Cardiology News/Literature Review/2021

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Combined Transaortic Valve Implantation and off-pump Coronary Artery Bypass Graft surgery in a patient with aortic stenosis, left main disease and «porcelain» aorta: Transaortic Valve Implantation and CABG in a patient with severe aortic stenosis

Conventional aortic valve replacement in patients with porcelain aorta can be technically challenging and is even sometimes seen as contraindication. Trans-aortic valve implantation has been proposed as an alternative to other trancutaneous routes of implantation and is feasible when there is a small healthy area in the right anterolateral aspect of the ascending aorta. Herein we report an interesting case of combined transaortic valve implantation and off-pump coronary artery bypass grafting in a patient with severe aortic stenosis, severe ostial left main coronary artery disease and porcelain aorta

Cardiology News / Literature Review / 2018-2019

CARDIOLOGY CORNE

Cryoballoon versus Radiofrequency Ablation for Atrial Fibrillation: A Meta-analysis of 16 Clinical Trials.

Introduction: We aimed to study the procedural characteristics, efficacy and safety of cryoballoon ablation (CBA) versus radiofrequency ablation (RFA) for catheter ablation of paroxysmal atrial fibrillation (AF). Methods: A systematic literature search was performed using PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials to clinical trials comparing CBA and RFA for AF. Outcomes were evaluated for efficacy, procedure characteristics and safety. For each study, odd ratio (OR) and 95% confidence intervals (CIs) were calculated for endpoints for both approaches. Results: We analyzed a total of 9,957 participants (3,369 in the CBA and 6,588 in RFA group) enrolled in 16 clinical trials. No significant difference was observed between CBA and RFA with regards to freedom from atrial arrhythmia at 12-months, recurrent atrial arrhythmias or repeat catheter ablation. CBA group had a significantly higher transient phrenic nerve injury (OR 14.19, 95% CI: 6.92-29.10;

SPECT/CT Fusion Imaging Integrating Anatomy and Perfusion of the Heart

In the rapidly changing world of medicine, boundaries between specialties are constantly being challenged. Fused and hybrid imaging with integration of single photon emission computed tomography (SPECT) and computed tomography (CT)(SPECT/ CT) and positron emission tomography (PET) and CT (PET/CT), represent an area of very rapid growth with significant implications for the medical profession. SPECT and PET scanners have now been linked to computer topographic (CT) scanners, which are digital radiological systems which acquire data in the axial plane, producing images of the heart, as well as other internal organs, of high spatial and contrast resolution. The combination of SPECT or PET and CT for image fusion, either as a single unit or as a software???based integration of SPECT or PET myocardial perfusion imaging (MPI) and CT angiography (CTA) data sets from standalone scanners, can provide us with a simultaneous noninvasive assessment of coronary anatomy and myocardial perfusion

Health Hazards From Trans Fatty Acids: Ban of Artificial Trans Fats Long Overdue

  Although we are all abundantly aware of the health risk of saturated fat, not much attention and proper warning is given to the even more hazardous effects of unsaturated trans fatty acids. Trans fatty acids (TFA) are created by the partial hydrogenation of vegetable oils, a process converting them into semisolid fats for use in margarines, commercial cooking, and manufacturing processes, as they offer certain commercial advantages. However, major concern has been raised for TFA as they are associated with an elevated risk of ischemic heart disease (IHD). Trans fat behaves similar to saturated fat by raising LDL levels, but furthermore, it has the additional effect of decreasing HDL levels. Health authorities should advise the public to minimize the intake of trans fats, to recognize and avoid foods containing trans fats, and impose rules and regulations restricting TFA in the industry and the restaurants and thus prevent thousands of IHD events each year worldwide

Thromboaspiration of Heavy Thrombotic Load Salvages Myocardium and Prevents the No-Reflow Phenomenon in Acute Myocardial Infarction

The combination of thromboaspiration of heavy thrombotic load, coronary stenting and use of a IIB/IIIA antiplatlet agent led to full mechanical recanalization and complete restoration of TIMI 3 blood flow to the right coronary artery and obviation of the no-reflow phenomenonin in a patient with acute inferior ST-elevation myocardial infarction

Optimizing Cardiac Resynchronization Therapy Device Programming

Cardiac resynchronization therapy (CRT) improves symptoms and cardiac function, reduces hospitalizations and increases survival in selected patients with heart failure. It is mandatory to maximize mechanical and electrical synchronicity. Atrio-ventricular and ventriculo-ventricular intervals optimization have a substantial impact on the hemodynamic response to pacing. The number of patients with an implanted CRT system is increasing and many issues have not yet been answered about who and how will benefit the most

Indications for Renal Artery Stenting

Renal artery disease (RAD) is a relatively common condition in the elderly, especially in the setting of concomitant vascular disease in other anatomical sites and is most often of atheromatous origin. Rarely is it encountered in young women as a result of fibromuscular dysplasia. RAD with significant renal artery stenosis is considered responsible for refractory or accelerated hypertension, progressive loss of renal function and deterioration of patients’ cardiovascular status, with episodes of angina or pulmonary edema disproportional to the extent of coronary artery disease and left ventricle functional capacity, dominating the clinical presentation. This article summarizes the pathophysiological implications and diagnostic methods and attempts a review of the current literature on indications and efficacy of the available therapeutic options for renal artery stenosis, focusing on interventional treatment