All the patients had a complete relief of angina. In a small single center experience, even very old occlusions >20-year old can be effectively treated with dedicated systems, excellent guiding catheter support and experienced physicians. ? 2012 Wiley Periodicals, Inc. ""We sought to (1) determine the bleeding rates after primary percutaneous coronary intervention (PPCI) in our institution, where the default strategy has been transradial (TR) access in combination with unfractionated heparin (UFH) plus eptifibatide, and (2) Selleck LY2606368
compare these with the outcomes of patients treated with bivalirudin in HORIZONS-AMI. HORIZONS-AMI demonstrated that in PPCI undertaken via the transfemoral route, routine use of bivalirudin was associated with lower bleeding rates and improved mortality compared to routine use of UFH plus glycoprotein IIb/IIIa inhibitor (GPI). This was a single-center prospective registry of consecutive patients undergoing PPCI from January 2009 to August 2011 at the Queen Elizabeth Hospital Birmingham, UK. Thirty-day major bleeding was defined as per the HORIZONS-AMI criteria and also according to TIMI and GUSTO scales. Of the 432 consecutive patients, 350 fulfilled entry criteria for HORIZONS-AMI. In contrast with HORIZONS-AMI, Dimethyl sulfoxide
these subjects were older (62.5 �� 13.7 yr vs. 59.8 �� 11.1 yr, P < 0.05) with a higher rate of cardiogenic shock (6.3% vs. 0.8%, P < 0.0001). Despite this higher risk population, the rate of major bleeding was favorable (3.7% [95% CI: 2.0�C6.3%] vs. 4.9% [4.0�C6.1%], P = 0.32). Similarly, TIMI major bleeding (2.0% [0.8�C4.1%] vs. 3.1% [2.3�C3.4%], P = 0.10) and GUSTO severe or life-threatening bleeding (0.6% [0.1�C2.5%] vs. 0.4% [0.2�C0.9%], P = 0.75) were comparable. Routine TR access for PPCI using UFH plus GPI is associated with a low 30-day rate of major bleeding equivalent to the bivalirudin arm of HORIZONS-AMI. Default transradial access for PPCI permits routine use of a GPI without the penalty of high bleeding rates. ? 2013 Wiley Periodicals, Inc. ""In patients with hypoplastic left heart syndrome who experience the Norwood ABC294640 datasheet
surgical palliative program, development of the pulmonary artery branches is crucial. Balloon dilation and stenting may relieve potential stenosis but complete occlusion remains difficult to address with transcatheter therapy. We report the use of radiofrequency followed by balloon dilation and stenting to treat a long segment left pulmonary artery occlusion in a 15-month-old boy bidirectional Glenn. The left pulmonary artery was successfully recanalized with an excellent short-term outcome. This further enhances the interest of radiofrquency for recanalization of occluded pulmonary artery branches, as an alternative to surgical reconstruction. ? 2009 Wiley-Liss, Inc. ""New intra-operative mitral regurgitation is an unusual complication of tricuspid annuloplasty and maybe ischemic in etiology as a consequence of right coronary artery distortion.