Editor’s Message - January 2002

Dear Readers, This issue of the Journal of Invasive Cardiology ushers in another new and exciting year in the publication of the Journal. During the past year we have witnessed dramatic changes in both our society and our health care system. The events of September 11th have shaken us to our roots and have caused us to rethink priorities. We have all seen further decreases in the already limited reimbursement for health care services and the apparent degradation of health care, especially in the area of cardiovascular medicine. In the face of all these challenges, it is up to us as healthcare professionals to promote cardiovascular health in this country and to further the technologies that will help in effectively treating cardiovascular disease. I am committed as editor-in-chief to support this effort through dissemination in the journal of information that makes a difference in the day-to-day treatment of patients with cardiovascular disease. This issue includes original research reports, commentaries, case studies and the special sections on Interventional Pediatric Cardiology, Intervention in Peripheral Vascular Disease, the Electrophysiology Corner and Clinical Decision Making. In the first original research article, Dr. Beatriz Villegas and colleagues from the Institut Cardiovasculaire Paris Sud in Massy, France present their analysis of in-hospital and late results in patients undergoing the treatment triple vessel disease with multiple stents. They showed that this group comprised less than 2% of their overall population. A majority of patients had uncomplicated procedures and 3-year event-free survival equivalent to that reported in surgical controlled studies, although repeat revascularization was more frequently required. Drs. Gruberg, Nikolsky and Beyar from the Rambam Medical Center in Haifa, Israel have provided a commentary on the article. They provide an excellent review of studies comparing catheterization intervention and coronary artery bypass surgery in the treatment of multivessel disease and conclude that stenting is a reasonable alternative to surgery in selected patients. The second original research article, submitted by Dr. Haresh Mehta and associates at the Swiss Cardiovascular Center Bern, University Hospital in Bern, Switzerland, present their experience with a new suture mediated closure device. They demonstrated that the device could be used successfully in 94% of patients with a very low rate of complications and shorter time to discharge. A commentary by Dr. Paramjeet Chopra is included; he discusses the potential advantages of this new device and the role of closure devices in managing access sites used in catheter-based interventions. The third research article, submitted by Dr. Yoshio Kobayashi and colleagues from the Lenox Hill Heart and Vascular Institute in New York, describes their study of initial angiographic and clinical results using the NIR w/SOX stent. The authors demonstrate that good results are achieved with this stent, especially in lesions where deployment with other stents has failed. In the last research article, Dr. Bin Lu and collaborators from Harbor-UCLA Medical Center, St. John’s Cardiovascular Research Center in Torrance, California present their research on using electron-beam tomography (EBT) to evaluate flow characteristics and presence of occlusions in coronary artery bypass grafts. They demonstrate an excellent correlation between EBT and coronary angiographic analysis of the same grafts in detection occlusion and patency of the conduits. This issue of the Journal also includes two interesting case reports. In the first, submitted by Dr. Denes Korpas and colleagues from Western Pennsylvania Hospital in Pittsburgh, Pennsylvania, describes a patient presenting with chest pain and severe LAD disease was treated with a coronary stent. The procedure resulted in a perforation; subsequently, a shunt developed between the LAD and the right ventricle. No intervention was performed at the time, but the patient returned 6 months later with restenosis of the stent and disappearance of the fistula. The authors discuss this case and review treatment alternatives. In the second case report, Drs. Hennebry, Calkins and Chandra-Strobos from Johns Hopkins Hospital in Baltimore, Maryland, discuss an 85-year-old woman who presented with syncope and Epstein’s anomaly of the tricuspid valve, and was successfully treated with radiofrequency ablation. They discuss the unique aspects of the case and summarize the major points to consider in treating similar patients. This issue includes articles from 4 special sections. The first section, Interventional Pediatric Cardiology, which is edited by Dr. P. Syamasundar Rao from Saint Louis University School of Medicine in St. Louis, Missouri, includes two articles. In the first, submitted by Dr. Makram Ebeid of the University of Mississippi Medical Center in Jackson, Mississippi, is a thorough review of the current approaches and technology available for the treatment of atrial septal defects using percutaneous catheter closure devices. The second selection in this section, submitted by Dr. Chi Di Liang and colleagues from Chang Gung Memorial Hospital in Taiwan, describes the successful use of endovascular stent placement in an 8-year-old for treatment of a renal artery occlusion. This issue also includes an article from the section “Intervention for Peripheral Vascular Disease”, edited by Dr. Frank Criado at the Union Memorial Hospital/Medstar Health in Baltimore, Maryland. The article, submitted by Dr. Nicholas Morrissey and colleagues from Mount Sinai School of Medicine in New York, provides an in-depth analysis of the utility of transrenal bare stents in enhancing the success of endovascular treatment of abdominal aortic aneurysms with stent grafts. This issue also includes an article from one of our other special sections, “The Electrophysiology Corner”, edited by Dr. Todd Cohen at Winthrop-University Hospital in Mineola, New York. Dr. Cohen and his colleague, Dr. Jeffrey Klein, have provided a paper discussing the history and current application of cardiac resynchronization therapy in the treatment of chronic heart failure. In the last special section, “Clinical Decision Making”, edited by Dr. Michael Sketch from Duke University Medical Center in Durham, North Carolina, Dr. Can M. Nguyen and associates from Duke University Medical Center in Durham, North Carolina, describe the clinical history of a patient with established coronary artery disease. Drs. Gregg Stone, H. Vernon Anderson, and Sheldon Goldberg offer their perspectives on the management of this kind of clinical scenario. It is my hope that this issue of the Journal and those of the coming year will contribute to improving the delivery of state-of-the-art and cost-effective health care to cardiac patients.