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Background. The MAVIG X-ray protective drape (MXPD) has been shown to reduce operator radiation dose during percutaneous coronary interventions (PCI). Whether MXPDs are also effective in reducing operator radiation during chronic total occlusion (CTO) PCI, often with dual access, is unknown. Methods. We performed a prospective, randomized-controlled study comparing operator radiation dose during CTO PCI (n = 60) with or without pelvic MXPDs. The primary outcomes were the difference in first operator radiation dose (μSv) and relative dose of the first operator (radiation dose normalized for dose area product) at the level of the chest in the two groups. The effectiveness of MXPD in CTO PCI was compared with non-CTO PCI using a patient-level pooled analysis with a previously published non-CTO PCI randomized study. Results. The use of the MXPD was associated with a 37% reduction in operator dose (weighted median dose 26.0 (IQR 10.00–29.47) μSv in the drape group versus 41.8 (IQR 30.82–60.59) μSv in the no drape group; P < 0.001 ) and a 60% reduction in relative operator dose (median dose 3.5 (IQR 2.5–5.4) E/DAPx10−3 in the drape group versus 8.6 (IQR 4.2–12.5) E/DAPx10−3 in the no drape group; P = 0.001 ). MXPD was equally effective in reducing operator dose in CTO PCI compared with non-CTO PCI ( P value for interaction 0.963). Conclusions. The pelvic MAVIG X-ray protective drape significantly reduced CTO operator radiation dose. This trial is clinically registered with https://www.clinicaltrials.gov (unique identifier: NCT04285944).

Background: Shear wave elastography (SWE) has been proposed as a novel noninvasive method for the assessment of myocardial stiffness, a relevant determinant of diastolic function. It is based on tracking the propagation of shear waves, induced, for instance, by mitral valve closure (MVC), in the myocardium. The speed of propagation is directly related to myocardial stiffness, which is defined by the local slope of the nonlinear stress-strain relation. Therefore, the operating myocardial stiffness can be altered by both changes in loading and myocardial mechanical properties. Objectives: This study sought to evaluate the capability of SWE to quantify myocardial stiffness changes in vivo by varying loading and myocardial tissue properties and to compare SWE against pressure-volume loop analysis, a gold standard reference method. Methods: In 15 pigs, conventional and high–frame rate echocardiographic data sets were acquired simultaneously with pressure-volume loop data after acutely changing preload and afterload and after inducting an ischemia/reperfusion (I/R) injury. Results: Shear wave speed after MVC significantly increased by augmenting preload and afterload (3.2 ± 0.8 m/s vs 4.6 ± 1.2 m/s and 4.6 ± 1.0 m/s, respectively; P = 0.001). Preload reduction had no significant effect on shear wave speed compared to baseline (P = 0.118). I/R injury resulted in significantly higher shear wave speed after MVC (6.1 ± 1.2 m/s; P < 0.001). Shear wave speed after MVC had a strong correlation with the chamber stiffness constant β (r = 0.63; P < 0.001) and operating chamber stiffness dP/dV before induction of an I/R injury (r = 0.78; P < 0.001) and after (r = 0.83; P < 0.001). Conclusions: Shear wave speed after MVC was influenced by both acute changes in loading and myocardial mechanical properties, reflecting changes in operating myocardial stiffness, and was strongly related to chamber stiffness, invasively derived by pressure-volume loop analysis. SWE provides a novel noninvasive method for the assessment of left ventricular myocardial properties.

Background Interventional cardiologists are occupationally exposed to high doses of ionising radiation. The MAVIG X-ray Protective Drape (MXPD) is a commercially available light-weight, lead-free shield placed over the pelvic area of patients in order to minimize operator radiation dose. The aim of this study was to examine the efficacy of the MXPD during routine cardiac catheterization including percutaneous coronary interventions (PCI). Methods We performed a prospective, randomized-controlled study comparing operator radiation dose during cardiac catheterization and PCI (n=632) with or without pelvic MXPD. We measured operator radiation dose at four sites: left eye, chest, left ring finger and right ring finger. The primary outcomes were the difference in first operator radiation dose (µSv) and relative dose of the first operator (radiation dose normalized for dose area product) at the level of the chest in the two groups. Results The use of the MXPD was associated with a 50% reduction in operator radiation dose (median dose 30.5 (IQR 23.0-39.7) µSv in No Drape group, versus 15.3 (IQR 11.1-20.0) µSv in the Drape group; P Conclusions The pelvic MXPD significantly reduces first operator radiation dose during routine cardiac catheterization and PCI.

ispartof: Minerva Cardioangiologica status: Published online

Bioresorbable scaffold (BRS) technology provides transient vessel support with drug-delivery capability without the long-term limitations of the permanent metallic drug-eluting stents (DES). Numerous scaffolds have been developed and investigated by device manufacturers, many of which, due to device deficiencies, have fallen by the way side. This short review will focus on the resorbable magnesium scaffold "Magmaris", the only metallic bioresorbable scaffold currently available, providing an evaluation of the most up to date clinical data whilst also briefly highlighting learning points regarding the ideal patient and lesion choice and optimal implantation technique. ispartof: Minerva Cardioangiol ispartof: location:Italy status: Published online

https://www.scitechnol.com/peer-review/hybrid-myocardial-revascularization-or-multivessel-minimally-invasive-direct-coronary-artery-bypass-two-case-reports-unwv.php?article_id=10342 ispartof: International Journal of Cardiovascular Research vol:8 issue:4 pages:1-3 status: published