1,721,310 research outputs found
Suture-Mediated Percutaneous Patent Foramen Ovale Closure: A Call for Careful Imaging Assessment
No full text
Comprehensive multidisciplinary patient assessment and selection before TAVI procedure
No full textAortic stenosis is a common disorder that affects nearly 5% of persons >75 years of age. Aortic valve replacement is indicated for symptomatic patients with severe aortic stenosis, as the prognosis of untreated patients is poor. Nevertheless, many patients with symptomatic severe aortic stenosis do not undergo surgical valve replacement, which has been attributed to comorbidities. Transcatheter aortic valve implantation (TAVI) is a novel method to treat selected high-risk patients with aortic stenosis. Patient screening and anatomic measurements of the aortic root are of great importance to ensure procedural success and appropriate patient selection. This review outlines comprehensive multidisciplinary assessment and selection of these patients and the evolving role of the echocardiogram and the multislice computed tomography in support of TAVI program
Left main thrombotic occlusion following balloon aortic valvuloplasty for severe aortic stenosis
No full textPercutaneous balloon aortic valvuloplasty is used in high-risk patients with significant aortic stenosis, either as palliation or as a bridge to more definitive treatment. We report the case of a high-risk patient, a man aged 71 years and with multiple comorbidities, undergoing this procedure. Following the procedure, he was given protamine to aid with vascular closure. This immediately led to hemodynamic collapse and cardiopulmonary arrest with angiographic evidence of thrombus occluding the left main coronary artery. This extremely rare complication requires prompt and aggressive treatment to enable good functional recovery of the individual
A ‘twice closed’ patent foramen ovale: a case report of percutaneous management of a residual interatrial shunt in a patient with persistent migraine symptoms
Full text linkBackground Residual interatrial shunt following percutaneous patent foramen ovale (PFO) closure is a rare complication that can be associated with persistent migraine.Case summary A 32-year-old woman with a history of percutaneous PFO closure due to a previous coronary paradoxical embolism and a condition of drug-refractory migraine underwent transoesophageal echocardiography (TOE) to investigate further recurrent migraine attacks. A partial displacement of a PFO occluder device was found, and it was successfully treated through the fluoroscopic and TOE-guided positioning of a second occluder in overlap with the previous one. The patient reported no more migraine attacks at the 6-month follow-up visit.Discussion Residual interatrial shunt should be suspected in patients with persistent migraine and a history of percutaneous PFO closure. Fluoroscopic and TOE-guided closure of residual interatrial shunt with a second PFO occlude device seems to be a safe and clinically effective strategy to manage persistent migraine
Usefulness of Buddy Wire Technique During Transcatheter Transseptal Mitral Valve Implantation in Degenerated Mitral Bioprosthesis
No full textJapan's largest platform for academic e-journals: J-STAGE is a full text database for reviewed academic papers published by Japanese societie
Intravascular coronary lithotripsy for the treatment of iatrogenic calcium embolization: The “block and crack” technique
No full textIntracoronary calcium embolization during percutaneous procedure is a very rare and unpredictable event, that can lead to serious complications and even expert operators could face some technical issues to solve it. This case report presents a technique called “block and crack” used to manage iatrogenic intracoronary calcium embolization of left anterior descending coronary artery. The technique involves implanting a drug eluting stent (DES) to block the embolus against the vessel wall, followed by the use of lithotripsy balloon inflated inside the DES to crack the calcium and achieve a better stent expansion. This technique allowed to avoid further distal calcium embolization as well as to minimize residual stenosis degree after stent implantation
Percutaneous coronary intervention for unprotected left main distal bifurcation lesions in elderly people
No full textBackground: In the elderly people with unprotected left main distal bifurcation lesions (ULMD), percutaneous coronary intervention (PCI) is often selected as first choice treatment strategy because of perioperative high risk of coronary artery bypass graft surgery due to their large number of comorbidities. Also, some recent papers reported that geriatric nutritional risk index (GNRI) is also strongly associated with clinical outcomes after interventional procedures in elderly patients. Objectives: We assessed clinical outcomes after PCI for ULMD and the impact of GNRI in elderly patients. Methods: We identified 669 non dialysis patients treated with current generation drug-eluting stent for ULMD from MITO registry. We divided the patients to the following 2 groups; elderly group (n = 240, age ≥75) and young group (n = 429, age <75). Additionally, we could calculate GNRI and divided elderly group into 2 group based on the median value of the GNRI. The primary endpoint was all-cause mortality. Results: All-cause mortality was significantly higher in elderly group [adjusted hazard ratio (HR) 2.37; 95% confidence interval (CI), 1.40–4.02; p = 0.001]. All-cause mortality was significantly higher in low GNRI elderly group compared to other 2 groups (Adjusted HR of elderly with low GNRI: 3.56, 95%CI (1.77–7.14), p < 0.001). Cardiovascular mortality was comparable between two groups. TLR rate was significantly lower in elderly group (adjusted HR 0.57; 95% CI, 0.34–0.97; p = 0.035). Conclusions: The elderly had higher all-cause mortality after PCI for ULMD compared to young people. Especially, the elderly with low GNRI were extremely associated with poorer outcomes
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
- …
