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May 2021 Table of Contents
Transcatheter Aortic Valve Replacement
Comparing the Safety and Effectiveness of 5 Leading New-Generation Devices for Transcatheter Aortic Valve Implantation: 12-Month Results From the RISPEVA Study
Nicola Corcione, MD; Alberto Morello, MD; Paolo Ferraro, MD; Michele Cimmino, MD; Luca Testa, MD; Anna Sonia Petronio, MD; Alessandro Iadanza, MD; Antonio L. Bartorelli, MD; Sergio Berti, MD; Damiano Regazzoli, MD; Enrico Romagnoli, MD, PhD; Carmen Spaccarotella, MD; Maurizio Tespili, MD; Martino Pepe, MD; Giacomo Frati, MD, MSc; Giuseppe Biondi-Zoccai, MD, MStat; Arturo Giordano, MD, PhD; on behalf of the Registro Italiano GISE sull’Impianto di Valvola Aortica Percutanea (RISPEVA) Study Investigators
To learn more about the comparative effectiveness and safety of contemporary TAVI devices, we queried data from the national Italian TAVI registry comparing features, procedural details, and 12-month outcomes of Acurate Neo, Evolut Pro/R, Lotus, Portico, and Sapien/Sapien S3 Ultra aortic valves.
J INVASIVE CARDIOL 2021;33(5):E320-E327. Epub 2021 March 19.
Original Contribution
Predictors of Clinical Outcome After Early Veno-Arterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock Complicating ST-Elevation Myocardial Infarction
Lukasz Szczanowicz, MD; Nicolas Majunke, MD; Suzanne de Waha-Thiele, MD; Franziska Tietz, MD; Stephan Schürer, MD; Katharina Kirsch, MD; Steffen Desch, MD; Holger Thiele, MD; Marcus Sandri, MD
Despite increasing use of VA-ECMO in patients with CS secondary to STEMI, a paucity of adequate evidence for this therapy remains. The aim of this single-center clinical registry study was to identify predictors of survival and discern the possible optimal time to initiate VA-ECMO in this cohort.
J INVASIVE CARDIOL 2021;33(5):E329-E335.
Original Contribution
Effects of Real-Time Dosimetry on Staff Radiation Exposure in the Cardiac Catheterization Laboratory
Dilschad Murat, MD*; Christian Wilken-Tergau, MD*; Uta Gottwald, MD; Ole Nemitz, MD; Thomas Uher, MD; Eberhard Schulz, MD
*Joint first authors
Instant feedback about the actual radiation dose received may help operators optimize the use of existing shielding devices. The current study was designed to investigate whether routine use of real-time dosimetry may be able to reduce staff radiation exposure.
J INVASIVE CARDIOL 2021;33(5):E337-E341. Epub 2021 April 5.
Editorial Commentary
Lloyd W. Klein, MD
The study by Murat demonstrates that positive feedback in real-time helps operators reduce exposure.
J INVASIVE CARDIOL 2021;33(5):E342-E343
Brief Communication
Performance of the Edwards Sapien 3 Ultra Transcatheter Aortic Valve System in Patients With Aortic Stenosis and Annulus Diameter in Proximity to Valve Size
Peter Ong, MD; Stephan Hill, MD; Hardy Baumbach, MD; Samir Ahad, MD; Alina Stan, MD; Alexander Becker, MD; Ingmar Tiefenbach, MD; Angela Geissler, MD; Christian Wunder, MD; Schahriar Salehi-Gilani, MD; Ulrich F.W. Franke, MD; Raffi Bekeredjian, MD
The new Sapien 3 Ultra valve was designed to improve paravalvular sealing. We assess its performance in patients with an annulus size in proximity to the prosthesis size.
J INVASIVE CARDIOL 2021;33(5):E344-E348. Epub 2021 March 17.
Review
Coronary Computed Tomography Angiography (CCTA) vs Functional Imaging in the Evaluation of Stable Ischemic Heart Disease
Vishal I. Patel, MD; Sion K. Roy, MD; Matthew J. Budoff, MD
Evidence to support anatomical imaging is growing, with CCTA gaining attention as the more accurate non-invasive testing modality. We review current literature and formulate a direction for CCTA-based future research.
J INVASIVE CARDIOL 2021;33(5):E349-E354. Epub 2021 March 26.
