The Single Coronary Artery: A Rare Anatomic Variant.

We report the case of a 67-year-old female with heart failure and a reduced ejection fraction (25%). Angiography revealed that all of her major coronary vessels stemmed from a single ostium at the right aortic sinus.

Complete Revascularization of Multiple Coronary CTOs in a Single Session Using Hydrodynamic Contrast Recanalization.

Background: Percutaneous coronary intervention (PCI) of chronic total occlusions (CTO) is technically more challenging than non-CTO PCI. The development of novel CTO-specific PCI techniques, such as hydrodynamic contrast recanalization (HDR), has led to improved technical success with low complication rates. We present a case of successful single-session PCI of multiple CTOs using HDR in an elderly patient.

Myocardial Infarction Triggered by Marijuana Use.

Chronic marijuana use has been increasingly linked to cardiovascular events, though reports of acute myocardial infarction in young adults without traditional risk factors remain limited. A 24-year-old man with a 9-year history of daily marijuana use presented with acute chest pain. Emergency evaluation revealed anterior ST-segment elevation myocardial infarction with 100% proximal left anterior descending coronary artery occlusion, treated successfully with percutaneous intervention.

SAICR-CTO: Single Access Impella-Guided Complete Revascularization in Chronic Total Occlusion-A Novel Approach to High-Risk PCI.

The Impella is a ventricular assist device (VAD) that provides circulatory assistance to patients with impaired heart function during percutaneous coronary intervention (PCI). It ejects blood from the left ventricle directly into the aorta. Although most cases of Impella-assisted PCI are done using two access ports, the single access technique was described by Jason Wollmuth et al.

Characterization and timing of gastrointestinal bleeding in continuous flow left ventricular assist device recipients.

Background And Aims: Heart failure is one of the leading causes of morbidity and mortality in the United States. The advent of left ventricular assist devices (LVAD) has improved the survival and quality of life in patients with end stage heart failure. Gastrointestinal bleeding (GIb) remains one of the limitations of LVADs.

Reversal of severe hypertriglyceridemia with intermittent fasting and a very-low-carbohydrate ketogenic diet: a case series.

Purpose Of Review: To illustrate successful reversal of hypertriglyceridemia using a very-low-carbohydrate ketogenic diet in conjunction with intermittent fasting in two patients.

Recent Findings: Hypertriglyceridemia remains an important component of residual risk for atherosclerotic cardiovascular disease. Current guidelines from the AHA/ACC recommend the initiation of a very-low-fat diet to treat persistently elevated triglycerides, whereas the National Lipid Association argues that a very-low-carbohydrate, high-fat diet is contraindicated in severe hypertriglyceridemia.

Patient Versus Physician Variation in Use of Transradial Percutaneous Coronary Intervention.

The prevalence of radial access for transradial catheterization remains low in the United States, occurring in only 28% of cases in the National Cardiovascular Data Registry (NCDR) CathPCI. It is unknown whether the low adoption rate has been influenced by patient characteristics or is more operator dependent. In a 10-center study, we compared clinical and demographic characteristics among 323 radial and 1,506 femoral access percutaneous coronary intervention (PCIs) performed by 65 interventionists capable of radial PCI.

Transesophageal echocardiographic diagnosis of a WATCHMAN left atrial appendage closure device thrombus 10 years following implantation.

Left atrial appendage closure with the WATCHMAN device is an alternative to chronic oral anticoagulation for thromboembolic prophylaxis in atrial fibrillation patients. Left atrial device-related thrombus (DRT) has been described in the first year after implant with an incidence of ~6%. A 79-year-old man underwent WATCHMAN device placement in 2006.

Electrocardiograhic findings resulting in inappropriate cardiac catheterization laboratory activation for ST-segment elevation myocardial infarction.

Background: Prompt reperfusion has been shown to improve outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI) with a goal of culprit vessel patency in <90 minutes. This requires a coordinated approach between the emergency medical services (EMS), emergency department (ED) and interventional cardiology. The urgency of this process can contribute to inappropriate cardiac catheterization laboratory (CCL) activations.

Red yeast rice for dysipidemia.

Red yeast rice is an ancient Chinese food product that contains monacolins, chemical substances that are similar to statins in their mechanisms of action and lipid lowering properties. Several studies have found red yeast rice to be moderately effective at improving the lipid profile, particularly for lowering the low-density lipoprotein cholesterol levels. One large randomized controlled study from China found that red yeast rice significantly improved risk of major adverse cardiovascular events and overall survival in patients following myocardial infarction.