Online Exclusives


The Anchor-Balloon Technique for Difficult Chronic Total Occlusions

Rajiv Goswami, DO, Assistant Professor of Medicine, Baylor College of Medicine, Ben Taub Hospital, Houston, Texas

This report describes intervention on a 73-year-old female with significant left main and triple-vessel coronary artery disease. We describe the sequence of multi-vessel intervention on the left main, obtuse marginal, and left anterior descending coronary artery CTO. Success in this case depended on application of the anchor balloon technique to deliver the balloon catheter for initial dilatation after successful crossing of the CTO with the guide wire.

Revisiting the Angiographic “Dot” Sign: A Useful Clue to Diagnose Anomalous Origin of Coronary Arteries

Visualization of the “dot” sign on the left ventricular (LV) angiogram in the RAO view (just posterior and to the left of the posterior aortic margin) is an easy clue to the identification of an anomalously arising circumflex artery with a retroaortic course. 

Two Louisiana Interventional Cardiologists Find a Good Fit with CardioSolution: 7 Days On, 7 Days Off

Two board-certified interventional cardiologists have found the unique model offered by CardioSolution to be a good fit. Dr. Yunus Moosa is an interventionalist practicing in Zachary, Louisiana (close to Baton Rouge) and Dr. Chris Mallavarapu is an interventionalist practicing out of Lafayette, Louisiana. Both are seasoned interventional cardiologists with experience doing no-surgical-backup percutaneous coronary intervention.

Aberrant Circumflex Coronary Artery Intervention Using the “Anchoring Wire” Technique

Mzee Ngunga, MD, William Hui, MD, FRCPC, FACC, CK Hui Heart Centre, Royal Alexandra Hospital, Edmonton, Canada


Two Louisiana Interventional Cardiologists Find a Good Fit with CardioSolution: 7 Days On, 7 Days Off

Two board-certified interventional cardiologists have found the unique model offered by CardioSolution to be a good fit. Dr. Yunus Moosa is an interventionalist practicing in Zachary, Louisiana (close to Baton Rouge) and Dr. Chris Mallavarapu is an interventionalist practicing out of Lafayette, Louisiana. Both are seasoned interventional cardiologists with experience doing no-surgical-backup percutaneous coronary intervention.



Percutaneous Intervention of a Complex Ventricular Septal Defect

Harit Desai, DO, Nemalan Selvaraj, DO, Ulrich Luft, MD, and Jon C. George, MD, Division of Interventional Cardiology and Endovascular Medicine, Deborah Heart and Lung Center, Browns Mills, New Jersey

A 62-year-old female with a known history of congenital heart disease, including coarctation of aorta post-angioplasty and a ventricular septal defect (VSD), presented to our facility for a second opinion regarding her persistent dyspnea on exertion, exertional angina, and back discomfort with activity.

Transradial Renal Artery Stenting

Kintur Sanghvi, MD, David Hsi, MD, Deborah Heart & Lung Institute, Browns Mills, New Jersey

A 69-year-old black female with previous history of coronary artery disease, coronary artery bypass surgery, uncontrolled hypertension and hyperlipidemia was evaluated for repeated episodes of congestive heart failure. She had refractory hypertension with very high systolic blood pressure on each of these admissions. Her medicine regimen included carvedilol 25 mg twice daily, losartan 100 mg daily, furosemide 80 mg daily and clonidine 0.2 mg three times daily. Her echocardiogram showed concentric left ventricular hypertrophy with grade III diastolic dysfunction and normal left ventricular systolic function. A stress Myoview imaging test was negative for inducible ischemia. Her serum creatinine was 1.4 mg/dL. She was investigated with magnetic resonance angiogram for renal artery stenosis, which showed a high-grade stenosis of the right renal artery while the left renal artery was occluded and the left kidney was non-functional.

Coronary Angiography Through the Eyes of the Interventional Cardiologist

Forward: Thomas H. Maloney, RT, RCIS, Richmond, Virginia

Presentation: George W. Vetrovec, MD, FACC, FSCAI, Professor of Medicine, Director of the Adult Cardiac Catheterization Laboratory, Virginia Commonwealth University Pauley Heart Center, Richmond, Virginia

Robotic-Assisted PCI – A New Approach to the Transcatheter Treatment of Coronary Artery Disease

Joseph P. Carrozza Jr., MD, Steward St. Elizabeth’s Medical Center and Tufts University Medical School, Boston, Massachusetts

"While operating the robotic-assisted system, the interventional cardiologist can elect to wear a protective apron under a sterile gown, and perform functions at the bedside and the interventional cockpit, or he/she may elect not to scrub and manipulate the PCI devices from the control console, thus allowing a fellow or a cath lab technologist to load PCI devices into the cassette."

Assessment of Geriatric Patients Undergoing Percutaneous Coronary Intervention

Geriatric patients may have diminished physiological reserves that can impact their ability to recover from PCI.

Cath Lab Digest talks with Sarwat I. Chaudhry, MD, Associate Professor of Medicine (General Medicine), Yale School of Medicine, New Haven, Connecticut.

Fibromuscular Dysplasia: The Registry and Results

Registry data regarding patients with fibromuscular dysplasia (FMD) was recently published in Circulation.1 Cath Lab Digest talks with Pam Mace, RN, FMD patient, Executive Director, Fibromuscular Dysplasia Society of America, Rocky River, Ohio, about the registry and her long experience with FMD.

Transcatheter Mitral Valve Repair: Nursing Considerations from a U.K. Hospital

Sally Madden’s “An alternative treatment approach to mitral regurgitation” appeared in the November 2011 issue of Nursing Standard.1 Ms. Madden discusses transcatheter mitral valve repair and her experiences in taking care of these patients.

The MitraClip (Abbott Vascular) received CE Mark approval in 2008. It is not yet approved for use in the United States.

Suggestions for Nurses and Technologists Working in the Cath Lab Regarding Patients With Psychosocial Concerns

Along with Kawkab Shishani, PhD, Drs Froelicher and Madan published an article in the Journal of Cardiovascular Nursing1 based on their experience caring for patients with coronary artery disease. We talk with them about the psychosocial concerns that can be suffered by these patients, how depression should be assessed in patients with heart disease, and how cath labs can help.