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Eddin MJ, Armstrong EJ, Javed U, Rogers JH. Transradial interventions with the GuideLiner catheter: role of proximal vessel angulation. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2013; 14:275-9. [PMID: 23972538 DOI: 10.1016/j.carrev.2013.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Revised: 07/03/2013] [Accepted: 07/11/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Transradial coronary intervention (TRI) is increasingly common, but anatomic variations and lack of guide catheter support may increase the complexity of TRI. The GuideLiner catheter (Vascular Solutions, Minneapolis,MN) is a guide catheter extension developed to provide increased guide catheter support. We hypothesized that TRI cases requiring GuideLiner support would have a greater proximal vessel angle and increased lesion angle tortuosity. METHODS This was a retrospective study reviewing 146 TRI cases performed at a single institution between August 2010 and June 2012. 22 cases (15%) required use of the GuideLiner support catheter. Procedural and angiographic characteristics of all cases were analyzed. Multivariable analysis and receiver operator curves (ROC) were used to analyze predictors of GuideLiner use. RESULTS The indications for TRI were similar between both groups. Subjects who required use of the GuideLiner support catheter at the time of TRI were significantly older (69±12years vs. 62±13years, p=0.03). The proximal vessel angle was significantly greater in the cases requiring GuideLiner support (74°±35° vs. 37°±23°, p<0.001). Lesion angle in the Guideliner group was also significantly greater (48°±32° vs. 28°±25°, p<0.001). On multivariable analysis, proximal vessel angle independently predicted the need for GuideLiner support (AOR 1.4 per 10°, p<0.001). A 45° proximal vessel angle predicted the need for GuideLiner use with a sensitivity of 73% and specificity of 74% (c-statistic 0.79). None of the Guideliner TRI cases required conversion to femoral access. CONCLUSIONS TRIs requiring GuideLiner catheter support had significantly increased lesion complexity and vessel tortuosity. Proximal vessel angulation is significantly associated with the need for GuideLiner use during transradial intervention. Use of the Guideliner facilitated successful completion of PCI despite the use of a wide variety of guiding catheters in this series.
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Waldo SW, Armstrong EJ, Yeo KK, Patel M, Reeves R, MacGregor JS, Low RI, Mahmud E, Rogers JH, Shunk K. Procedural success and long-term outcomes of aspiration thrombectomy for the treatment of stent thrombosis. Catheter Cardiovasc Interv 2013; 82:1048-53. [DOI: 10.1002/ccd.25007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Revised: 01/29/2013] [Accepted: 05/10/2013] [Indexed: 11/11/2022]
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Foster E, Kwan D, Feldman T, Weissman NJ, Grayburn PA, Schwartz A, Rogers JH, Kar S, Rinaldi MJ, Fail PS, Hermiller J, Whitlow PL, Herrmann HC, Lim DS, Glower DD. Percutaneous Mitral Valve Repair in the Initial EVEREST Cohort. Circ Cardiovasc Imaging 2013; 6:522-30. [DOI: 10.1161/circimaging.112.000098] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Percutaneous repair of mitral regurgitation (MR) permits examination of the effect of MR reduction without surgery and cardiopulmonary bypass on left ventricular (LV) dimensions and function. The goal of this analysis was to determine the extent of reverse remodeling at 12 months after successful percutaneous reduction of MR with the MitraClip device.
Methods and Results—
Of 64 patients with 3 and 4+ MR who achieved acute procedural success after treatment with the MitraClip device, 49 patients had moderate or less MR at 12-month follow-up. Their baseline and 12-month echocardiograms were compared between the group with and without LV dysfunction. In patients with persistent MR reduction and pre-existing LV dysfunction, there was a reduction in LV wall stress, reduced LV end-diastolic volume, LV end-systolic volume and increase in LV ejection fraction in contrast to those with normal baseline LV function, who showed reduction in LV end-diastolic volume, LV wall stress, no change in LV end-systolic volume, and a fall in LV ejection fraction.
Conclusions—
Patients with pre-existing LV dysfunction demonstrate reverse remodeling and improved LV ejection fraction after percutaneous mitral valve repair.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifiers: NCT00209339, NCT00209274.
