OBJECTIVES: This study sought to report long-term clinical outcomes in patients treated with the provisional T-stenting and small protrusion (TAP) technique. BACKGROUND: Several strategies have been proposed for treating bifurcation lesions, each with its own merits and technical challenges. The TAP technique is a relatively new strategy that is technically ...

Several methods of making expanded polytetrafluoroethylene valved conduit have been reported, but these techniques are complicated and less reproducible. We have developed a new simplified technique for making a tricuspid expanded polytetrafluoroethylene valved conduit for right ventricular outflow tract reconstruction and have been using this conduit for approximately 3 years ...

The quantification of global myocardial blood flow (MBF) by measuring coronary sinus flow by magnetic resonance (MRI) was demonstrated to be very well correlated with positron emission tomography (PET). We proposed a new method for the quantification of regional myocardial perfusion with MRI by the integration of MBF and first ...

BACKGROUND: Coronary-artery-bypass-grafting (CABG) with conventional extracorporeal circulation (CECC) is associated with adverse effects such as systemic inflammatory response leading to a decrease in systemic vascular resistance and hemodynamic instability. Modern "less invasive" procedures have been established recently which potentially avoid negative side effects of CECC. The aim of this study ...

Treatment for postinfarction ventricular septal defect has been improving for several decades. Aggressive resection of the infarcted myocardium (infarctectomy and closure technique) and preserving infarcted myocardium (infarct exclusion technique) have been technically modified. Recent improvement includes use of surgical glue, using an additional patch for infarct exclusion, septal exclusion, sandwich ...

Over the past decade, the therapeutic strategies for acute myocardial infarction have changed considerably. Progress in experimental models, as well as noninvasive myocardial imaging techniques, has identified myocardial reperfusion injury as a significant contributor to the final infarct size in human patients. Following 3 decades devoted to the improvement of ...

OBJECTIVES: The aim of this study was to determine the accuracy of the contrast "bolus only" T1 mapping cardiac magnetic resonance (CMR) technique for measuring myocardial extracellular volume fraction (ECV). BACKGROUND: Myocardial ECV can be measured with T1 mapping before and after contrast agent if the contrast agent distribution between ...

Stroke prevention is the major goal in treating patients with atrial fibrillation. Warfarin therapy, if used appropriately, is highly effective in preventing thromboembolic events, but is simultaneously burdened by a narrow therapeutic window, multiple food and drug interactions, and a substantial bleeding risk. New pharmacological agents show only a modest ...

BACKGROUND: The efficacy of retrograde cardioplegia for myocardial protection is still controversial. In our institution, we exclusively use intermittent administration of tepid, undiluted blood supplemented with potassium and magnesium for the cases with aortic insufficiency, requiring aortotomy, or undergoing mitral valve repair. In using this retrograde technique, we make a ...

Left ventricular free wall rupture is a fatal and catastrophic complication after acute myocardial infarction. The sutureless technique with a fibrin tissue-adhesive collagen fleece is reportedly safe and effective in the oozing type of left ventricular free wall rupture. However, late pseudoaneurysm formation after this technique has been reported. We ...

BACKGROUND: Biventricular pacing through the coronary sinus (CS) is effective for the treatment of patients with heart failure and left bundle-branch block. However, this approach is not always feasible. Although surgical epicardial lead implantation is an alternative, the technique may be deleterious in some patients. Thus, direct left ventricular (LV) ...

BACKGROUND: Few studies have compared the long-term major adverse cardiac events (MACEs) between the one-stent technique (stenting only the main branch) and the two-stent technique (stenting of both the main and side branches) for the treatment of true coronary bifurcation lesions in the drug-eluting stent era. Therefore, we investigated this ...

BACKGROUND: Left atrial linear lesions are part of the ablation strategy for persistent atrial fibrillation. Radiofrequency (RF) energy is the standard energy modality. Pulmonary vein (PV) balloon cryoablation has similar success rates to RF energy but is unsuitable for linear lesions. This study assessed the feasibility and safety of left ...

No-reflow phenomenon is a consequence of percutaneous coronary intervention (PCI) which arises most of the time in the setting of myocardial infarction, but can be also the consequence of PCI in stable angina patients (rotatablator ablation technique or angioplasty in saphenous vein grafts). In this review, we summarize two ways ...

We describe a simple and reproducible technique permitting both effective left atrial reduction plasty and safe mitral annulus reconstruction, using a patch of left atrium tissue. In a 64-year-old patient undergoing redo mitral valve replacement for mechanical prosthesis disinsertion, a giant left atrium and extensive calcification of the mitral annulus ...

The left ventricular assist device may be a lifesaving therapy for a patient awaiting a heart transplant. The most common complications of this device are mediastinal bleeding, infections, embolic events, right-sided heart failure, and mediastinal adhesions. We are reporting a patient who had a Levitronix left ventricular assist device implanted ...

