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Complex Percutaneous Coronary Intervention - Indication, Preprocedural Planning, Techniques and Influence on Myocardium

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A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Cardiovascular Clinical Research".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 6800

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Special Issue Editors

Dr. Umberto Barbero

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Guest Editor

Cardiology Unit, “Santissima Annunziata” Hospital, 12038 Savigliano, Italy
Interests: coronary artery disease

Dr. Maksymilian Opolski

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Guest Editor

Department of Interventional Cardiology and Angiology, National Institute of Cardiology, 04-628 Warsaw, Poland
Interests: coronary artery disease

Special Issue Information

Dear Colleagues,

The aim of this Special Issue is to explore the field of ischaemic heart disease with a critical focus on complex coronary artery disease, a setting increasingly encountered in clinical practice. Patients with multivessel disease, left main involvement, coronary chronic total occlusions, or severely reduced left ventricular ejection function, often excluded from large trials, pose daily decision-making challenges to both clinical cardiologists and interventionalists or cardiac surgeons. This issue aims to involve different specialists and researchers to provide the latest viewpoints on potential indications, planning strategies, and up-to-date interventional and surgical techniques in the aforementioned patient population.

Dr. Umberto Barbero
Dr. Maksymilian Opolski
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

percutaneous coronary intervention
left main
bifurcation disease
ventricular assistance
myocardial viability
myocardial ischemia
coronary chronic total occlusion
coronary computed tomography angiography

Published Papers (4 papers)

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Research

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12 pages, 1254 KiB

Open AccessArticle

Validation of Quantitative Flow Ratio-Derived Virtual Angioplasty with Post-Angioplasty Fractional Flow Reserve—The QIMERA-I Study

by Ignacio J. Amat-Santos, Giorgio Marengo, Juan Pablo Sánchez-Luna, Carlos Cortés Villar, Fernando Rivero Crespo, Víctor Alfonso Jiménez Díaz, José María de la Torre Hernández, Armando Pérez de Prado, Manel Sabaté, Ramón López-Palop, José Miguel Vegas Valle, Javier Suárez de Lezo, Clara Fernandez Cordon, Jose Carlos Gonzalez, Mario García-Gómez, Alfredo Redondo, Manuel Carrasco Moraleja and J. Alberto San Román

J. Cardiovasc. Dev. Dis. 2024, 11(1), 14; https://doi.org/10.3390/jcdd11010014 - 31 Dec 2023

Cited by 1 | Viewed by 1562

Abstract

Background: Quantitative flow ratio (QFR) virtual angioplasty with pre-PCI residual QFR showed better results compared with an angiographic approach to assess post-PCI functional results. However, correlation with pre-PCI residual QFR and post-PCI fractional flow reserve (FFR) is lacking. Methods: A multicenter prospective study including consecutive patients with angiographically 50–90% coronary lesions and positive QFR results. All patients were evaluated with QFR, hyperemic and non-hyperemic pressure ratios (NHPR) before and after the index PCI. Pre-PCI residual QFR (virtual angioplasty) was calculated and compared with post-PCI fractional flow reserve (FFR), QFR and NHPR. Results: A total of 84 patients with 92 treated coronary lesions were included, with a mean age of 65.5 ± 10.9 years and 59% of single vessel lesions being the left anterior descending artery in 69%. The mean vessel diameter was 2.82 ± 0.41 mm. Procedural success was achieved in all cases, with a mean number of implanted stents of 1.17 ± 0.46. The baseline QFR value was 0.69 ± 0.12 and baseline FFR and NHPR were 0.73 ± 0.08 and 0.82 ± 0.11, respectively. Mean post-PCI FFR increased to 0.87 ± 0.05 whereas residual QFR had been estimated as 0.95 ± 0.05, showing poor correlation with post-PCI FFR (0.163; 95% CI:0.078–0.386) and low diagnostic accuracy (30.9%, 95% CI:20–43%). Conclusions: In this analysis, the results of QFR-based virtual angioplasty did not seem to accurately correlate with post-PCI FFR. Full article

(This article belongs to the Special Issue Complex Percutaneous Coronary Intervention - Indication, Preprocedural Planning, Techniques and Influence on Myocardium)

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11 pages, 5606 KiB

Open AccessArticle

Embolization of Perforated Coronary Artery with a Fragment of Balloon Catheter (Cut Balloon Technique)—Multicenter Study

by Grzegorz Sobieszek, Bartosz Zięba, Wojciech Dworzański, Rafał Celiński, Umberto Barbero and Maksymilian P. Opolski

