• Issue

    Catheterization and Cardiovascular Interventions: Volume 97, Issue 5

    i-ix, 755-961, E607-E747
    April 1, 2021

ISSUE INFORMATION - COPYRIGHT

Free Access

Issue Information - Copyright

  • Page: i
  • First Published: 14 April 2021

ISSUE INFORMATION - EDITORIAL BOARD

Free Access

Issue Information - Editorial Board

  • Page: ii
  • First Published: 14 April 2021

ISSUE INFORMATION - TOC

Free Access

Issue Information - TOC

  • Pages: iv-ix
  • First Published: 14 April 2021

CORONARY ARTERY DISEASE

EDITORIAL COMMENT

We can, but should we?

  • Pages: 764-765
  • First Published: 14 April 2021
Key Points

  • Octogenarians can and do undergo successful coronary interventions.
  • Complexity, calcification, and more diffuse disease are more common in this group.
  • Randomized trials of medical and/or surgical and/or percutaneous approaches in octogenarians are needed.

EDITORIAL COMMENT

Bivalirudin versus heparin in PCI: Is the pendulum swinging again in favor of heparin?

  • Pages: 774-775
  • First Published: 14 April 2021
Key Points

  • The optimal antithrombotic strategy in patients with left main disease (LMD) and undergoing percutaneous coronary intervention (PCI) remains unknown due to the underrepresentation of these high-risk patients in clinical trials.
  • Bivalirudin does not seem to offer any additional benefits when compared with heparin, even in high-risk patients such as those with LMD.
  • Additional randomized clinical trials are needed to establish the optimal antithrombotic therapy regimen among LMD patients undergoing PCI.

EDITORIAL COMMENT

PCI for left main bifurcation stenting: A treatment paradigm at a crossroads?

  • Pages: 786-787
  • First Published: 14 April 2021
Key Points

  • Percutaneous Coronary Intervention (PCI) with Drug-eluting stents (DES) for significant left main (LM) disease is an accepted therapeutic alternative to coronary artery bypass grafting (CABG) in appropriate patients based on SYNTAX II score stratification.
  • Conflicting outcome data regarding use of single versus dual-stent strategies for LM disease exist.
  • Further prospective randomized data using current generation DES and contemporary PCI techniques will provide more insight into optimal treatment strategies.

EDITORIAL COMMENT

Genotype-guided antiplatelet therapy for acute coronary syndrome percutaneous coronary intervention patients: A new standard of care?

  • Pages: 795-796
  • First Published: 14 April 2021
Key Points

  • In acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention, ischemic and bleeding outcomes at 1 year can be meaningfully improved with genotype-guided antiplatelet therapy (GGT).
  • At the population level, GGT appears cost-effective and perhaps cost-saving in ST-elevation myocardial infarction patients only when initiated during the index ACS hospitalization.
  • At the individual patient level, practical clinical and economic factors undercut the feasibility of GGT becoming a new standard of care.

EDITORIAL COMMENT

New generation drug eluting stents: Closing the gap in sex disparity in cardiovascular outcomes in women

  • Pages: 805-806
  • First Published: 14 April 2021
Key Points

  • Use of the novel COMBO stent, circumferentially coated with anti-CD34 antibodies to promote endothelialization and decrease inflammation led to extremely low 1-year event rates with no sex differences .
  • Technological advances in new generation drug-eluting stents has closed the gap in sex disparities for cardiovascular outcomes.
  • Women continue to be underrepresented in clinical trials and there is room to improve procedure related aspects such as radial access and potent antiplatelet therapy.

ORIGINAL STUDIES

EDITORIAL COMMENT

QFR accuracy and Pd/pa:FFR discordance: Too much inside baseball or novel physiologic insight?

  • Pages: 833-835
  • First Published: 14 April 2021
Key Points

  • The accuracy of angiographic fractional flow reserve (FFR) compared with wire-based FFR remains suboptimal.
  • This patient-level meta-analysis demonstrates that discordance between Pd/Pa and FFR is associated with QFR discordance
  • Limits to the predictability of FFR include variation in myocardial resistance, myocardial mass, and adenosine responses.

VALVULAR AND STRUCTURAL HEART DISEASES

EDITORIAL COMMENT

Gender and left atrial appendage occlusion: Not the exception in cardiovascular procedures

  • Pages: 893-894
  • First Published: 14 April 2021
Key Points

  • Gender disparities have been described in many cardiovascular procedures, but reports about left atrial appendage occlusion are limited.
  • In a large national database, women were associated with lower utilization and worse clinical results.
  • There is a need to better understand the root of the observed gender disparities and interventions to reverse it.

