Chronic total occlusion occurs in 10% of patients with
|
|
- Miles Blair
- 6 years ago
- Views:
Transcription
1 Off-Pump Revascularization of Chronically Occluded Left Anterior Descending Artery Through Left Anterior Small Thoracotomy: Early and Late Angiographic and Clinical Follow-Up Gabriele Di Giammarco, MD, Marco Pano, MD, Mirko Giancane, MD, Alessandro Di Francesco, MD, and Michele Di Mauro, MD Department of Clinical Science and Bioimaging, Division of Cardiac Surgery, University G D Annunzio, Chieti, Pescara, Italy Background. The aim of this retrospective study was to evaluate the safety and efficacy of left anterior small thoracotomy for treatment of isolated chronic total occlusion of the left anterior descending artery. Methods. From November 21, 1994, to December 31, 2002, 143 patients with isolated left anterior descending artery chronic occlusion underwent off-pump surgery through left anterior small thoracotomy. Safety was evaluated analyzing 30-day mortality, major adverse cardiac events, and major complications; efficacy was evaluated analyzing 6-month angiographic results and 12-month survival, freedom from cardiac death, freedom from acute myocardial infarction, either in all areas or in the grafted one, freedom from redo or percutaneous coronary intervention, freedom from target vessel revascularization, and freedom from major adverse cardiac events and from any event. Eight-year outcome was reported as well. Results. Thirty-day mortality was 0.7% (1 patient). No patient experienced acute myocardial infarction, cerebrovascular accident, or urgent repeat revascularization. One-year survival was 98.6% 0.7%; freedom from cardiac death was 99.3% 0.7%; freedom from acute myocardial infarction in either all areas or in the grafted one was 100%; freedom from redo or percutaneous coronary intervention or from target vessel revascularization was 99.3% 0.7%, and freedom from major adverse cardiac events or any event was 97.9% 1.2%. Eight-year survival was 94.9% 1.9%; freedom from cardiac death was 96.3% 1.6%, from acute myocardial infarction in all or in the grafted area 99.2% 0.8%, from redo or percutaneous coronary intervention 94.4% 2.1, from target vessel revascularization 97.8% 1.3%, from major adverse cardiac events 92.8% 2.2%, and from any event 89.5% 2.7%. Six months after surgery, 56% of survivors underwent angiographic control, showing a patency rate of 98.2%. Conclusions. In our experience, left anterior small thoracotomy operation can be considered a suitable choice for treatment of left anterior descending artery chronic occlusion. (Ann Thorac Surg 2006;82: ) 2006 by The Society of Thoracic Surgeons Chronic total occlusion occurs in 10% of patients with coronary artery lesions treated by percutaneous coronary intervention (PCI) and can be defined as the obstruction of a native coronary artery with no luminal continuity and with angiographic flow grading 0 or 1 according to the Thrombolysis In Myocardial Infarction study group (TIMI) [1, 2]. The duration of a chronic total occlusion can be established on the basis of clinical data (myocardial infarction, sudden onset or worsening of the symptoms, or proven by previous angiography), and it should last more than 30 days [3]. The TOAST-GISE study [3] demonstrated that chronic total occlusion has to be still considered one of the most important risk factor for early and late PCI failure, either with or without stenting. The interventional treatments of chronic total occlusions are burdened with high rate of early complications, such as coronary perforation/ Accepted for publication May 4, Address correspondence to Dr Di Giammarco, Division of Cardiac Surgery, S Camillo de Lellis Hospital, Via Forlanini 50, Chieti, Italy; gabriele.digiammarco1@tin.it. dissection (in 25% of cases) or acute/subacute coronary thrombosis (ranging from 2.1% to 6%), with a 6% incidence of acute coronary syndrome demanding an emergent coronary artery bypass grafting (3.2% of cases) [3 5]. In addition, high 6-month restenosis or reocclusion rate has been always considered the main drawback of PCI treatment of chronic total occlusions. In this scenario, minimally invasive off-pump surgery could play an important role in providing better early and late outcomes. We, therefore, retrospectively analyzed a group of patients affected by isolated left descending artery (LAD) chronic total occlusion, submitted to left internal mammary artery-to-lad off-pump revascularization through left anterior small thoracotomy. The aim was to assess the safety and efficacy of the treatment, evaluating 30-day and 12-month clinical outcome along with 6-month angiographic results. Patients and Methods From November 21, 1994, to December 31, 2002, 853 patients underwent off-pump surgery through left ante by The Society of Thoracic Surgeons /06/$32.00 Published by Elsevier Inc doi: /j.athoracsur
2 Ann Thorac Surg DI GIAMMARCO ET AL 2006;82: MINIMALLY INVASIVE CABG FOR LAD OCCLUSION 1447 rior small thoracotomy, grafting left internal mammary artery to LAD; in 143 cases (16.8%), preoperative angiography showed isolated LAD chronic occlusion. This subset of patients has been considered for this retrospective analysis. Use of our data base was authorized by our Institutional Review Board on October 13, The authorization waived patient consent. The mean age was years; 11 patients (7.7%) were older than 75 years, and 19 (13.3%) were female. All the patients were symptomatic for angina. The mean grade according to Canadian Cardiovascular Society (CCS) was Twenty-five patients complained of some degree of dyspnea (mean New York Heart Association class was ). In 15 cases (10.4%), the left anterior small thoracotomy operation was an emergent procedure. Mean ejection fraction was 60% 11%. Sixty-seven patients (46.9%) had a history of anterior acute myocardial infarction. In no case was it recent (less than 3 months); myocardial scintigraphy, preoperatively performed in all of them, demonstrated the presence of myocardial viability in the infracted area. Mean logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) [6] was 2.7%. Twenty-two patients (15.4%) were affected by diabetes mellitus; in 3 cases (2.1%), a chronic pulmonary disease was present. Fourteen (9.8%) patients showed extracoronary vasculopathy. No patient was on chronic