COMPLEX HIGH RISK CORONARY INTERVENTION. John Michael Chua Chiaco, MD, FACC Iowa Heart Center Fort Dodge
|
|
|
- Tabitha Day
- 6 years ago
- Views:
Transcription
1 COMPLEX HIGH RISK CORONARY INTERVENTION John Michael Chua Chiaco, MD, FACC Iowa Heart Center Fort Dodge
2 OBJECTIVES Determine how to risk stratify patients undergoing PCI Understand the concept of complex coronary interventions
3 COMPONENTS OF RISK STRATIFICATION FOR PCI / CABG Clinical characteristics Coronary anatomy variables Personal preferences
4 EXAMPLES OF RISK MODELS Risk Model Number of Variables Validated in PCI/CABG Clinical / Angiographic PCI CABG EuroScore Mayo Clinic RS ACEF NCDR AHA/ACC SYNTAX STS Global Risk Class Clinical Syntax Textbook of Interventional Cardiology, 6 th Edition, Topol E., Teirstein P.
5 THE ADDITIVE EUROSCORE (CLINICAL) PATIENT FACTORS CARDIAC FACTORS Age (per 5>60) 1 Unstable angina 2 Female 1 Endocarditis 3 Lung disease 1 Critical pre-op state 3 Extracardiac arteriopathy 1 LVEF 30-50% 1 Neurologic dysfunction 2 LVEF <30% 3 Redo CABG 3 Recent MI 2 Creatinine > 200 micrmol/l 2 Systolic PAP > 60 mmhg 2 OPERATIVE FACTORS EuroSCORE risk groups Emergency surgery 2 Low risk 0-2 Other than isolated CABG 2 Medium risk 3-5 Surgery of the thoracic aorta 3 High risk 6+ Post-MI septal rupture repair 4 European Journal of Cardiothoracic Surgery 1999; 16:9
6 ACEF (AGE, CREATININE, EJECTION FRACTION) SCORE (CLINICAL) The Easier Predicts Better: Multicentric External Validation and Superior Clinical Performance of the ACEF Score Compared to Additive and Logistic EuroSCORE in 29,659 Elective Cardiac Surgery Patients. Ranucci M et, al, J Thorac Cardiovasc Surg Sep;142(3):581-6
7 EYEBALL CRITERIA Low Moderate High
8 VARIABLES INCREASING RISK OF PCI Acute myocardial infarction Cardiogenic shock Emergent procedure Aortic stenosis (severe) Atrial / ventricular arrhythmias Decompensated heart failure Anemia / active bleeding / anticoagulation Cerebrovascular disease DM / Renal insufficiency / Pulmonary disease Contrast allergy Very small or very large body habitus Cardiac Catheterization Handbook, 6 th Edition, Morton Kern
9 BLEEDING May drastically increase risk AFTER PCI PCI will commit the patient to indefinite aspirin and DAPT for at least 1 year PCI on a patient with bleeding out of the frying pan and into the fire May turn a symptomatic 80% stenosis into a STEMI after PCI followed by DAPT cessation Aspirin discontinuation can NEVER be SAFELY recommended
10 PCI HOW IT SHOULD BE
11 PCI HOW IT SHOULD BE
12 PCI HOW IT SHOULD BE
13 PCI HOW IT SHOULD BE
14 PCI HOW IT SHOULD BE
15 SYNTAX SCORE (ANGIOGRAPHIC)
16 TORTUOSITY (AORTOILIAC) Cardiac Catheterization Handbook, 5 th Edition, Morton Kern. Angiography and Endovascular Therapy for Aortoiliac Artery Disease, Fukuda E. Endovascular Today Case Report: The GORE EXCLUDER Iliac Branch Endoprosthesis in a Tortuous Aortoiliac Aneurysm
17 RADIAL ARTERY LOOP Balloon-Assisted Tracking of a Guide Catheter Through Radial Artery Loop and Spasm. Shah, Ashish et. al. Cath Lab Digest, Volume 21, Issue 2, Feb 2013
18 CORONARY TORTUOSITY
19 CORONARY TORTUOSITY Cases in Interventional Cardiology: Expert Consult Online and Print, 1 st Edition, Ragosta, Michael
20 MULTIVESSEL CAD Cases in Interventional Cardiology: Expert Consult Online and Print, 1 st Edition, Ragosta, Michael
21 MULTIVESSEL CAD Multivessel PCI vs CABG PCI associated with: Large contrast load Extensive stenting (requiring long-term DAPT) Risk of stent thrombosis rare but often fatal Higher rates of repeat revascularization Burning bridges bypass graft cannot be placed over stented area
22 CHRONIC TOTAL OCCLUSION Utility of Intravascular Ultrasound in PCI of CTO, Galassi, Alfredo; JACC: Cardiovascular Interventions, Volume 9 Issue 19, October 2016
