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Lunardi M, Scarsini R, Venturi G, Pesarini G, Gratta A, Piccoli A, Ferrero V, Ribichini F. TCT-10 Physiological Versus Angiographic Guidance for Myocardial Revascularization in Patients Undergoing Transcatheter Aortic Valve Implantation. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1086] [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: 10/28/2022]
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127
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Russo G, Burzotta F, D'Amario D, Ribichini F, Piccoli A, Paraggio L, Previ L, Pesarini G, Porto I, Leone AM, Niccoli G, Aurigemma C, Verdirosi D, Trani C, Crea F. TCT-452 Hemodynamics and its Predictors During Impella-Protected PCI in High Risk Patients with Reduced Ejection Fraction. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1620] [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: 10/28/2022]
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128
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Scarsini R, Cantone R, Venturi G, De Maria GL, Lunardi M, Feola M, Kharbanda R, Banning A, Ribichini F, Ribichini F. TCT-315 Correlation between fractional flow reserve and non-invasive myocardial perfusion imaging in patients with severe aortic stenosis and coronary artery disease. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1457] [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: 11/25/2022]
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129
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van den Brink F, Zivelonghi C, Bleeker G, Ribichini F, Berg JT. TCT-698 VA-ECMO for the treatment of cardiogenic shock in primary PCI for STEMI; a multi-centre perspective. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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130
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Russo G, Burzotta F, D'Amario D, Ribichini F, Piccoli A, Paraggio L, Previ L, Pesarini G, Porto I, Leone AM, Niccoli G, Aurigemma C, Verdirosi D, Trani C, Crea F. P1831Hemodynamics and its predictors during impella-protected pci in high risk patients with reduced ejection fraction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1831] [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: 11/13/2022] Open
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131
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Russo G, Burzotta F, D'Amario D, Ribichini F, Piccoli A, Paraggio L, Previ L, Pesarini G, Porto I, Leone AM, Niccoli G, Aurigemma C, Verdirosi D, Trani C, Crea F. P1832Results and outcome predictors of impella-protected pci in complex-higher-risk and indicated patients (chips). Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1832] [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: 11/13/2022] Open
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132
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Russo G, Burzotta F, D'Amario D, Ribichini F, Piccoli A, Paraggio L, Previ L, Pesarini G, Porto I, Leone AM, Niccoli G, Aurigemma C, Verdirosi D, Trani C, Crea F. Hemodynamics and its predictors during Impella-protected PCI in high risk patients with reduced ejection fraction. Int J Cardiol 2018; 274:221-225. [PMID: 30057165 DOI: 10.1016/j.ijcard.2018.07.064] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 06/23/2018] [Accepted: 07/12/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Percutaneous ventricular-assistance by Impella (IMP) represents an emerging strategy to manage patients with reduced left-ventricular (LV) ejection-fraction (EF) undergoing percutaneous-coronary-intervention (PCI). The hemodynamic behave during IMP-protected PCI has been scarcely investigated. METHODS We reviewed the IMP console's function and hemodynamic data (which are continuously recorded during assistance) in a consecutive series of 37 patients who underwent elective IMP-protected PCI in two high-volume centers. All patients had multivessel disease and impaired LVEF. Coronary artery disease burden was graded using the British-Cardiovascular-Intervention-Society jeopardy-score (BCIS-JS) score. IMP motor speed and pressure signals (systolic blood pressure, SBP, and mean blood pressure, MBP) were analyzed. Primary hemodynamic end-points were "critical systolic blood pressure (SBP) drop" (SBP decrease ≥ 20 mm Hg reaching ≤90 mm Hg values) and "critical mean blood pressure (MBP) drop" (MBP decrease reaching ≤60 mm Hg). RESULTS Over mean assistance duration of 254 ± 549 min, no IMP motor drop occurred. During PCI, SBP and MBP significantly decreased but all patients had SBP values >78 mm Hg. Critical SBP and MBP drops occurred in 10.8% of patients. Among all baseline and procedural characteristics, BCIS-JS was the only significant predictor of SBP drop (p = 0.001) while BCIS-JS and LV end-diastolic volume significantly predicted MBP drop (p = 0.001 for both). CONCLUSIONS In patients with reduced EF undergoing IMP-protected PCI, a significant pressure decrease occurs during PCI but pressure is systematically maintained at levels warranting vital organ perfusion. Critical pressure drops during PCI occur in some patients with higher jeopardized myocardium and left ventricular diastolic volumes.
