Feb-04

Dear Readers, Our February 2004 issue of the Journal of Invasive Cardiology includes a diverse mix of articles including original research articles, case reports, case reports with brief literature reviews, and articles from the journal special sections "Acute Coronary Syndromes, Clinical Decision Making and Clinical Images. Dr. Philip Wong and colleagues from the Division of Cardiology and Department of Medicine and Therapeutics at the Prince Wales Hospital, Chinese University of Hong Kong in Hong Kong, People’s Republic of China report on their study of recanalization of chronic total occlusions after conventional guidewire failure using guided optical coherent reflectometry facilitated by radiofrequency energy ablation. They demonstrated a very high success rate in these very complex coronary lesions. Dr. Nicholas Shammas of the journal editorial board has provided a commentary to accompany this article. Dr. Carlos Cafri and collaborators from the Cardiology Department at the Soroka Medical Center and Faculty of Health Sciences, Ben Gurion University in Beer Sheva, Israel present their findings comparing ACS patients who present with angiographically documented thrombus and are treated immediately versus those who have PCI delayed. They found that those who received delayed PCI had much better outcomes. Dr. Francesco Saia and colleagues from the Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center in Rotterdam, The Netherlands, review the long-term outcome of patients having PCI after failed brachytherapy. They report that this approach yields reasonably good long term outcomes in this complex pathologic process. The initial experience using the Ikari guide catheter for transradial coronary intervention is reported by Dr. Yuji Ikari and associates from the Division of Cardiology at Mitsui Memorial Hospital in Tokyo, Japan. They showed that very high success rates and low complication rates are achievable using the Ikari guide catheter. In our special section on acute coronary syndromes, edited by Dr. Lloyd Klein from Rush Presbyterian Medical Center in Chicago, Dr. David S. Lee and colleagues from the Cleveland Clinic Foundation have submitted the results of a study done at the clinic evaluating the combination of enoxaparin, glycoprotein IIb/IIIa inhibitors and an early invasive approach in the treatment of acute coronary syndrome patients. The authors have provided an excellent discussion of the current status of research in this area. Dr. James Hermiller from St. Vincent Hospital in Indianapolis, Indiana and a member of the journals advisory board has provided a commentary discussing this exciting area of research. Several case reports and two case reports with and without brief reviews of the literature are included this month. Dr. Nicolas Shammas and collaborators from the Genesis Heart Institute and River Valley Healthcare in Davenport, Iowa and the University of Iowa Hospitals and Clinics in Iowa City describe their successful management of a patient with a late protrusion of the umbrella of a CardioSeal device following closure of the patent foramen ovale. Dr. Italo Porto and colleagues from the Department of Cardiology, John Radcliff Hospital in Oxford and the Universita Cattolica del Sacro Cuore in Roma, Italy report on a case in which a spontaneous dissection of the left anterior descending artery occurred in an otherwise healthy post-menopausal woman. She was successfully treated when two drug-eluting stents implanted with IVUS guidance. Dr. Steven Siu-lung Li and associates from the Division of Cardiology and Department of Medicine at Queen Elizabeth Hospital in Kowloon, Hong Kong present the results of their study examining the treatment of long diffuse in-stent restenosis using the Sirolimus-eluting stent. They show that good results can be achieved in this challenging clinical situation. An unusual case in which a patient developed isolated right-sided pulsus alternans as a result of a stuck prosthetic valve is described by Akram Abu-Ful and colleagues from the Cardiology Department at Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University in Beer-Sheva, Israel. Surgical intervention was successful in treating this rare condition. A complex case in which cutting balloon angioplasty was successfully used for a bifurcated lesion jailed by a NIR stent is described by Drs. Kawamura, Asakura, and Okabe from Keio University School of Medicine in Tokyo, Japan. We have also included a case from Drs. Cardozo, Rihani and Moukahal from the Service de Cardiologie, Centre Hospitalier Saint Philibert in Lomme Cedex, France describing a patient with an AMI due to left main compression by aortic dissection that was successfully treated by direct stenting. In addition, they review this clinical situation and discuss various treatment approaches. The last case report, submitted by Drs. Brendan Doyle and Craig Philip Juergens from the Departments of Cardiology at Mater Misericordiae Hospital in Dublin, Ireland and Liverpool Health Service in Liverpool, Australia, describe their conservative approach to managing a patient who developed a dissection into the ascending aorta following an unsuccessful effort to recanalize a vessel complicated by a coronary dissection during PCI. The authors present a review of the literature which suggests that surgical intervention has been the treatment of choice in this situation, although the patient from this case, who had a very high surgical risk, fared well with conservative management . Dr. Michael Sketch from Duke University has selected an interesting case from the Cardiac Interventional Unit at San Giovanni Bosco Hospital in Torino, Italy for the Clinical Decision Making section. Drs. Vito Paolillo and Daniela Gastaldo describe a patient presenting with AMI that was treated initially with full dose abciximab and recombinant tPA, but later was found to have extensive thrombosis and required intervention in the catheterization laboratory. Drs. Ramsdale, Werner and Bhatt from the journal editorial board have offered their individual approaches to this case situation. Dr. David Rizik from the Scottsdale Heart Group in Scottsdale, Arizona has selected a case for the Clinical Images section in which a severe narrowing of the LMCA may have been due to catheter-induced spasm. The case and the accompanying images were submitted by Drs. Umesh Arora of the University of South Florida, Tampa, Florida and Meeney Dhir of the Baylor College of Medicine in Houston, Texas. We are pleased to provide a CME Offering this month which discusses the off-label use of brachytherapy for treating in-stent restenosis occuring in saphenous vein grafts. In the Electrophysiology Corner, a case in which three-dimensional noncontact mappping catheters facilitated ectopic left atrial tachycardia ablation is presented by Drs. Todd Cohen, George Juang and Ramesh Daggubati. It is my hope that the articles in this issue of the journal provide cardiovascular specialists with new perspectives for meeting the challenges they face in the daily treatment of patients with cardiovascular disease. Sincerely, Richard E. Shaw, PhD, FACC Editor-In-Chief