23 CHRONIC TOTAL OCCLUSION Cases in Interventional Cardiology: Expert Consult Online and Print, 1 st Edition, Ragosta, Michael
24 CHRONIC TOTAL OCCLUSION Retrograde CTO Crossing Through Invisible Collaterals, Nicholson, William. Cath Lab Digest, Volume 24, Issue 8, August 2016
25 CHRONIC TOTAL OCCLUSION
26 CHRONIC TOTAL OCCLUSION Extremely challenging Varying reports of long-term patency / clinical outcomes Lengthy / high contrast load / high radiation / more equipment Most common reason to abort PCI and proceed with CABG
27 THROMBUS Cases in Interventional Cardiology: Expert Consult Online and Print, 1 st Edition, Ragosta, Michael
28 NO REFLOW Cases in Interventional Cardiology: Expert Consult Online and Print, 1 st Edition, Ragosta, Michael
29 THROMBUS Rochon B, Chami Y, Sachdeva R, Bissett JK, Willis N, Uretsky BF. Manual aspiration thrombectomy in acute ST elevation myocardial infarction: New gold standard. World J Cardiol 2011; 3(2): 43-47
30 CORONARY ARTERY CALCIFICATION Cases in Interventional Cardiology: Expert Consult Online and Print, 1 st Edition, Ragosta, Michael
31 CORONARY ARTERY CALCIFICATION Clinical Utility of Intravascular Imaging and Physiology in Coronary Artery Disease. Mintz, Gary. JACC, Volume 64, Issue 2, July 2014
32 CORONARY ARTERY CALCIFICATION Lesions very difficult to dilate Stent underexpansion is a cause of stent thrombosis High pressure balloons / atherectomy devices often required DIAMOND BACK ROTABLATOR
33 UNPROTECTED LEFT MAIN Fatal Subacute Stent Thrombosis Induced by Guidewire Fracture with Retained Filaments in the Coronary Artery. Kim, Tae-Jin et al., (Korean Circ J 2013;43: )
34 LEFT MAIN Typically performed with hemodynamic support Intraaortic balloon pump Impella Tandem Heart
35 BIFURCATIONS
36 BIFURCATIONS Cases in Interventional Cardiology: Expert Consult Online and Print, 1 st Edition, Ragosta, Michael
37 BIFURCATIONS: POTENTIALLY LOTS OF STEPS Provisional side branch stenting vs. double stenting Alegría-Barrero, Eduardo & Foin, Nicolas & Chan, Pak Hei & Syrseloudis, Dimitrios & Lindsay, Alistair & Dimopolous, Konstantinos & Alonso-Gonzalez, Rafael & Viceconte, Nicola & Silva, Ranil & Di Mario, Carlo. (2012). Optical coherence tomography for guidance of distal cell recrossing in bifurcation stenting: Choosing the right cell matters. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology /EIJV8I2A34. Coronary Stenting: A Companion to Topol s Textbook of Interventional Cardiology, 1 st Edition. Expert Consult Online and Print.
38 BIFURCATIONS Complex Increased risk of side branch closure Higher rate of restenosis / stent thrombosis Stent struts often jailing side branch Increased risk of: Stent malapposition Incomplete lesion coverage Delayed endotheliaization E Moore, James & Timmins, Lucas & LaDisa, John. (2010). Coronary Artery Bifurcation Biomechanics and Implications for Interventional Strategies. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions /ccd
39 WHAT TO DO POST COMPLEX PCI? CONTINUE DAPT! Clear benefit in reduction of major adverse cardiovascular events with long term DAPT use in complex PCI Efficacy and Safety of Dual Antiplatelet Therapy After Complex PCI. Giustino et. al. Joural of American College of Cardiology, Volume 68 Issue 17, October 2016
40 WHAT TO DO PRIOR TO PCI (NON-ACS, STABLE ANGINA PECTORIS) Stress test if stable Establish diagnosis Define extent / severity of ischemia Braunwald s Heart Disease: A Textbook of Cardiovascular Medicine, Tenth Edition (taken from Circulation, 2003)
41 WHAT TO DO PRIOR TO PCI (NON-ACS, STABLE ANGINA PECTORIS) Start anti-anginal therapy (at least 2 medications) Beta blockers / Calcium channel blockers Nitrates Sodium channel blocker (Ranexa) Proceed with cardiac catheterization if If moderate / high risk findings noted Persistent angina despite medical therapy with 2 or more meds
