Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Nov 2009
Case ReportsCombined use of Impella device and intra-aortic balloon pump to improve survival in a patient in profound cardiogenic shock post cardiac arrest.
Patients who suffer cardiogenic shock after cardiac arrest have a very poor prognosis. Left ventricular assist devices have proven to be useful in these patients to improve survival. ⋯ We describe a case where intra-aortic balloon pump by itself was not enough to provide hemodynamic support in a patient with cardiogenic shock after cardiac arrest. The Impella Recover LP 2.5 system (ABIOMED, Inc., Danvers, MA) was successfully used along with the balloon pump for hemodynamic support and resulted in dramatic improvement of the patient's condition.
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Catheter Cardiovasc Interv · Nov 2009
Comparative StudyImpact of day versus night as intervention time on the outcomes of primary angioplasty for acute myocardial infarction.
Conflicting datas exist regarding the outcomes of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) when the intervention is performed during night hours. ⋯ Primary PCI can be performed safely during the night at a high-volume PCI center with suitable and effective organization of cardiology department and catheterisation laboratory with 24 hours per day, 7 days per week onsite staffing.
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Catheter Cardiovasc Interv · Nov 2009
Case ReportsThe risk of cardiac complications following noncardiac surgery in patients with drug eluting stents implanted at least six months before surgery.
Given the anecdotal reports and case series suggesting that drug-eluting coronary stents [DES] may be still vulnerable to coronary thrombosis after six months, we sought to assess this risk in patients undergoing non-cardiac surgery six months after stenting. ⋯ Perioperative cardiac events during non cardiac surgery after six months of DES deployment still occur. These cardiac complications [not entirely prevented by continued dual antiplatelet agents] remain a matter of diagnostic and therapeutic challenge and concern.
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Catheter Cardiovasc Interv · Nov 2009
The impact of micro troponin leak on long-term outcomes following elective percutaneous coronary intervention.
To evaluate the clinical impact of microleaks of troponin, which are below the reference standard defining troponin elevation, on cardiovascular outcomes in stable coronary patients undergoing elective percutaneous coronary intervention (PCI). ⋯ Microleak of troponin following elective PCI suggests myocardial injury and predicts an increased risk of subsequent MI and death. Troponins should be routinely assessed following PCI, and preventive therapies are needed to reduce micro and macro troponin elevation in the PCI setting.
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Catheter Cardiovasc Interv · Nov 2009
Case ReportsNovel mobile telemedicine system for real-time transmission of out-of-hospital ECG data for ST-elevation myocardial infarction.
The guidelines recommend routine use of 12-lead electrocardiogram (ECG) and advance notification to the emergency department for patients with ST-elevation myocardial infarction (STEMI). However, transmission of out-of-hospital 12-lead ECG to emergency department is still not widely practiced and ECG interpretation before arrival at the emergency department is not established. ⋯ When used, this system immediately identifies patients with STEMI and it is coupled to a centralized system to alert the cardiac catheterization teams to prepare for prompt intervention. This report presents the first case with STEMI who was successfully treated using this novel mobile telemedicine system.