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Migliorini F, Tafuri A, Inverardi D, Sebben M, Ribichini F, Artibani W. 670 Percutaneous angioplasty of internal pudendal arteries in the treatment of erectile dysfunction not responsive to pharmacological therapy. Our initial experience in five patients. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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134
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Zivelonghi C, Teeuwen K, Agostoni P, van der Schaaf RJ, Ribichini F, Adriaenssens T, Kelder JC, Tijssen JGP, Henriques JPS, Suttorp MJ. Impact of ultra-thin struts on restenosis after chronic total occlusion recanalization: Insights from the randomized PRISON IV trial. J Interv Cardiol 2018; 31:580-587. [DOI: 10.1111/joic.12516] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 03/25/2018] [Accepted: 04/03/2018] [Indexed: 11/30/2022] Open
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135
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Kikuta Y, Cook CM, Sharp ASP, Salinas P, Kawase Y, Shiono Y, Giavarini A, Nakayama M, De Rosa S, Sen S, Nijjer SS, Al-Lamee R, Petraco R, Malik IS, Mikhail GW, Kaprielian RR, Wijntjens GWM, Mori S, Hagikura A, Mates M, Mizuno A, Hellig F, Lee K, Janssens L, Horie K, Mohdnazri S, Herrera R, Krackhardt F, Yamawaki M, Davies J, Takebayashi H, Keeble T, Haruta S, Ribichini F, Indolfi C, Mayet J, Francis DP, Piek JJ, Di Mario C, Escaned J, Matsuo H, Davies JE. Pre-Angioplasty Instantaneous Wave-Free Ratio Pullback Predicts Hemodynamic Outcome In Humans With Coronary Artery Disease: Primary Results of the International Multicenter iFR GRADIENT Registry. JACC Cardiovasc Interv 2018; 11:757-767. [PMID: 29673507 DOI: 10.1016/j.jcin.2018.03.005] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 03/01/2018] [Accepted: 03/06/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The authors sought to evaluate the accuracy of instantaneous wave-Free Ratio (iFR) pullback measurements to predict post-percutaneous coronary intervention (PCI) physiological outcomes, and to quantify how often iFR pullback alters PCI strategy in real-world clinical settings. BACKGROUND In tandem and diffuse disease, offline analysis of continuous iFR pullback measurement has previously been demonstrated to accurately predict the physiological outcome of revascularization. However, the accuracy of the online analysis approach (iFR pullback) remains untested. METHODS Angiographically intermediate tandem and/or diffuse lesions were entered into the international, multicenter iFR GRADIENT (Single instantaneous wave-Free Ratio Pullback Pre-Angioplasty Predicts Hemodynamic Outcome Without Wedge Pressure in Human Coronary Artery Disease) registry. Operators were asked to submit their procedural strategy after angiography alone and then after iFR-pullback measurement incorporating virtual PCI and post-PCI iFR prediction. PCI was performed according to standard clinical practice. Following PCI, repeat iFR assessment was performed and the actual versus predicted post-PCI iFR values compared. RESULTS Mean age was 67 ± 12 years (81% male). Paired pre- and post-PCI iFR were measured in 128 patients (134 vessels). The predicted post-PCI iFR calculated online was 0.93 ± 0.05; observed actual iFR was 0.92 ± 0.06. iFR pullback predicted the post-PCI iFR outcome with 1.4 ± 0.5% error. In comparison to angiography-based decision making, after iFR pullback, decision making was changed in 52 (31%) of vessels; with a reduction in lesion number (-0.18 ± 0.05 lesion/vessel; p = 0.0001) and length (-4.4 ± 1.0 mm/vessel; p < 0.0001). CONCLUSIONS In tandem and diffuse coronary disease, iFR pullback predicted the physiological outcome of PCI with a high degree of accuracy. Compared with angiography alone, availability of iFR pullback altered revascularization procedural planning in nearly one-third of patients.