42 QUESTIONS?
Emergency surgery in acute coronary syndrome
Emergency surgery in acute coronary syndrome Teerawoot Jantarawan Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Upgrade of Recommendation
Challenges in LM PCI Decision-making process for stenting Young-Hak Kim, MD, PhD, Heart Institute, University of Ulsan College of Medicine Asan Medical Center, Seoul, Korea Upgrade of Recommendation for
Rationale for Prophylactic Support During Percutaneous Coronary Intervention
Rationale for Prophylactic Support During Percutaneous Coronary Intervention Navin K. Kapur, MD, FACC, FSCAI Assistant Director, Interventional Cardiology Director, Interventional Research Laboratories
TREATMENT OF HIGHER RISK PATIENTS INTRODUCTION TO PROTECTED PCI WITH IMPELLA. IMP v4
1 TREATMENT OF HIGHER RISK PATIENTS INTRODUCTION TO PROTECTED PCI WITH IMPELLA FDA APPROVES IMPELLA FOR HIGH-RISK PCI 2 Impella is the only hemodynamic support device proven safe and effective in elective
Le# main treatment with Stentys stent. Carlo Briguori, MD, PhD Clinica Mediterranea Naples, Italy
Le# main treatment with Stentys stent Carlo Briguori, MD, PhD Clinica Mediterranea Naples, Italy Disclosure Statement of Financial Interest I, Carlo Briguori DO NOT have a financial interest/ arrangement
Indications of Coronary Angiography Dr. Shaheer K. George, M.D Faculty of Medicine, Mansoura University 2014
Indications of Coronary Angiography Dr. Shaheer K. George, M.D Faculty of Medicine, Mansoura University 2014 Indications for cardiac catheterization Before a decision to perform an invasive procedure such
Useful? Definition of High-risk? Pre-OP/Intra-OP/Post-OP? Complication vs Benefit? Mortality? Morbidity?
Preoperative intraaortic balloon counterpulsation in high-risk CABG Stefan Klotz, M.D. Preoperative IABP in high-risk CABG Questions?? Useful? Definition of High-risk? Pre-OP/Intra-OP/Post-OP? Complication
Supplementary Online Content
Supplementary Online Content Valle JA, Tamez H, Abbott JD, et al. Contemporary use and trends in unprotected left main coronary artery percutaneous coronary intervention in the United States: an analysis
Chronic Total Occlusions. Stephen Cook, MD Medical Director, Cardiac Catheterization Laboratory Oregon Heart & Vascular Institute
Chronic Total Occlusions Stephen Cook, MD Medical Director, Cardiac Catheterization Laboratory Oregon Heart & Vascular Institute Financial Disclosures /see -tee-oh / abbr. Med. Chronic Total Occlusion,
Rationale for Left Ventricular Support During Percutaneous Coronary Intervention
Rationale for Left Ventricular Support During Percutaneous Coronary Intervention Navin K. Kapur, MD, FACC, FSCAI Associate Professor, Division of Cardiology Director, Acute Circulatory Support Program
Coronary angiography and PCI
Coronary arteries Coronary angiography and PCI Samo Granda, Franjo Naji Department of Cardiology Clinical department of internal medicine University clinical centre Maribor Coronary arteries Atherosclerosis
Effect of Intravascular Ultrasound- Guided vs. Angiography-Guided Everolimus-Eluting Stent Implantation: the IVUS-XPL Randomized Clinical Trial
Effect of Intravascular Ultrasound- Guided vs. Angiography-Guided Everolimus-Eluting Stent Implantation: the IVUS-XPL Randomized Clinical Trial Myeong-Ki Hong, MD. PhD on behalf of the IVUS-XPL trial investigators
UNIVERSITY OF OKLAHOMA INTERVENTIONAL CARDIOLOGY FELLOWSHIP CURRICULUM
Curricular Components: UNIVERSITY OF OKLAHOMA INTERVENTIONAL CARDIOLOGY FELLOWSHIP The components of curriculum are: CURRICULUM 1. Cardiac Catheterization Laboratory: a. Competencies:,, Practice-Based
INTERVENTIONAL CARDIOLOGY (Dedicated Fellowship)
INTERVENTIONAL CARDIOLOGY (Dedicated Fellowship) Director: Dr. Edward O Leary Teaching Faculty: Drs. Edward O Leary, Gregory Pavlides and Yiannis Chatzizisis A. OBJECTIVES 1. Management of patients in
Unprotected LM intervention
Unprotected LM intervention Guideline for COMBAT Seung-Jung Park, MD, PhD Professor of Internal Medicine, Seoul, Korea Current Recommendation for unprotected LMCA Stenosis Class IIb C in ESC guideline
Timing of Surgery After Percutaneous Coronary Intervention
Timing of Surgery After Percutaneous Coronary Intervention Deepak Talreja, MD, FACC Bayview/EVMS/Sentara Outline/Highlights Timing of elective surgery What to do with medications Stopping anti-platelet
National Intervention Council
National Intervention Council Cardiological Society of India Registry Performa for Coronary, Non- Coronary & Peripheral Interventions Period January 1st 2016 to December 31 st 2016 Dr. (Prof.) N.N. Khanna
Alex versus Xience Registry Preliminary report
Interventional Cardiology Network Alex versus Xience Preliminary report Mariusz Gąsior 1,2, Marek Gierlotka 1, Lech Poloński 1,2 1 3rd Department of Cardiology, Medical University of Silesia Centre tor
Bifurcation stenting with BVS
Bifurcation stenting with BVS Breaking the limits or just breaking the struts? Maciej Lesiak Department of Cardiology University Hospital in Poznan, Poland Disclosure Speaker s name: Maciej Lesiak I have
Lessons learned From The National PCI Registry
Lessons learned From The National PCI Registry w a v e On Behalf of The Publication Committee of the National PCI Registry Objectives & Anticipated Achievements To determine the epidemiology of patients
LM stenting - Cypher
LM stenting - Cypher Left main stenting with BMS Since 1995 Issues in BMS era AMC Restenosis and TLR (%) 3 27 TLR P=.282 Restenosis P=.71 28 2 1 15 12 Ostium 5 4 Shaft Bifurcation Left main stenting with
STENTYS for Le, Main Sten2ng. Carlo Briguori, MD, PhD Clinica Mediterranea Naples, Italy
STENTYS for Le, Main Sten2ng Carlo Briguori, MD, PhD Clinica Mediterranea Naples, Italy Disclosure Statement of Financial Interest I, Carlo Briguori DO NOT have a financial interest/ arrangement or affilia2on
Case Report Left Main Stenosis. Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft Surgery (CABG)?
