Jun-06

Dear Readers, The first of our feature articles in the June issue is from Pierfrancesco Agostoni and colleagues of the University Verona and AZ Middelheim in Antwerp, Belgium and assesses the safety of percutaneous left heart catheterization directly performed by cardiology fellows. They concluded that, under supervision, cardiology fellows could perform direct cardiac catheterizations without an increase in local access site or major complications. Our next research article is from Dr. Rasih Ener and colleagues from Temple, Drexel and Hahnemann Universities in Philadelphia. They examined alveolar hemorrhage associated with the administration of platelet GP IIb/IIIa receptor inhibitors. In the next original article, Drs. Janet Hays, Michael Lujan and Robert Chilton, from the University of Texas Health Science Center evaluate the accuracy of a long sheath, single-puncture technique to obtain accurate transvalvular gradients in aortic stenosis. Using a 4-Fr pigtail catheter with a 55-cm long 6 Fr sheath, they demonstrated that the technique is a safe and efficient way to obtain hemodynamic data in an aortic stenosis catheterization. Dr. Ronald Krone has provided the commentary to this article. Next, Dr. Benigno Quintero-Moran and collaborators from the Hospital Clinico San Carlos in Madrid, report on the influence of immediate paramedical and medical assistance on outcomes following PCI for cardiac arrest secondary to ST-elevation acute myocardial infarction (AMI). They showed that combining immediate initiation of resuscitation maneuvers and PCI led to improved outcomes in patients with AMI and cardiac arrest. In the next research paper, Dr. Salah-Eddine Hassani and associates from Washington Hospital Center compared clinical outcomes after PCI with drug-eluting stents in dialysis and nondialysis patients. They concluded that PCI and DES are safe and feasible in dialysis patients, with similar reductions in repeat revascularization rates compared to nondialysis patients, although 6-month outcomes in dialysis patients were worse, attributable to more comorbidities at the time of initial DES placement. Next, Karen Wou and associates from the Jewish General Hospital in Montréal, report findings from the ROSETTA-CABG registry looking specifically at the impact of functional testing results on prescription patterns of anti-anginal medications after CABG surgery. The use of anti-anginal medications was only modestly reduced following CABG, and functional testing results during the first year post-CABG did not have a strong impact on prescription of anti-anginal medications. Finally, Akil Loli and colleagues from Banner Good Samaritan Regional Medical Center in Phoenix present their research on the intermediate-term outcomes following recanalization of long, chronic occlusions of native coronary arteries using the Frontrunner™ catheter. Favorable outcomes were achieved, but fluoroscopy times were long and contrast loads high when attempting to treat chronic total occlusions with this device. Next, a comprehensive review on percutaneous coronary intervention in elderly patients is provided by Dr. Lloyd Klein from Gottlieb Memorial Hospital in Melrose Park, Illinois. This review summarizes current data to provide a rational basis for managing these patients. In the Clinical Images section, Drs. Victor Mejia, Joseph Woo and Howard Herrmann from the University of Pennsylvania, present an unusual case in which a myocardial infarction was caused by an embolism in the LMCA in a patient with mitral valve repair admitted in cardiogenic shock with a pericardial effusion. Along with this print issue of the Journal of Invasive Cardiology, I encourage you to log on to our website to read the informative case reports that are also a part of this issue at www.invasivecardiology.com. In the first of these, Drs. Timothy Mixon and Patrick Fitzsimmons from Scott and White Hospital in Temple, Texas, describe the immediate and long-term results of percutaneous stenting of the left main with DES for in-stent restenosis. In the next online case report, Dr. Eisei Yamamoto and colleagues from the Nippon Medical School in Tokyo, describe their use of PCI under rigid restrictions on the dose of contrast media to treat chronic renal insufficiency. In the third case, Drs. Roger McCorry and Paul Johnston discuss their evaluation of a patient who suffered fatal delayed thrombocytopenia following abciximab treatment. Dr. Richard Bach and associates from the Washington University School of Medicine in St. Louis, Missouri, describe their successful use of magnetic navigation to facilitate transcatheter alcohol septal ablation for hypertrophic obstructive cardiomyopathy. Next, Drs. Mouhammed Joumaa and colleagues from St. John Hospital and Medical Center in Detroit, Michigan, present their management of a patient with acute ST-segment-elevation myocardial infarction and an occluded left main coronary artery. Next, Dr. Abdul Rashid and coworkers from the University of Oklahoma, describe a patient demonstrating a symptom of cold leg with high coated platelets, suggesting a possible association with the use of rofecoxib. Andre Olivier and Jay Hollman from Louisiana State University Health Sciences Center in Baton Rouge, Louisiana describe late in-stent thrombosis in a patient with systemic lupus erythematosus and hyperhomocysteinemia. In the next case, Angel Sanchez-Recalde, Luis Calvo Orbe, and Guillermo Galeote from the University Hospital La Paz in Madrid, Spain describe cardiogenic shock due to thrombotic occlusion in a young female. In the final case, Ashish Pershad, David Hoelzinger, and Shirish Patel describe a series of cases using thrombectomy in acute ST-segment MI. I sincerely hope that each of these articles provides the interventional cardiologist with information that will improve the daily care of cardiac patients. Sincerely, Richard E. Shaw, PhD, FACC, FACA Editor-in-Chief