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Prompt and effective cardiopulmonary resuscitation (CPR) is the first link in the chain of survival following cardiac arrest. We assessed a new device, the CPR-Ezy (Medteq Innovations Pty Ltd., Brisbane, Australia), to aid timing and effectiveness of external cardiac compressions (ECC), by 32 subjects who had prior community-based training in CPR. ECC was performed on a manikin for 4 min by all subjects without and with the device. There was a statistically significant improvement in timing of ECC. Effectiveness of compressions was also improved over the whole time period, especially so in the last minute. We conclude that the CPR-Ezy can improve timing and effectiveness of ECC, and reduce the effects of resuscitator fatigue, in community-trained subjects.

Background —Measurements of Doppler derived coronary flow reserve (CFR) and pressure derived fractional flow reserve (FFR) for coronary stenosis assessment depend on the induction of maximal hyperemia. Adenosine is the most widely used pharmacological agent but is expensive and poorly tolerated by some patients. Methods and Results —The objective of this study was to test the equivalency of adenosine 5′-triphosphate (ATP) to adenosine in their ability to cause maximal hyperemia as compared with the hyperemic response of complete coronary occlusion in 6 canines. Intracoronary administration of either ATP or adenosine resulted in a significant increase in CFR (2.79±0.64 and 2.22±0.7 for 10 μg versus 4.65±1.22 and 4.25±0.78 for 100 μg for ATP and adenosine, respectively, P for trend R =0.934, P R =0.985, P P P Conclusions —1) Step up in dosage of ATP and adenosine beyond currently recommended clinical doses resulted in a significant increase in coronary hyperemia; 2) ATP was equivalent to adenosine for both CFR and FFR; and 3) complete coronary occlusion yielded a better hyperemic response than either drug, indicating that maximal hyperemia was not achieved by either pharmacological stimulus.

Hypertension is one of the most prevalent chronic diseases worldwide and the incidence of resistant hypertension is increasing. Catheter-based renal denervation (RDN) offers a new approach to reaching blood pressure goals by targeting the renal nerves. The technique has demonstrated significant and sustained reductions in blood pressure (BP) in the Symplicity HTN-1 and Symplicity HTN-2 clinical trials. The Global SYMPLICITY Registry aims to demonstrate safety and effectiveness in a ‘real-world’ patient population. Real-world RDN experience has emphasised that patient selection is crucial to successful outcomes; a multidisciplinary referral network is recommended to increase awareness of the procedure and identify patients who are likely to respond best to RDN. Further advances in catheter technology have led to the development of the multi-electrode Symplicity Spyral™ multi-electrode catheter; preliminary data from the feasibility study using the Symplicity Spyral catheter indicate clinical efficacy and procedural safety with reduced procedure times. The Symplicity Spyral catheter is not yet commercially available. The indications of RDN may also expand beyond resistant hypertension – encouraging data have been seen in patients with moderate treatment resistant hypertension. Furthermore, RDN may be beneficial in other clinical states characterised by sympathetic nervous system overactivation including heart failure and chronic kidney disease. Additional data are needed to evaluate the efficacy of RDN in these disease states.

The MiStent® consists of a cobalt chromium stent with a PLGA absorbable polymer that elutes sirolimus. DESSOLVE-I is a prospective, single-arm, FIM trial that enrolled 30 patients with follow-up at 4, 6, or 8 months (10 patients each) and 18 months (all patients). This study aimed to evaluate

Introduction: Nursing in the cardiac catheterisation laboratory (CCL) varies globally in terms of scope and deployment. In the US, all allied staff are cross-trained into all CCL roles. The Australian and New Zealand experience has legislative frameworks that reserves specific functions to nurses. Yet, the nursing role within the CCL is poorly researched and defined. Aim: This study sought to gain deeper understanding of the perceived role of CCL nurses in Australia and New Zealand. Method: A descriptive qualitative study using semi-structured in-depth interviews was used. A cross-sectional sample of 23 senior clinical nurses or nursing managers representing 16 CCLs across Australia and New Zealand was obtained. Data were digitally recorded and transcribed verbatim prior to analysis by three researchers. Results: Five major themes emerged from the data. These themes were: 1. The CCL is a unique environment; 2. CCL nursing is a unique and advanced cardiac nursing discipline; 3. The recruitment attributes for CCL nurses are advanced; 4. Education needs to be standardised; and 5. The evidence to support practice is poor. Discussion: The CCL environment is a dynamic, deeply interdisciplinary setting with CCL nursing seen to be a unique advanced practice role. Yet the time has come for a scope of practice, educational standards, guidelines and competencies was expressed by the participants. Conclusion: Nursing in the CCL is an advanced practice role working within a complex interdisciplinary environment. Further work is required to define the role of CCL nurses together with the evidence-base for their practice.

