Coronary artery bypass grafting (CABG) is an established therapy for obstructive cardiovascular disease and ischemic cardiomyopathy. Utilization of the left-internal mammary artery as a graft has been a particularly successful aspect of CABG due to impressively durable patency rates. Despite this, adoption of bilateral mammary artery grafting has lagged in surgical practice. The Arterial Revascularization […]
Latest articles
Bleeding versus thromboembolic protection in atrial fibrillation and coronary stent procedures.
Five to 8% of people undergoing percutaneous coronary intervention (PCI) also have atrial fibrillation (AF). The optimal antiplatelet / anticoagulant regimen in these individuals remains unclear as stroke and stent thrombosis prevention need to be balanced against the risks of major bleeding. The PIONEER AF-PCI trial (Open-Label, Randomized, Controlled, Multicenter Study Exploring Two Treatment Strategies […]
No differences in on-pump versus off-pump bypass grafting at 5 years.
Coronary artery bypass grafting (CABG) may significantly improve quality of life and longevity. As with all therapies, however, these benefits must be weighed against potential risks. Some hypothesize that aortic cross clamping and cardiopulmonary bypass, historically utilized during CABG, increase the potential for certain complications and can be successfully avoided with newer “off-pump” CABG techniques. […]
Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis
The use of percutaneous coronary intervention (PCI) for unprotected left main coronary artery stenosis is increasing but it remains unclear whether this approach is non-inferior to coronary artery bypass grafting (CABG). Both the Nordic-Baltic-British left main revascularization study (NOBLE, n=1201) and Evaluation of an everolimus eluting stent versus coronary artery bypass surgery for effectiveness of […]
Amiodarone and lidocaine in refractory cardiac arrest
Out of hospital cardiac arrest with shock-refractory ventricular tachycardia (VT) or fibrillation (VF) carries a severe prognosis. Despite their frequent use and guideline inclusion in this scenario, evidence that amiodarone or lidocaine improve survival is lacking. In this large multicenter randomized controlled double-blind trial, 3026 adult patients with spontaneously occurring out-of-hospital cardiac arrest and shock-refractory […]
Adolescent body mass index predicts future cardiovascular risk
One-third of the adolescent population in Western countries is now considered to be overweight or obese. The implications of this epidemic remain unclear but may well lead to an increased prevalence of cardiovascular disease and an erosion in the mortality and morbidity gains that have been apparent in the last few decades. To further explore […]
Heart’s Twitter Journal Club
Join in our Journal Club on Twitter and engage with readers from across the world! Each month we will discuss a paper from Heart. We will select a recent paper ahead of time and then discuss four different aspects of it for about 15 minutes each. The paper under discussion will be free to access for a week […]
Contemporary Coronary Stents
Percutaneous treatment for obstructive coronary artery disease has evolved in conjunction with technological advances from the initial era of balloon angioplasty to the first bare metal stents (BMS) and then through various iterations of drug eluting stent (DES) technology. Current generation DES data suggest progressively improved re-stenosis and thrombosis rates and on-going trials are examining […]
CPAP fails to improve cardiovascular outcomes in OSA
Obstructive sleep apnea (OSA) is associated with increased cardiovascular events in observational studies. Randomized trials have demonstrated continuous positive airway pressure (CPAP) therapy reduces blood pressure, markers of oxidative stress and insulin insensitivity. Yet, it remains unclear whether treatment with CPAP reduces cardiovascular events. In the largest study of its kind, 2717 patients aged 45 […]
Von Willebrand Factor Multimers during Transcatheter Aortic-Valve Replacement
Patients with stenotic or regurgitant aortic valve disease appear to cleave multimers of Von Willebrand factor (HMW-multimer), presumably due to high-shear stresses and non-laminar flow. Van Belle and colleagues hypothesized that transcatheter aortic valve replacement (TAVR) would correct this process, but that significant residual paravalvular leak (PVL) following TAVR would abrogate this corrective effect. Moderate […]