hemodialysis. Patients converted to off-pump surgery through median sternotomy were excluded. An intramyocardial, calcified, small (less sthan 1.5 mm), or a too medial or too lateral LAD were all considered as anatomical contraindications to this surgical approach. Surgical Procedure The anesthesia protocol as well as the surgical technical details were previously reported by us [7, 8]. Clinical Data Collection, Monitoring and Definition The following set of perioperative data was collected prospectively for all patients undergoing myocardial revascularization at our institution, according to the definitions reported. Mortality included death from any cause. Cardiac mortality included any death from cardiac causes and sudden death. Cerebrovascular accident was defined as global or focal neurologic deficit, diagnosed by a neurologist and confirmed by a brain computed tomography scan. Acute myocardial infarction was defined as enzymatic elevation, electrocardiographic sign of necrosis, new akinetic segments at echocardiogram, ventricular arrhythmias non-k related. Major complications were defined as the sum of the following: death from any cause, cerebrovascular accidents, acute myocardial infarction, low output syndrome (need of intra-aortic balloon pump or inotropic drugs, or both, for more than 12 hours), need of mechanical ventilation for more than 24 hours, acute renal failure (postoperative blood creatinine 2.0 mg/dl, with a baseline preoperative value 1.4 mg/dl, or 1 mg/dl higher if preoperative value 1.4 mg/dl), and gastrointestinal complications. Major adverse cardiac events were death, acute myocardial infarction, and target vessel revascularization [9]. Any event included death from any cause, acute myocardial infarction, and redo or PCI. Follow-Up All the patients were followed up in our outpatient clinic 3, 6, and 12 months after surgery and at yearly intervals thereafter. The most recent information was obtained calling patients or the referring cardiologist from December 1 to December 31, Follow-up was 100% complete. Mean follow-up was months (range, 36 to 132). Statistical Analysis Continuous variables are expressed as mean value SD; otherwise, as frequencies in case of categorical variables. Actuarial results were obtained with the Kaplan-Meier method. The SPSS software (Chicago, Illinois) was used. Any difference with a p value less than 0.05 was considered statistically significant. Results Left internal mammary artery was directly grafted to LAD in 94% of cases, whereas in 6% of patients another graft (inferior epigastric artery 4%, saphenous vein graft 2%) was used as left internal mammary artery lengthening. One patient (0.7%) with preoperative ejection fraction lower than 28% died within the first 30 days from acute left ventricular failure. No patient experienced any acute myocardial infarction or cerebrovascular accident. Two patients showed postoperative acute renal failure, which recovered in 2 days after dopamine infusion. Mean awake and extubation time were hours and hours, respectively. Patients were discharged from the intensive care unit after a mean interval of hours. Mean duration of postoperative in-hospital stay was days. No patient suffered from any wound infection, pneumothorax, or pulmonary infection. Postoperative pain control was achieved in all cases. Survival After a mean time interval of months, 6 patients had died, 5 of them from cardiac causes. Of 142 survivors, 1 patient died 6 months after surgery; the 12-month mortality rate was 0.7%. One- and 8-year survival rates were 98.6% 0.7% and 94.9% 1.9%, respectively; freedom from cardiac death was 99.3% 0.7% at 1-year and 96.3% 1.6% at 8 years (Fig 1). Acute Myocardial Infarction One patient experienced a new acute myocardial infarction in the LAD area 54 months after surgery. One- and 8-year freedom from acute myocardial infarction in either all areas or in the grafted one was 100% and 99.2% 0.8%, respectively.
3 1448 DI GIAMMARCO ET AL Ann Thorac Surg MINIMALLY INVASIVE CABG FOR LAD OCCLUSION 2006;82: Fig 1. Eight-year survival (dashed line) and freedom from cardiac death (solid line). Fig 2. Eight-year freedom from redo or percutaneous coronary intervention (dashed line) and freedom from target vessel revascularization (solid line). Repeat Revascularization In 7 patients (4.9%), a repeat revascularization was necessary because of recurrence of angina. In 4 cases (at 36, 46, 71, and 72 months after surgery, respectively) a PCI was added on the circumflex system or right coronary artery because of the progression of a not-significant stenosis (less than 50%) at the time of surgery. The remaining 3 cases were scheduled for redo coronary artery bypass graft surgery in the previously grafted area (at 4, 27, and 54 months, respectively) because of left internal mammary artery-lad graft failure. None of the remaining survivors became symptomatic after surgery. One- and 8-year freedom from redo or PCI was 99.3% 0.7% and 94.4% 2.1%, respectively; freedom from target vessel revascularization (redo or PCI) was 99.3% 0.7% and 97.8% 1.3% for the same time interval (Fig 2). The patency rate [10] was 98.7%. None of the remaining 63 patients who did not accept to be scheduled for a new angiography experienced any clinical event within the first 6- or 12-month period. Comment Chronic total occlusions represents about 10% of lesions treated by PCI [1]. Although interventional cardiologists Events Nine patients (6.3%) experienced a new major adverse cardiac event during follow-up, 2 of them within the first 6 months after surgery, for a 12-month major adverse cardiac event rate of 1.4%. A new event (any cause) occurred in 13 cases (9.1%). One- and 8-year freedom from major adverse cardiac events was 97.9% 1.2% and 92.8% 2.2%, respectively; freedom from any event was 97.9% 1.2% and 89.5% 2.7%, respectively (Fig 3). Six-Month Angiographic Results Seventy-nine patients (56%) accepted undergoing a new angiographic control within the first 6 months after surgery; in 1 case, only for recurrence of angina. In this symptomatic patient (4 months after surgery), the graft was occluded at the anastomotic site. None of the remaining 78 patients showed any anastomotic stenosis. Fig 3. Eight-year freedom from major adverse cardiac events (solid line) and freedom from any event (dashed line).
