Nov-06

Dear Readers, This November 2006 issue of the Journal of Invasive Cardiology, which coincides with the 2006 American Heart Association (AHA) Annual Scientific Sessions held in Chicago, Illinois, includes original research articles, commentaries, articles from the journal’s special sections Clinical Images and Clinical Decision Making, a review article, a Rapid Communication article, as well as five online case reports. These case reports can be found on our website www.invasivecardiology.com. I encourage you to visit the journal’s newly-designed website to read these interesting and informative case reports, and to catch up on the latest news and events in the interventional cardiology arena. In the first research article, Dr. Ravi Ramana and associates from Loyola University Medical Center in Maywood, Illinois, present results of their study looking at the use of rotational atherectomy in patients with severe left ventricular dysfunction. They found that short-term outcomes were not adversely affected, and suggest that rotational atherectomy may be employed in this patient cohort by experienced operators. Dr. On Topaz of the journal’s editorial board has provided a commentary to accompany the Ramana et al research article. The second original research article by Dr. Jonathan Marmur and colleagues from SUNY Downstate Medical Center in Brooklyn, New York, features a study comparing the results achieved using a bolus-only strategy of glycoprotein IIb/IIIa inhibitors to outcomes from the REPLACE-2 trial. They found that this strategy appeared to maintain the anti-ischemic benefits with reduced bleeding complications, and possibly reduced costs and shortened hospital stays. Dr. George Dangas of the editorial board has provided a commentary on this group’s research. In the next original article, Dr. Stephen Worthley and colleagues from Royal Adelaide Hospital, Monash Medical Center and Flinders Medical Center in Australia, describe their study to evaluate the use of the RADI™ PressureWire® high-sensitivity thermistor in assessing the temperature of culprit lesions in patients with acute coronary syndromes. In a small sample of subjects, the PressureWire was unable to detect a temperature increase in acute coronary syndrome patients. In the next original research article, Dr. Alan Zajarias and collaborators from the Washington University School of Medicine in St. Louis, Missouri, report on their study to determine if there are echocardiographic characteristics that may identify patients who are likely to have residual right-to-left shunt after percutaneous closure of a patent foramen ovale (PFO). Their study showed that the percutaneous transcatheter approach does confer early closure of PFO, with residual shunts seen in patients with a redundant atrial septum and atrial septum aneurysm during the early period, but which resolved at 6 months postprocedure. A commentary by Dr. Steve Goldberg accompanies the article by Zajarias and colleagues. Next, Dr. John Young and colleagues from The Ohio Heart and Vascular Center, the Lindner Center for Research and Education at The Christ Hospital in Cincinnati, Ohio and Joseph Pastore of Boston Scientific Corporation, present an analysis to determine if early revascularization and ACC/AHA Guideline-compliant medical management improve left ventricular function and short-term prognosis in patients presenting with acute myocardial infarction and severe left ventricular dysfunction. This approach was successful in effectively managing these myocardial infarction patients with improvement in left ventricular ejection fraction for a majority of those studied. Dr. Adnan Chhatriwalla and collaborators from the University of Virginia Health Systems in Charlottesville, Virginia, the Medical University of South Carolina at Charleston, South Carolina, the University of Massachusetts in Amherst, Massachusetts and Emory University in Atlanta, Georgia, report on their study designed to demonstrate that fractional flow reserve (FFR) used to assess coronary lesion severity in patients with high left ventricular mass index (LVMI) is similar in patients who do not have high LVMI. They found no difference in FFR, regardless of the patient LVMI status. A commentary by Drs. Tarek Helmy and Richard Callihan on the broadening of FFR applications accompanies this article. Dr. Shaoliang Chen and collaborators from Nanjing First Hospital of the Nanjing Medical University in Nanjing, China and Beth Israel Medical Center in New York City, describe their research on the intracoronary transplantation of autologous bone marrow mesenchymal stem cells for ischemic cardiomyopathy due to an isolated chronic left anterior descending artery. They demonstrated that patients treated with stem cells showed improvements in reversible