EDITORIAL COMMENT

Paravalvular leak after TAVR: remarkable improvement but not the time to shift focus

  • Pages: 903-904
  • First Published: 14 April 2021
Key Points

  • Significant paravalvular leak (PVL) among patients undergoing transcatheter aortic valve replacement (TAVR) portends a poor prognosis and is often associated with increased mortality.
  • TAVR with the latest generation balloon-expandable valve platform, Edwards SAPIEN 3 Ultra, is associated with lower incidence of PVL (including lower rates of mild PVL and zero incidence of moderate and severe PVL) compared to its predecessor, the SAPIEN 3 valve platform.
  • The similar safety profile, comparable deliverability, and lower PVL observed with the Edwards SAPIEN 3 Ultra system will likely lead to its increased adoption in clinical practice. Future studies are needed to examine its long-term clinical outcomes and further decipher the procedural and patient factors associated with PVL.

PERIPHERAL VASCULAR DISEASE

EDITORIAL COMMENT

Reducing vascular complications of large-bore sheaths removal with a novel post-closure technique: Adapt and evolve

  • Pages: 910-911
  • First Published: 14 April 2021
Key Points

  • Vascular complications after structural heart intervention and use of percutaneous mechanical circulatory support predominantly result from vascular closure device failure.
  • This study showed the safety and feasibility of a novel “post-closing” technique using two Perclose Proglides, based on proximation of the large-size arteriotomy by pushing two stiff guidewires apart.
  • Future randomized studies should compare this novel suture-based vascular closure technique with plug-based vascular closure devices, such as MANTA.

VALVULAR AND STRUCTURAL HEART DISEASES

EDITORIAL COMMENT

Left atrial appendage closure: Moving toward a same day standard

  • Pages: 917-918
  • First Published: 14 April 2021
Key Points

  • Multicenter study showing the ability to perform TEE guided left atrial appendage occlusion using conscious sedation with same day discharge in selected patients
  • This study along with others highlight the need to move left atrial appendage closure to a conscious procedure
  • Further studies will be needed to prospectively validate selection criteria and the protocol used by the investigators

EDITORIAL COMMENT

Coronary arterial disease in patients undergoing percutaneous edge-to-edge mitral valve repair: Handle with care

  • Pages: 925-926
  • First Published: 14 April 2021
Key Points

  • Percutaneous mitral valve repair using the MitraClip System is a revolutionary treatment option for patients with severe mitral regurgitation (MR) and prohibitive surgical risk.
  • Coronary arterial disease is a frequent comorbidity in patients with severe MR.
  • The impact of concomitant coronary artery disease and revascularization on outcome in patients undergoing transcatheter mitral valve repair is still an ongoing debate.

CORONARY ARTERY DISEASE

EDITORIAL COMMENT

Postponing cardiac procedures during the pandemic: The balance between elective and selective!

  • Pages: 938-939
  • First Published: 14 April 2021
Key Points

  • What the article teaches:Postponing elective cardiac procedures may have an adverse impact on short-term outcomes.

  • How it will impact practice:Elective patients scheduled for cardiac procedures have different risk profiles and the decision for postponing should take into consideration the chances of complications related to the deferral.

  • What new research would help answer the question:Better validate tools to identify which subsets are more prone to early complications in case a scheduled invasive procedure is suspended.

VALVULAR AND STRUCTURAL HEART DISEASES

EDITORIAL COMMENT

Same day discharge: How much less is more for TAVR patients?

  • Pages: 948-949
  • First Published: 14 April 2021
Key Points

  • In a single-center retrospective analysis, 29 same day discharge (SDD) Transcatheter aortic valve replacement (TAVR) patients were treated and no patient had died or had a stroke event or needed a new pacemaker and/or experienced readmission to hospital at 30 days.
  • SDD criteria should focus on patient characteristics and procedural factors, but also on social support, tight ambulatory follow-up, and team consensus that hospital bed is no longer required.
  • As TAVR continues to develop, we should ask ourselves: how much less is more for the TAVR patient?

CORONARY ARTERY DISEASE

ORIGINAL STUDIES

CASE REPORTS

VALVULAR AND STRUCTURAL HEART DISEASES

CASE REPORTS