4 Ann Thorac Surg DI GIAMMARCO ET AL 2006;82: MINIMALLY INVASIVE CABG FOR LAD OCCLUSION 1449 Table 1. Overview of Studies on PCI Treatment of CTOs First Author [Reference Number] Simes et al [12] Rubartelli et al [13] Buller et al [14] Anzuini et al [5] Hoher et al [15] Lotan et al [16] Olivari et al [3] Rahel et al [17] Hoye et al [9] Werner et al [11] Ge et al [18] Number of patients / Type of stent BMS BMS BMS BMS BMS BMS BMS DES DES BMS/DES DES Percent of AMI /4.2 n/a Percent of subacute n/a n/a n/a 2 0 n/a thrombosis Angiographic 6 mo 9 mo 6 mo 6 mo 6 mo 6 mo n/a 6 mo 6 mo 6 mo 6 mo follow-up Percent of n/a /8 9.2 restenosis Percent of n/a /2 n/a reocclusion Clinical follow-up 300 days 6 mo 6 mo 19 mo 6 mo 6 mo 12 mo 12 mo 12 mo 12 mo 6 mo Percent of late n/a a 1.0 n/a 4.2/2.1 n/a mortality Percent of MACE n/a a / Percent of TVR a 13 n/a 44/ a This percentage is obtained on 286 not-failed procedures. AMI acute myocardial infarction; BMS bare metal stent; DES drug-eluting stent; MACE major adverse cardiac events; mo months; n/a not analyzed; TVR target vessel revascularization. have been increasing patient recruitment over the last decades, chronic total occlusion still represents an important challenge because of high restenosis or reocclusion rates [3, 4, 9, 18]. Furthermore, interventional treatment of chronic total occlusion is burdened with a high rate of early complications, such as coronary perforation/ dissection in 25% of cases or acute/subacute coronary thrombosis ranging from 2.1% to 6% (Table 1), with a 6% incidence of acute coronary syndrome, demanding an emergent coronary artery bypass grafting in more than 3% of cases [3 5]. This retrospective study aimed to analyze 30-day and 12-month clinical outcome along with 6-month angiographic results of a subset of patients showing isolated LAD chronic occlusion and treated by means of the left anterior small thoracotomy operation in order to prove its higher safety and efficacy if compared with the PCI results reported in the literature. In addition, 8-year clinical outcome is provided. Thirty-Day Clinical Results In our series, 30-day mortality was low (0.7%). Having registered neither Q- or non Q-wave myocardial infarction or urgent repeat revascularization, the 30-day major adverse cardiac event rate was coincident. Suero and colleagues [19] reported in-hospital results of a cohort of 2,007 patients with chronic total occlusion, with a mortality rate of 1.3% and an incidence of acute myocardial infarction of 2.4%. Urgent repeat revascularization was necessary in 2.4% of cases (0.7% coronary artery bypass graft, 1.5% PCI) leading to in-hospital major adverse cardiac event rate of 3.8%. Although other authors [4, 12 15] reported a very low mortality rate (0% to 0.3%), the in-hospital major adverse cardiac event rate stays higher (5.1% to 7.9%) than the major adverse cardiac event rate reported in this study [3, 5, 13]. Twelve-Month Clinical Results Table 1 summarizes the late outcome of several series of chronic total occlusions reported in the literature as treated by PCI. Twelve-month mortality rates ranged from 1% to 4.2% [3, 11, 17]. Suero and coworkers [19] reported 10-year survival of 2,007 patients with chronic total occlusion undergoing PCI, showing a survival of 73% in case of PCI success. The analysis of the curve clearly demonstrated that 8-year survival of these patients was close to 80%, definitely lower if compared with 92.8% in series herein reported. Twelve-month major adverse cardiac event rate ranged from 35% to 48% in case of bare metal stent use [3, 11], decreasing to 4% to 19% in case of drug-eluting stent use [9, 11, 17]. Concerning the 6-month major adverse cardiac event rate, the incidence still remains important (23% to 40% and 16.4% for bare metal stent and drugeluting stent, respectively) [13, 16, 18]. Before the drugeluting stent era, the target vessel revascularization rate ranged from 5.3% to 25% [13 16] 6 months after the procedure, increasing to 44% [11] at 12-month follow-up. Drug-eluting stent implantation reduced this incidence to 6.3% to 13% [11, 13, 18]. Hoye and colleagues [9] recently demonstrated that routinary use of drug-eluting stents significantly improves freedom from major adverse cardiac events of chronic total occlusions treated by PCI at 1 year after the procedure (82.1% bare metal stent versus 96.4%, p 0.05). The same finding was confirmed by Werner and associates [11], who reported 1-year freedom from major adverse cardiac events dramatically lower than that in
5 1450 DI GIAMMARCO ET AL Ann Thorac Surg MINIMALLY INVASIVE CABG FOR LAD OCCLUSION 2006;82: the Hoye series in either the bare metal stent group (52.1%) or the drug-eluting stent group (87.6%). The clinical findings reported by the above authors clearly demonstrates that, even if drug-eluting stent use has improved the intermediate outcome of patients with chronic total occlusion undergoing PCI treatment, target vessel revascularization or the major adverse cardiac event rate should be still considered higher if compared with those reported in this study. In fact, of 142 survivors listed in our series, 1 sudden death occurred 6 months after surgery, and 1 patient had to be reoperated on because of early graft failure, thus providing a 12-month target vessel revascularization and major adverse cardiac event rate of 0.7% and 1.4%, respectively, and a freedom from major adverse cardiac event rate of 97.9%. Furthermore, no patients experienced acute myocardial infarction within the first postoperative year. Six-Month Angiographic Results A high restenosis and