Our case demonstrates that rapid and complete revascularization by PCI can save a patient with acute myocardial infarction caused by simultaneous acute occlusion of the three major coronary arteries.We present a case in which optical coherence tomography was useful to characterize in vivo superficial calcific sheet and exclude other causes of acute coronary syndromes.In the current era of transcatheter edge-to-edge repair, deciding clip size in each case is still a challenge. We demonstrate that the XTR clip can achieve a better outcome than the NTR clip in a calcified leaflet.Traditionally, management of lung sequestrations has been surgical. This is one of the few reports where a percutaneous management has resulted in resolution of symptoms and offers a novel approach for management.Sterile inflammatory reactions at vascular access sites have rarely been reported in the literature. Simple conservative treatment, as in this case, can lead to resolution of even extensive sterile abscesses.In order to assess the vascular effects of rotational orbital atherectomy, we performed intravascular imaging with virtual histology intravascular optical coherence tomography in a 72-year-old man with critical limb ischemia of the right lower extremity.Self-expanding valves have been associated with superior hemodynamics versus balloon-expandable valves. Our aim was to compare invasive gradients between valve types for similarly sized valves. Patients who underwent transcatheter aortic valve replacement (TAVR) at the Malcom Randall Veterans Affairs Medical Center and the Bern University Hospital were considered for this analysis. From 1623 subjects who underwent TAVR, a total of 566 had available invasive hemodynamic data. After applying exclusion criteria, we included 499 for analysis. With immediate invasive hemodynamic assessment, balloon- expandable valves were associated with similar/marginally lower transvalvular gradients versus self-expanding valves. With postoperative echocardiography within 24 hours, self-expanding valves were associated with lower Doppler gradients versus balloon-expandable valves for all size categories.
  Patients with single-ventricle congenital heart disease undergo staged surgical palliations leading to a final Fontan procedure. After Fontan, cardiac index (CI) is primarily determined by pulmonary vascular resistance (PVR). Lower Fontan pressure has been achieved after relieving obstruction within the Fontan circuit, but to date the effect on PVR has not been quantified. We hypothesized that there would be significant reduction in PVR after relief of obstruction within the Fontan circuit; the purpose of this study is therefore to describe the change in PVR after relief of Fontan obstruction.
 
  Retrospective, single-center review of post-Fontan patients who underwent cardiac catheterization with hemodynamics, pulmonary vasodilator testing, and stenting of Fontan circuit obstructions from October 2016 to August 2019. Baseline hemodynamics were obtained on 21% fraction of inspired oxygen (FiO2), followed by administration of 80 ppm inspired nitric oxide (iNO) with repeat hemodynamics. After stenting of Fontan obstructions, hemodynamics were repeated on 21% FiO2. Patient demographics, hemodynamics, CI, and PVR were compared.
 
  Twelve patients underwent stenting of Fontan circuit obstructions. There was complete relief of gradient and angiographic obstruction after stent placement in all patients. There was larger decrease in PVR after stent placement compared with iNO administration (32.1% vs 19.3%, respectively; P=.03).
 
  This case series provides novel data quantifying the decrease in PVR after relief of Fontan circuit obstruction, suggesting a mechanism for symptomatic improvement after intervention. These data are a compelling addition to the longterm management of this complex patient population.
 This case series provides novel data quantifying the decrease in PVR after relief of Fontan circuit obstruction, suggesting a mechanism for symptomatic improvement after intervention.  https://www.selleckchem.com/products/tulmimetostat.html  These data are a compelling addition to the longterm management of this complex patient population.Sizing of iliac vein stents remains controversial. We present the first Venovo venous stent (BD/Bard) that was explanted because of worsening of back and leg pain post treatment and analyze data from the first 50 consecutive Venovo venous stents from our center. Stent size was obtained with intravascular ultrasound of the ipsilateral common iliac vein. The data indicate that there is no statistical relationship between the stent size and worsening or emergence of low back and leg pain. Patient-specific factors may be contributing to this extremely rare and persistent pain beyond the 30-day follow-up.
  Atrioventricular block is a common complication of transcatheter aortic valve implantation (TAVI). Although conventional transvenous dual-chamber (DDD) pacemaker (PM) is ideal for atrioventricular block, leadless PM, which is less invasive, may be suitable for frail TAVI patients. Little is known about clinical outcomes of this newer device following TAVI.
 
  A total of 330 consecutive patients undergoing TAVI were reviewed. Of these, PM cases without atrial fibrillation were studied. Indication for leadless PM was based on heart team discussion.
 
  PM implantations were performed in 30 patients (9.1%), and 24 patients (7.3%) had no atrial fibrillation. These 24 patients had 14 DDD-PMs and 10 leadless PMs, and formed the two study groups. Baseline characteristics were similar except for ejection fraction median ages were 83.0 years (IQR, 81.0-87.0 years) vs 86.5 years (IQR, 83.5-90.3) (P=.18); 11 (78.6%) vs 8 (80%) were women (P=.67); Society of Thoracic Surgeons scores were 5.1% (IQR, 3.8%-5.9%) vs 5.3% (IQRy have shorter hospital stays, and clinical outcomes can be comparable with DDD-PMs. Leadless PMs may therefore be a reasonable option for frail TAVI patients.
  We assess the proportion, baseline characteristics, and outcomes of a cohort of very high bleeding risk (HBR) patients discharged with no antithrombotic therapy after left atrial appendage closure (LAAC).
 
  The optimal antithrombotic therapy after LAAC remains controversial. However, a substantial proportion of patients have HBR and are contraindicated to any antithrombotic therapy. Data regarding the feasibility and safety of such a strategy are scarce.
 
  All patients who underwent LAAC at our institution between October 2013 and December 2018 were included. Clinical, procedural, and imaging data were collected prospectively, and patients receiving no antithrombotic therapy were compared with those receiving at least 1 agent.
 
  A total of 152 patients were included. At discharge, 72 (47.3%) received single-antiplatelet therapy (SAPT), 57 (37.5%) received dual-antiplatelet therapy (DAPT), and 22 (14.5%) received no antithrombotic therapy (NATT). One patient received a combination of aspirin and vitamin K antagonist.