy of HGF gene in infarct scar delivered under magnetic resonance (MR) guidance and (b) the potential of multiple MR sequences in assessing the effects of pCK-HGF-X7 (treatment) and pCK-LacZ (control) genes on myocardial structure and function. ⋯ Hepatocyte growth factor gene (pCK-HGF-X7) delivered under MR guidance into infarct scar ameliorated global function and 3D strain, increased regional perfusion and infarct resorption, and enhanced angiogenesis/arteriogenesis. This feasibility study provides novel approach and analysis methods and instrumentation for delivering and evaluating new locally delivered therapies.
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Cardiovasc Revasc Med · Jan 2011
Case ReportsLate stent thrombosis secondary to carbon monoxide poisoning.
Carbon monoxide poisoning has a variety of deleterious cardiac effects including arrhythmias, coronary spasm and myocardial infarction. The pro-thrombotic effect of carbon monoxide poisoning is one of the important postulated mechanisms of cardiac injury. ⋯ However, there is no published case of carbon-monoxide-poisoning-induced stent thrombosis. We present a 50-year-old female with late stent thrombosis of a sirolimus-eluting stent secondary to acute carbon monoxide poisoning.