reocclusion rate has been always considered the main drawback of interventional treatment of chronic total occlusions. In fact, the 6-month restenosis and reocclusion rate ranged from 32% to 55% and from 3% to 23%, respectively, in the case of bare metal stents [10 16]. The use of drug-eluting stents has improved the angiographic results, reducing 6-month restenosis and reocclusion rates to 8.0% to 22% and 2% to 8%, respectively [10, 16 19]. In our analysis 6 months after surgery, 79 patients underwent a new angiography to check left internal mammary artery to LAD graft patency. One patient, who complained of angina, showed occlusion of the anastomosis 4 months after surgery, leading to a reocclusion rate of 1.3%. Study Limitations The main limitation of this retrospective study is the low percentage of angiographic controls performed 6 months after surgery. In spite of our efforts, we were able to recruit only 56% of patients. That is due partly to the well-known patient reluctance to undergo such an invasive procedure in the absence of symptoms and partly to the cardiologist willingness to save resources for diagnostic or interventional procedures. In conclusion, although a randomized trial comparing patients with LAD chronic total occlusion undergoing the left anterior small thoracotomy operation or PCI has to be considered mandatory to clarify which treatment should be assigned to this subset of patients, the results of this retrospective study should help the focus on off-pump revascularization, especially if done through a minimal surgical access, as representing a valid option in this case to achieve better clinical results. References 1. Delacretaz E, Meier B. Therapeutic strategy with total coronary artery occlusions. Am J Cardiol 1997;79: TIMI Study Group. The Thrombolysis In Myocardial Infarction (TIMI) trial: phase I findings. N Engl J Med 1985;312: Olivari Z, Rubartelli P, Piscione F, et al, for the TOAST-GISE Investigators. Immediate results and one-year clinical outcome after percutaneous coronary interventions in chronic total occlusions: data from a multicenter, prospective, observational study (TOAST-GISE). J Am Coll Cardiol 2003;41: Moussa I, Di Mario C, Moses J, et al. Comparison of angiographic clinical outcome of coronary stenting of total coronary occlusion versus subtotal occlusions. Am J Cardiol 1998;81: Anzuini A, Rosanio S, Legrand V, et al. Wiktor stent for treatment of chronic total coronary artery occlusion. Shortand long-term clinical and angiographic results from a large multicenter experience. J Am Coll Cardiol 1998;31: Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg 1999;16: Calafiore AM, Scipioni G, Teodori G, et al. Day 0 intensive care unit discharge risk or benefit for the patient who undergoes myocardial revascularization? Eur J Cardiothorac Surg 2002;21: Di Giammarco G, Pano M, Contini M, et al. Left anterior small thoracotomy procedure. MMCTS. Available at: mmcts.ctsnetjournals.org. Accessed August 9, Hoye A, Tanabe K, Lemos PA, et al. Significant reduction in restenosis after the use of sirolimus-eluting stents in the treatment of chronic total occlusions. J Am Coll Cardiol 2004;43: FitzGibbon GM, Leach AJ, Keon WJ, Burton JR, Kafka HP. Coronary bypass graft fate. Angiographic study of 1,179 vein grafts early, one year, and five years after operation. J Thorac Cardiovasc Surg 1986;91: Werner GS, Krack A, Schwarz G, Prochnau D, Betge S, Figulla HR. Prevention of lesion recurrence in chronic total coronary occlusions by paclitaxel-eluting stents. J Am Coll Cardiol 2004;44: Sirnes PA, Golf S, Myreng Y, et al. Stenting in Chronic Coronary Occlusion (SICCO): a randomized, controlled trial of adding stent implantation after successful angioplasty. J Am Coll Cardiol 1996;28: Rubartelli P, Niccoli L, Verna E, et al. Stent implantation versus balloon angioplasty in chronic coronary occlusions: results from the GISSOC trial. Gruppo Italiano di Studio sullo Stent nelle Occlusioni Coronariche. J Am Coll Cardiol 1998;32: Buller CE, Dzavik V, Carere RG, et al. Primary stenting versus balloon angioplasty in occluded coronary arteries: the Total Occlusion Study of Canada (TOSCA). Circulation 1999;100: Hoher M, Wohrle J, Grebe OC, et al. A randomized trial of elective stenting after balloon recanalization of chronic total occlusions. J Am Coll Cardiol 1999;34: Lotan C, Rozenman Y, Hendler A, et al. Stents in total occlusion for restenosis prevention. The multicentre randomised STOP study. The Israeli Working Group for Interventional Cardiology. Eur Heart J 2000;21: Rahel BM, Suttorp MJ, Laarman GJ, et al. Primary stenting of occluded native coronary arteries: final results of the Primary Stenting of Occluded Native Coronary Arteries (PRISON) study. Am Heart J 2004;147:e Ge L, Iakovou I, Cosgrave J, et al. Immediate and mid-term outcomes of sirolimus-eluting stent implantation for chronic total occlusions. Eur Heart J 2005;26: Suero JA, Marso SP, Jones PG, et al. Procedural outcomes and long-term survival among patients undergoing percutaneous coronary intervention of a chronic total occlusion in native coronary arteries: a 20-year experience. J Am Coll Cardiol 2001;38:
Significant Reduction in Restenosis After the Use of Sirolimus-Eluting Stents in the Treatment of Chronic Total Occlusions
Journal of the American College of Cardiology Vol. 43, No. 11, 2004 2004 by the American College of Cardiology Foundation ISSN 0735-1097/04/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2004.01.045
More informationPrognostic factors in primary and elective percutaneous coronary intervention Claessen, B.E.P.M.