Cronicon OPEN ACCESS CARDIOLOGY Case Report Left Main Stenosis. Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft Surgery (CABG)? Valentin Hristov* Department of Cardiology, Specialized
Evidence-Based Management of CAD: Last Decade Trials and Updated Guidelines
Evidence-Based Management of CAD: Last Decade Trials and Updated Guidelines Enrico Ferrari, MD Cardiac Surgery Unit Cardiocentro Ticino Foundation Lugano, Switzerland Conflict of Interests No conflict
Ruofei Jia, Zening Jin, Hong Li, Jing Han. Introduction
Case Report Re-crossing the distal cell in bifurcation verified by using an enhanced stent visualization system and optical coherence tomography: a report of two cases Ruofei Jia, Zening Jin, Hong Li,
ISAR-LEFT MAIN: A Randomized Clinical Trial on Drug-Eluting Stents for Unprotected Left Main Lesions
Julinda Mehilli, MD Deutsches Herzzentrum Technische Universität Munich Germany ISAR-LEFT MAIN: A Randomized Clinical Trial on Drug-Eluting Stents for Unprotected Left Main Lesions Background Left main
CPT Code Details
CPT Code 93572 Details Code Descriptor Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically
Assessing Cardiac Risk in Noncardiac Surgery. Murali Sivarajan, M.D. Professor University of Washington Seattle, Washington
Assessing Cardiac Risk in Noncardiac Surgery Murali Sivarajan, M.D. Professor University of Washington Seattle, Washington Disclosure None. I have no conflicts of interest, financial or otherwise. CME
NCDR CathPCI Registry v4.4 Diagnostic Catheterization and Percutaneous Coronary Intervention Registry
A. DEMOGRAPHICS Last Name 2000 : First Name 2010 : Middle Name 2020 : SSN 2030 : - - - SSN N/A 2031 Patient ID 2040 : (auto) Other ID 2045 : Birth Date 2050 : *** @ Sex 2060 : *** @ O Male O Female Race:
Clinical Value of OCT. Guidance for Coronary Stenting. Giulio Guagliumi, MD
Clinical Value of OCT Guidance for Coronary Stenting Giulio Guagliumi, MD 100 % Endovascular Imaging Indications of use 87.5 % 75 % 57.5 % 50 % 45 % 25 % 15 % 0 Lesion morphology Stent optimization Lesion
Ted Feldman, M.D., MSCAI FACC FESC
Support Technologies and High Risk Intervention Patient Selection: When Not to Use Them Ted Feldman, M.D., MSCAI FACC FESC Evanston Hospital SCAI Fall Fellows Course Las Vegas December 7-10 th, 2014 Ted
Surgery Grand Rounds
Surgery Grand Rounds Coronary Artery Bypass Grafting versus Coronary Artery Stenting Charles Ted Lord, R1 Coronary Artery Disease Stenosis of epicardial vessels Metabolic & hematologic Statistics 500,000
New Jersey Cardiac Catheterization Data Registry, Version 2.0 (Please report data only for patients 16 years or older.)
A. ADMINISTRATIVE New Jersey Cardiac Catheterization Data Registry, Version 2.0 (Please report data only for patients 16 years or older.) 1. Facility Code: 2. Facility Name: 3. Procedure Type (Choose only
Integrated Use of IVUS and FFR for LM Stenting
Integrated Use of IVUS and FFR for LM Stenting Gary S. Mintz, MD Cardiovascular Research Foundation Four studies have highlighted the inaccuracy of angiography in the assessment of LMCA disease Fisher
Euro-Asia CTO Club Can we Implement Japanese Techniques in Europe?
Euro-Asia CTO Club Can we Implement Japanese Techniques in Europe? T. Lefèvre,, Massy, France Background Despite continuous improvement, PTCA of chronic total occlusion remains a real technical challenge.