OBJECTIVES: To determine whether recent technical modifications have improved clinical outcomes for patients undergoing contemporary bifurcation lesion percutaneous coronary intervention (PCI). BACKGROUND: Provisional side branch (SB)-stenting has become the preferred strategy for bifurcation PCI. Newer generation drug-eluting stents, the proximal optimization technique (POT), and the use of non-compliant (NC) balloons ...

OBJECTIVES: Postinfarction ventricular septal defect (VSD) is a rare, but feared, complication after acute myocardial infarction. Although numerous techniques and materials have been used, the best technique has not yet been settled upon. We present a novel technique of VSD closure through the VSD via right ventricular (RV) incision and ...

AIMS: This study describes and reports preliminary outcomes using K-TAP (kissing T-stenting and small protrusion), a novel modification of traditional T-stenting and small protrusion (TAP). METHODS AND RESULTS: Nine patients who were treated with K-TAP between May 2008 and February 2012 at two hospitals were retrospectively included in this study. ...

We developed a needle stick technique for treating hypertrophic obstructive cardiomyopathy. Three 21-gauge needles are inserted into the interventricular septum just below the aortic valve annulus beyond the far side of the septal bulge. The right and left needles are both side margins, and the center needle is a guide ...

Drug-eluting balloons (DEB) were developed to address in-stent restenosis among other indications but have also recently been shown safe and efficacious in the context of bifurcation. By eliminating both the stent and the polymer, stent thrombosis can be avoided, while still delivering an antiproliferative agent to reduce the risk of ...

This article provides a detailed review of the most important studies on interventional cardiology reported in publications or presentations during the year 2012. With regard to coronary interventions, ST-elevation myocardial infarction is extensively addressed in studies focusing on the relevance of reducing the reperfusion time and the utility of various ...

Object The objective of this study was to compare the accuracy of 3 methods of ventricular catheter placement during CSF shunt operations: the freehand technique using surface anatomy, ultrasonic guidance, and stereotactic neuronavigation. Methods This retrospective cohort study included all patients from a single institution who underwent a ventricular CSF ...

Heart type fatty acid binding protein (HFABP) as an early marker of cardiac injury holds a promising future with studies indicating surpassing performance as compared to myoglobin. As a plasma marker, this cytoplasmic protein owing to its small size (∼15kDa) and water solubility, appears readily in the blood-stream following cardiomyocyte ...

Cardiovascular magnetic resonance (CMR) is a valuable clinical tool in everyday practice providing additional information to echocardiography. The late gadolinium enhancement (LGE) technique is now part of nearly every CMR protocol and enables in-vivo tissue characterization in ischemic (identification of scaring due to infarction) and many nonischemic cardiomyopathies (identification of ...

Echocardiography is the fundamental tool in the management of children with congenital heart disease (CHD), and cross-sectional echocardiography is still the main technique used for diagnosis and therapeutic planning. Recent advances in pediatric echocardiography include 3D echocardiography and functional imaging. The recent development of specific pediatric probes allows imaging of ...

The clinical significance of myocardial bridging has been a subject of discussion and controversy since the introduction of coronary arteriography (CAG) in the early 1960s. More recently computed tomography coronary angiography (CTCA) has made it possible to visualise the overlying muscular bands and appears to have a higher sensitivity for ...

Cardiac surgery with cardiopulmonary bypass is routinely used in neonates who require early repair of congenital heart diseases. However, the bypass temperature and use of deep hypothermic circulatory arrest, the composition of the priming and the acceptable degree of hemodilution, the prophylactic use of antifibrinolytic agents and steroids, the choice ...

BACKGROUND: The presence of large thrombus burden in patients presenting with acute myocardial infarction (AMI) is common and associated with poor prognosis. This study aimed to describe the feasibility and safety of the novel 'mother-in-child' thrombectomy (MCT) technique in patients presenting with AMI and large thrombus burden undergoing percutaneous coronary ...

INTRODUCTION AND OBJECTIVES: An experimental model is used to analyze the characteristics of ventricular fibrillation in situations of variable complexity, establishing relationships among the data produced by different methods for analyzing the arrhythmia. METHODS: In 27 isolated rabbit heart preparations studied under the action of drugs (propranolol and KB-R7943) or ...

The most appropriate surgical approach for patients with post-infarction left ventricular (LV) aneurysm remains undetermined. We compared the efficacy of the linear versus patch repair techniques, and investigated the mid-term changes of LV geometry and cardiac function, for repair of LV aneurysms. We reviewed the records of 194 patients who ...

There are several experimental models for the in vivo investigation of myocardial infarction (MI) in small (mouse, rat) and large animals (dog, pig, sheep and baboons). The application of large animal models raises ethical concerns, the design of experiments needs longer follow-up times, requiring proper breeding and housing conditions, therefore ...

Routine closure of the sternum after cardiovascular surgery sometimes causes severe cardiac depression because of tamponade, leading to cardiogenic shock. We describe a full-thickness chest wall traction suture taken parasternally and tied to an intravenous fluid stand. Upward (outward) traction is applied to the anterior chest while the sternum is ...