defects, exercise tolerance, NYHA functional class and left ventricular ejection fraction compared to a control group. This issue of the journal also contains articles from two of our special sections. The first, from the Clinical Decision Making section, edited by Dr. Michael Sketch, Jr. from the Department of Cardiology at Duke University in North Carolina, features a case report from Dr. Kent Nilsson and colleagues, also from Duke University. This interesting case involves the simultaneous restenosis of Taxus^® and Cypher™ drug-eluting stents in a patient. Drs. Antonio Colombo, John P. Liuzzo and Bernhard Meier have provided their insights into their assessment of this patient and what they believe would be the best therapeutic approach. Next, the Clinical Images section, edited by Dr. David Rizik from the Scottsdale Heart Group at Scottsdale Healthcare Hospital in Arizona, features a case presentation from Dr. Owen Raffel and colleagues from the Massachusetts General Hospital and Harvard Medical School in Boston. They present a series of images portraying coronary stent malapposition resulting from a post-stenotic aneurysm detected by optical coherence tomography, an imaging technology that enabled the detection and determination of the cause of the stent’s malapposition. We are also pleased to feature a review article by Dr. Ajay K. Jain et al on the coronary venous system as an alternative access route to the myocardium. This paper provides a thorough review about the anatomy of the coronary venous system and the techniques most often employed for its catheterization. The authors discuss how catheter-based techniques for retroperfusion of coronary veins may offer new options for patients who have none in terms of conventional revascularization techniques, and how the coronary venous system has been utilized for drug, cell and gene delivery. This month’s issue also features a Rapid Communication article from Drs. Jim, Ho and Chow from Queen Mary Hospital and Grantham Hospital in Hong Kong. The authors present their unique approach to treating saphenous vein graft disease using an export aspiration catheter-enhanced FilterWire™ delivery system which they believe will be useful for vein graft intervention and primary angioplasty in the future. The journal’s online November issue features five case reports. The first of these, submitted by Drs. Karen de Man, Mark Patterson and Ferdinand Kiemeneij from the OLVG in Amsterdam, describes the successful management of a patient with left main shock syndrome using a bifurcation balloon system to facilitate simultaneous reperfusion of the left anterior descending and circumflex arteries as a bridge to surgery. Next, Drs. Michael De Young and Samer Kazziha of Mount Clemens Regional Medical Center in Mount Clemens, Michigan, describe their successful use of a thrombus extraction catheter in the treatment of a patient with acute myocardial infarction after coronary embolism following mitral valve replacement. The third case report, submitted by Drs. Lozano, Avanzas and Moris, from the Hospital Central Asturias in Oviedo, Spain, also includes a brief review of the literature. The authors describe a patient who presented with a new occlusion at the balloon inflation site, beyond where the stents were implanted, three months after receiving two drug-eluting stents in the left main artery. This case has led the authors to question whether the left main artery should be covered entirely with drug-eluting stents during percutaneous intervention. Drs. Murasato, Suzuki and Suzuki from Chikuho Social Insurance Hospital in Nogata, Japan, have submitted a case report with review demonstrating their management of incomplete stent apposition in a left main bifurcation lesion after kissing stent implantation. The authors used a three-dimensional phantom model depicting a left main coronary artery (LMCA) bifurcation to investigate the cause of the incomplete stent apposition and deformation, and found that kissing stent implantation using different-sized stents caused the left circumflex artery stent to compress at the distal LMCA. The fifth and final case report also features a brief review of the literature. In this report, Drs. Raza, Rodriguez and Miller from East Carolina University – Brody School of Medicine in Greenville, North Carolina, discuss their success in treating a patient by performing percutaneous revascularization of a circumflex artery injury following minimally invasive mitral valve repair and left atrial Cryo-MAZE. It is my hope that the articles in this issue of the journal provide cardiovascular healthcare professionals with important information that will assist them in the effective management of their cardiac patients. Sincerely, Richard E. Shaw, PhD, FACC, FACA Editor-in-Chief