Ray Matthews MD Professor of Clinical Medicine Chief of Cardiology University of Southern California
High Risk PCI Making Possible the Impossible Ray Matthews MD Professor of Clinical Medicine Chief of Cardiology University of Southern California Disclosures Abiomed Research Support Consulting Agreement
Pathology of percutaneous interventions (PCI) in coronary arteries. Allard van der Wal, MD.PhD; Pathologie AMC, Amsterdam, NL
Pathology of percutaneous interventions (PCI) in coronary arteries Allard van der Wal, MD.PhD; Pathologie AMC, Amsterdam, NL Percutaneous Coronary Intervention (PCI) Definition: transcatheter opening of
Unexpected evolution of a non-stenotic lesion in the left main coronary artery of a patient with non ST-segment elevation myocardial infarction
Case Report Unexpected evolution of a non-stenotic lesion in the left main coronary artery of a patient with non ST-segment elevation myocardial infarction Alexandru Florin Ispas, Lionel Mangin, Alexandru
Stable Ischemic Heart Disease. Ivan Anderson, MD RIHVH Cardiology
Stable Ischemic Heart Disease Ivan Anderson, MD RIHVH Cardiology Outline Review of the vascular biology of atherosclerosis Why not just cath everyone with angina? Medical management of ischemic cardiomyopathy
Myocardial revascularisation in multivessel disease: The value of risks scores
Myocardial revascularisation in multivessel disease: The value of risks scores ESC 2012 Marie Claude Morice, Darren Mylotte, Institut cardiovasculaire Paria Sud, Massy,France Declaration of conflict of
Peripheral and Cardiology Coder 2018
Peripheral and Cardiology Coder 2018 Cardiovascular Services and Procedures Prepared and Published By: MedLearn Publishing A Division of MedLearn Media, Inc. 445 Minnesota Street, Suite 514 St. Paul, MN
Antonio Colombo. Centro Cuore Columbus and S. Raffaele Scientific Institute, Milan, Italy. Miracor Symposium. Speaker: 15. Parigi: May 16-19, 2017
Parigi: May 16-19, 2017 Miracor Symposium Speaker: 15 Antonio Colombo Centro Cuore Columbus and S. Raffaele Scientific Institute, Milan, Italy Nothing to disclose PiCSO Impulse System Elective high risk
PCIs on Intermediate Lesions NCDR Cath-PCI Registry
Practical Application Of Coronary Physiology in The Cath Lab Talal T Attar, MD, MBA, FACC PCIs on Intermediate Lesions NCDR Cath-PCI Registry Fraction of stenoses 50-70% treated with PCI without further
Belinda Green, Cardiologist, SDHB, 2016
Acute Coronary syndromes All STEMI ALL Non STEMI Unstable angina Belinda Green, Cardiologist, SDHB, 2016 Thrombus in proximal LAD Underlying pathophysiology Be very afraid for your patient Wellens
Perioperative Management After Coronary Stenting: Risk Assessment Before Surgery. Christian Seiler No conflict of interest to declare.
Perioperative Management After Coronary Stenting: Risk Assessment Before Surgery Christian Seiler No conflict of interest to declare PCI Long-Term Outcome Perioperative Management After Coronary Stenting:
2017 Cardiology Survival Guide
2017 Cardiology Survival Guide Chapter 4: Cardiac Catheterization/Percutaneous Coronary Intervention A cardiac catheterization involves a physician inserting a thin plastic tube (catheter) into an artery
Supplementary Material to Mayer et al. A comparative cohort study on personalised
Suppl. Table : Baseline characteristics of the patients. Characteristic Modified cohort Non-modified cohort P value (n=00) Age years 68. ±. 69.5 ±. 0. Female sex no. (%) 60 (0.0) 88 (.7) 0.0 Body Mass
Clinical Considerations for CTO
38 RCTs Clinical Considerations for CTO 18,000 pts Revascularization Whom to treat, Who derives benefit and What can we achieve? David E. Kandzari, MD FACC, FSCAI Director, Interventional Cardiology Research
Left Main Intervention: Will it become standard of care?
Left Main Intervention: Will it become standard of care? David Cox, MD FSCAI, FACC Director, Interventional Cardiology Research Associate Director, Cardiac Cath Lab Lehigh Valley Health Network Allentown,
SUPPLEMENTAL MATERIAL
SUPPLEMENTAL MATERIAL Table S1: Number and percentage of patients by age category Distribution of age Age
Index. Note: Page numbers of article titles are in boldface type.
Cardiol Clin 24 (2006) 299 304 Index Note: Page numbers of article titles are in boldface type. A Abciximab in PCI, 180 182 ACE trial, 182 Actinomycin D-eluting stent, 224 ACUITY trial, 190 Acute myocardial
For Personal Use. Copyright HMP 2013
Case Report J INVASIVE CARDIOL 2013;25(2):E39-E41 A Case With Successful Retrograde Stent Delivery via AC Branch for Tortuous Right Coronary Artery Yoshiki Uehara, MD, PhD, Mitsuyuki Shimizu, MD, PhD,
Background. Drug-eluting stents (DES) are increasingly used in complex patients with a high clinical or lesion-related risk of adverse events.