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Scarsini R, Pesarini G, Lunardi M, Piccoli A, Zanetti C, Cantone R, Bellamoli M, Ferrero V, Gottin L, Faggian G, Ribichini F. Observations from a real-time, iFR-FFR “hybrid approach” in patients with severe aortic stenosis and coronary artery disease undergoing TAVI. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2018; 19:355-359. [DOI: 10.1016/j.carrev.2017.09.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 09/29/2017] [Accepted: 09/29/2017] [Indexed: 02/02/2023]
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137
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Dolci G, Bergamini C, Fiorio E, Ribichini F. Irreversible left atrium dilatation preceding left ventricular dysfunction during trastuzumab therapy. Minerva Cardiol Angiol 2018; 66:223-224. [DOI: 10.23736/s0026-4725.17.04483-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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138
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Lunardi M, Zivelonghi C, van den Brink FS, Ghione M, Vinco G, Benfari G, Scarsini R, Ribichini F, Agostoni P. Drug eluting balloon for the treatment of patients with coronary artery disease: Current perspectives. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2018; 19:215-220. [DOI: 10.1016/j.carrev.2017.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/03/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022]
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139
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Pesarini G, Lunardi M, Piccoli A, Gottin L, Prati D, Ferrero V, Scarsini R, Milano A, Forni A, Faggian G, Ribichini F. Effectiveness and Safety of Transcatheter Aortic Valve Implantation in Patients With Pure Aortic Regurgitation and Advanced Heart Failure. Am J Cardiol 2018; 121:642-648. [PMID: 29329825 DOI: 10.1016/j.amjcard.2017.11.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 11/16/2017] [Accepted: 11/20/2017] [Indexed: 11/25/2022]
Abstract
Results of transcatheter aortic valve implantation (TAVI) for treatment of severe noncalcific isolated aortic regurgitation (AR) complicated by advanced heart failure or cardiogenic shock has been previously reported only in isolated case reports. Current self-expanding transcatheter aortic valves are designed to treat aortic valve stenosis, and have also been implanted in cases of severe AR due to degenerated bioprosthesis and in very few cases of native aortic valves. We report 13 consecutive inoperable patients with noncalcific, pure AR, and advanced heart failure treated with emergency percutaneous transfemoral implantation with self-expandable CoreValves at our institution between July 2012 and September 2017. The immediate and long-term clinical outcome was prospectively assessed according to the Valve Academic Research Consortium-2 criteria for device success and safety. All but 3 patients had previous surgery of the aortic root, including 2 implants of Heart Mate-II left ventricle assist device; none had surgical aortic bioprosthesis at the time of the TAVI. Valve implantation was successful in 12 of 13 patients (92%) and 1 patient required a second unplanned valve procedure within 18 hours. Oversizing the prosthesis by approximately 15% yielded better results with 1 valve. Two patients with left ventricle assist device died within 30 days of TAVI. All patients who survived to hospital discharge had none or just mild residual AR, improved their cardiac function, and survived at long-term without recurrence of clinical events. In conclusion, implanting self-expandable transcatheter valves in patients pure AR in this small study was safe and effective, and represented an important option for inoperable patients with noncalcific severe AR.
