Journal of cardiovascular medicine
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J Cardiovasc Med (Hagerstown) · Aug 2007
Randomized Controlled Trial Multicenter StudyInvestigation on Colchicine for Acute Pericarditis: a multicenter randomized placebo-controlled trial evaluating the clinical benefits of colchicine as adjunct to conventional therapy in the treatment and prevention of pericarditis; study design amd rationale.
Colchicine is safe and effective in the treatment and prevention of recurrent pericarditis after failure of conventional treatment. The recent guidelines of the European Society of Cardiology suggest that colchicine might be useful even in the treatment of the first episode. However, the use of the drug is not based on any strong evidence obtained from clinical trials, and no randomized placebo-controlled trial is available to guide the management of acute pericarditis. ⋯ The ICAP trial will be the first randomized placebo-controlled trial in this area. This trial will provide important evidence regarding the possible benefit of the early use of colchicine in the treatment of acute pericarditis and the primary prevention of recurrences, the most troublesome and commonest complication of pericarditis.
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J Cardiovasc Med (Hagerstown) · May 2007
Edge-to-edge mitral valve repair for isolated prolapse of the anterior leaflet caused by degenerative disease.
The use of new techniques to correct mitral regurgitation due to prolapse of the anterior leaflet has been shown to expand the original surgical armamentarium and to improve postoperative outcome. We retrospectively analysed our experience with isolated prolapse of the anterior mitral leaflet repaired using the edge-to-edge technique. ⋯ Our study demonstrates that the 'edge-to-edge' technique is a reliable procedure to correct prolapsing leaflets. The addition of this technique to the surgical armamentarium has neutralized prolapse of the anterior leaflet as an incremental risk factor for reoperation.
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J Cardiovasc Med (Hagerstown) · Apr 2007
Primary angioplasty and routine utilization of thrombus aspiration devices: feasibility and results in a consecutive series of 486 patients.
Primary percutaneous transluminal coronary angioplasty (PTCA) is the treatment of choice for acute ST-segment elevation myocardial infarction (STEMI) in high-volume centres with experienced operators, but is often limited by a suboptimal microvascular perfusion due to distal embolization and impaired myocardial perfusion. The present study investigates whether routine use of thrombus aspiration (TA) devices is feasible in daily practice, along with its safety and effectiveness. ⋯ In our case series, 486 consecutive unselected patients with STEMI were treated in a primary PTCA high-volume centre using TA devices. Our study demonstrates that, in STEMI patients treated with primary PTCA, a routine strategy with TA before angioplasty guided by angiographic selection criteria is feasible in almost 50% of cases, is safe and effective, does not increase procedural time and offers good results in terms of tissue perfusion, both epicardial (TIMI flow) and myocardial (MBG, ST regression). When successfully performed, TA identifies a population with favourable in-hospital and 6-month outcome.
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J Cardiovasc Med (Hagerstown) · Apr 2007
Case ReportsUnusual presentation of ruptured descending thoracic aortic aneurysm.
We here report a very unusual presentation of ruptured thoracic aortic aneurysm. In a 50-year-old patient, almost asymptomatic and in stable clinical conditions, the chest radiograph and computed tomography scan revealed a right-sided rupture of a previously undiagnosed thoracic aortic aneurysm. The patient was treated successfully with an emergency surgical procedure.
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J Cardiovasc Med (Hagerstown) · Feb 2007
ReviewAutografts, homografts, and xenografts: overview on stentless aortic valve surgery.
Stentless valves, either human (autografts, homografts) or animal (porcine xenografts), were historically among the first substitutes to be used to replace the diseased aortic valve. Forty years after those pioneering days and 15 years after revival of such valves, stentless grafts have become a mainstay in aortic surgery. Although limitations associated with the use of autografts, homografts and xenografts remain, stentless valves have profoundly improved quality of life after aortic valve/root replacement. In addition, stentless surgery has greatly advanced the understanding of aortic root anatomy, physiology and pathology among surgeons.