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International Journal of Interventional Cardioangiology #46/47
Endovascular Transcatheter Aortic Valve Implantation (TAVI) Combined with Coronary Stenting in Patients with Aortic Stenosis and CHD: Strategy for Subsequence of these Two Interventions
D.G. Ioseliani1, 2*, Å.À. Kovaleva2, Î.V. Zakharova2, Å.À. Savelov2, À.V. Stepanov2, V.À. Kryukov2, À.N. Rogatova2, V.V. Fomenko2, D.À. Asadov2
1 Department of Interventional Cardioangiology of the Institute of Vocational Education, Federal State Autonomous Budgetary Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University, Ministry of Healthcare of the Russian Federation
2 State Budgetary
Combination of surgical aortic valve replacement and coronary artery bypass grafting is the “golden standard" for patients with aortic stenosis and coronary heart disease (CHD). Nevertheless, in patients at high surgical risk and in inoperable patients endovascular transcatheter aortic valve implantation (TAVI) and coronary stenting replace conventional surgery more frequently. The issue on subsequence of these interventions is not clearly understood. The clinicians' opinions on this issue are controversy. Currently, there is no developed strategy regarding how and when to treat CHD in patients referred for TAVI. At the same time, many experts consider both simultaneous and staged interventions as possible treatment options for patients with aortic stenosis and concomitant CHD.
Keywords: aortic stenosis, coronary heart disease, coronary arteries, subsequence of endovascular interventions
Mid-Term Results of Urgent, Early and Delayed Stenting in Non-STEMI Patients
T.S. Sandodze, P.S. Vasiliev, N.V. Tsereteli, I.A. Kovalchuk, D.G. Iosseliani*
Our study was aimed at the comparison of the results of endovascular myocardial reperfusion in non-STEMI patients performed at various time intervals after the onset of the disease. For this purpose, 141 patients were included into the study. Depending on the timing of myocardial revascularization, the patients were assigned into three groups. Group 1 – 49 patients who underwent revascularization within the first 24 hours after the onset of angina attack; Group 2 – 45 patients with revascularization performed within 24 – 72 hours; Group 3 – 47 patients who had revascularization performed within 7–14 days after the onset of angina attack. The groups were comparable by all characteristics.
The study of immediate and mid-term results revealed the lack of significant differences in the clinical course of patients who received urgent revascularization within the first hours after the onset of the disease and those who underwent this procedure within up to 15 days after the onset of angina attack. Meanwhile, functional capacities of the left ventricle seem preferable in patients who underwent the procedure within the early stage of the disease. Hence, the earlier is endovascular myocardial revascularization performed in non-STEMI patients, the higher is the probability of the preservation of the viability of a larger part of the myocardium and, thus, of the improvement of the left ventricular functionality.
Key words: acute myocardial infarction non-STEMI, myocardial revascularization for non-STEMI.
Non-thyroidal Illness Syndrome in Cardiovascular Diseases (Review)
Î.V. Zakharova1, 2*
1 State Budgetary
2 Department of Interventional Cardioangiology of the Institute of Vocational Education, Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University, Ministry of Healthcare of the Russian Federation, Moscow, Russia
Non-thyroidal illness syndrome is quite frequently registered in patients with cardiovascular diseases. It is determined that the level of free T3 which is an independent risk factor affecting the disease prognosis is reduced in this population. Considering this fact, it is advisable to monitor thyroid status in patients with both acute and chronic CHD, including situations prior to the coronary interventions and surgeries.
Key words: non-thyroidal illness syndrome, review, cardiovascular diseases, endovascular interventions, prognosis.
Optical Coherence Tomography
V.V. Plechev, I.Å. Nikolaeva, I.V. Buzaev, I.G. Zagitov*, R.Yu. Risberg, B.À. Oleynik, I.Å. Yamanaeva
The authors describe the use of optical coherence tomography for the study of coronary blood flow, for the planning and the realization of percutaneous coronary interventions, including stenting, and for the prediction of their results.
Key words: optical coherence tomography, intravascular imaging, atherosclerotic plaque, percutaneous coronary intervention, stenting.
Clinical Case of a Female Patient with Takotsubo Cardiomyopathy
I.Yu. Kostyanov1, G.I. Gasanova1, À.N. Rogatova1, I.E. Chernysheva1, N.V. Tsereteli1, V.À. Nuridzhanyan1, D.G. Iosseliani1,2*
1 State Budgetary
2 Department of Interventional Cardioangiology of the Institute of Vocational Education, Federal State Autonomous Budgetary Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University, Ministry of Healthcare of the Russian Federation
The article describes a clinical case of a rare heart disease – Takotsubo cardiomyopathy. The disease is characterized by cardiac pain mimicking acute myocardial infarction, shortness of breath, transient dysfunction of the left ventricle and almost unchanged or slightly changed coronary arteries. Despite the sufficiently severe course of the disease in the first days of the syndrome onset, the outcome is rather favourable with almost fully recovered left ventricular function.
Key words: Takotsubo (octopus trap), stress-induced cardiomyopathy, systolic dysfunction.