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140
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Zivelonghi C, van Kuijk JP, Nijenhuis V, Poletti E, Suttorp MJ, van der Heyden JAS, Eefting FD, Rensing BJ, ten Berg JM, Azzalini L, van den Brink FS, Ribichini F, Colombo A, Henriques JPS, Agostoni P. First report of the use of long-tapered sirolimus-eluting coronary stent for the treatment of chronic total occlusions with the hybrid algorithm. Catheter Cardiovasc Interv 2018; 92:E299-E307. [DOI: 10.1002/ccd.27539] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 01/17/2018] [Accepted: 01/20/2018] [Indexed: 11/07/2022]
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141
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Ribichini F. Remembering Corrado Vassanelli. Am J Med 2018; 131:119. [PMID: 28986070 DOI: 10.1016/j.amjmed.2017.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 09/20/2017] [Indexed: 11/30/2022]
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142
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Scarsini R, Pesarini G, Zivelonghi C, Piccoli A, Ferrero V, Lunardi M, Gottin L, Zanetti C, Faggian G, Ribichini F. Physiologic evaluation of coronary lesions using instantaneous wave-free ratio (iFR) in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation. EUROINTERVENTION 2018; 13:1512-1519. [DOI: 10.4244/eij-d-17-00542] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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143
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D'Ascenzo F, Benedetto U, Bianco M, Conrotto F, Moretti C, D'Onofrio A, Agrifoglio M, Colombo A, Ribichini F, Tarantini G, D'Amico M, Salizzoni S, Rinaldi M. Which is the best antiaggregant or anticoagulant therapy after TAVI? A propensity-matched analysis from the ITER registry. The management of DAPT after TAVI. EUROINTERVENTION 2017; 13:e1392-e1400. [PMID: 28870875 DOI: 10.4244/eij-d-17-00198] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS The safety and efficacy of single vs. dual antiplatelet therapy (DAPT) in patients undergoing TAVI remain to be addressed. The aim of our study was to evaluate the usefulness of a DAPT compared to a single platelet therapy in patients undergoing TAVI with a balloon-expandable prosthesis. METHODS AND RESULTS All consecutive patients enrolled in the ITER registry were included. Patients undergoing TAVI discharged with aspirin alone were compared to those taking DAPT before and after selection using propensity score with matching. Subgroup analysis was performed for those on OAT. Prosthetic heart valve dysfunction at follow-up was the primary endpoint, whereas all-cause death, cardiovascular death, bleedings, vascular complications and cerebrovascular accidents were the secondary ones. From 1,364 patients, after propensity score with matching, 605 were selected for each group (aspirin alone vs. DAPT). At 30 days, rates of VARC mortality were lower in patients with aspirin alone (1.5% vs. 4.1%, p=0.003), mainly driven by a reduction of major vascular complications (5.3% vs. 10.7%, p<0.001) and of major bleedings (6.6% vs. 11.5%, p<0.001), without a difference in prosthetic heart valve dysfunction after 45±14 months (2.8% vs. 3.0%, p=0.50). These results were confirmed on multivariable analysis. CONCLUSIONS After TAVI with a balloon-expandable prosthesis, aspirin alone does not increase the risk of prosthetic valve dysfunction, and reduces the risk of periprocedural complications and of 30-day all-cause death.
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144
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Maggio S, Gambaro A, Scarsini R, Ribichini F. Preventive left main and right coronary artery stenting to avoid coronary ostia occlusion in high-risk stentless valve-in-valve transcatheter aortic valve implantation. Interact Cardiovasc Thorac Surg 2017; 25:147-149. [PMID: 28379441 DOI: 10.1093/icvts/ivx068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 02/07/2017] [Indexed: 11/13/2022] Open
Abstract
Transcatheter aortic valve implantation is becoming an attractive and promising alternative to redo surgery for aortic bioprosthetic valves degeneration, especially in high-risk patients. However, valve-in-valve transcatheter aortic valve implantation itself carries some procedural risks and potential challenges that interventionists must be aware of. An accurate preprocedural planning is fundamental for the prevention of potentially fatal complications. This case describes a novel strategy of simultaneous right and left coronary artery stenting preventing bilateral coronary obstruction in a patient with a stentless surgical aortic valve and extremely low origin of the 2 coronary arteries.