UvA-DARE (Digital Academic Repository) Prognostic factors in primary and elective percutaneous coronary intervention Claessen, B.E.P.M. Link to publication Citation for published version (APA): Claessen,
More informationClinical, Electrocardiographic, and Procedural Characteristics of Patients With Coronary Chronic Total Occlusions
ORIGINAL ARTICLE DOI 10.4070 / kcj.2009.39.3.111 Print ISSN 1738-5520 / On-line ISSN 1738-5555 Copyright c 2009 The Korean Society of Cardiology Clinical, Electrocardiographic, and Procedural Characteristics
More informationClinical 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
More informationImportance of the third arterial graft in multiple arterial grafting strategies
Research Highlight Importance of the third arterial graft in multiple arterial grafting strategies David Glineur Department of Cardiovascular Surgery, Cliniques St Luc, Bouge and the Department of Cardiovascular
More informationDeclaration of conflict of interest NONE
Declaration of conflict of interest NONE Claudio Muneretto MD, PhD Director of Division of Cardiac Surgery University of Brescia Medical School Italy Hybrid Chymera Different features and potential advantages
More informationMyocardial revascularization without cardiopulmonary
Multiple Arterial Conduits Without Cardiopulmonary Bypass: Early Angiographic Results Antonio M. Calafiore, MD, Giovanni Teodori, MD, Gabriele Di Giammarco, MD, Giuseppe Vitolla, MD, Nicola Maddestra,
More informationChronic 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
More informationUnprotected 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
More informationThe Influence of Previous Percutaneous Coronary Intervention in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting
Original Article The Influence of Previous Percutaneous Coronary Intervention in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting Toshihiro Fukui, MD, Susumu Manabe, MD, Tomoki Shimokawa, MD,
More informationThe 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:
More informationCurrent Perspectives on Coronary Chronic Total Occlusions
Journal of the American College of Cardiology Vol. 59, No. 11, 2012 2012 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2011.12.007
More informationAssessing 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
More informationOutcome of Successful Versus Unsuccessful Percutaneous Coronary Intervention in Chronic Total Occlusions in One Year Follow-Up
Elmer Press Original Article Outcome of Successful Versus Unsuccessful Percutaneous Coronary Intervention in Chronic Total Occlusions in One Year Follow-Up Bahram Sohrabi a, Samad Ghaffari a, Afshin Habibzadeh
More informationRecent Progress of the Use of Interventional Therapy for Chronic Total Occlusion
REVIEW Korean Circ J 2008;38:295-300 Print ISSN 1738-5520 / On-line ISSN 1738-5555 Copyright c 2008 The Korean Society of Cardiology Recent Progress of the Use of Interventional Therapy for Chronic Total
More informationClinical 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
More informationThe MAIN-COMPARE Registry
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:
More informationComparison of Coronary Artery Bypass Grafting With Drug-Eluting Stent Implantation for the Treatment of Multivessel Coronary Artery Disease
Comparison of Coronary Artery Bypass Grafting With Drug-Eluting Stent Implantation for the Treatment of Multivessel Coronary Artery Disease Jeong Hoon Yang, MD, Hyeon-Cheol Gwon, MD, Soo Jin Cho, MD, Joo
More informationEffect 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
More informationCoronary Artery Bypass Grafting Versus Coronary Implantation of Sirolimus-Eluting Stents in Patients with Diabetic Retinopathy
Coronary Artery Bypass Grafting Versus Coronary Implantation of Sirolimus-Eluting Stents in Patients with Diabetic Retinopathy Takayuki Ohno, MD, Shinichi Takamoto, MD, Noboru Motomura, MD, Minoru Ono,
More informationEarly results after myocardial revascularization without cardiopulmonary bypass
Cardiopulmonary Support and Physiology Calafiore et al Bilateral internal thoracic artery grafting with and without cardiopulmonary bypass: Six-year clinical outcome Antonio M. Calafiore, MD, a Gabriele
More informationLM 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
More informationPCI TO CHRONIC TOTAL OCCLUSION, LIAQUAT NATIONAL HOSPITAL EXPERINCE
SUMMARY PCI TO CHRONIC TOTAL OCCLUSION, LIAQUAT NATIONAL HOSPITAL EXPERINCE INTRODUCTION GHAZALA IRFAN*, MANSOOR AHMAD**, DAD JAN BALOCH @, ABDUL RASHEED @@ BACKGROUND PCI of chronic total occlusion represents
More informationPercutanous revascularization of chronic total occlusion of diabetic patients at Iraqi center for heart diseases, a single center experience 2012
www.muthjm.com Muthanna Medical Journal 2015; 2(2):76-82 Percutanous revascularization of chronic total occlusion of diabetic patients at Iraqi center for heart diseases, a single center experience 2012
More informationPCI in Patients with Transplant Coronary Artery Disease. Michael S. Lee, MD, FACC, FSCAI Assistant Professor UCLA School of Medicine
PCI in Patients with Transplant Coronary Artery Disease Michael S. Lee, MD, FACC, FSCAI Assistant Professor UCLA School of Medicine Faculty Disclosure Honararia for Boston Scientific, BMS, Daiichi Sankyo,
More informationDrug-Eluting Stents in Coronary CTOs Recommendations for treating patients with CTOs using new DES technology.
Drug-Eluting Stents in Coronary CTOs Recommendations for treating patients with CTOs using new DES technology. BY RAJESH M. DAVE, MD, FACC, FSCAI Coronary chronic total occlusions (CTOs) remain the most
More informationPROMUS Element Experience In AMC
Promus Element Luncheon Symposium: PROMUS Element Experience In AMC Jung-Min Ahn, MD. University of Ulsan College of Medicine, Heart Institute, Asan Medical Center, Seoul, Korea PROMUS Element Clinical
More informationBSIC, Manchester, September 15, Gerald S. Werner, MD, FESC, FACC Klinikum Darmstadt, Germany
BSIC, Manchester, September 15, 2006 Gerald S. Werner, MD, FESC, FACC Klinikum Darmstadt, Germany BSIC, Manchester, September 15, 2006 Chronic total occlusions update A European perspective Gerald S. Werner,
More informationPredictors of Reocclusion After Successful Drug-Eluting Stent Supported Percutaneous Coronary Intervention of Chronic Total Occlusion
Journal of the American College of Cardiology Vol. 61, No. 5, 2013 2013 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00 Published by Elsevier Inc. http://dx.doi.org/10.1016/j.jacc.2012.10.036
More informationCORONARY CHRONIC TOTAL OCCLUSIONS IN THE SETTING OF ACUTE MYOCARDIAL INFARCTION
CORONARY CHRONIC TOTAL OCCLUSIONS IN THE SETTING OF ACUTE MYOCARDIAL INFARCTION *Bimmer Claessen, Loes Hoebers, José Henriques Department of Cardiology, Academic Medical Center, University of Amsterdam,
More informationCan a Penetration Catheter (Tornus) Substitute Traditional Rotational Atherectomy for Recanalizing Chronic Total Occlusions?