AIMS: Limitations imposed by the coronary sinus venous anatomy triggered the transseptal approach for endocardial LV lead placement. The alignment of the interatrial septum (IAS) and its neighborhood anatomy does not favor transseptal puncture from the pre-pectoral area. Locating and advancing a pre-pectoral LV lead delivery catheter (PDC) through an ...

ABSTRACT: BACKGROUND: Left ventricular aneurysm (LVA) is a serious complication of myocardial infarction and reduces the chances of survival. Controversy still exists regarding the optimal surgical technique for LVA repair. We analyze the efficacy of two techniques, linear vs. endoventricular circular patch plasty, for repair of LVA and the efficacy ...

BACKGROUND: The crush and culotte are probably the most common two-stent techniques utilized for percutaneous coronary intervention (PCI) of complex bifurcation lesions. Long-term outcome associated with the utilization of these techniques is unknown. Our objective was to evaluate the long-term outcomes after bifurcation PCI utilizing these 2 techniques with a ...

We describe a new technique for removing distal emboli that became visible on angiography during percutaneous coronary intervention for acute myocardial infarction. Three patients presented with distal embolization as a filling defect with an abrupt cut-off in 1 of the peripheral coronary vessels of the infarct-related coronary artery. After a ...

A new look at an old approach finds no harm, but no benefit.

We present a case in which the sandwich technique was successfully applied via right ventriculotomy for posterior infarction ventricular septal perforation 2 days after acute posterior myocardial infarction in a 73-year-old male patient. The sealant BioGlue was applied to the space between the two patches instead of gelatin-resorcinol-formaldehyde biological glue. The ...

Total occlusion of a saphenous vein graft (SVG) can present as abrupt thrombotic occlusion in an atherosclerotic graft with resultant acute cardiac events or chronic total occlusion (CTO) with resultant angina symptoms. The risks of percutaneous coronary intervention (PCI) within an occluded graft include not only periprocedural myocardial infarction (MI), ...

Left ventricular dysfunction in the setting of severe coronary artery disease poses a major diagnostic and therapeutic dilemma. While this clinical scenario is generally associated with poor outcomes, some but not all patients benefit from coronary revascularization. For example, patients with severe, transmural myocardial infarctions may derive little or no ...

Percutaneous coronary intervention of aorto-ostial lesions is associated with high rates of major adverse cardiovascular events. Precise implantation of coronary stents in the ostium is important in order to prevent adverse clinical outcomes. The presented case demonstrates a simple technique to accurately position a stent during aorto-ostial percutaneous coronary intervention.

Left ventricular pseudoaneurysm (LVPA) is a known serious complication of myocardial infarction or mitral valve replacement. As an alternative option, transmitral patch repair for LVPA has been reported. However, it is very difficult to complete the procedure for LVPA with a large defect. A 68-year old man with a history ...

In patients with chronic ischaemic left ventricular dysfunction, revascularization may lead to symptomatic and prognostic improvement. Cardiovascular magnetic resonance (CMR) imaging with its high spatial resolution provides the qualitative and quantitative, global and regional information on myocardial anatomy and function. In combination with a gadolinium-based contrast agent, CMR allows an ...

Annual surveillance coronary angiograpyhy to screen for graft coronary vasculopathy is routine practice after orthotopic heart transplantation. Traditionally, this is performed with direct coronary angiography using static single-plane or biplane angiography. Recently, technological advances have made it possible to perform dual-axis rotational coronary angiography (RA). This technique differs from standard ...

This paper presents a useful technique for totally automatic detection of myocardial infarction from patients ECGs. Due to the large number of heartbeats constituting an ECG and the high cost of having all the heartbeats manually labeled, supervised learning techniques have achieved limited success in ECG classification. In this paper, ...

We propose a denoising and segmentation technique for the second heart sound (S2). To denoise, Matching Pursuit (MP) was applied using a set of non-linear chirp signals as atoms. We show that the proposed method can be used to segment the phonocardiogram of the second heart sound into its two ...

Right ventricular (RV) function is a strong independent predictor of outcome in a number of distinct cardiopulmonary diseases. The RV has a remarkable ability to sustain damage and recover function which may be related to unique anatomic, physiologic, and genetic factors that differentiate it from the left ventricle. This capacity ...

Cardiac regenerative therapy is still not used in daily clinical practice. A reason for this might be the modest effect on relevant global clinical endpoints [i.e. ejection fraction (EF)] in preclinical studies. To introduce proper improvement strategies, it is important to extend the focus from clinical endpoints to more detailed ...

INTRODUCTION: The most common indication for surgical correction of giant left atrium is associated with mitral valve insufficiency with or without atrial fibrillation. Several techniques for this purpose are already described with varying results. OBJECTIVE: To present the initial experience with the tangential triangular resection technique (Pomerantzeff). METHODS: From 2002 ...