Editor’s Message (December 2001)

Dear Readers, This issue of the Journal of Invasive Cardiology includes original research articles, commentaries, case reports, and articles from the Journal special sections "Clinical Decision Making" and "The Electrophysiology Corner". The first research article, submitted by Dr. Deepak Bhatt and colleagues from the Departments of Cardiology and Neurology at the Cleveland Clinic Foundation in Cleveland, Ohio, presents their study of the impact of dual antiplatelet therapy on thrombotic events following use of stents for the treatment of carotid artery stenosis. Their study demonstrates excellent results for patients receiving a combination of clopidogrel and aspirin. In a companion editorial commentary written by Dr. George Dangas from the Lenox Hill Heart and Vascular Institute in New York, Dr. Dangas discusses some of the recent work with combination platelet therapy and suggests that this may be one of the most important treatment regimens available in current cardiovascular therapeutics. In the second original research article, Dr. Martin Unverdorben and collaborators from the Center for Cardiovascular Diseases in Rotenburg, Germany and Institute for Medical Statistics in Mainz, Germany, present their randomized study of the effect of controlled balloon inflation on long-term restenosis after coronary angioplasty. Their study demonstrates that computer-assisted dilatation resulted in a significantly lower restenosis rate compared to procedures done with standard balloon inflation. The third original research article, from Dr. Ian Crocker and colleagues of the Montreal Heart Institute in Montreal, Quebec, Canada, describes the treatment of long diffuse in-stent restenosis with beta radiation utilizing a sequential positioning "pullback" technique. They demonstrate excellent clinical results in this challenging clinical situation. The fourth research article, submitted by Ms. Wendy Vlasic and colleagues from the London Health Sciences Centre in London, Ontario, Canada, describes the "reducing bedrest following arterial puncture for coronary interventional procedures" (BAC) randomized trial to determine the minimal amount of bedrest necessary for adequate hemostasis following arterial puncture. They demonstrate that patients, even those receiving glycoprotein IIb/IIIa inhibitors, can be ambulated within two hours of the procedure without significant vascular complications and need for vascular closure devices. In a commentary on this article, S.K. Chugh and John G. Webb, of St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada discuss the benefits to having many approaches to facilitating early hemostasis and mobilization. The last original research article, submitted by Dr. Humberto Dighero and colleagues from the Department of Cardiology at the Hospital San Juan de Dios in Santiago, Chile, presents a six-year follow-up after mitral balloon valvotomy. This study shows that this procedure is a viable alternative to surgical approaches to this condition and produces results that are maintained six years after the initial procedure. Dr. Zoltan G. Turi of the John Ross Cardiac Catheterization Laboratory, Division of Cardiology, University of California, San Diego, California, has provided a commentary on this article, voicing his concerns regarding the follow-up data available. This issue of the Journal includes interesting case reports representing unusual clinical situations. In the first case report, Dr. Yoshio Kobayashi and colleagues from the Lenox Hill Heart and Vascular Institute in New York describe their evaluation of a patient in whom angiography revealed a 60% stenosis at the ostium of the left circumflex followed by IVUS that revealed no significant stenosis. They did not intervene and attributed the apparent stenosis to negative remodeling at the ostium. In the second case report, submitted by Marco Roffi and associates from the Swiss Cardiovascular Center Bern, University Hospital in Bern, Switzerland, the authors present their approach to treating an unusual presentation of an anomalous origin of a single coronary artery requiring balloon dilatation and stenting. This issue also includes articles from two of our special sections. In the Clinical Decision Making section, edited by Dr. Michael Sketch from Duke University Medical Center in Durham, North Carolina, Dr. Ziyad Hijazi and colleagues from the Department of Pediatrics and Section of Cardiology, The University of Chicago Children’s Hospital and the Pritzker School of Medicine, Chicago, Illinois, present a patient with residual inferior atrial septal defect following surgical repair. Three perspectives are provided, by Drs. P. Syamasundar Rao, John Moore, and Satinder K. Sandhu, for deciding on treatment for this complicated case. These perspectives demonstrate how these kinds of difficult cases can challenge the decision-making process of clinicians. This issue includes articles from one of our other special Journal sections, the Electrophysiology Corner, edited by Dr. Todd Cohen of the Department of Cardiology at Winthrop-University Hospital in Mineola, New York. Dr. Cohen and his colleagues, Dr. Hanna Mieszczanska and Dr. Bassiema, have provided an article summarizing their initial clinical experience with an implantable loop recorder. They demonstrate that the loop recorder can be a valuable tool in the diagnosis of patients with recurrent unexplained syncope. It is my hope that all of the articles in this issue of the Journal provide information that is useful for cardiologists in the daily care of patients with cardiac disease.