Complex CTO Case with Dr. John Troy Owens Dr. John Troy Owens of Virginia Commonwealth University (VCU) presents a case of a 62-year-old male with history of extensive coronary artery disease and prior CABG (LIMA-LAD, SVG-OM, SVG-PDA), severely reduced left ventricular function with history of apical aneurysm and resolved LV thrombus. Additionally, the patient had … Continue reading “Complex Chronic Total Occlusion”
Dig into the details as Dr. James Stewart explains how he successfully revascularized a 47 year old patient who had been turned down for CABG by 3 surgeons. This patient with diabetes presented to a neighboring hospital with heart failure and was found to have challenging coronary anatomy: 95% distal left main bifurcation 100% CTO … Continue reading “Never Say Never: A Case Beset with Grim Doubt”
- Previous studies indicate the presence of chronic total occlusion (CTO) in hospitalized acute coronary syndrome patients correlates with higher incidences of in-hospital and long-term mortality.
- This study shows that presence of CTO in coronary artery disease (CAD) patients with ischemic heart failure results in adverse long-term prognosis.
In 2016, the recorded prevalence of heart failure (HF) in the United States was 5.7 million, with an estimated 670,000 new diagnoses each year.1
The rates of post-discharge mortality and readmissions following treatment for HF have remained unchanged, despite the improvement in outcomes of ambulatory HF patents.2 Continue readingCTO Impact on the Long-Term Prognosis of Ischemic Systolic Heart Failure
Dr. Jonathan Hill of Kings College Hospital speaks at the CHIP Seattle 2016 on CTO as a key barrier to an increase of PCI procedures and an advancement of complex PCI techniques. Dr. Hill concludes that, with the growth of new CTO techniques and devices, CTO must be part of comprehensive complex PCI program that … Continue reading “Why CTO is Key to PCI Risk Avoidance and New Complex PCI Techniques”
The University of Washington’s Dr. Ravi Hira shares a case of a low EF patient undergoing a retrograde CTO treated with hemodynamic support using Impella. Tweet this, subscribe or find educational opportunities near you.
William L. Lombardi, MD, Mark Reisman, MD, Ravi Hira, MD, and Robert Riley, MD, of the University of Washington Medical Center in Seattle presented a live case at ACC.16 on April 2 in which they performed a Protected PCI with Impella on a high-risk patient.The team performed the procedure on a 68-year-old man who was referred for complete percutaneous revascularization and had a history of coronary artery disease and moderate to severe chronic obstructive pulmonary disease. Continue readingTotal Revascularization of High Risk Complex 68-year old Patient: ACC.16 Live Case Wrap-Up
Trying again after a failed chronic total occlusion (CTO) percutaneous coronary intervention (PCI) did not significantly impact the success or safety of subsequent CTO-PCI procedures, according to a study presented at the American College of Cardiology 2016 Scientific Sessions in Chicago.Reporting on an analysis of 1,213 patients who underwent CTO-PCI procedures between 2012 and 2015 at 12 U.S. centers, Aya J. Alame, BA, and Judit Karacsonyi, MD, said that technical and procedural success rates were similar in the two groups of patients that they and her colleagues from the VA North Texas Healthcare System and UT Southwestern Medical Center (Dallas) and from the University of Szeged (Hungary) focused on for this study. Continue readingCTO PCIs Safe and Successful, Study Shows: ACC. 16
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) procedures achieved high technical success rates among all age groups examined in a multicenter U.S. registry study of more than 1,000 cases; however, the oldest patients (≥75 years) were more likely than the younger patients to suffer major adverse cardiac events (MACE). The study results were presented April 2 at the American College of Cardiology Scientific Sessions in Chicago.Rahel Iwnetu, MD, and colleagues at the VA North Texas Healthcare System in Dallas studied clinical, angiographic and outcomes data of 1,216 CTO-PCI procedures performed in 1,195 patients whom they grouped by age (<65, 65-74 and ≥75 years). Continue readingTechnical Success of CTO-PCI Not Impacted by Age. ACC. 16
Using the retrograde approach in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is associated with lower success and higher major adverse cardiovascular event (MACE) rates compared with an antegrade-only approach, according to study results presented at the American College of Cardiology 2016 Scientific Sessions.“The retrograde approach is integral to the hybrid algorithm for CTO PCI,” said abstract presenter Aris Karatasakis, MD, of the University of Texas Southwestern and VA North Texas Healthcare System in Dallas. “It is essential for achieving high success rates; however, it must be used judiciously due to higher potential for complications.” Continue readingMore Complications with Retrograde vs. Antegrade-Only CTO-PCI. ACC. 16
Today’s case review comes from the University of Washington’s Dr. Ravi Hira, who presents a ProtectedPCI case involving three-vessel intervention. Dr. Hira is Assistant Professor and Director of the Acute Cardiac Catheterization Service at Harborview Medical Center. His case involves the complete revascularization of a patient, who was successfully released from the hospital in relatively … Continue reading “Heart Team Recommends Protected PCI vs. Medical Management for Treatment of 3VD After Surgical Turn Down”