J. Cardiovasc. Dev. Dis. 2023, 10(12), 496; https://doi.org/10.3390/jcdd10120496 - 14 Dec 2023

Viewed by 2078

Abstract

Background: Iatrogenic distal coronary artery perforation can be a life-threatening complication. While there are different dedicated devices for the embolization of distal perforations, there are scarce data about the embolization using the fragmented balloon catheter, the so-called cut balloon technique (CBT). Methods: We included consecutive patients with distal coronary perforations treated with CBT in four cardiac centers between 2017 and 2023. Clinical, angiographic and procedural characteristics as well as in-hospital outcomes were recorded. Results: Twenty-six patients (68% men, mean age: 71 ± 10.6 years) with 25 distal coronary perforations and one septal collateral perforation were included. Eleven patients (42%) had elective percutaneous coronary intervention, while fifteen patients (58%) were treated for acute coronary syndrome. The site of perforation was most frequently distributed in the left anterior descending artery (40%), followed by the circumflex artery (28%) and right coronary artery (24%). The diameter of balloons for CBT ranged from 1.5 to 4.0 mm, with most balloons (76%) being either 2.0 or 2.5 mm in diameter. Most balloons (88%) were previously used for lesion predilatation. The numbers of cut balloons needed to seal the perforation were 1, 2 and ≥3 in 48%, 20% and 32% of cases, respectively. The in-hospital prognosis was favorable, with cardiac tamponade requiring pericardiocentesis in only four (16%) patients. Neither emergency surgery nor cardiac death occurred. Conclusions: CBT is a safe, efficient and easy-to-implement technique for the embolization of coronary perforations. Most distal coronary perforations can be sealed with one or two fragments of cut balloons, obviating the need for additional devices. Full article

(This article belongs to the Special Issue Complex Percutaneous Coronary Intervention - Indication, Preprocedural Planning, Techniques and Influence on Myocardium)

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13 pages, 1226 KiB

Open AccessArticle

A Simple Strategy to Reduce Contrast Media Use and Risk of Contrast-Induced Renal Injury during PCI: Introduction of an “Optimal Contrast Volume Protocol” to Daily Clinical Practice

by Aiste Zebrauskaite, Greta Ziubryte, Lukas Mackus, Austeja Lieponyte, Evelina Kairyte, Ramunas Unikas and Gediminas Jarusevicius

J. Cardiovasc. Dev. Dis. 2023, 10(9), 402; https://doi.org/10.3390/jcdd10090402 - 19 Sep 2023

Viewed by 1246

Abstract

Contrast-induced acute kidney injury is the leading cause of iatrogenic acute nephropathy. Development of contrast-induced nephropathy (CIN) increases the risk of adverse long- and short-term patients outcomes, the hospital costs, and length of hospitalization. There are a couple of methods described for CIN prevention (statin prescription, prehydration, contrast media (CM) clearance from the blood system, and decrease amounts of contrast volume). The CM volume to patient’s creatinine clearance ratio is the main factor to predict the risk of CIN development. The safe CM to creatinine clearance ratio limits have been established. The usage of CM amount depends on personal operators habits and inside center regulations. There is no standardized contrast usage protocol worldwide. The aim of this study was to establish an easy to use, cheap, and efficient protocol to estimate a personalized safe CM dose limit for every patient based on their kidney function. These limits are announced during the “Time Out” before the procedure. Our study included 519 patients undergoing interventional coronary procedures: 207 patients into the “Optimal Contrast Volume” arm and 312 into the control group. Applying the protocol into a daily clinical practice leads to a significant reduction in CM volume used for all type of procedures and the development of CIN in comparison with a control group. Full article

(This article belongs to the Special Issue Complex Percutaneous Coronary Intervention - Indication, Preprocedural Planning, Techniques and Influence on Myocardium)

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Other

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7 pages, 711 KiB

Open AccessSystematic Review

Percutaneous Coronary Intervention Outcomes in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis

by Harshwardhan Khandait, Vikash Jaiswal, Muhammad Hanif, Abhigan Babu Shrestha, Alisson Iturburu, Maitri Shah, Angela Ishak, Vamsi Garimella, Song Peng Ang and Midhun Mathew

J. Cardiovasc. Dev. Dis. 2023, 10(3), 92; https://doi.org/10.3390/jcdd10030092 - 21 Feb 2023

Cited by 1 | Viewed by 1550

Abstract

There is a paucity of data and minimal literature on outcomes of percutaneous coronary intervention (PCI) among liver cirrhosis patients. Therefore, we conducted a systematic review and meta-analysis to evaluate the clinical outcomes among liver cirrhosis patients post-PCI. We conducted a comprehensive literature search in the PubMed, Embase, Cochrane, and Scopus databases for relevant studies. Effect sizes were pooled using the DerSimonian and Laird random-effects model as an odds ratio (OR) with 95% confidence intervals (CI). A total of 3 studies met the inclusion criteria, providing data from 10,705,976 patients. A total of 28,100 patients were in the PCI + Cirrhosis group and 10,677,876 patients were in the PCI-only group. The mean age of patients with PCI + Cirrhosis and PCI alone was 63.45 and 64.35 years. The most common comorbidity was hypertension among the PCI + Cirrhosis group compared with PCI alone (68.15% vs. 73.6%). Cirrhosis patients post-PCI were had higher rates of in-hospital mortality (OR, 4.78 (95%CI: 3.39–6.75), p < 0.001), GI bleeding (OR, 1.91 (95%CI:1.83–1.99), p < 0.001, I² = 0%), stroke (OR, 2.48 (95%CI:1.68–3.66), p < 0.001), AKI (OR, 3.66 (95%CI: 2.33–6.02), p < 0.001), and vascular complications (OR, 1.50 (95%CI: 1.13–1.98), p < 0.001) compared with the PCI group without cirrhosis. Patients with cirrhosis are at a high risk for mortality and adverse outcomes post-PCI procedure compared to the PCI-only group of patients. Full article

(This article belongs to the Special Issue Complex Percutaneous Coronary Intervention - Indication, Preprocedural Planning, Techniques and Influence on Myocardium)

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