Original Contribution
The ALSTER-TAVI All-Comers Registry: Procedural and 1-Year Clinical Outcomes of Balloon-Expandable vs Self-Expanding Contemporary TAVI Valves
Christina Paitazoglou, MD*; Felix Meincke, MD*; Thorsten Hanke, MD; Michael Laß, MD; Jan Noack, MD; Anna Grüning; Christian Frerker, MD; Britta Goldmann, MD; Philipp Peitsmeyer, MD; Michael Schmöckel, MD; Stephan Willems, MD; Martin W. Bergmann, MD *Joint first authors
We compared procedural and clinical outcome variables of the Sapien 3 balloon-expandable valve and the Evolut R/Pro self-expanding valve in an all-comers collective.
J INVASIVE CARDIOL 2021;33(5):E356-E364.
Original Contribution
Procedural and 3-Year Outcomes of Peripheral Vascular Interventions Performed in Office-Based Labs: LIBERTY 360 Sub-Analysis
Stefanos Giannopoulos, MD; George Pliagas, MD; Ehrin J. Armstrong, MD, MSc
Few data are available on the safety of interventions for peripheral arterial disease performed in the office-based laboratory (OBL) setting. Thus, the aim of this study was to investigate the short- and late-term outcomes of patients treated in OBL vs hospital settings. We included patients with PAD treated with any FDA-approved or cleared devices for distal femoropopliteal and/or infrapopliteal disease. Data were retrieved from the LIBERTY 360 study.
J INVASIVE CARDIOL 2021;33(5):E365-E377.
Original Contribution
Balloon Angioplasty for Pulmonary Artery Stenosis After Complete Unifocalization and Repair of Tetralogy of Fallot With Major Aortopulmonary Collaterals
Zsofia B. Long, MD; Gregory T. Adamson, MD; Lynn F. Peng, MD; Stanton B. Perry, MD; Lisa Wise-Faberowski, MD; Frank L. Hanley, MD; Doff B. McElhinney, MD
The objective of this study was to assess procedural outcomes of balloon pulmonary artery (PA) angioplasty procedures after complete repair of tetralogy of Fallot with major aortopulmonary collateral arteries (TOF/MAPCAs). Our approach to patients with TOF/MAPCAs emphasizes early complete unifocalization and repair. Major PA reinterventions are relatively uncommon. Balloon PA angioplasty is often used, but the effectiveness of balloon PA angioplasty in this population is unknown.
J INVASIVE CARDIOL 2021;33(5):E378-E386. Epub 2021 April 29.
Original Contribution
VA-ECMO With IABP is Associated With Better Outcome Than VA-ECMO Alone in the Treatment of Cardiogenic Shock in ST-Elevation Myocardial Infarction
Floris S. van den Brink, MD; Carlo Zivelonghi, MD; Tessel N. Vossenberg, MD; Gabe B. Bleeker, MD, PhD; Vivian L. Winia, MD; Krischan D. Sjauw, MD, PhD; Jurrien M. ten Berg, MD, PhD
Veno-arterial extracorporeal membrane oxygenation (VA- ECMO) is an upcoming technique in the treatment of cardiogenic shock; however, it increases afterload. VA-ECMO combined with intra-aortic balloon pump (IABP has been suggested to reduce afterload and increase survival. Our objective was to assess whether combining VA-ECMO + IABP improves outcomes in ST-segment elevation myocardial infarction over VA-ECMO alone.
J INVASIVE CARDIOL 2021;33(5):E387-E392. Epub 2021 April 20.
Brief Communication
Intravascular Ultrasound Insights Into Perforation After Coronary Atherectomy
Laura Young, MD; Chetan P. Huded, MD; Rishi Puri, MD, PhD; Jaikirshan J. Khatri, MD
In recent years, there has been strong evidence to support the regular use of intravascular ultrasound (IVUS) imaging to optimize the results of percutaneous coronary intervention (PCI). This holds particularly true in more complex cases, such as calcific lesions, whereby angiographic evaluation is often insufficient to determine whether a vessel has been adequately prepared or to perform reference vessel sizing. We provide a descriptive analysis, including IVUS findings, of 10 patients who underwent PCI complicated by coronary perforation following coronary atherectomy.
