Surgical myocardial revascularization in patients with reduced systolic left ventricular function.
Authors: Bruno P, Iafrancesco M, Massetti M
Abstract
Surgical myocardial revascularization in patients with reduced left ventricular function has been a matter of debate for decades. Recently published 10-years extension follow-up of the STICH trial have conclusively demonstrated benefit of surgical myocardial revascularization in patients with significant coronary artery disease and low left ventricular ejection fraction. However, selection of patients for surgery remains challenging as well as decision to perform percutaneous rather than surgical revascularization in this class of patients. New evidence ...
Source: Minerva Cardioangiologica - April 25, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
The obestiy paradox: the protective effect of obesity on right ventricular function using echocardiographic strain imaging in patients with pulmonary hypertension.
CONCLUSIONS: Obesity is associated with subclinical RV dysfunction as assessed by RV strain imaging, but paradoxically it may confer a protective effect on RV function once the patient develops PHTN. Future studies should evaluate the clinical impact of this paradox.
PMID: 29642689 [PubMed - as supplied by publisher] (Source: Minerva Cardioangiologica)
Source: Minerva Cardioangiologica - April 15, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Impella-protected PCI: the clinical results achieved so far.
Authors: Pesarini G, Gratta A, Dolci G, Lunardi M, Ribichini FL
Abstract
The ability of interventional cardiologists to identify high-risk percutaneous coronary interventions (PCI) patients, requires the integration of different features belonging to medical history, organ damage, coronary anatomy and the nature of the acute event. The selection of a subgroup of patients that could benefit from mechanical support during interventions is a key feature to success. The introduction of the Impella percutaneous axial pump have added an easy to set-up, less-invasive and time consuming active-support device to th...
Source: Minerva Cardioangiologica - April 15, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
High-risk PCI: how to define it today?
Authors: DE Marzo V, D'Amario D, Galli M, Vergallo R, Porto I
Abstract
Before the percutaneous spread, the mortality rate of patients with coronary heart disease not suitable for cardiac surgery was markedly high. This limit has been progressively exceeded with the advent of minimally invasive approaches, which, although was initially intended exclusively for low risk patients, was then employed in complex patients often too compromised to undergo cardiac surgery. Given to the rising of high-risk population, due to an increase of patients with multiple chronic conditions linked to the best care offered, we...
Source: Minerva Cardioangiologica - April 15, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Noncardiac chest pain: a 2018 update.
Authors: Durazzo M, Gargiulo G, Pellicano R
Abstract
Noncardiac chest pain (NCCP) is defined as recurring, angina-like, chest pain of noncardiac origin. Studies have estimated that gastroesophageal reflux disease (GERD) is the most common contributing factor for NCCP. In patients with non-GERD related NCCP, esophageal motility disorders, and functional chest pain (FCP) of presumed esophageal origin are the main underlying mechanisms for symptoms. Epidemiologic studies show a high prevalence of panic disorder, anxiety and major depression in NCCP patients. The diagnostic esophageal workup starts only after ...
Source: Minerva Cardioangiologica - April 15, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Tricuspid valve surgery: repair and replacement.
Authors: El-Eshmawi A, Dimosthenis P, Tang GH
Abstract
The tricuspid valve has historically received less attention than any other cardiac valve with regard to pathophysiology and surgical management. The tricuspid valve is part of a complex functional apparatus that includes the right atrium, right ventricle, and pulmonary circulation. Functional tricuspid regurgitation is the most common tricuspid valve disease and it occurs secondary to dilatation of tricuspid annulus and/or tethering of valve leaflets from right ventricular dilatation and dysfunction. However, recent expansion in the use of right-sided...
Source: Minerva Cardioangiologica - April 15, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Integrated quadruple stress echocardiography.
Authors: Picano E, Morrone D, Scali MC, Huqi A, Coviello K, Ciampi Q
Abstract
Stress Echocardiography (SE) is an established diagnostic technique. For 40 years, the cornerstone of the technique has been the detection of regional wall motion abnormalities (RWMA), due to the underlying physiologically-relevant epicardial coronary artery stenosis. In the last decade, three new parameters (more objective than RWMA) have shown the potential to integrate and comple- ment RWMA: 1- B-lines, also known as ultrasound lung comets, as a marker of extra-vascular lung water, measured using lung ultrasound with the 4-sit...
Source: Minerva Cardioangiologica - April 15, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Tricuspid valve imaging.
