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[en] A saline-jet aspiration thrombectomy (JAT) catheter was used in a patient with acute myocardial infarction. A right coronary arteriogram showed complete thrombotic occlusion at the proximal segment. With this catheter the thrombus was removed without complications in 5 sec. The patient underwent percutaneous transluminal coronary angioplasty and placement of a Palmaz-Schatz stent after successful thrombectomy. Thrombectomy with a JAT catheter was very useful in this patient.
[en] Tomographic radionuclide ventriculography has the potential to be a significant improvement over conventional planar imaging. Although tomographic imaging can now be performed with relative ease, it is little used. This is most probably due to a perceived imbalance between potential clinical benefit and the extra complications of imaging. We investigated this matter by examining a series of 30 patients with isolated inferior or anterior myocardial infarction, identified by cardiac catheterization. Using either radionuclide imaging method, a significant wall motion abnormality was defined as matching (and appropriately located) phase and amplitude values outwith of two standard deviations from control values. These values were obtained from a series of 25 controls and represent construction values used to create a conventional polar map display. Overall detection rates for anterior myocardial infarction were 93 and 100% for planar and tomographic imaging, respectively (ns). For inferior myocardial infarction the rates were 7 and 93% respectively (p <0.001). Identical results were found using a novel three-dimensional method of displaying wall motion abnormalities. Tomography is therefore superior to planar imaging for the detection of inferior myocardial infarction but similar to planar imaging for the detection of anterior myocardial infarction. (Author)
[en] Coronary artery disease (CAD) and myocardial infarction (MI) are recognized as leading causes of mortality in developed countries. Although typically associated with behavioral risk factors, such as smoking, sedentary lifestyle, and poor dietary habits, such vascular phenotypes have also long been recognized as being related to genetic background. We review the currently available data concerning genetic markers for CAD in English and non-English articles with English abstracts published between 2003 and 2018. As genetic testing is increasingly available, it may be possible to identify adequate genetic markers representing the risk profile and to use them in a clinical setting. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.
[en] Background/Purpose: The ORBIT I trial evaluated the safety and performance of an orbital atherectomy system (OAS) in treating de novo calcified coronary lesions. Severely calcified coronary arteries pose ongoing treatment challenges. Stent placement in calcified lesions can result in stent under expansion, malapposition and procedural complications. OAS treatment may be recommended to facilitate coronary stent implantation in these difficult lesions. Materials/Methods: Fifty patients with de novo calcified coronary lesions were enrolled in the ORBIT I trial. Patients were treated with the OAS followed by stent placement. Our institution treated 33/50 patients and continued follow-up for 3 years. Results: Average age was 54.4 years and 90.9% were males. Mean lesion length was 15.9 mm. The average number of OAS devices used per patient was 1.3. Procedural success was achieved in 97% of patients. Angiographic complications were observed in five patients (two minor dissections, one major dissection and two perforations). The cumulative major adverse cardiac event (MACE) rate was 6.1% in-hospital, 9.1% at 30 days, 12.1% at 6 months, 15.2% at 2 years, and 18.2% at 3 years. The MACE rate included two in-hospital non Q-wave myocardial infarctions (MI), one additional non Q-wave MI at 30 days leading to target lesion revascularization (TLR), and three cardiac deaths. Conclusions: The ORBIT I trial suggests that OAS treatment may offer an effective method to modify calcified coronary lesion compliance to facilitate optimal stent placement in these difficult-to-treat patients with acceptable levels of safety up to 3 years post-index procedure
[en] Scintigraphic myocardial imaging, using Thallium-201, finds its most rational application if the sensitivity and specificity of the test are used combined with the prevalence of the disease in a given age group. Clinical data remains invaluable in assuring a good interpretation in myocardial imaging
[en] ObjectiveWe hypothesized that Displacement Encoding with Stimulated Echoes (DENSE) and feature-tracking derived circumferential strain would provide incremental prognostic value over the extent of infarction for recovery of segmental myocardial function.