• Issue

    Catheterization and Cardiovascular Interventions: Volume 88, Issue 4

    501-670, E103-E131
    October 2016

Coronary Artery Disease

Editorial Comment

The Third Rail of Interventional Cardiology: Revascularization of Non-Infarct-Related Arteries During Primary PCI

  • Pages: 506-507
  • First Published: 19 October 2016
Key Points

  • Despite current guidelines, there is expanding evidence for the safety and efficacy of routine multivessel PCI for STEMI patients.
  • FFR has incremental value for assessing stenosis severity in STEMI patients with multivessel disease.
  • Further studies of vulnerable plaque are needed to obtain a complete risk assessment in STEMI patients.

Original Studies

Editorial Comment

Not just a FREAK finding, but perhaps an important insight

  • Pages: 562-564
  • First Published: 19 October 2016
Key Points

  • Chronic renal failure patients carry enhanced risk for coronary artery disease that may not be captured by simple FFR measurements
  • Microvascular resistance appears elevated in renal insufficiency and is a potential confounder that could result in a FFR higher than otherwise measured in a patient with normal microvascular system
  • The potential for microvascular resistance in the final interpretation of FFR values in chronic renal insufficient patients raises interesting questions for further outcomes based research

Pediatric and Congenital Heart Disease

Editorial Comment

Small Acute Mechanical Circulatory Support Pumps for Small People

  • Pages: 590-591
  • First Published: 19 October 2016
Key Points

  • Webb and Dimas identify that use of vascular chimney grafts is better than direct cannulation for delivering the Impella 2.5 axial flow pump via the carotid artery in a swine model.
  • Given the growing demand for acute mechanical circulatory support (AMCS) pumps among pediatric patients, this report highlights vascular access techniques and equipment as a major unmet need for the pediatric population.
  • New vascular sheaths, grafts, and techniques are required for greater adoption of AMCS devices in pediatric patients.

Valvular and Structural Heart Diseases

Editorial Comment

Surgical vs Percutaneous Approaches to Paravalvular Leak: Is Closure Too Little Too Late, or Just Not Soon Enough: Editorial Comment on CCI-15-1144.R1: Two-year Follow-up After Surgical Versus Percutaneous Paravalvular Leak Closure: A Non Randomized Analysis.

  • Pages: 634-635
  • First Published: 19 October 2016
Key Points

  • Percutaneous paravalvular leak (PVL) closure has lower procedure mortality than surgical closure in a non-randomized comparison
  • Both percutaneous and surgical PVL closure have high long-term mortality with nearly half of patients dead after 2.5 years
  • Multivariate analysis showed age, worse NYHA class, and renal failure were associated with worse prognosis
  • Earlier detection and treatment of PVL should be considered to improve late results