Feb-08

This issue of the Journal of Invasive Cardiology includes original research articles, a review article, selections from the journal special section Clinical Images and online case reports which can be found in the archive section on our website, as well as in the new Digital JIC at: www.invasivecardiology.com. I encourage you to visit the website to read these interesting and informative case reports.
In the first research article, submitted by Dr. Robert Huang and colleagues from the Veterans Administration National Quality Scholars Program, the VA Tennessee Valley Healthcare, the Geriatrics Research Education Clinical Center and the Departments of Cardiovascular Medicine, Emergency Medicine and Internal Medicine at Vanderbilt University in Nashville, Tennessee, quality improvement methods to reduce door-to-balloon (D2B) times in an academic medical center environment are described. Utilizing a process flow-chart based on evaluation of historical processes and identification of bottlenecks, they were able to implement evidence-based strategies that resulted in a reduction of D2B time from 108 to 64 minutes.
Next, Dr. Jonathan Marmur and colleagues from the Division of Cardiology and Department of Medicine at the State University of New York, Downstate Medical Center, present data from their study comparing high-dose bolus tirofiban with double-bolus eptifibitide administered during percutaneous coronary intervention (PCI). They found that tirofiban compared favorably with eptifibitide in achieving adequate platelet inhibition safely during PCI. Dr. Tim Fischell of the editorial board has provided a commentary to accompany the article by Dr. Marmur et al.
The next original research paper is from Dr. Salvatore Azzarelli and associates from the Division of Cardiology at the Cannizzaro Hospital and the Clinical Division of Cardiology at the Ferrarotto Hospital in Catania, Italy. They describe their two-year clinical follow up of patients treated with drug-eluting stents who were at high risk for coronary restenosis. Their study demonstrated that initial presence of a total occlusion, the number of lesions treated and age of the patient were associated with higher risk of MACE at 2 years. In the next original research article, Dr. Sanjay Rajdev and associates from the Cardiovascular Institute at Mount Sinai Medical Center in New York, describe their evaluation of the safety and efficacy of the prophylactic use of a percutaneous transseptal ventricular assist device in high-risk PCI using a suture-mediated femoral artery pre-closure technique. In their study of 20 patients, they recorded 1 minor vascular complication and a periprocedural and in-hospital mortality rate of 0%. An insightful commentary on the Rajdev et al paper is provided by Dr. Fayaz Shawl of the journal’s editorial board.
Dr. Gui Fu Wu and associates from the Division of Cardiology at the First Affiliated Hospital, Sun Yat-Sen University in Guangzhou, China, the Division of Cardiology and Cardiac Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School in Boston, and the University of Pittsburgh, present their study in pigs of the effects of Btype natriuretic peptide on coronary epicardial arteries, systemic vasculature and microvessels. They found that intravenous and intracoronary nesiritide did not result in adverse effects on the normal coronary circulation, but had profound effects on microvessels, with potentially beneficial effects on myocardial perfusion at a tissue level.
Also included in this issue of the journal is part 1 of a special Review article provided by Drs. David Rizik, Kevin Klassen and James Hermiller from Scottsdale Healthcare Hospital in Scottsdale, Arizona. In this review (as well as part 2, which will appear in next month’s issue of the journal), Dr. Rizik and colleagues present a thorough analysis of the current techniques and future directions for treatment of bifurcation coronary artery disease, an extremely challenging situation for interventional cardiologists.
This issue of the journal also contains an article from the special section, Clinical Images, edited by Dr. David Rizik. In the article, Drs. Rizwan Siddiqui and Sachinder Hans from the Division of Cardiology and Vascular Surgery at Henry Ford Macomb Hospital in Clinton Township, Michigan, present their approach to successfully treating a patient with a duplicate inferior vena cava using doubleinferior vena cava filter implantation.
This issue of the journal also includes case reports that are published directly online. In the first of these online case reports, Drs. Rohit, Bagga and Talwar from the Department of Cardiology, Post Graduate Medical Education and Research in Chandigarh, India, report on their successful treatment of a patient with a double right coronary artery who presented with an acute inferior wall myocardial infarction.
In the second case report, Drs. Gruenstein, Beekman and Spicer, from the University of Minnesota Children’s Hospital, in Minneapolis, Minnesota, the Department of Pediatrics, at the University of Minnesota Medical School, in Minneapolis, Minnesota, the Cincinnati Children’s Hospital, in Cincinnati, Ohio, and the Department of Pediatrics, at theUniversity of Cincinnati College of Medicine, in Cincinnati, present the case of an adult patient with complex cyanotic congenital heart disease who was successfully treated with a unique combination of PDA stent placement and occlusion of a persistent cavo-atrial connection.
Next, Drs. Hussain, Rusnak and Tam, from St. Boniface General Hospital, University of Manitoba, Winnipeg, Manitoba, Canada, describe an unusual situation in which a detached, partially expanded stent was retrieved using the SpideRX and EnSnare devices. Following the case report by Hussain et al, Drs. Jaime Molden, John Kao, and Atman P. Shah from the Department of Medicine, Division of Cardiology, Harbor- UCLA Medical Center, Torrance, California, and the Hospital of the Good Samaritan, in Los Angeles, present an unusual case involving a young patient who presented with a high-burden thrombus in a large right coronary artery and their successful treatment via thrombectomy and biliary stent deployment.
Next, Dr. Scott Baron and Clifford Nielson, CVT, from the Department of Cardiac Services at Mercy San Juan Medical Center in Carmichael, California, present their approach using double balloon angioplasty for unstentable large-caliber right coronary stenosis. In the next case report, Drs. Attar, Moore and Khan report on a patient who presented with a rare coronary artery anomaly of twin circumflex arteries. Another case report features a report from Drs. Butera, Aime and Carminati from Pediatric Cardiology – Policlinic San Donato IRCCS, Italy, who present three cases in which they used radiofrequency energy and covered stents in managing patients who presented with occluded superior vena cava and needing endocardial pacemaker implantation.
Next, Drs. Cohoon, Howe and McKierman from the Department of Medicine and Division of Cardiology at Loyola University Medical Center in Maywood, Illinois present their management of an immunocompetent patient who presented with primary cardiac diffuse large B-cell lymphoma. Following Cohoon et al, Drs. Collins, Beecroft and Horlick from the Interventional Cardiology Program and Division of Vascular and Interventional Radiology at University Health Network/Toronto General Hospital in Toronto, Canada describe their approach to managing a patient who experienced a complex right subclavian artery dissection during diagnostic cardiac catheterization. And finally, Drs. Mark Walsh, Coin McMahon and Kevin Walsh from the Cardiac Department at Our Lady’s Hospital for Sick Children in Dublin, Ireland, report on their use of an Amplatzer Ductal Occluder device to occlude a residual Sano shunt in an infant with a variant of hypoplastic left heart syndrome. It is my hope that the articles in this issue of the journal provide cardiovascular healthcare professionals with important information that assists them in the effective diagnosis and treatment of patients presenting with cardiovascular disease.

Sincerely,

Richard E. Shaw, PhD, FACC, FACA
Editor-in-Chief