Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Feb 2012
Case ReportsVery late thrombosis in a bare metal stent: mechanistic analysis from optical coherence tomography.
Recent publications have emphasized the concept that restenosis of a bare metal stent (BMS) is not as clinically benign as previously believed. We present a case of very late stent thrombosis 9 years after implantation of a BMS is described. ⋯ These findings suggest that the formation and progression of a neoatheroma over a previously healed intrastent vascular intima may represent a "new" mechanism for stent thrombosis. Evidence from the current case supports this hypothesis.
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Catheter Cardiovasc Interv · Feb 2012
Case ReportsVacuum thrombectomy of large right atrial thrombus.
We report a novel technique for percutaneous removal of the right heart thrombi using a suction cannula. This method allowed complete en bloc removal of the right atrial thrombus avoiding surgical procedure in a high risk patient.
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Catheter Cardiovasc Interv · Jan 2012
Primary percutaneous coronary intervention for acute myocardial infarction in the elderly aged ≥75 years.
We aimed to see whether primary percutaneous coronary intervention (PCI) benefits for ST-segment elevation myocardial infarction (STEMI) in the aged could be validated. ⋯ Pre-existing comorbidities characterize older patients developing STEMI. Aggressive PCI in older patients improves prognosis, and short door-to-balloon time is an important parameter conditioning the prognosis.
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Catheter Cardiovasc Interv · Jan 2012
Comparative StudyEarly- and mid-term outcomes of transcatheter aortic valve implantation in patients with logistic EuroSCORE less than 20%: a comparative analysis between different risk strata.
Transcatheter aortic valve implantation (TAVI) is an emerging alternative to medical therapy reserved to a limited population with severe aortic stenosis. The European consensus document recommended TAVI for prohibitive-risk patients not eligible for conventional surgery (prohibitive risk defined as expected mortality ≥ 20% calculated with the Logistic EuroScore (LES) in association with clinical judgment). To date, there is lack of clarity on data about outcomes of TAVI in lower risk patients. We sought to evaluate the outcomes of patients undergoing TAVI with LES ≥ 20% in comparison with patients with LES < 20%. ⋯ This study tends to suggest that current mortality reported after TAVI could be significantly affected by the very-high risk profile of the population which currently undergoes this procedure, making comparison with surgical series rather unreliable.
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Catheter Cardiovasc Interv · Dec 2011
Performance of valve-in-valve for severe para-prosthetic leaks due to inadequate transcatheter aortic valve implantation.
This study reports on mid-term safety and performance of valve-in-valve implantation as rescue strategy to overcome acute PPL after TAVI. ⋯ Valve-in-valve implantation using self-expandable bioprosthesis seems safe and highly effective to overcome severe PPL due to prosthesis malposition early after TAVI. Moreover, the implantation of two valves does not affect the performance of prosthesis at follow-up.