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Rogers JH, Goldstein I, Rocha-Singh KJ. Reply: To PMID 23177300. J Am Coll Cardiol 2013; 61:2569-70. [PMID: 23542101 DOI: 10.1016/j.jacc.2013.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 03/12/2013] [Indexed: 12/01/2022]
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Armstrong EJ, Rogers JH, Swan CH, Upadhyaya D, Viloria E, McCulloch C, Slater J, Qureshi M, Williams J, Whisenant B, Feldman T, Foster E. Echocardiographic predictors of single versus dual MitraClip device implantation and long-term reduction of mitral regurgitation after percutaneous repair. Catheter Cardiovasc Interv 2013; 82:673-9. [DOI: 10.1002/ccd.24645] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 08/28/2012] [Indexed: 11/11/2022]
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Balwanz CR, Javed U, Singh GD, Armstrong EJ, Southard JA, Wong GB, Yeo KK, Low RI, Laird JR, Rogers JH. Transradial and transfemoral coronary angiography and interventions: 1-year outcomes after initiating the transradial approach in a cardiology training program. Am Heart J 2013; 165:310-6. [PMID: 23453098 DOI: 10.1016/j.ahj.2012.10.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Accepted: 10/03/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Limited data are available regarding the safety and feasibility of initiating transradial (TR) diagnostic coronary angiography (CA) and percutaneous coronary intervention (PCI) in cardiology fellowship programs. METHODS From July 2010 to June 2011, University of California, Davis Medical Center, adopted the TR approach with supervised cardiology fellows as the primary operators. Procedural variables and clinical outcomes of TR and transfemoral (TF) procedures were compared. To minimize confounding variables, ST-elevation myocardial infarction, bypass graft interventions, chronic total occlusions, and procedures with concomitant right heart catheterizations were excluded. To reflect the learning curve of the TR approach, this experience was assessed in 2 sequential 6-month periods. RESULTS A total of 402 diagnostic CAs and 255 PCIs were included. Transradial access was used in 141 (35%) of the CAs and in 72 (28%) of PCIs. Within the TR-CA and TF-CA (n = 261) groups, there was no difference between fluoroscopy (10.4 ± 6.0 vs 11.0 ± 8.9, P = .63) or procedure (31.8 ± 11.5 vs 33.2 ± 13.8, P = .55) time throughout the academic year with a significant trend toward lower contrast use (128 ± 52 vs 110 vs 50, P = .04) by the second half. In addition, during the second half of the academic year, the TR-CA showed significantly higher fluoroscopy (11.0 ± 8.9 vs 6.7 ± 6.8, P = .001) and procedure (33.2 ± 13.8 vs 27.2 ± 11.6, P = .0015) times when compared with TF-CA. Transfemoral PCI (n = 183) and TR-PCI showed no significant difference between all fluoroscopy and procedure time and contrast use when comparing the 2 halves of the academic year. When comparing TF with TR within each academic half year, there was no difference within the PCI group. Vascular complications were less with the TR approach. Overall procedural success rates were high, and there were low rates of crossover and periprocedural complications in both the TR and the TF groups. CONCLUSION A TR approach is safe for CA and PCI when performed by supervised operators in training. Although the learning curve for trainees appears slower for TR-CA compared with TF-CA, cardiology fellowship training programs should be encouraged to adopt TR procedures as part of their curriculum.
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Rogers JH, Goldstein I, Kandzari DE, Köhler TS, Stinis CT, Wagner PJ, Popma JJ, Jaff MR, Rocha-Singh KJ. Zotarolimus-Eluting Peripheral Stents for the Treatment of Erectile Dysfunction in Subjects With Suboptimal Response to Phosphodiesterase-5 Inhibitors. J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.08.1016] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Armstrong EJ, Kwa AT, Yeo KK, Mahmud E, Javed U, Patel M, Shunk KA, MacGregor JS, Low RI, Rogers JH. Angiographically confirmed stent thrombosis in contemporary practice: insights from intravascular ultrasound. Catheter Cardiovasc Interv 2012; 81:782-90. [PMID: 22511567 DOI: 10.1002/ccd.24460] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 04/13/2012] [Indexed: 11/05/2022]
Abstract
OBJECTIVE We hypothesized that patients presenting with stent thrombosis (ST) have a high prevalence of stent underexpansion and malapposition when assessed by intravascular ultrasound (IVUS). BACKGROUND IVUS can provide mechanistic insight into mechanical factors, including stent underexpansion, malapposition, and fracture that may predispose to ST. METHODS All consecutive cases of angiographically confirmed ST from a multicenter registry (from 2005 to 2010) were reviewed. All IVUS images were reviewed off-line for the presence of stent underexpansion, malapposition, and fracture. Kaplan-Meier analysis was used to determine whether use of IVUS at the time of ST was associated with long-term mortality and major adverse cardiovascular events. RESULTS IVUS was performed in 32 of 173 subjects with ST (18%). Stent underexpansion was present in 82% of cases and in all cases of early ST, with a mean stent expansion of 0.7 ± 0.23 by MUSIC criteria. Stent malapposition was most frequently observed in very late ST (40%). In-hospital mortality was similar between subjects who had IVUS performed at the time of ST when compared with the non-IVUS group (3.2% vs. 4.3%, P = 0.8). Subjects who had IVUS performed at the time of ST had lower rates of mortality (HR 0.4, 95% CI 0.1-1.6, P =0.2) and major adverse cardiovascular events (HR 0.5, 95% CI 0.2-1.4, P =0.2) at follow-up, but these values were not statistically significant. CONCLUSIONS There is a high prevalence of stent underexpansion in early ST, while the prevalence of malapposition is higher in very late ST. Use of IVUS during treatment for ST may identify mechanisms underlying the development of ST.
