Volume 7 - Issue 2 - February 2010
Clinical Review »
Cardiogenic Shock: From Reperfusion to Revascularization and Hemodynamic Support
Amar R. Chadaga, MD, Jamil B. Dihu, MD, Timothy A. Sanborn, MD
Abstract
Cardiogenic shock represents the most ominous challenge of acute myocardial infarction (AMI), with an incidence of 8–9% and a mortality rate approaching 50%. The majority of cases of cardiogenic shock are secondary to AMI complicated by left ventricular failure leading to refractory hypoperfusion and hypotension. Placement of an intra-aortic balloon pump (IABP) and primary percutaneous coronary intervention (PCI), particularly in young patients, remain the America
Case Study »
Delayed Carotid Artery-Internal Jugular Vein Fistula after Central Vein Cannulation for Coronary Bypass Surgery
Imad F. Tabry, MD
Case Presentation
A 91-year-old female was admitted in June 2009 with left-sided hemiplegia and congestive heart failure. She had undergone aortic valve replacement with coronary bypass surgery in 2003, an inferior vena cava filter insertion in 2006 and re-do coronary bypass off-pump in 2008. In addition to her neurologic findings, she also had a loud bruit at the base of the right neck associated with a palpable thrill. Review of her most recent surgery records confirmed the use of a right internal jugular central venous catheter f
New Technique »
A Technique for Retrograde Popliteal Artery Access in a Supine Patient
Immad Sadiq, MD and Kurush Setna, MD*
Abstract
The objective of this article is to demonstrate that supine retrograde popliteal artery access is feasible, safe and effective. No published reports of supine popliteal artery access exist in the English language literature. We define this technique and demonstrate with two cases the successful application of this method in femoropopliteal arterial percutaneous revascularization. This is a case report that outlines a new technique for arterial access. We have tried this technique in multiple
Interview »
The Mo.Ma® Ultra Proximal Cerebral Protection Device: An Effective New Tool
Interview with Co-Principal Investigators of the ARMOUR Trial: Gary Ansel, MD and L. Nelson Hopkins, MD
What was the purpose and scope of the ARMOUR trial? What were the trial’s
primary and secondary end points?
ANSEL: The purpose of the trial was to test a proximal protection device for carotid artery stenting (CAS) called the Mo.Ma® Ultra Proximal Cerebral Protection Device (Invatec, Inc., Bethlehem, Pennsylvania). This is a flow-clamping device to allow for CAS. The primary endpoints were MACE, which included any myocardial inf
Special Focus: TAVI »
Who Should Receive a Percutaneous Aortic Valve and Who Should Not?
Ibrahim Akin, MD, Stephan Kische, MD, Henrik Schneider, MD, Tim C. Rehders, MD, Jasmin Ortak, MD, Andreas Liebold, MD*, Christoph A. Nienaber, MD, Hüseyin Ince, MD
Introduction
Rising life expectancy results in an increase in degenerative and neoplastic diseases. Population-based observational studies revealed that 1–2% of patients > 65 years of age have moderate-to-severe aortic stenosis (AS).1 Surgical aortic valve replacement (AVR) dates back to 1960 and is currently the only treatment option for severe AS. It has been shown t