Clinical Studies Can a Penetration Catheter (Tornus) Substitute Traditional Rotational Atherectomy for Recanalizing Chronic Total Occlusions? Hsiu-Yu Fang, 1* MD, Chih-Yuan Fang, 1* MD, Hisham Hussein,
More informationChronic 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,
More informationCoronary Artery Disease: Revascularization (Teacher s Guide)
Stephanie Chan, M.D. Updated 3/15/13 2008-2013, SCVMC (40 minutes) I. Objectives Coronary Artery Disease: Revascularization (Teacher s Guide) To review the evidence on whether percutaneous coronary intervention
More informationMethods Study organization
Frequency and time course of reocclusion and restenosis in coronary artery occlusions after balloon angioplasty versus Wiktor stent implantation: Results from the Mayo-Japan Investigation for Chronic Total
More informationBeating-heart surgery avoids cardiopulmonary bypass
Intraoperative Ischemia and Long-Term Events After Minimally Invasive Coronary Surgery Marco Zimarino, MD, Sabina Gallina, MD, Maria Di Fulvio, MD, Michele Di Mauro, MD, Gabriele Di Giammarco, MD, Raffaele
More informationSafety of Single- Versus Multi-vessel Angioplasty for Patients with AMI and Multi-vessel CAD
Safety of Single- Versus Multi-vessel Angioplasty for Patients with AMI and Multi-vessel CAD Mun K. Hong, MD Associate Professor of Medicine Director, Cardiovascular Intervention and Research Weill Cornell
More informationSummary HTA. Drug-eluting stents vs. coronary artery bypass-grafting. HTA-Report Summary. Gorenoi V, Dintsios CM, Schönermark MP, Hagen A
Summary HTA HTA-Report Summary Drug-eluting stents vs. coronary artery bypass-grafting in coronary heart disease Gorenoi V, Dintsios CM, Schönermark MP, Hagen A Scientific background The coronary heart
More informationMinimally Invasive Coronary Artery Bypass Graft Surgery. Original Policy Date
MP 7.01.47 Minimally Invasive Coronary Artery Bypass Graft Surgery Medical Policy Section Surgery Issue 12:2013 Original Policy Date 12:2013 Last Review Status/Date Reviewed with literature search/12:2013
More informationSupplementary Table S1: Proportion of missing values presents in the original dataset
Supplementary Table S1: Proportion of missing values presents in the original dataset Variable Included (%) Missing (%) Age 89067 (100.0) 0 (0.0) Gender 89067 (100.0) 0 (0.0) Smoking status 80706 (90.6)
More informationTCTAP Upendra Kaul MD,DM,FACC,FSCAI,FAMS,FCSI
Indian TUXEDO Trial In Medically Treated Diabetics Upendra Kaul MD,DM,FACC,FSCAI,FAMS,FCSI Executive Director and Dean Escorts Heart Institute & Medical Research Center and Fortis Hospitals, New Delhi
More informationCoronary Artery Bypass Grafting For Acute Myocardial Infarction in Stent ERA
Original Article Coronary Artery Bypass Grafting For Acute Myocardial Infarction in Stent ERA Tamaki Takano, MD, Hirohisa Goto, MD, Kazuo Hoshino, MD, Hirohide Shimada, MD, Hiroyuki Ichinose, MD, and Norihiko
More informationISAR-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
More informationPercutaneous Coronary Interventions Without On-site Cardiac Surgery
Percutaneous Coronary Interventions Without On-site Cardiac Surgery Hassan Al Zammar, MD,FESC Consultant & Interventional Cardiologist Head of Cardiology Department European Gaza Hospital Palestine European
More informationPercutaneous Coronary Intervention (PCI) in Patients with Chronic Total Occlusion (CTO): A Single Center Experiences
Percutaneous Coronary Intervention (PCI) in Patients with Chronic Total Occlusion (CTO): A Single Center Experiences AHMW Islam, S Munwar, S Talukder, AQM Reza Dept. of Interventional and Invasive Cardiology,
More informationSolving 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
More informationMyocardial enzyme release after standard coronary artery bypass grafting
Cardiopulmonary Support and Physiology Schachner et al Myocardial enzyme release in totally endoscopic coronary artery bypass grafting on the arrested heart Thomas Schachner, MD, a Nikolaos Bonaros, MD,
More informationCase 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
More informationMidterm Follow-Up After Minimally Invasive Direct Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention Techniques
Midterm Follow-Up After Minimally Invasive Direct Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention Techniques Sandra Fraund, MD, Gunhild Herrmann, PhD, Anja Witzke, Jürgen Hedderich,
More informationAntiplatelet therapy in myocardial infarction and coronary stent thrombosis Heestermans, Antonius Adrianus Cornelius Maria
University of Groningen Antiplatelet therapy in myocardial infarction and coronary stent thrombosis Heestermans, Antonius Adrianus Cornelius Maria IMPORTANT NOTE: You are advised to consult the publisher's
More informationPeriprocedural Myocardial Infarction and Clinical Outcome In Bifurcation Lesion
Periprocedural Myocardial Infarction and Clinical Outcome In Bifurcation Lesion Hyeon-Cheol Gwon Cardiac and Vascular Center Samsung Medical Center Sungkyunkwan University School of Medicine Dr. Hyeon-Cheol
More informationInfluence of Planned Six-Month Follow-Up Angiography on Late Outcome After Percutaneous Coronary Intervention A Randomized Study
Journal of the American College of Cardiology Vol. 38, No. 4, 2001 2001 by the American College of Cardiology ISSN 0735-1097/01/$20.00 Published by Elsevier Science Inc. PII S0735-1097(01)01476-0 Influence
More informationDuring the last years, many reports have clearly
Single Versus Bilateral Internal Mammary Artery for Isolated First Myocardial Revascularization in Multivessel Disease: Long-Term Clinical Results in Medically Treated Diabetic Patients Antonio Maria Calafiore,
More informationKomplexe Koronarintervention heute: Von Syntax zu bioresorbierbaren Stents
Komplexe Koronarintervention heute: Von Syntax zu bioresorbierbaren Stents Prof. Dr. med. Julinda Mehilli Medizinische Klinik und Poliklinik I Klinikum der Universität München Campus Großhadern Key Factors
More informationUnprotected 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
More informationLeft Subclavian Artery Stenosis in Coronary Artery Bypass: Prevalence and Revascularization Strategies
Left Subclavian Artery Stenosis in Coronary Artery Bypass: Prevalence and Revascularization Strategies Ho Young Hwang, MD, Jin Hyun Kim, MD, Whal Lee, MD, PhD, Jae Hyung Park, MD, PhD, and Ki-Bong Kim,
More informationFFR 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
More informationReoperative Coronary Artery Bypass Grafting: Analysis of Early And Late Outcomes
Original Article Reoperative Coronary Artery Bypass Grafting: Analysis of Early And Late Outcomes AR Jodati, MA Yousefnia From Department of Cardiothoracic Surgery, Madani Heart Hospital, Tabriz University
More informationComparison of 30-day outcomes of coronary artery bypass grafting surgery verus hybrid coronary revascularization stratified by SYNTAX and euroscore
Comparison of 30-day outcomes of coronary artery bypass grafting surgery verus hybrid coronary revascularization stratified by SYNTAX and euroscore Marzia Leacche, MD, John G. Byrne, MD, Natalia S. Solenkova,
More informationJournal of the American College of Cardiology Vol. 37, No. 2, by the American College of Cardiology ISSN /01/$20.
