The Journal of invasive cardiology
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Review Meta Analysis Comparative Study
Single versus double stenting for unprotected left main coronary artery bifurcation lesions: a systematic review and meta-analysis.
We conducted a meta-analysis to assess outcomes for a single-stent (SS) strategy versus a double-stent (DS) strategy in treatment of distal unprotected left main coronary artery (ULMCA) lesions in the drug-eluting stent (DES) era. ⋯ Compared to the DS strategy of percutaneous ULMCA bifurcation intervention, an SS approach may be associated with better outcomes.
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Case Reports
Novel use of an apical-femoral wire rail to assist with transfemoral transcatheter aortic valve replacement.
The inability to reposition or retrieve balloon-expandable transcatheter aortic valves once they have been deployed requires implantation of the valve in the descending aorta or open surgical procedures to extract the valve. We describe the challenging transfemoral delivery of an Edwards Lifesciences Sapien valve wherein we had difficulty crossing the aortic valve and the guidewire position was compromised. We performed a transapical puncture to snare the guidewire and create a left ventricular to femoral wire rail, allowing us to deliver the transfemoral transcatheter valve, salvaging a situation where we would have been required to implant the valve in the descending aorta. We believe this is the first time this technique has been reported and represents an important method to facilitate delivery of transcatheter valves where guidewire support is insufficient or lost.
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To analyze the effectiveness of transthoracic echocardiography (TTE) for device closure of secundum atrial septal defect in children ≤5 years old. ⋯ TTE can be used as a primary tool for the measurement of atrial septal defect and guidance during device deployment in young children by skilled and professional hands, yet more experience is awaited.
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Data are limited regarding the clinical results of transradial coronary intervention (TRI) in acute myocardial infarction (AMI) complicated by cardiogenic shock. ⋯ TRI is associated with fewer major bleeding and vascular complications than TFI, and it appears suitable for both low- and high-risk AMI patients, especially when AMI is complicated by cardiogenic shock.
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Acute kidney injury is a common complication after surgical aortic replacement and entails a worse prognosis. Percutaneous valve implantation is an alternative to surgical replacement. We sought to elucidate incidence, predictors, and effects of acute kidney injury after percutaneous aortic valve implantation. ⋯ Incidence of acute kidney injury after transcatheter aortic valve implantation was 13% in our cohort. Patients with acute kidney injury showed longer hospitalization and higher 30-day mortality rate. Euroscore II was an independent predictor of acute kidney injury.