The Journal of invasive cardiology
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Comparative Study Clinical Trial
Comparison of multiple drug-eluting stent percutaneous coronary intervention and surgical revascularization in patients with multivessel coronary artery disease: one-year clinical results and total treatment costs.
Consecutive patients with multivessel coronary artery disease treated with multiple drug-eluting-stent (DES) percutaneous coronary intervention (PCI) (111 patients) or coronary artery bypass graft (CABG) (95 patients) on the basis of clinico-anatomical judgment were examined to investigate mediumterm clinical results and initial and total costs. ⋯ Multiple DES PCI showed good earlyand medium-term results with substantially lower costs than CABG.
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The incidence of probe-patent foramen ovale (PFO) at autopsy is approximately 27% with slit widths ranging from 1 mm to 19 mm (mean 4.9 mm) in diameter. In patients with end-stage heart failure requiring mechanical support, implantation of a left ventricular assist device (LVAD) abruptly decreases diastolic filling pressures and can cause right-to-left shunting with profound systemic hypoxemia. In this report, we describe the first successful PFO closure for refractory hypoxemia after implantation of an axial flow Heartmate II LVAD (Thoratec Corp., Pleasanton, California).
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Transcatheter closure of patent ductus arteriosus (PDA) has been in place for more than three decades. We share our experience with the newer devices. ⋯ Transcatheter closure of PDA is the preferred alternative to surgical ligation, which should be reserved for small infants and premature babies or large unfavorably-shaped ducts.
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We present the case of a young woman who developed an acute onset of classic cardiac symptoms, but because of her age and lack of risk factors, had a significant delay in transfer for cardiac catheterization. She was found to have spontaneous dissection of the left coronary system, eventually requiring emergent bypass surgery. ⋯ The role of hormonal influences on the coronary vasculature is not entirely understood, but the incidence of spontaneous coronary dissection is higher in women, and is usually related to changes in hormones such as pregnancy and oral contraceptive use. We review the literature on spontaneous coronary dissection, the influence of hormones on the vasculature, as well as diagnosis and treatment options.