Journal of the American College of Cardiology Vol. 37, No. 2, 2001 2001 by the American College of Cardiology ISSN 0735-1097/01/$20.00 Published by Elsevier Science Inc. PII S0735-1097(00)01133-5 Coronary
More informationClinical Investigations
Clinical Investigations Clinical Outcomes for Single Stent and Multiple Stents in Contemporary Practice Qiao Shu Bin, MD; Liu Sheng Wen, MD; Xu Bo, BS; Chen Jue, MD; Liu Hai Bo, MD; Yang Yue Jin, MD; Chen
More informationSurgical vs. Percutaneous Revascularization in Patients with Diabetes and Acute Coronary Syndrome
Surgical vs. Percutaneous Revascularization in Patients with Diabetes and Acute Coronary Syndrome Chris C. Cook, MD Associate Professor of Surgery Director, CT Residency Program, WVU ACOI 10/17/18 No Disclosures
More informationRevascularization after Drug-Eluting Stent Implantation or Coronary Artery Bypass Surgery for Multivessel Coronary Disease
Impact of Angiographic Complete Revascularization after Drug-Eluting Stent Implantation or Coronary Artery Bypass Surgery for Multivessel Coronary Disease Young-Hak Kim, Duk-Woo Park, Jong-Young Lee, Won-Jang
More informationRationale for Percutaneous Revascularization ESC 2011
Rationale for Percutaneous Revascularization Marie Claude Morice, Massy FR MD, FESC, FACC ESC 2011 Paris Villepinte - 27-31 August, 2011 Massy, France Potential conflicts of interest I have the following
More informationControversies in Cardiac Surgery
Controversies in Cardiac Surgery 3 years after SYNTAX : Percutaneous Coronary Intervention for Multivessel / Left main stem Coronary artery disease Pro ESC Congress 2010, 28 August 1 September Stockholm
More informationCORONARY ARTERY BYPASS GRAFT (CABG) MEASURES GROUP OVERVIEW
CONARY ARTERY BYPASS GRAFT (CABG) MEASURES GROUP OVERVIEW 2015 PQRS OPTIONS F MEASURES GROUPS: 2015 PQRS MEASURES IN CONARY ARTERY BYPASS GRAFT (CABG) MEASURES GROUP: #43 Coronary Artery Bypass Graft (CABG):
More informationDrug-eluting stents (DESs) show a lower incidence of
ADULT CARDIAC Comparison of Off-pump Coronary Artery Bypass Grafting With Percutaneous Coronary Intervention Versus Drug-Eluting Stents for Three-Vessel Coronary Artery Disease Gijong Yi, MD, Young-Nam
More informationSUPPLEMENTAL MATERIAL
SUPPLEMENTAL MATERIAL Table S1: Number and percentage of patients by age category Distribution of age Age
More informationCover 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 :
More informationComplication management and long-term outcome after percutaneous coronary intervention
Complication management and long-term outcome after percutaneous coronary intervention ESC meeting 2012, Munich, Germany Session: Chronic total occlusion: a challenge for percutaneous coronary intervention
More informationJournal of the American College of Cardiology Vol. 48, No. 2, by the American College of Cardiology Foundation ISSN /06/$32.
Journal of the American College of Cardiology Vol. 48, No. 2, 2006 2006 by the American College of Cardiology Foundation ISSN 0735-1097/06/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2006.03.039
More informationImpact of the Presence of Chronic Total Occlusion in a Non-Infarct-Related Coronary Artery in Acute Myocardial Infarction Patients
Impact of the Presence of Chronic Total Occlusion in a Non-Infarct-Related Coronary Artery in Acute Myocardial Infarction Patients Validation in a Subset of Patients With Preserved Left Ventricular Function
More informationStent for chronic total coronary occlusions: benefits and drawbacks after the introduction of drug-eluting stents
review Stent for chronic total coronary occlusions: benefits and drawbacks after the introduction of drug-eluting stents Chronic total occlusion (CTO) is a common finding on diagnostic coronary angiography
More informationAbstract Background: Methods: Results: Conclusions:
Two-Year Clinical and Angiographic Outcomes of Overlapping Sirolimusversus Paclitaxel- Eluting Stents in the Treatment of Diffuse Long Coronary Lesions Kang-Yin Chen 1,2, Seung-Woon Rha 1, Yong-Jian Li
More informationImproved Noninvasive Assessment of Coronary Artery Bypass Grafts With 64-Slice Computed Tomographic Angiography in an Unselected Patient Population
Journal of the American College of Cardiology Vol. 49, No. 9, 2007 2007 by the American College of Cardiology Foundation ISSN 0735-1097/07/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2006.10.066
More informationChronic total coronary occlusions (CTO) are present
Is Chronic Total Coronary Occlusion a Risk Factor for Long-Term Outcome After Minimally Invasive Bypass Grafting of the Left Anterior Descending Artery? David M. Holzhey, MD, Stephan Jacobs, MD, Thomas
More informationTarget vessel only revascularization versus complet revascularization in non culprit lesions in acute myocardial infarction treated by primary PCI
Target vessel only revascularization versus complet revascularization in non culprit lesions in acute myocardial infarction treated by primary PCI Gamal Abdelhady, Emad Mahmoud Department of interventional
More informationSupplementary 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
More informationSetting The setting was a hospital. The economic study was carried out in Australia.
