Clinical Editors Corner

Compiled by Morton J. Kern, MD, from conversations with Steven R. Bailey, MD, University of Texas Health Sciences Center at San Antonio, San Antonio, Texas; James Blankenship, MD, Geisinger Cardiovascular Center for Clinical Research, Harrisburg, Pennsylvania; Kirk N. Garratt, MD, Christiana Care, Wilmington, Delaware; Mitchell W. Krucoff, MD, Duke University, Raleigh, North Carolina; Jeffrey Moses, MD, Columbia University, New York City, New York; Gregg W. Stone, MD, Columbia University, New York City, New York; Bonnie Weiner, MD, University of Massachusetts, Worchester, Massachusetts; Barry Uretsky, MD, University of Arkansas, Little Rock, Arkansas; Peter Ver Lee, MD, Bangor, Maine; Fred Welt, MD, Salt Lake City, Utah.
10/8/2018   |   1,422 views

For STEMI patients, what labs (e.g., glucose, electrolytes, lactate or pH) are being obtained prior to the patient going to the cath suite? More importantly, are POC labs being done in the emergency department prior to the STEMI patient going to the cath lab?

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Morton Kern, MD, MSCAI, FACC, FAHA
9/4/2018   |   5,806 views

“When is the right time to accept the fractional flow reserve (FFR) during the adenosine hyperemic recording?” I thought this issue had been settled a few years ago, but after speaking with Arnold, we thought we should revisit some of the fundamentals of FFR now that both hyperemic and resting non-hyperemic pressure ratios (NHPRs) are mainstream in the cath lab.

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Jeannie Yu1,2,3, MD, FACC, FSCCT, and Morton J. Kern1,2,3, MD, MSCAI, FAHA, FACC
8/3/2018   |   1,485 views

How we understand patients with aortic stenosis has changed as the therapeutic approach has evolved.

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Morton J. Kern, MD, MSCAI, FACC, FAHA
7/8/2018   |   7,886 views

Recently, manual compression has emerged as a potentially viable alternative to shorter radial artery hemostasis times.

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Morton J. Kern, MD, and Arnold H. Seto, MD, MPA Dr. Seto is the Chief of Cardiology at Long Beach VA Medical Center, in Long Beach, California.  
5/29/2018   |   3,468 views

A question came from one of our cath lab staff, who asked if we could describe how chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is done and what the options are for a successful procedure.

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Morton J. Kern, compiler, with contributions from Andrew Doorey, Christiana Hospital, Delaware; Kirk Garratt, Christiana Hospital, Delaware; John Hirshfeld, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania; David Kandzari, Piedmont Hospital, Atlanta, Georgia; Michael Lim, St. Louis University, St. Louis, Missouri; Jeffery Moses, Columbia University, New York, New York; Pinak Bipin Shah, Brigham and Women’s Hospital, Boston, Massachusetts; Will Suh, University of California, Los Angeles, California; Paul Teirstein, Scripps Clinic, La Jolla, California; Chris White, Ochsner Medical Center, New Orleans, Louisiana; George Vetrovec, Medical College of Virginia, Richmond, Virginia; Jeannie Yu, VA Long Beach, California
5/7/2018   |   1,509 views

Dr. Paul Teirstein, Chief of Cardiology, at Scripps Clinic, La Jolla, California, asked our cath lab experts for their opinions on what to do with an asymptomatic executive who had a screening CTA (Figure 1).

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Morton J. Kern, MD
4/5/2018   |   3,713 views

In everyone’s career life, including the nursing and technical staff in the cath lab, mentors take on a multitude of roles during the training periods and early work life, and continue to have an impact well into the future years of the daily experiences in the lab.

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Morton J. Kern, MD, with contributions from Andrew Michaels, MD, Director of the Cardiac Catheterization Laboratory at St. Joseph Hospital in Eureka, California; Jim Blankenship, MD, The Geisinger Clinic, Harrisburg, Pennsylvania; Jeff Moses, MD, Columbia University, New York City, New York; Lloyd Klein, MD, Rush University, Chicago, Illinois; Charles Chambers, MD, Pennsylvania State University, Harrisburg, Pennsylvania.
3/2/2018   |   2,152 views

One of our colleagues, Andrew Michaels, MD, Director of the Cardiac Catheterization Laboratory at St. Joseph Hospital in Eureka, California, recently asked about the consent process for cardiac cath cases. 

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Morton J. Kern, MD
2/6/2018   |   2,802 views

When FFRCT and angio-derived FFR technology ultimately become more widely available, they will radically change the way diagnostic angiography is performed in the same way that invasive FFR changed the way we approach patients needing PCI. 

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Morton Kern, MD Clinical Editor; Chief of Medicine, Long Beach Veterans Administration Health Care System, Long Beach, California; Associate Chief Cardiology, Professor of Medicine, University of California Irvine, Orange, California mortonkern2007@gmail.com
1/2/2018   |   5,014 views

Stimulated by a couple of recent articles on the efficiency of the RADPAD protection drape in reducing operator’s exposure1 and the effects of shielding on nurses and technologists in the cath lab2, I thought it would be a good idea to see what was new and what we should be thinking about to reduce radiation exposure to ourselves, our team, and our patients.  

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