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Armstrong EJ, Kwa AT, Bhat A, Romick B, Smith T, Rogers JH. Intracardiac echocardiography to guide percutaneous closure of atrial baffle defects. THE JOURNAL OF INVASIVE CARDIOLOGY 2012; 24:473-476. [PMID: 22954570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Patients with complex congenital heart disease may require surgical construction of interatrial baffles to shunt blood between atria. Long-term complications of these procedures may include stenosis or leak of the baffle, typically along the suture line. There are limited data on transcatheter management and intraprocedural imaging of these anatomically complex lesions. METHODS We describe three cases of adults who each presented with baffle leaks more than 20 years after surgical construction of an atrial baffle. In each case, intracardiac echocardiography was essential for intraprocedural guidance, sizing of the defect, and successful percutaneous deployment of an Amplatzer septal occluder device to close the baffle leak. RESULTS AND CONCLUSIONS One patient had a baffle leak along the inferior surface of the baffle suture line; the second patient had a baffle leak along the superior border with the left atrium; the third patient had a leak along the sutures of surgical shunt for an anomalous pulmonary vein. Percutaneous closure was successful in all cases, with deployment of an Amplatzer occluder device in each case. Intracardiac echocardiography may be may be useful for procedural guidance during percutaneous closure of atrial baffle defects.
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Javed U, Levisman J, Rogers JH. A tale of two balloons: assessment of hemodynamics with atrial septal defect temporary balloon occlusion. THE JOURNAL OF INVASIVE CARDIOLOGY 2012; 24:248-249. [PMID: 22562924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We describe two cases in which temporary balloon occlusion (TBO) was used to determine the suitability of atrial septal defect (ASD) closure. These cases underscore the utility of TBO in select patients undergoing percutaneous closure of ASDs.
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Armstrong AW, Harskamp CT, Ledo L, Rogers JH, Armstrong EJ. Coronary artery disease in patients with psoriasis referred for coronary angiography. Am J Cardiol 2012; 109:976-80. [PMID: 22221950 DOI: 10.1016/j.amjcard.2011.11.025] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 11/11/2011] [Accepted: 11/11/2011] [Indexed: 11/30/2022]
Abstract
Patients with psoriasis may have an increased risk of cardiovascular disease and myocardial infarction. The aim of this study was to investigate whether psoriasis is associated with an increased prevalence of coronary artery disease (CAD) independent of established cardiovascular risk factors in patients undergoing coronary angiography. A retrospective cohort analysis was performed by linking records of all patients undergoing coronary angiography from 2004 through 2009 with dermatology medical records. From an overall cohort of 9,473 patients, we identified 204 patients (2.2%) with psoriasis before coronary angiography. Patients with psoriasis had higher body mass index (31.3 ± 8.1 vs 29.3 ± 7.1 kg/m(2), p <0.001) but the prevalence of other risk factors was similar. Median duration of psoriasis before cardiac catheterization was 8 years (interquartile range 2 to 24). Patients with psoriasis were more likely to have CAD (84.3% vs 75.7%, p = 0.005) at coronary angiography. After adjusting for established cardiovascular risk factors, psoriasis was independently associated with presence of angiographically confirmed CAD (adjusted odds ratio 1.8, 95% confidence interval 1.2 to 2.8, p = 0.006). In patients with psoriasis, duration of psoriasis >8 years was also independently associated with angiographically confirmed CAD after adjusting for established cardiovascular risk factors (adjusted odds ratio 3.5, 95% confidence interval 1.3 to 9.6, p = 0.02). In conclusion, patients with psoriasis and especially those with psoriasis for >8 years have a higher prevalence of CAD than patients without psoriasis undergoing coronary angiography.