Coronary artery bypass grafting (CABG) after initially successful percutaneous transluminal coronary angioplasty (PTCA): a review of 17 years experience Barakate M S, Hemli J M, Hughes C F, Bannon P G,
More informationPrevention of Coronary Stent Thrombosis and Restenosis
Prevention of Coronary Stent Thrombosis and Restenosis Seong-Wook Park, MD, PhD, FACC Division of Cardiology, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea 9/12/03 Coronary
More informationStatistical analysis plan
Statistical analysis plan Prepared and approved for the BIOMArCS 2 glucose trial by Prof. Dr. Eric Boersma Dr. Victor Umans Dr. Jan Hein Cornel Maarten de Mulder Statistical analysis plan - BIOMArCS 2
More informationPathology 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
More informationCoronary atherosclerotic heart disease remains the number
Twenty-Year Survival After Coronary Artery Surgery An Institutional Perspective From Emory University William S. Weintraub, MD; Stephen D. Clements, Jr, MD; L. Van-Thomas Crisco, MD; Robert A. Guyton,
More informationReview Article Comparison of 12-Month Outcomes with Zotarolimus- and Paclitaxel-Eluting Stents: A Meta-Analysis
International Scholarly Research Network ISRN Cardiology Volume 2011, Article ID 675638, 6 pages doi:10.5402/2011/675638 Review Article Comparison of 12-Month Outcomes with Zotarolimus- and Paclitaxel-Eluting
More informationJournal of the American College of Cardiology Vol. 35, No. 5, by the American College of Cardiology ISSN /00/$20.
Journal of the American College of Cardiology Vol. 35, No. 5, 2000 2000 by the American College of Cardiology ISSN 0735-1097/00/$20.00 Published by Elsevier Science Inc. PII S0735-1097(00)00546-5 CLINICAL
More informationThe most important advantage of CABG over PTCA is its
Coronary Artery Bypass With Only In Situ Bilateral Internal Thoracic Arteries and Right Gastroepiploic Artery Hiroshi Nishida, MD; Yasuko Tomizawa, MD; Masahiro Endo, MD; Hitoshi Koyanagi, MD; Hiroshi
More informationSupplementary material 1. Definitions of study endpoints (extracted from the Endpoint Validation Committee Charter) 1.
Rationale, design, and baseline characteristics of the SIGNIFY trial: a randomized, double-blind, placebo-controlled trial of ivabradine in patients with stable coronary artery disease without clinical
More informationMinimally invasive direct coronary artery bypass for left anterior descending artery revascularization analysis of 300 cases
Original paper Videosurgery Minimally invasive direct coronary artery bypass for left anterior descending artery revascularization analysis of 300 cases Lufeng Zhang, Zhongqi Cui, Zhiming Song, Hang Yang,
More informationCPT 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
More informationLong-term freedom from angina and
Hellenic J Cardiol 2010; 51: 368-373 Case Report The Crush Technique as a Therapeutic Approach for a Bifurcation Lesion in a Saphenous Venous Graft Io a n n i s Ka r a l i s, Ge o r g e Ko c h i a d a
More informationPatient. 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
More informationDiabetes mellitus (DM) has been identified as an independent
Diabetes Does Not Affect Long-Term Results After Total Arterial Off-Pump Coronary Revascularization Ho Young Hwang, MD, Jae-Sung Choi, MD, PhD, and Ki-Bong Kim, MD, PhD Department of Thoracic and Cardiovascular
More informationSurgery 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
More informationUnprotected Left Main Stenting: Patient Selection and Recent Experience. Alaide Chieffo. S. Raffaele Hospital, Milan, Italy
Unprotected Left Main Stenting: Patient Selection and Recent Experience Alaide Chieffo S. Raffaele Hospital, Milan, Italy Class IIa (Level B) AHA/ACC 2005 Guidelines Left Main CAD The use of PCI for pts
More informationLong-Term Clinical Outcome of Chronic Total Occlusive Lesions Treated With Drug-Eluting Stents
Circulation Journal Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp ORIGINAL ARTICLE Cardiovascular Intervention Long-Term Clinical Outcome of Chronic Total Occlusive Lesions
More informationRadial Artery and Saphenous Vein Patency More Than 5 Years After Coronary Artery Bypass Surgery
Journal of the American College of Cardiology Vol. 60, No. 1, 2012 2012 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00 Published by Elsevier Inc. http://dx.doi.org/10.1016/j.jacc.2012.03.037
More informationManagement during Reoperation of Aortocoronary Saphenous Vein Grafts with Minimal Atherosclerosis by Angiography
Management during Reoperation of ortocoronary Saphenous Vein Grafts with therosclerosis by ngiography William G. Marshall, Jr., M.D., Jeffrey Saffitz, M.D., and Nicholas T. Kouchoukos, M.D. STRCT The proper
More informationMULTIVESSEL PCI. IN DRUG-ELUTING STENT RESTENOSIS DUE TO STENT FRACTURE, TREATED WITH REPEAT DES IMPLANTATION
MULTIVESSEL PCI. IN DRUG-ELUTING STENT RESTENOSIS DUE TO STENT FRACTURE, TREATED WITH REPEAT DES IMPLANTATION C. Graidis, D. Dimitriadis, A. Ntatsios, V. Karasavvides Euromedica Kyanous Stavros, Thessaloniki.
More informationC hronic total occlusion (CTO) remains one of the more
iii42 Chronic total occlusions a stiff challenge requiring a major breakthrough: is there light at the end of the tunnel? S Aziz, D R Ramsdale... C hronic total occlusion (CTO) remains one of the more
More informationΔημήτριος Αγγοσράς, FETCS
ΣΕΜΙΝΑΡΙΟ ΟΜΑΔΩΝ ΕΡΓΑΣΙΑΣ Δημήτριος Αγγοσράς, FETCS Επίκοσρος Καθηγηηής Καρδιοτειροσργικής Ιαηρική Πανεπιζηημίοσ Αθηνών Πανεπιζηημιακό Γενικό Νοζοκομείο Αηηικόν Randomized Controlled Trials (RCTs) Why
More informationCardiac evaluation for the noncardiac. Nathaen Weitzel MD University of Colorado Denver Dept of Anesthesiology
Cardiac evaluation for the noncardiac patient Nathaen Weitzel MD University of Colorado Denver Dept of Anesthesiology Objectives! Review ACC / AHA guidelines as updated for 2009! Discuss new recommendations
More information