Authors: Ancona F, Stella S, Capogrosso C, Marini C, Fisicaro A, Margonato A, Denti P, Agricola E
Abstract
The right ventricle and tricuspid valve (TV) have long been neglected by cardiologists. Functional tricuspid regurgitation (TR) is nowadays the most common cause of severe TR and is emerging as a prognostic factor in many heart diseases. A multimodality imaging approach is fundamental for defining the pathophysiology of TR, using both 2-dimensional and 3-dimensional (3D) echocardiography, as well as CT scan. In particular, 3D echocardiography can characterize TV apparatus and tricuspid annulus; CT off...
Source: Minerva Cardioangiologica - April 15, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Periprocedural and perioperatory management of patients with tricuspid valve disease.
In conclusion the patients undergoing TV surgery are complex and only a detailed anesthesiological and surgical workup may decrease the perioperative mortality and morbidity.
PMID: 29642696 [PubMed - as supplied by publisher] (Source: Minerva Cardioangiologica)
Source: Minerva Cardioangiologica - April 15, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
New percutaneous interventions in heart failure.
Authors: Moscarella E, Brugaletta S, Sabaté M
Abstract
Chronic heart failure (HF) is one of the main causes of mortality and morbidity worldwide and represents a growing challenge in interventional cardiology. Its prevalence is recently increasing due to the improvements in cardiac care with subsequent significant reduction in the HF acute mortality. HF may occur with either a reduced left ventricular ejection fraction (LVEF) (LVEF<40%, HFrEF) or a preserved EF (typically LVEF≥50%, HFpEF) indicative of diastolic dysfunction. Despite recent advances in drug therapies as well as in nonpharmacological s...
Source: Minerva Cardioangiologica - April 15, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
A review of percutaneous tricuspid valve replacement: orthotopic and heterotopic valves.
Authors: Atianzar K, Zhang M, Gafoor S
Abstract
The tricuspid valve has long been described as the "forgotten valve", leaving tricuspid valve disease relatively neglected. However, the number of people in the United States affected by severe tricuspid regurgitation is growing. Isolated surgery for severe tricuspid regurgitation in the setting of right ventricular heart failure carries a high mortality risk, and therefore, attention to corrective therapies has increased. Because of the different etiologies for tricuspid regurgitation, multiple percutaneous transcatheter options for tricuspid valve repair fo...
Source: Minerva Cardioangiologica - March 29, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Percutaneous coronary intervention risk scores: an overview.
Authors: DE Candia G
Abstract
Percutaneous coronary interventions in patients at high clinical risk with anatomical complexity is one of the most important topics in interventional cardiology. The development of materials and techniques allowed the interventional cardiologist to be able to treat virtually any coronary lesion. The patient's evaluation with clinical and anatomic risk scores allow the physicians to choose the best therapeutic strategy for each individual patient.
PMID: 29589669 [PubMed - as supplied by publisher] (Source: Minerva Cardioangiologica)
Source: Minerva Cardioangiologica - March 29, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Standardization of Impella ®-assisted patient management.
Standardization of Impella®-assisted patient management.
Minerva Cardioangiol. 2018 Mar 28;:
Authors: Sanna T, Battistoni I, Marini M, Valente S
Abstract
The presence of high-risk features on candidates to percutaneous revascularization is increasingly leading to Impella®-assisted procedures (IAPs). While IAPs are safe and effective procedures, they still require managing a degree of complexity. Clinicians often rely on their ability to recall every step of operative procedures. However, during stressful situations, levels of cognitive function are compromised leading to plannin...
Source: Minerva Cardioangiologica - March 29, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Tricuspid valve regurgitation: epidemiology and pathophysiology.
Authors: Topilsky Y
Abstract
Compared with the vast literature concerning the prevalence, pathophysiology, and outcome of left valvular disease, the data concerning tricuspid regurgitation (TR) is very limited. In this review we summarized the present data concerning these important issues. We show that TR is as prevalent as aortic stenosis in the community, with increasing prevalence with age, and much more common in women. We review the present knowledge concerning the pathogenesis of TR, focusing on functional TR. We show that functional TR is multifactorial, resulting from both RV remodeling and pulmon...
Source: Minerva Cardioangiologica - March 29, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
The synergy stent in high-bleeding risk patients: why design matters.
Authors: Chiarito M, Cao D, Cannata F, Panico C, Reimers B, Stefanini GG
Abstract
Antithrombotic management after percutaneous coronary intervention is based on dual antiplatelet therapy (DAPT), that has unequivocally shown to reduce the risk of recurrent ischemic events at cost of an important risk of bleeding. In order to balance ischemic and bleeding risks, DAPT duration should be based on patients and lesions features as well as stent type. Based on these considerations, patients at high bleeding risk (HBR) undergoing PCI represent a challenging subgroup. The Synergy stent (Boston Scientific, Marlborou...
Source: Minerva Cardioangiologica - March 29, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