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Smith T, McGinty P, Bommer W, Low RI, Lim S, Fail P, Rogers JH. Prevalence and echocardiographic features of iatrogenic atrial septal defect after catheter-based mitral valve repair with the mitraclip system. Catheter Cardiovasc Interv 2012; 80:678-85. [DOI: 10.1002/ccd.23485] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 11/12/2011] [Indexed: 01/01/2023]
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Javed U, Smith TW, Rogers JH. Percutaneous repair of anterior mitral leaflet perforation. THE JOURNAL OF INVASIVE CARDIOLOGY 2012; 24:134-137. [PMID: 22388309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 59-year-old male underwent coronary artery bypass grafting and mitral ring annuloplasty 4 years ago. The procedure was complicated by sternal wound infection. Recently, he presented with multiple admissions for decompensated heart failure with volume overload and pulmonary edema. He was found to have severe mitral regurgitation (MR) and transesophageal echocardiography (TEE) demonstrated severe MR through an anterior mitral leaflet perforation. Due to high surgical risk, he was referred for transcatheter repair of his mitral valve. This case illustrates the first reported use of an Amplatzer atrial septal occluder device for percutaneous mitral leaflet repair using three-dimensional TEE guidance after prior surgical mitral ring annuloplasty repair.
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Rogers JH, Rocha-Singh KJ. Endovascular Therapy for Vasculogenic Erectile Dysfunction. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2012; 14:193-202. [DOI: 10.1007/s11936-012-0171-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Armstrong EJ, Feldman DN, Wang TY, Kaltenbach LA, Yeo KK, Wong SC, Spertus J, Shaw RE, Minutello RM, Moussa I, Ho KK, Rogers JH, Shunk KA. Clinical Presentation, Management, and Outcomes of Angiographically Documented Early, Late, and Very Late Stent Thrombosis. JACC Cardiovasc Interv 2012; 5:131-40. [DOI: 10.1016/j.jcin.2011.10.013] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 10/19/2011] [Accepted: 10/28/2011] [Indexed: 01/21/2023]
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Armstrong EJ, Yeo KK, Javed U, Mahmud E, Patel M, Shunk KA, MacGregor JS, Low RI, Rogers JH. Angiographic Stent Thrombosis at Coronary Bifurcations. JACC Cardiovasc Interv 2012; 5:57-63. [DOI: 10.1016/j.jcin.2011.09.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 09/03/2011] [Indexed: 01/18/2023]
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Rogers JH, Bolling SF. Editorial comment: Surgery after MitraClip therapy: you can't win them all. Eur J Cardiothorac Surg 2011; 40:1526-8. [PMID: 21664143 DOI: 10.1016/j.ejcts.2011.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Revised: 04/20/2011] [Accepted: 04/21/2011] [Indexed: 11/29/2022] Open
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Rogers JH, Bolling SF. Valve repair for functional tricuspid valve regurgitation: anatomical and surgical considerations. Semin Thorac Cardiovasc Surg 2011; 22:84-9. [PMID: 20813323 DOI: 10.1053/j.semtcvs.2010.05.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2010] [Indexed: 12/31/2022]
Abstract
Functional tricuspid regurgitation (TR) primarily arises from asymmetric dilation of the tricuspid annulus in the setting of right ventricular dysfunction and enlargement in response to left-sided myocardial and valvular abnormalities. Even if TR is not severe at the time of mitral valve surgery, TR can worsen and even appear late after successful mitral valve surgery, which portends a poor prognosis. Despite data demonstrating inferior outcomes in the presence of residual TR, surgical repair for functional TR remains underused. However, "benign neglect" of TR, especially in the presence of tricuspid annular dilation, is unacceptable. Surgical repair should consist of placement of a rigid or semirigid annular ring, which has been shown to provide superior durability compared with suture and flexible band-based therapies. Finally, minimally invasive and percutaneous approaches for correcting functional TR may increase the delivery of therapy and allow treatment of patients with recurrent TR at high risk for reoperation.
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Rogers JH, Franzen O. Percutaneous edge-to-edge MitraClip therapy in the management of mitral regurgitation. Eur Heart J 2011; 32:2350-7. [PMID: 21606080 DOI: 10.1093/eurheartj/ehr101] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
MitraClip therapy consists of percutaneous edge-to-edge coaptation of the mitral leaflets that is analogous to the surgical Alfieri technique. The safety profile of the MitraClip device is favourable, and survival outcomes in high-surgical-risk patients are superior to historical controls. However, questions remain regarding long-term efficacy and durability. In the U.S.A., the MitraClip device has been studied in a safety and feasibility trial, a randomized pivotal trial against surgical mitral valve repair, and a non-randomized high-risk registry. In addition, the MitraClip now has over 2 years of CE-mark approval and a rapidly expanding clinical experience in Europe, primarily in patients at high risk for surgery. A dedicated multidisciplinary team is necessary, as well as thoughtful patient selection, familiarity with the technical aspects of the procedure including transesophageal ultrasound imaging and post-procedure monitoring. Currently available clinical data are herein reviewed, with emphasis on the current role of MitraClip therapy in relation to existing surgical techniques. Since the MitraClip procedure is still relatively new, continued investigation is required to further define patient populations that will benefit most.
