Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Transhepatic right heart catheterization is an uncommon procedure for adult interventional cardiologists. We report its successful use for closure of a patent foramen ovale in an elderly patient without femoral vein access. Also described is a novel method of using a vascular plug to achieve hemostasis of the hepatic venous access site.
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Catheter Cardiovasc Interv · Jan 2010
ReviewAntithrombotic strategies in patients on oral anticoagulant therapy undergoing percutaneous coronary intervention: a proposed algorithm based on individual risk stratification.
An increasing number of patients on chronic oral anticoagulant therapy undergo percutaneous coronary intervention. There is a lack of evidence-based data and no practice guidelines are available about the optimal antithrombotic treatment of such patients after the procedure; thus, the adopted strategies are highly variable and are often left to the discretion of the attending physician. In this article, we review current evidence and propose an algorithm of antithrombotic strategies tailored to the individual patient, which takes into account the relative risks of bleeding, ischemic complications, and thromboembolism.
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Catheter Cardiovasc Interv · Jan 2010
Outcome in high risk patients with unprotected left main coronary artery stenosis treated with percutaneous coronary intervention.
We examined mortality, risk of myocardial infarction (MI), and target lesion revascularization (TLR) in high-risk patients with unprotected left main (LM) percutaneous coronary intervention (PCI) in Western Denmark. ⋯ After PCI, patients with STEMI and LM culprit lesion have a high-mortality risk, whereas long-term outcome for patients with NSTEMI and stable angina pectoris is comparable with other high surgical risk patients with unprotected left main lesion. Further, TLR rates and risk of stent thrombosis were low.
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Catheter Cardiovasc Interv · Jan 2010
Impact of intravascular ultrasound guidance in patients with acute myocardial infarction undergoing percutaneous coronary intervention.
The aim of this study was to examine the utility of routine intravascular ultrasound (IVUS) guidance in patients with acute myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI) with stent implantation. ⋯ This study does not support the routine use of IVUS guidance for stent deployment in patients who present with acute MI and undergo primary PCI.
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Catheter Cardiovasc Interv · Dec 2009
Case ReportsTranscatheter closure of a traumatic VSD in an adult requiring an ASD occluder device.
Traumatic ventricular septal defects (VSD) can occur after blunt or penetrating chest trauma or cardiac procedures. There are few publications reporting the safety and efficacy of transcatheter closure of traumatic VSDs. ⋯ Because of the late identification of the VSD postoperatively, transcatheter closure after the original surgical procedure was recommended and performed requiring an Amplatzer atrial septal defect occluder device because of defect size and configuration. This case describes the technique and postprocedure imaging leading to a cautionary note regarding VSD closure device techniques.