Complex Patients Treated with Second- Generation Zotarolimus-Eluting Resolute and Everolimus-Eluting Xience V Stents in the Randomized TWENTE Trial: Comparison of 2- Year Clinical Outcome Hanim Sen, MD
WHI Form Report of Cardiovascular Outcome Ver (For items 1-11, each question specifies mark one or mark all that apply.
WHI Form - Report of Cardiovascular Outcome Ver. 6. COMMENTS To be completed by Physician Adjudicator Date Completed: - - (M/D/Y) Adjudicator Code: OMB# 095-044 Exp: 4/06 -Affix label here- Clinical Center/ID:
When should we indisputably perform CABG? Quand faut-il indiscutablement opérer? Dr Hakim BENAMER
When should we indisputably perform CABG? Quand faut-il indiscutablement opérer? Dr Hakim BENAMER ICPS, Massy ICV-GVM La Roseraie, Aubervilliers Hôpital FOCH, Suresnes Disclosure Statement of Financial
Cover Page. The handle holds various files of this Leiden University dissertation
Cover Page The handle http://hdl.handle.net/1887/21543 holds various files of this Leiden University dissertation Author: Dharma, Surya Title: Perspectives in the treatment of cardiovascular disease :
INTERVENTIONAL CARDIOLOGY Maintenance of Certification (MOC) Examination Blueprint
INTERVENTIONAL CARDIOLOGY Maintenance of Certification (MOC) Examination Blueprint ABIM invites diplomates to help develop the Interventional Cardiology MOC exam blueprint Based on feedback from physicians
Consensus Core Set: Cardiovascular Measures Version 1.0
Consensus Core Set: Cardiovascular s NQF 0330 Hospital 30-day, all-cause, riskstandardized readmission rate (RSRR) following heart failure hospitalization 0229 Hospital 30-day, all-cause, riskstandardized
Management of Cardiogenic shock. Prof. Christian JM Vrints
Management of Cardiogenic shock Prof. Christian JM Vrints none conflicts Management of Cardiogenic Shock Incidence and trends Importance of early revascularization Multivessel disease Left main disease
Chapter 4 Section 9.1
Surgery Chapter 4 Section 9.1 Issue Date: August 26, 1985 Authority: 32 CFR 199.4(c)(2) and (c)(3) 1.0 CPT 1 PROCEDURE CODES 33010-33130, 33140, 33141, 33200-37186, 37195-37785, 92950-93272, 93303-93581,
Solving the Dilemma of Ostial Stenting: A Case Series Illustrating the Flash Ostial System
Volume 1, Issue 1 Case Report Solving the Dilemma of Ostial Stenting: A Case Series Illustrating the Flash Ostial System Robert F. Riley * and Bill Lombardi University of Washington Medical Center, Division
When Aspiration Thrombectomy Does Not Work? A A R O N W O N G N A T I O N A L H E A R T C E N T R E S I N G A P O R E
When Aspiration Thrombectomy Does Not Work? A A R O N W O N G N A T I O N A L H E A R T C E N T R E S I N G A P O R E Thrombus in STEMI Over 70% of STEMI patients has angiographic evidence of thrombus
Quality Measures MIPS CV Specific
Quality Measures MIPS CV Specific MEASURE NAME Atrial Fibrillation and Atrial Flutter: Chronic Anticoagulation Therapy CAHPS for MIPS Clinician/Group Survey Cardiac Rehabilitation Patient Referral from
The SYNTAX-LE MANS Study
The SYNTAX-LE MANS Study Synergy Between PCI with TAXUS Express and Cardiac Surgery: Late (15-month) Left Main Angiographic Substudy A. Pieter Kappetein, MD, PhD Erasmus MC, Rotterdam, NL SYNTAX-LE MANS
(For items 1-12, each question specifies mark one or mark all that apply.)