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Yeo KK, Mahmud E, Armstrong EJ, Bennett WE, Shunk KA, MacGregor JS, Li Z, Low RI, Rogers JH. Contemporary clinical characteristics, treatment, and outcomes of angiographically confirmed coronary stent thrombosis: Results from a multicenter California registry. Catheter Cardiovasc Interv 2011; 79:550-6. [DOI: 10.1002/ccd.23011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Accepted: 01/20/2011] [Indexed: 11/06/2022]
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McGinty PM, Smith TW, Rogers JH. Transseptal left heart catheterization and the incidence of persistent iatrogenic atrial septal defects. J Interv Cardiol 2011; 24:254-63. [PMID: 21545526 DOI: 10.1111/j.1540-8183.2011.00630.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Access to the left atrium for invasive and interventional cardiac procedures requires a transseptal (TS) puncture that creates an iatrogenic atrial septal defect (iASD). The utilization of TS access is increasing in cardiology, and the frequency of iASD is, therefore, likely to increase as well. Here, we discuss the TS technique, review existing series of iASD with regard to incidence and clinical significance of residual iASD, and present emerging techniques utilizing TS access where iASD may result. METHODS AND RESULTS A PubMed search for "iatrogenic atrial septal defects" was performed to identify prospective series addressing the incidence of iASDs after TS procedures. We identified 10 series with primary attention to iASD. Cases involving TS access included electrophysiology ablation procedures, atrial appendage closure, and percutaneous balloon mitral valvuloplasty. Immediate postprocedural incidence of iASD was as high as 87%, with decreased incidence of residual iASD detected over time. At 18 months of follow-up, up to 15% of iASD cases persisted. Residual iASDs were not associated with clinical sequelae of embolism, cyanosis, or right heart failure. CONCLUSIONS iASDs are frequent following TS access and a majority resolve over time. Available evidence suggests iASDs are well tolerated but late term follow-up is limited. With the increased utilization of TS transcatheter procedures, the frequency and size of iASDs may rise. Understanding the rare but serious clinical implications of iASD and the need for systematic surveillance in the future is warranted.
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Feldman DN, Armstrong EJ, Wang TY, Kaltenbach LA, Yeo KK, Spertus J, Wong SC, Minutello RM, Moussa I, Shaw R, Rogers JH, Shunk KA. PRESENTATION TREATMENT AND OUTCOMES OF EARLY LATE AND VERY LATE STENT THROMBOSIS: A REPORT FROM THE AMERICAN COLLEGE OF CARDIOLOGY NATIONAL CARDIOVASCULAR DATA REGISTRY®. J Am Coll Cardiol 2011. [DOI: 10.1016/s0735-1097(11)61103-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Armstrong EJ, Swan CH, Upadhyaya D, Garg R, Rogers JH, Foster E, Feldman T. MITRAL VALVE PATHO-ANATOMIC PREDICTORS OF THE NUMBER OF MITRACLIP DEVICES IMPLANTED FOR PERCUTANEOUS REPAIR OF MITRAL REGURGITATION. J Am Coll Cardiol 2011. [DOI: 10.1016/s0735-1097(11)61686-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Armstrong EJ, Swan CH, Upadhyaya D, Garg R, Rogers JH, Feldman T, Foster E. TRANSESOPHAGEAL ECHOCARDIOGRAPHIC CHARACTERIZATION OF MITRAL VALVE PATHOLOGY IN SUBJECTS WITH DEGENERATIVE MITRAL REGURGITATION UNDERGOING PERCUTANEOUS REPAIR WITH THE MITRACLIP DEVICE. J Am Coll Cardiol 2011. [DOI: 10.1016/s0735-1097(11)61388-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rogers JH, Karimi H, Kao J, Link D, Javidan J, Yamasaki DS, Dolan M, Laird JR, Low RI. Internal pudendal artery stenoses and erectile dysfunction: Correlation with angiographic coronary artery disease. Catheter Cardiovasc Interv 2010; 76:882-7. [PMID: 20928837 DOI: 10.1002/ccd.22646] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Accepted: 05/03/2010] [Indexed: 12/21/2022]
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