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145
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Scarsini R, Pesarini G, Lunardi M, Piccoli A, Zanetti C, Zivelonghi C, Ribichini F. TCT-30 Instantaneous wave-free period variations after aortic valve replacement in patients with severe aortic valve stenosis. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.055] [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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146
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Scarsini R, Pesarini G, Lunardi M, Piccoli A, Ribichini F. TCT-31 Hybrid iFR-FFR decision-making strategy in coronary revascularization of patients with severe aortic stenosis undergoing TAVI. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.056] [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: 11/26/2022]
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147
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Burzotta F, Russo G, Ribichini F, Piccoli A, D'Amario D, Paraggio L, Previ L, Pesarini G, Porto I, Leone AM, Niccoli G, Aurigemma C, Verdirosi D, Trani C, Crea F. TCT-590 Results and Outcome Predictors of Impella-protected PCI in High Risk Patients: A Two-centre Experience. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.776] [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: 11/16/2022]
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148
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Scarsini R, Pesarini G, Zivelonghi C, Piccoli A, Ferrero V, Lunardi M, Barbierato M, Caprioglio F, Vassanelli C, Ribichini F. Coronary physiology in patients with severe aortic stenosis: Comparison between fractional flow reserve and instantaneous wave-free ratio. Int J Cardiol 2017; 243:40-46. [DOI: 10.1016/j.ijcard.2017.05.117] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/13/2017] [Accepted: 05/29/2017] [Indexed: 01/10/2023]
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149
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Zivelonghi C, Pesarini G, Scarsini R, Lunardi M, Piccoli A, Ferrero V, Gottin L, Vassanelli C, Ribichini F. Coronary Catheterization and Percutaneous Interventions After Transcatheter Aortic Valve Implantation. Am J Cardiol 2017; 120:625-631. [PMID: 27964903 DOI: 10.1016/j.amjcard.2016.10.046] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/18/2016] [Accepted: 10/18/2016] [Indexed: 11/17/2022]
Abstract
Coronary artery disease (CAD) is often present in patients with severe aortic valve stenosis candidates to transcatheter aortic valve implantation (TAVI). Mild CAD may also worsen and need treatment years after TAVI. The implantation of a transcatheter valve may interfere with the capability of reengaging the coronary arteries. We prospectively assessed the feasibility of performing coronary angiography (CA), fractional flow reserve, and, where indicated, percutaneous coronary intervention after valve implantation in a consecutive series of patients with CAD undergoing TAVI. Valve type and size were decided according to accurate computed tomography scan and angiographic measurement of the aortic root structures. We analyzed 66 consecutive patients undergoing TAVI, 41 with balloon-expandable, and 25 with self-expandable transcatheter valves. Right and left coronary catheterization (132 vessels) was successful in all cases except in 1 left coronary artery after a high implantation of a self-expandable valve (unsuccess rate, 1 in 50 vessels). In 6 of 132 vessels (4%), CA was initially nonselective, but after positioning the 0.014″ intracoronary guidewire, selective injections were obtained in all these cases. Percutaneous coronary intervention was performed successfully in 19 coronary vessels (17 patients) as indicated by fractional flow reserve measurements. In conclusion, catheterization of the coronary ostia after transfemoral TAVI with balloon or self-expandable valves is safe and feasible in almost all cases. Accurate imaging of the aortic root and procedural planning may help to avoid too high implantation of supra-annular self-expandable valves to obviate difficulties in accessing coronary ostia. Use of intracoronary guidewires facilitates selective CA in cases with difficult access.
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Borio G, Scarsini R, Rossi A, Cuman M, Piccoli A, Forni A, Pesarini G, Vassanelli C, Ribichini F. P2975Pulmonary arterial compliance is a major determinant of right ventricular dysfunction: an echocardiographic/invasive hemodynamic study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p2975] [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: 11/12/2022] Open
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