Jan-07

Dear Readers, This issue of the Journal of Invasive Cardiology includes six original research articles, a review article, three submissions for Rapid Communication, two Clinical Images, and seven online case reports. These case reports can be found on our website (www.invasivecardiology.com). I encourage you to visit the website to read these interesting and informative case reports. The first research article was submitted by Dr. Shahrzad Shareghi and collaborators from Harbor UCLA Medical Center and Good Samaritan Hospital in Torrance, California. They describe their results in performing balloon aortic valvuloplasty in high-risk patients. They demonstrate that these patients have acceptable short- and long-term outcomes, especially in light of their initial presentation as poor surgical risks and their high rate of cardiogenic shock. In the next original article, Dr. Jang-Young Kim and colleagues from the Wong College of Medicine, Bonsai University in Wong, Kangwon Province, South Korea, describe their analysis of the effect of eutectic mixture of local anesthetic cream on wrist pain during transradial coronary procedures. In this placebo-controlled study, they showed that the cream was effective in reducing pain, especially when applied 1 to 3 hours prior to the procedure. Next, Dr. Yuji Oikawa and associates from the Department of Cardiology and The Cardiovascular Institute in Tokyo, Japan, report on the acute and late follow up outcomes of directional coronary atherectomy using the Flexi-Cut device for treatment of proximal LAD lesions and the influence of this treatment on left circumflex ostial sites. They found a low recurrence rate at the proximal LAD site and no manifestation of stenoses in the ostial portion of the left circumflex artery. In the next original research article, Dr. Ronald Lo and co-authors from Winthrop-University Hospital describe the occurrence of electrocautery-induced ventricular tachycardia and fibrillation during device implantation and explantation over a five and a half year experience. They describe the factors related to the occurrence of this electrical disturbance and propose the mechanisms of action that may cause it. In the next original contribution, Dr. Sergey Yalonetsky and associates from the Rambam Medical Center in Haifa, Israel, present their study looking at the use of coronary angiography in patients undergoing transcatheter closure of interatrial shunt. They found that use of coronary angiography in patients with suspected coronary disease provided valuable information that altered the ultimate course of treatment. In the last original research article, Farhan Aslam and colleagues from Geisinger Medical Center in Danville, Pennsylvania, investigate the feasibility of safely performing percutaneous patent foramen ovale closure for recurrent cryptogenic stroke and transient ischemic attack outside of the high-volume centers in which the major U.S. studies have been performed. They conclude that low-volume PFO closure (15 per year) can be performed safely and effectively in a moderate-volume interventional laboratory with good short-term clinical results. Dr. Bernhard Meier from the Swiss Cardiovascular Center Bern, and a member of the JIC editorial advisory board, has provided a commentary to accompany the Aslam article and discusses the relative safety of performing PFO closure at low-volume centers. Several important and current topics are featured in this issue of the journal as part of the Rapid Communication section. The first paper, submitted by Dr. Inigo Lozano and colleagues from the Department of Cardiology, Hospital Central Asturias in Oviedo, Spain, presents data on their study of patients who have had drug-eluting stents placed in bifurcation lesions using the balloon-crush technique and 6 Fr guiding catheters via radial access. They report that initial success was achievable in this high-risk group, but there were significant events that occurred over the first year of follow up, suggesting that the approach should be used cautiously. In the second, Dr. Nicolas Shammas from Genesis Heart Institute in Davenport, Iowa, proposes a new, simplified classification system for trifurcation coronary artery disease and describes methodologies to treat the various presentations of a complex atherosclerotic process. In the third Rapid Communication, Drs. Laurence Schneider and Gary Roubin from Lenox Hill Hospital in New York, New York provide a case that demonstrates the concept that carotid stenting can be done with minimal amounts of contrast, which is extremely important for patients presenting with renal insufficiency. Also included in this issue of the journal is a special review article from Dr. Rajiv Sankaranarayanan and collaborators from Taunton and Somerset Hospital in Taunton, United Kingdom and the Aintree Cardiac Centre. This review focuses on the occurrence of stroke as a result of cardiac catheterization, presenting mechanisms as to why it occurs, ways to prevent it and current management strategies that improve the outcomes of patients who experience stroke. This issue of the journal contains two articles from the special section Clinical Images, edited by Dr. David Rizik from the Scottsdale Heart Group at Scottsdale Healthcare Hospital in Scottsdale, Arizona. Dr. Emmanouil Brilakis and colleagues from the Dallas VA Medical Center in Dallas, Texas, present an unusual occurrence of stent deformation caused by catheter advancement through a recently deployed self-expanding stent. They have also provided a brief discussion of the mechanisms for this occurrence and its management. In addition, Spyros Kokolis and colleagues from the Department of Cardiology, SUNY Downstate Medical Center at Brooklyn, Brooklyn, New York, present images from a case of coronary air embolism in a 62-year-old woman undergoing PCI along with a discussion about how to avoid this serious complication during cardiac catheterization. This issue of the journal also includes case reports that are published online. Drs. Gumina, Callahan and Murphy from the Mayo Clinic in Rochester, Minnesota, have provided an unusual case of an adult who presented with a rare congenital abnormality, Bland-White-Garland syndrome, which is an unusual occurrence if surgical intervention is not done in childhood. In the next case report, Drs. Minden, Just and Butter from the Heart Center Bernau in Bernau, Germany, describe their approach to managing a rare complication of cardiac bypass surgery in which a large pseudoaneurysm developed in the left anterior descending artery post surgery. Their treatment utilizing a PTFE-coated coronary stent and coil embolization was successful. Drs. Jim, Ho and Chow from Grantham Hospital in Hong Kong report on their use of a sirolimus-eluting stent using the “sleeve” technique to successfully treat a double-bifurcation lesion. In the next case report, Dr. Manu Rajachandran and colleagues from the Deborah Heart and Lung Center in Browns Mills, New Jersey, describe their successful management of an iatrogenic pseudoaneurysm using a covered stent graft. Drs. Trehan, Girish and Gupta from GB Pant Hospital and MAM College in New Delhi, India, present a unique case in which they used a monorail catheter to deliver bailout abciximab in a situation of stent thrombosis. Next, Dr. Hideaki Kaneda and colleagues from the Shonan Kamakura General Hospital and Stanford University, report their use of the retrograde approach via a collateral vessel to successfully treat a chronic total occlusion in an anomalous right coronary artery. In the last case report, Drs. Rajdev, Hillegass and Misra from the University of Alabama at Birmingham, report the first successful use of the Tandem Heart™ to support a high-risk percutaneous balloon aortic valvuloplasty case, and also the first use of bivaluridin as the periprocedural antithrombin agent. 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 management of cardiovascular patients. Sincerely, Richard E. Shaw, PhD, FACC, FACA Editor-in-Chief