Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
-
Catheter Cardiovasc Interv · Aug 2013
Observational StudyTranscatheter aortic valve implantation without balloon predilation: a single-center pilot experience.
To assess the results of transcatheter aortic valve implantation (TAVI) using the Medtronic CoreValve prosthesis (Medtronic, Minneapolis, MN), without balloon predilation, in high-risk patients with degenerated severe aortic stenosis. ⋯ These results suggest that direct CoreValve implantation in patients with severe aortic stenosis is feasible and may lead to hemodynamic and clinical improvement in patients who are poor candidates for aortic valve surgery, pending confirmation in larger series with longer follow-up.
-
Catheter Cardiovasc Interv · Aug 2013
Case ReportsTranscatheter aortic valve implantation for treatment of failing homograft with preexisting mechanical mitral prosthesis.
Transcatheter aortic valve implantation is increasingly used to treat bioprosthetic degeneration. Valve-in-valve technique has been performed successfully to treat homograft, stentless, and stented bioprosthetic dysfunction. The presence of a prosthesis in the mitral position can make the transcatheter aortic valve implantation procedure challenging due to proximity of the mitral and aortic annuli. We describe the case of a 66-year-old who underwent the first successful implantation of Edwards Sapien device in a failing homograft in the presence of a mechanical mitral valve prosthesis.
-
Catheter Cardiovasc Interv · Jul 2013
ReviewRecommendations for occupational radiation protection in interventional cardiology.
The radiation dose received by cardiologists during percutaneous coronary interventions, electrophysiology procedures and other interventional cardiology procedures can vary by more than an order of magnitude for the same type of procedure and for similar patient doses. There is particular concern regarding occupational dose to the lens of the eye. This document provides recommendations for occupational radiation protection for physicians and other staff in the interventional suite. ⋯ Effective use of these methods requires both appropriate education and training in radiation protection for all interventional cardiology personnel, and the availability of appropriate protective tools and equipment. Regular review and investigation of personnel monitoring results, accompanied as appropriate by changes in how procedures are performed and equipment used, will ensure continual improvement in the practice of radiation protection in the interventional suite. These recommendations for occupational radiation protection in interventional cardiology and electrophysiology have been endorsed by the Asian Pacific Society of Interventional Cardiology, the European Association of Percutaneous Cardiovascular Interventions, the Latin American Society of Interventional Cardiology, and the Society for Cardiovascular Angiography and Interventions.
-
Catheter Cardiovasc Interv · Jul 2013
Observational StudyDevelopment of a high-volume, multiple-operator program for percutaneous chronic total coronary occlusion revascularization: procedural, clinical, and cost-utilization outcomes.
Development of a specialized chronic total coronary occlusion (CTO) revascularization program attentive to procedural guidelines, quality oversight, and cost/resource utilization has not been described. ⋯ Following initiation of a dedicated program with implementation of quality and performance guidelines, complex CTO revascularization may be safely performed with outcomes comparable with reports from established centers. Despite higher resource utilization, CTO revascularization is associated with a positive contribution margin. Requirement of educational and performance standards, mentorship from experts, consensus review for appropriateness and provision of catheterization laboratory policies may represent a model for program development.
-
Catheter Cardiovasc Interv · Jul 2013
Comparative StudyA comparative study of Cardi-O-Fix septal occluder versus Amplatzer septal occluder in percutaneous closure of secundum atrial septal defects.
We sought to investigate the safety and efficacy of Cardio-O-Fix septal occluder (CSO) in percutaneous closure of atrial septal defects (ASD) as compared to the Amplatzer septal occluder (ASO). ⋯ Transcatheter ASD occlusion with CSO is safe and effective and it appeared to be an attractive alternative to ASO in closing simple-type ASD because of its relatively low cost.