J INVASIVE CARDIOL 2021;33(5):E393-E395. Epub 2021 March 15.
Letter to the Editor
Wolf in Sheep's Clothing – The False Sense of Security in Patients With Anomalous Aortic Origin of a Coronary Artery Undergoing Submaximal Stress Testing
Marius Reto Bigler, MD; Christian Seiler, MD; Lorenz Räber, MD, PhD; Christoph Gräni, MD, PhD
Whether novel computational fluid-dynamic simulated computed tomography angiography fractional flow reserve (FFR) can improve diagnostics and refine risk stratification, needs to be studied in comparison with the gold standard of invasive FFR with dobutamine.
J INVASIVE CARDIOL 2021;33(5):E396-E399.
Clinical Images
Hemopneumothorax – An Unexpected Cath Lab Diagnosis
Sandeep Arunothayaraj, MBBS; Dang-Khoa Phan, MBBS; Akshat Saxena, MBBS
A 57-year-old woman presented with chest pain. Electrocardiography (ECG) revealed an inferior ST-segment elevation myocardial infarction. Thrombolysis was initiated and repeat ECG showed reduction of ST elevation. The patient reported ongoing pain and developed hypotension. Fluoroscopy of the chest demonstrated gross tracheal deviation and collapse of the left lung. This case highlights the importance of maintaining a broad differential diagnosis and of harnessing the various skills within a multidisciplinary team.
J INVASIVE CARDIOL 2021;33(5):E399.
Acute Stent Thrombosis: Severe In-Stent Malapposition and Insufficient Platelet Inhibition as Partners in Crime!
Giuseppe Talanas, MD; Alessandro Murgia, MD; Filippo Dossi, MD; Guido Parodi, MD, PhD
Acute stent thrombosis is a rare event. When it occurs, procedure- and patient-related factors need to be assessed. First, our case showed that wiring was only successful with a chronic total occlusion-derived technique, indirectly demonstrating a stent-related problem. In fact, OCT showed a remarkable in-stent malapposition. Second, insufficient platelet inhibition was another important factor that contributed to acute stent thrombosis, since morphine negatively affected ticagrelor absorption and onset of action.
J INVASIVE CARDIOL 2021;33(5):E400.
Acute Inferior ST-Elevation Myocardial Infarction Caused by Occlusion of a Giant Coronary Artery Aneurysm
Sarah L. Fairley, MBBCh, BAO, PhD, MRCP (UK)
An approach to the treatment of a giant aneurysm of the proximal right coronary artery with thrombotic occlusion is described.
J INVASIVE CARDIOL 2021;33(5):E401-E402.
Accidental Stent Withdrawal Through an Entrapped Rotational Atherectomy Burr
Felipe Homem Valle, MD, DSc; Felipe Costa Fuchs, MD, MSc, DSc; Fernando Pivatto Júnior, MD, MSc; Gustavo Neves de Araújo, MD, DSc; Rodrigo Vugman Wainstein, MD, MSc, DSc
Coronary intravascular ultrasound assessment demonstrated severe stent underexpansion and circumferential superficial calcification. Following a failed attempt to predilate the in-stent restenosis, rotational atherectomy was performed.
J INVASIVE CARDIOL 2021;33(5):E403-E404.
Minimalist Management of Occlusive Spontaneous Coronary Artery Dissection With Workhorse Guidewire: The Prick-and-Wait Technique
Louis-Marie Desroche, MD; Thibault Ronchard, MD, PharmD; Pascal Motreff, MD, PhD
We describe what could be a bailout strategy in the event of (1) failure to reach the distal true lumen, (2) slight improvement in the distal flow, but allowing clinical resolution of STEMI, or (3) a situation not suited to surgery. The “prick-and-wait” technique presented in this case led to a complete recovery.
J INVASIVE CARDIOL 2021;33(5):E405.
Radial Artery Pseudoaneurysm Following Percutaneous Coronary Intervention
Ankur Gupta, MD, DM and Sourabh Agstam, MD, DM
Radial artery pseudoaneurysm is a very rare complication. In the presented case, computed tomography 3 months post percutaneous coronary intervention demonstrated contrast extravasation, suggestive of radial artery pseudoaneurysm. This complication was managed with thrombin infusion at the distal radial artery.
