Feb-06

Dear Readers, This issue of the Journal of Invasive Cardiology includes several interesting research articles, commentaries and selections from the Journal’s special sections, Adjunctive Therapy, Pediatric Intervention, and Clinical Images. Our February case reports can be found on www.invasivecardiology.com. I encourage you to visit our online version to read the informative articles we have chosen to complete this issue. The first research article by Dr. Shaun Senter and associates from Rush University, provides their cost analysis of embolic complications and strategies for distal embolic protection during PCI of saphenous vein grafts. They found that the selective use of distal protection in vein grafts was effective compared to routine use, and selective use resulted in a 50% reduction in overall costs compared to the routine strategy. Next, Drs. Chi Hang Lee and associates from the National University Hospital in Singapore, report on their single-center study comparing the use of Cypher and Taxus drug-eluting stents for the treatment of bifurcation lesions. They demonstrated that both stents had similar procedural success rates and 30-day outcomes. Dr. James Hermiller has provided a commentary on this topic. Dr. Marc Cohen, from Newark Beth Israel Medical Center, and colleagues from the University of São Paulo Medical School, assess the feasibility of immediate sheath removal after PCI in patients given a single low-dose IV enoxaparin bolus as the primary anticoagulation therapy. Most patients’ sheaths could be removed immediately after PCI, but many had anti-Xa levels below what was considered to be therapeutic after the injection. In the next original article, Dr. Luis Gruberg and collaborators from the Rambam Medical Center, present their study assessing the effect of GP IIb/IIIa Inhibitor therapy in patients undergoing PCI for failed thrombolytic therapy. They found that the use of GP IIb/IIIa inhibitors was safe in this setting, and that this approach may have beneficial effects on 30-day event-free survival. Drs. John Young and Dean Kereiakes have provided the commentary to accompany this study. Our next original article is also an Interventional Pediatric section contribution. Dr. S. Harikrishnan and collaborators present their study evaluating long-term results in patients undergoing percutaneous transvenous mitral commissurotomy using a metallic commissurotome. They demonstrate that this approach is safe and produces good results. In the last original research paper, Dr. Kursad Tokel and colleagues from Baskent University, describe their use of sequential balloon dilatation for combined aortic valvular stenosis and coarctation of the aorta during a single catheterization procedure. They achieved very favorable results, with no severe complications during the procedure and no deaths during the early period following the intervention. In the Adjunctive Therapy section, Dr. Ron Waksman from the Washington Hospital Center highlights the concepts, material designs, preclinical and clinical experimental studies with bioabsorbable stents. In Clinical Images this month, Dr. Srihari Naidu describes a novel intracoronary steerable support catheter for complex coronary intervention. In addition, we have also included an interesting collection of images from Drs. Low, Pomerantsev and Ferrell on saphenous vein graft rheology which appears to be a thrombotic lesion. In the first of our Online Case Reports, Drs. Spargias, Kariofyllis and Mavrogeni describe their use of PCI in anomalous right coronary arteries arising from the left sinus of Valsalva. In the next case report, Drs. El-Bialy, Shenoda and Carang report on their use of cyproheptadine in the treatment of refractory coronary vasospasm following the placement of a drug-eluting stent. In the third case report, Drs. Zagol, Book and Krasuski discuss their evaluation of a patient with adult-form scimitar syndrome who presented with infantile complications. Drs. Sirker, Hyde and Hildick-Smith describe their successful percutaneous treatment of refractory hypoxemia that occurred following mitral valve surgery. In the next case report, Drs. Huizar, Awasthi and Kozman describe three cases of fibromuscular dysplasia that presented with acute myocardial infarction and discuss possible pathophysiologic mechanisms that may be responsible for the acute coronary syndrome. Drs. Zambrano, De la Hera and De Marchena describe a case of primary angioplasty and stenting in a patient with dextrocardia and situs inversus and the electrocardiographic correlation of successful myocardial reperfusion. In the last case report, Dr. William van Gaal presents his late clinical, angiographic and IVUS follow up of a patient with a spontaneous coronary dissection treated with drug-eluting stents. In our Rapid Communication article, Dr. Ashish Awasthi and colleagues report on the successful treatment of the popliteal and superficial femoral arteries using retrograde access of the dorsalis pedis artery. And finally, an editorial from Dr. Mezzapelle and colleagues cautions Journal readers about the importance of relying on demonstrated efficacy when treating coronary bifurcation disease. It is my hope that each of the articles in this issue of the Journal provides cardiovascular healthcare professionals with information that improves the daily care of their cardiac patients. Sincerely, Richard E. Shaw, PhD, FACC, FACA Editor-in-Chief