Form 121 - Report of Cardiovascular Outcome Ver. 9.2 COMMENTS -Affix label here- Member ID: - - To be completed by Physician Adjudicator Date Completed: - - (M/D/Y) Adjudicator Code: - Central Case No.:
Important LM bifurcation studies update
8 th European Bifurcation Club 12-13 October 2012 - Barcelona Important LM bifurcation studies update I Sheiban E-mail: isheiban@yahoo.com Unprotected LM Percutaneous Revascularization What is important
Diagnostic & Therapeutic Cardiac Catheterization Coder 2017
Diagnostic & Therapeutic Cardiac Catheterization Coder 2017 Including peripheral and cardiovascular services and procedures Prepared and Published By: MedLearn Publishing A Division of Panacea Healthcare
FFR and CABG Emanuele Barbato, MD, PhD, FESC Cardiovascular Center Aalst, Belgium
FFR and CABG Emanuele Barbato, MD, PhD, FESC Cardiovascular Center Aalst, Belgium Conflict of Interest Institutional research grants and speaker s fee from St. Jude Medical and Boston Scientic to Cardiovascular
Chapter 4 Section 9.1
Surgery Chapter 4 Section 9.1 Issue Date: August 26, 1985 Authority: 32 CFR 199.4(c)(2) and (c)(3) 1.0 CPT 1 PROCEDURE CODES 33010-33130, 33140, 33141, 33361-33369, 33200-37186, 37195-37785, 92950-93272,
Counterpulsation. John N. Nanas, MD, PhD. Professor and Head, 3 rd Cardiology Dept, University of Athens, Athens, Greece
John N. Nanas, MD, PhD Professor and Head, 3 rd Cardiology Dept, University of Athens, Athens, Greece History of counterpulsation 1952 Augmentation of CBF Adrian and Arthur Kantrowitz, Surgery 1952;14:678-87
Ziyad Ghazzal MD, FACC, FSCAI Professor of Medicine Deputy Vice President/Dean Associate Dean for Clinical Affairs American University of Beirut
Ziyad Ghazzal MD, FACC, FSCAI Professor of Medicine Deputy Vice President/Dean Associate Dean for Clinical Affairs American University of Beirut Adjunct Professor Emory University School of Medicine Indication
Is bypass surgery needed for elderly patients with LMT disease? From the surgical point of view
CCT 2003 (Kobe) Is bypass surgery needed for elderly patients with LMT disease? From the surgical point of view Hitoshi Yaku, MD, PhD Department of Cardiovascular Surgery Kyoto Prefectural University of
Acute Coronary Syndrome. Sonny Achtchi, DO
Acute Coronary Syndrome Sonny Achtchi, DO Objectives Understand evidence based and practice based treatments for stabilization and initial management of ACS Become familiar with ACS risk stratification
CPORT E Trial. Atlantic C PORT
CPORT E Trial Randomized trial comparing medical, economic and quality of life outcomes of non primary PCI at hospitals with and without on site cardiac surgery Mo#va#on for Trial Sustain primary PCI program
Unprotected Left Main Coronary Artery Disease in Patients With Low Predictive Risk of Mortality
Unprotected Left Main Coronary Artery Disease in Patients With Low Predictive Risk of Mortality Shun Watanabe, MD, Tatsuhiko Komiya, MD, Genichi Sakaguchi, MD, PhD, and Takeshi Shimamoto, MD, PhD Department
Clinical Considerations for CTO Revascularization
Clinical Considerations for CTO Revascularization Whom to treat, Who derives benefit and What can we achieve? David E. Kandzari, MD, FACC, FSCAI Chief Medical Officer Cordis Cardiology Johnson & Johnson
Ischemic Heart Disease Interventional Treatment
Ischemic Heart Disease Interventional Treatment Cardiac Catheterization Laboratory Procedures (N = 11,61) is a regional and national referral center for percutaneous coronary intervention (PCI). A total
Cardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition
Cardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition Table of Contents Volume 1 Chapter 1: Cardiovascular Anatomy and Physiology Basic Cardiac
The MAIN-COMPARE Study
Long-Term Outcomes of Coronary Stent Implantation versus Bypass Surgery for the Treatment of Unprotected Left Main Coronary Artery Disease Revascularization for Unprotected Left MAIN Coronary Artery Stenosis:
Non ST Elevation-ACS. Michael W. Cammarata, MD
Non ST Elevation-ACS Michael W. Cammarata, MD Case Presentation 65 year old man PMH: CAD s/p stent in 2008 HTN HLD Presents with chest pressure, substernally and radiating to the left arm and jaw, similar
DECLARATION OF CONFLICT OF INTEREST
DECLARATION OF CONFLICT OF INTEREST Multivessel disease and cardiogenic shock: CABG is the optimal revascularization therapy. Contra Prof. Christian JM Vrints Cardiogenic Shock Spiral Acute Myocardial
PCI for Renal Artery stenosis
PCI for Renal Artery stenosis Why should we treat Renal Artery Stenosis? Natural History of RAS RAS is progressive disease Study Follow-up (months) Pts Progression N (%) Total occlusion Wollenweber Meaney
Management of High-Risk Coronary Artery Disease
Management of High-Risk Coronary Artery Disease Jeffrey J. Popma, MD Director, Interventional Cardiology Clinical Services Beth Israel Deaconess Medical Center Associate Professor of Medicine Harvard Medical
J. Schwitter, MD, FESC Section of Cardiology
J. Schwitter, MD, FESC Section of Cardiology CMR Center of the CHUV University Hospital Lausanne - CHUV Switzerland Centre de RM Cardiaque J. Schwitter, MD, FESC Section of Cardiology CMR Center of the
Unprotected left main coronary stenting with a second generation drug-eluting stent. One-year clinical follow-up of the LeMaX pilot study.
Unprotected left main coronary stenting with a second generation drug-eluting stent. One-year clinical follow-up of the LeMaX pilot study. N. Boudou, N. Salvatella, N. Dumonteil, M.C. Morice, O. Darremont,
What do the guidelines say?