Twelve-Month Results from the CoreValve Transcatheter Aortic Valve Australia–New Zealand Study I. Meredith1,∗, D. Walters 2, T. Walton3,4, S. Worthley5, J. Ormiston6, S. Pasupati 7, G. Yong8, R. Whitbourn9, D. Muller 10 1MonashHEART, Monash University, Melbourne, Australia 2 The Prince Charles Hospital, Brisbane, Australia 3 The Alfred Hospital, Melbourne, Australia 4 Epworth Hospital, Melbourne, Australia 5 Royal Adelaide Hospital, Adelaide, Australia 6 Mercy Hospital, Auckland, New Zealand 7 Waikato Hospital, Hamilton, New Zealand 8 Royal Perth Hospital, Perth, Australia 9 St. Vincent’s Hospital-Melbourne, Melbourne, Australia 10 St. Vincent’s Hospital-Sydney, Sydney, Australia

Background: There is limited outcome data in patients (pts) undergoing Primary percutaneous coronary intervention (PPCI) for acute myocardial infarction (AMI) caused by acute left main stem (LMS) thrombosis. Previous studies have reported in-hospital mortality rates of 50–60%.We report early and long-termoutcomes in a contemporary cohort of consecutive pts undergoing PPCI for unprotected LMS thrombosis. Methods: Data were obtained from review of the cardiac catheterization database, folder audit and telephone follow-up. Results: Twenty-eight pts (2.5%) from 1115 consecutive PPCI pts were identified between January 2004 and September 2007. The mean age of pts was 68± 14years (male 75%, diabetes 21%) Significant morbidity was 422 UseofExportAspirationCatheter inSTElevationMyocardial Infarction (STEMI)

Three types of renal cortical damage were found in rats 2 mth after papillary necrosis had been induced by ethylenimine: (1) Circumscribed areas of interstitial nephritis affecting either deep or superficial nephrons. (2) Wedge-shaped or conical scars, extending from capsule to inner medulla. (3) Widespread tubular dilatation and cyst formation with a diffuse increase in interstitial tissue, usually associated with dense fibrous repair of the papillary remnant. The extent and character of the cortical changes did not appear to be determined by the severity of the papillary necrosis, and even the more severe cortical lesions were not accompanied by any major reduction in kidney size. Although these chronic experimental cortical lesions are the products of a less complex and less protracted natural history than end stage cortical damage in analgesic nephropathy, some of the factors influencing their evolution, such as infection, may also determine the natural history of the clinical lesion.

Transcatheter aortic valve replacement is recommended in inoperable patients with severe, symptomatic aortic stenosis (AS), and is an accepted alternative to surgical AVR in high risk patients. However, increased stroke, bleeding, vascular complications and aortic regurgitation (AR) rates may

Previous studies have shown that PNS by emergency medical services (EMS) reduces time to reperfusion. PNS was introduced into all PCI capable public and one private hospital in the state of Victoria, Australia in early 2010. We report on the outcomes. STEMI patients were taken to the nearest PCI

The safety and performance of the Absorb Bioresorbable Vascular Scaffold (Absorb BVS) (Abbott Vascular, Santa Clara, CA) has been previously established in 131 patients from Cohort A and Cohort B of the First-in-Man ABSORB trial. Results out to 3 years have been presented in 100 patients from the

The MiStent is a new drug–eluting stent characterized by the use of crystalline sirolimus and a fully absorbable PLGA polymer on a thin–strut (64 µm) cobalt–chromium stent. Prior preclinical studies showed the stent coating being eliminated in 45–60 days with full absorption of the polymer

The MiStent SES (Micell Technologies, Durham, NC) is an investigational DES characterized by use of crystalline sirolimus and a fully absorbable polymer on a thin strut (64um) cobalt-chromium stent. The stent coating is eliminated from the stent in 45-60 days with full absorption of the polymer by