Mar-04

Dear Readers, This issue of the Journal of Invasive Cardiology coincides with the annual scientific sessions of the American College of Cardiology and includes original research articles, commentaries, review articles, case reports and offerings from our journal special sections Acute Coronary Syndromes, Interventions in Peripheral Vascular Disease, Clinical Decision Making and Clinical Images. The research articles in this issue cover a broad range of topics that touch on important aspects of patient care. The first research article, submitted by Dr. Evgenia Nikolsky and colleagues from the Division of Invasive Cardiology, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology in Haifa, Israel, looks at the question of whether or not complete revascularization is necessary when using PCI to treat diabetic patients with multivessel coronary disease. Their study demonstrated that completeness of revascularization is a powerful predictor of 5-year survival in diabetic patients treated with PCI. Drs. Mehta and Sketch from Duke University Medical Center have written a commentary raising several points about the study and offering a perspective on treating this challenging clinical group. In the second research article, Dr. Carlos Pedra and collaborators from Instituto Dante Pazzanese de Cardiologia and the Hospital do Coração da Associação Sanatório Sírio, both in São Paulo, Brazil present their research on transcatheter closure of secundum atrial defects with complex anatomy. They showed that the technique was safe and effective in many patients, but was limited by large defects associated with a deficient anterior rim and floppy posterior septum. Dr. Rao of the editorial board has written a commentary to accompany this article. In the next research article, Dr. Ralf-Peter Frank and associates from the Department of Biomaterials at the University of Ulm, the Heart Center Dresden at the Technical University Dresden, the Institute of Pathology at the Technical University Aachen and the Dresden Institute of Cardiovascular Research present their study of the interaction between perfluorocarbon emulsion and radiographic contrast media in pigs. Their research suggests that care needs to be taken when administering perfluorocarbon emulsions as blood substitutes in combination with x-ray contrast media. We have also included a study which attempts to determine if 4 French diagnostic catheters can be used for quantitative angiography as compared to 6 French catheters. Dr. Marcelo Sanmartin and colleagues from the Interventional Cardiology Unit at the Hospital do Meixoeiro in Vigo, Spain found that 4 French catheters do allow for adequate quantification of luminal diameters and may be useful for follow-up assessment of patients. In the fifth original research article, Dr. Rosenstein Gabriel and collaborators from the Cardiology Department at the Soroka Medical Center in Beer Sheva, Israel describe their research to develop a simple clinical risk stratification to help manage ambulation after 6 French diagnostic heart catheterization. They found that a simple system was helpful in identifying patients who could safely undergo early ambulation following elective diagnostic catheterization. In addition, we have included the original research of Dr. Antonios Ziakas and his colleagues from the Royal Jubilee Hospital in Victoria, B.C., Canada. Their research on the use of the radial artery in treating left main disease with PCI describes how it was equally fast to do procedures using the radial approach and they experienced fewer vascular complications with this access method in comparison to those patients having the femoral approach. This issue of the journal includes several case reports and multiple case reports with brief reviews of the literature. Drs. Wu, Nakamura and Rezaee from the Division of Cardiovascular Medicine at the Stanford University School of Medicine in Stanford, California present a case in which they treated a moderate size aneurysm in the proximal LAD with stenoses at both edges using intravascular ultrasound evaluation to guide stent implantation and surveillance after stent delivery. Drs. Duong, Khurana and Francoz from the Departments of Cardiology and Medicine at California Pacific Medical Center in San Francisco, California, describes two unusual cases involving severe intravascular hemolysis following mitral valve repair procedures. In addition, Dr. Cameron Haery and colleagues from the Department of Cardiovascular Medicine at the Cleveland Clinic Foundation in Cleveland, Ohio, present four cases in which the PercuSurge GuardWire was used in native coronary arteries during acute myocardial infarction. Successful use of intracoronary brachytherapy for in-stent restenosis of the left anterior descending artery done via the left internal mammary artery using the Galileo Centering Catheter is described by Drs. Joseph Aragon and Frank Litvak from the Division of Cardiology at Cedars Sinai Medical Center in Los Angeles, California. Primary stenting of an anomalous left main trunk originating from the right coronary artery during an acute myocardial infarction is discussed by Dr. Raul Moreno and colleagues from the Division of Interventional Cardiology, Instituto Cardiovascular in Madrid, Spain. This issue of the journal also has articles representing four of our special sections. In Acute Coronary Syndromes, section editor Lloyd Klein from the Section of Cardiology, Rush Heart Institute at Rush-Presbyterian-St. Luke’s Medical Center in Chicago Illinois has included an excellent review of low-molecular-weight heparins and glycoprotein IIb/IIIa antagonists in the treatment of acute coronary syndromes written by Dr. James Ferguson from the Texas Heart Institute, St. Luke’s Episcopal Hospital in Houston, Texas. In the next special section, Interventions in Peripheral Vascular Disease, edited by Dr. Frank Criado of the Division of Vascular Surgery at the Union Memorial Hospital /Medstar Health in Baltimore, Maryland, Dr. Michael Tamberella and colleagues from the Department of Cardiovascular Medicine at the Cleveland Clinic Foundation in Cleveland, Ohio present a case of carotid artery restenosis that was treated using cutting balloon therapy as an alternative to repeat surgical revascularization. In the third special section, Clinical Decision Making, edited by Dr. Michael Sketch from the Department of Cardiology at Duke University, Drs. Francis Almeda and R. Jeffrey Snell from the Section of Cardiology at Rush-Presbyterian-St. Luke’s Medical Center in Chicago, Illinois present an unusual presentation in which a patient developed an ST-Segment elevated myocardial infarction immediately after a successful coiling procedure of a basilar tip aneurysm for a subarachnoid hemorrhage. Drs. Berger and Jacobs from the Boston University Medical Center, Dr. Luis de la Fuente from Buenos Aires and Dr. Nicolas Shammas from Davenport, Iowa provide their perspectives on the management of this patient. In the last special section, Clinical Images, edited by Dr. David Rizik from Scottsdale, Arizona, Dr. Alexander Goldberg and associates from the Division of Cardiology, Rambam Medical Center and the Technion-Israel Institute of Technology in Haifa, Israel show their approach to visualizing and treating a patient with a stent lost in two arteries. It is my hope that all of the articles in this issue of the journal provide information that is timely and useful for all professionals involved in the delivery of health care to cardiac patients.