Percutaneous coronary intervention in 3-vessel disease and main stem What do the guidelines say? Nothing to disclose Dariusz Dudek Institute of Cardiology, Jagiellonian University Krakow, Poland The European
Preoperative Cardiac Risk Assessment: Approach & Guidelines
Preoperative Cardiac Risk Assessment: Approach & Guidelines By, Liam Morris, MD., FACC (02/03/18) CPG : Clinical Practice Guidelines GDMT : Guidelines Directed Medical Therapy GWC : Guideline Writing Committee
National Imaging Associates, Inc. Clinical guidelines CARDIAC CATHETERIZATION -LEFT HEART CATHETERIZATION. Original Date: October 2015 Page 1 of 5
National Imaging Associates, Inc. Clinical guidelines CARDIAC CATHETERIZATION -LEFT HEART CATHETERIZATION CPT Codes: 93451, 93452, 93453, 93454, 93455, 93456, 93457, 93458, 93459, 93460, 93461 LCD ID Number:
PCI for Chronic Total Occlusions
PCI for Chronic Total Occlusions Chronic Total Occlusions Why not Medical Treatment? Medical Treatment CTO in 891 pts over 24 years High 10% Mortality Low 2 % 1 year 10 years Puma JA, et al. JACC 1994;23:390A
Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017
Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017 Explain the efficacy and safety of triple therapy, in regards to thromboembolic and bleeding risk Summarize the guideline recommendations
Simultaneous Acute ST Elevation Myocardial Infarction And Acute Left Subclavian Artery Thrombosis
Simultaneous Acute ST Elevation Myocardial Infarction And Acute Left Subclavian Artery Thrombosis Chee Yang CHIN, MBChB, MRCP(UK) C.W.L. Chin, P.T.L. Chiam, R.S. Tan National Heart Centre Singapore 26
Chronic Total Occlusion: a case for coronary artery bypass grafting
Chronic Total Occlusion: a case for coronary artery bypass grafting Rune Haaverstad Professor & Chief Dept. of Cardiothoracic Surgery Haukeland University Hospital Bergen, Norway Disclosure Research cooperation
Mitigating Operator Risk in Complex Interventional Procedures. Tanveer Rab, MD, FACC Ajay Kirtane, MD, FACC Prashant Kaul, MD, FACC
Mitigating Operator Risk in Complex Interventional Procedures Tanveer Rab, MD, FACC Ajay Kirtane, MD, FACC Prashant Kaul, MD, FACC Risk assessment Documentation Informed consent Public reporting Steps
PCI for Left Main Coronary Artery Stenosis. Jean Fajadet Clinique Pasteur, Toulouse, France
PCI for Left Main Coronary Artery Stenosis Jean Fajadet Clinique Pasteur, Toulouse, France Athens, October 19, 2018 Left Main Coronary Artery Disease Significant unprotected left main coronary artery disease
4. Which survey program does your facility use to get your program designated by the state?
STEMI SURVEY Please complete one survey for each TCD designation you have in your facility. There would be a maximum of three surveys completed if your facility was designated as a trauma, stroke and STEMI
Valve Disease in Patients With Heart Failure TAVI or Surgery? Miguel Sousa Uva Hospital Cruz Vermelha Lisbon, Portugal
Valve Disease in Patients With Heart Failure TAVI or Surgery? Miguel Sousa Uva Hospital Cruz Vermelha Lisbon, Portugal I have nothing to disclose. Wide Spectrum Stable vs Decompensated NYHA II IV? Ejection
Patient. Clinical data Indications: Operation date. Comorbidities: Patient code Birth date: / /
Patient Patient code Birth date: / / Sex: Male Height (cm): Female Weight (kg): Risk Factors: Family history of coronary disease: Hypertension Dyslipidemia Peripheral disease Diabetes Comorbidities: No
CHRONIC HEART FAILURE : WHAT ELSE COULD WE OFFER TO OUR PATIENTS? Cardiac Rehabilitation Society of Thailand
CHRONIC HEART FAILURE : WHAT ELSE COULD WE OFFER TO OUR PATIENTS? Cardiac Rehabilitation Society of Thailand ENHANCED EXTERNAL COUNTER PULSATION Piyanuj Ruckpanich, MD. Cardiac Rehabilitation Center Perfect
Gender-Based Outcomes in Percutaneous Coronary Intervention with Drug-Eluting Stents (from the National Heart, Lung, and Blood Institute Dynamic
Gender-Based Outcomes in Percutaneous Coronary Intervention with Drug-Eluting Stents (from the National Heart, Lung, and Blood Institute Dynamic Registry) J. D. Abbott, et al. Am J Cardiol (2007) 99;626-31
Protection of side branch is essential in treating bifurcation lesions: overview
Angioplasty Summit TCT Asia Pacific Seoul, April 26-28, 2006 Protection of side branch is essential in treating bifurcation lesions: overview Alfredo R Galassi, MD, FACC, FSCAI, FESC Head of the Catetherization