1,720,995 research outputs found
Safety and Effectiveness of a Novel Intravascular Lithotripsy Device Using the Hertz Contact Stress Mechanism for Calcium Fragmentation: Six-Month Outcomes of the PINNACLE I Clinical Trial
No full textMyocardial Ischemia Is Present and Mostly Reversible in Patients With a Chronic Total Occlusion and a Viable Perfusion Territory: The DISTAL CTO Study
No full textACKGROUNDThe highest benefit of revascularization isfound in patients with very low fractionalflow reserve (FFR).In chronic total occlusion (CTO) patients, instant wave-freeratio (iFR, Philips) may be more appropriate to evaluateischemia as it does not require maximal microvascular vaso-dilation, which may be hampered by microvasculardysfunctioninuptoone-halfofCTOpatients.Thestudyaimsto prove through iFR measurements that the myocardiumdistal to a CTO is ischemic and that ischemia is reversible by apercutaneous coronary intervention (PCI).METHODSCTO patients with proven viable myocardium andclinical or other signs of ischemia were prospectively andconsecutively enrolled in 6 Belgian CTO PCI centers. Pd/Paand iFR was measured with a pre-normalized pressure wire(Verrata, Philips) before (advanced through a microcatheter)and after PCI. If iFR was still below 0.90 after stenting, furtheroptimization with intracoronary imaging was performed.RESULTSA total of 38 patients were included. All patientshad significant ischemia distal to the CTO. iFR improvedfrom 0.32 (0.26 to 0.43) to 0.92 (0.89 to 0.96) post-PCI(p<0.001). In total, 23.7% of patients had a suboptimalpost-PCI iFR below 0.90 despite a satisfactory angio-graphic result. After furtheroptimization, only 7.9% had afinal iFR below 0.90 attributed to residual diffuse disease(Figure).CONCLUSIONIn CTO patients selected for PCI based onpresence of viability and ischemia, myocardial ischemiadistal to a CTO was always present and largely reversible. Alow post-PCI iFR helped guide further optimization of theresul
Safety and Effectiveness of a Novel Intravascular Lithotripsy Device Using the Hertz Contact Stress Mechanism for Calcium Fragmentation: Six-Month Outcomes of the PINNACLE I Clinical Trial
No full textDeferred Revascularization of Left Main Stenosis According to iFR: A Subanalysis of the PHYNAL Study
No full textMechanistic Effects of Coronary Hertz Contact Intravascular Lithotripsy on Treatment of Calcified Lesions: PINNACLE I OCT Substudy Procedural Imaging Outcomes
No full textDeferred Revascularization of Left Main Stenosis According to iFR: A Subanalysis of the PHYNAL Study
No full textMechanistic Effects of Coronary Hertz Contact Intravascular Lithotripsy on Treatment of Calcified Lesions: PINNACLE I OCT Substudy Procedural Imaging Outcomes
No full text
Revascularisation of chronic total occlusions and recurrence rate of ventricular arrhythmias
No full textBACKGROUND: The impact of revascularisation of chronic total occlusions (CTO) on the incidence of ventricular arrhythmias (VA) remains to be elucidated. METHODS: Based on prospectively gathered data, the recurrence rate of VAs following CTO treatment was retrospectively investigated. Patients presenting with VAs as clinical indication for CTO revascularisation were retrospectively selected out of three Belgian CTO registries (i.e. Ziekenhuis Oost-Limburg, UZ Leuven and CHR de la Citadelle). Freedom of VAs was defined as absence of non-sustained or sustained tachycardias (VT), ventricular fibrillations (Vfib) and ventricular extrasystoles (VES; 2500 VES/24 hrs, non-sustained VT, sustained VT and Vfib, respectively. In those patients with a one-year follow-up available (n = 34), overall recurrence rate of VAs was 38% (within VA group: VES: 25%, non-sustained VT: 46%; sustained VT: 25% and Vfib: 60%). CONCLUSION: Based on this retrospective data analysis, CTO revascularisation, in patients presenting with VAs as the main clinical indication, seems to beneficially impact the incidence of VAs, which ultimately might result in improved patients' outcome.sponsorship: This work was supported by the Limburg Clinical Research Programme (LCRP) UHasselt-ZOL-Jessa, supported by the foundation Limburg Sterk Merk, Hasselt University, Ziekenhuis Oost-Limburg and Jessa Hospital. (Limburg Clinical Research Programme (LCRP) UHasselt-ZOL-Jessa, foundation Limburg Sterk Merk, Jessa Hospital, Ziekenhuis Oost-Limburg, Hasselt University)status: Publishe
How to BYPASS to a better quality of life: Determining and improving clinical and patient-centred outcomes after totally endoscopic cardiac surgery
No full textIntroduction
Totally endoscopic coronary artery bypass grafting (TECAB) is a minimally
invasive approach to achieve surgical revascularisation through a minimally
invasive approach. Still, data regarding non-robotic TECAB is limited. This report
presents the results of a TECAB technique using long-shafted instruments, defined
as Endo-CABG, from a single-centre experience in 1500 consecutive patients.
Methods
A total of 1500 patients underwent Endo-CABG between January 2016 and
February 2023. Data were collected retrospectively, and patients were followed
up for one year. The primary outcome of this study was major adverse cardiac
and cerebrovascular events (MACCE)-free survival. Secondary efficacy outcomes
were graft failure and mortality. Furthermore, we analysed factors influencing
long-term freedom from MACCE and all-cause mortality.
Results
The mean age was 68 [61-75] years, of which 193 (12.87%) were octogenarians.
Multivessel disease was present in 1409 (93.93%) patients, and the mean
EuroSCORE II was 1.64% [1.09-2.92]. All patients underwent complete arterial
revascularisation with bilateral internal mammary grafting in 88.47%. Graft failure
occurred in 1.80% of cases after one year (n=27). Thirty-day mortality was
1.73% (n=26), one-year survival was 94.7% (95%CI:93.5-95.9%), and 1-year
MACCE-free survival was 91.7% (95%CI:90.2-93.2%). Younger age, good left
ventricular ejection fraction, absence of arterial hypertension, and absence of
urgent surgery were significantly associated with 1-year MACCE-free survival.
Conclusions
Endo-CABG appears to be a safe procedure, achieves surgical revascularisation,
and provides good outcomes regarding graft failure and major adverse cardiac
and cerebrovascular events at one year, while age, left ventricular ejection fraction, arterial hypertension, and urgency were associated with one-year
outcomes.Yilmaz Alaaddin zat mee in de jur
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