Adriaan O. Kraaijeveld

Subadventitial stenting around occluded stents: A bailout technique to recanalize in-stent chronic total occlusions

To evaluate the outcomes of subadventitial stenting (SS) around occluded stents for recanalizing in‐stent chronic total occlusions (IS‐CTOs).

Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention Through Ipsilateral Collateral Channels: A Multicenter Registry

OBJECTIVES The aim of this study was to describe the procedural aspects and outcomes of retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) through ipsilateral collateral channels (ILCs). BACKGROUND Retrograde CTO PCI via ILCs is rarely performed, usually when no other retrograde options exist, and available evidence derives mostly from case reports. METHODS A large retrospective multinational registry was compiled, including all consecutive patients undergoing retrograde CTO PCI through ILCs at 6 centers between September 2011 and October 2016. Success rates, as well as procedural complications and in-hospital outcomes, were studied. RESULTS A total of 126 patients (17% of all retrograde CTO PCIs) were included. The mean age was 65.7 ± 11.2 years, and the mean J-CTO (Multicenter CTO Registry in Japan) score was 2.36 ± 1.13. The target vessel was the circumflex coronary artery in 42%, the left anterior descending coronary artery in 39%, and the right coronary artery in 19%. The ILCs used were epicardial in 76% and septal in 24%. ILC anatomy was very heterogeneous. One guiding catheter was used in 80%, whereas the ping-pong technique was used in 20%. A retrograde wire could be advanced to the distal cap in 81%. Technical and procedural success rates were 87% and 82%, respectively. ILC perforation with need for intervention was observed in 5.6% and tamponade due to ILC perforation in 2.4%. One patient (0.8%) died. CONCLUSIONS Retrograde CTO PCI through ILCs is a challenging intervention that can be performed in difficult occlusions with high success rates and reasonable rates of complications by experienced operators.

First dutch experience of the accurate neo self-expanding supra-annular valve for valve-in-valve transcatheter aortic valve implantation

We describe the first two cases of valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) using Accurate Neo device in the Netherlands. A 73-year-old man underwent transfemoral ViV-TAVI for severe stenosis in his 25-mm Carpentier-Edwards Perimount bioprosthesis. After balloon predilatation, a mediumsize Accurate Neo was advanced to the bioprosthetic annulus. First, its upper part was released with the upper crowns positioned below the superior margin of the pre-existing bioprosthesis (Fig. 1a; [1]). Next, the device was deployed by releasing the lower crowns without ventricular pacing (Movie-1). The results were excellent. A 79-year-old man underwent transfemoral ViV-TAVI for severe regurgitation of his 27-mmMosaic bioprosthesis. A small-size Accurate Neo was deployed with its upper crowns positioned along the eyelets of the bioprosthesis (Fig. 1b). After balloon postdilatation, a paravalvular leak was reduced to trace.

Anomalous coronary artery originating from the opposite sinus of Valsalva (ACAOS), fractional flow reserve- and intravascular ultrasound-guided management in adult patients

To describe the use of fractional flow reserve (FFR) and intravascular ultrasound (IVUS) in the evaluation of patients with anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS).

Rare device landing zone ruptures after transcatheter aortic valve implantation (TAVI)

Abstract Rupture of the “device landing zone” is a rare but severe complication of transcatheter aortic valve implantation (TAVI). Recently, the small segment of muscular left ventricular outflow tract (LVOT) located between the left–right commissure and left fibrous trigone was identified as the most vulnerable region at risk of external rupture. We here provide the first pictures of a rupture adjacent to this vulnerable area, inducing a connection between the LVOT and the left atrium. We also report a case of supra-annular rupture, a less usual location of rupture. These illustrations may help pathologists and clinicians to get familiar with early rare complications of TAVI, an important new field of interest of autopsy in cardiovascular pathology.

Clinical outcomes of diabetic patients treated with an amphilimus-eluting stent and a short duration of dual antiplatelet therapy in routine clinical practice : first results of the Utrecht Cre8 (U-Cre8) Registry

TCT-267 Clinical outcomes of diabetic patients treated with an amphilimus-eluting stent and a short duration of dual antiplatelet therapy in routine clinical practice: first results of the Utrecht Cre8 (U-Cre8) Registry Rik Rozemeijer, Mera Stein, Michiel Voskuil, Adriaan Kraaijeveld, Leo Timmers, Ramon Rodríguez-Olivares, Saskia Rittersma, Pieter Stella UMC Utrecht, Utrecht, Netherlands; Utrecht, Netherlands; UMC Utrecht; UMC Utrecht, Leiden, Netherlands; The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai; ErasmusMC, Rotterdam, Netherlands; University Medical Center Utrecht; University Medical Center Utrecht, Utrecht, Netherlands

TCT-606 Can we justify conservative treatment in adults with Anomalous Coronary Artery Originating from the Opposite Sinus of Valsalva (ACAOS) with inter-arterial course (IAC)?

ACAOS of the right and left coronary are rare, but may give complaints and impose a risk for sudden cardiac death, depending on several anatomical features. Assessment and risk estimation is challenging in (non-athlete) adults, especially if they present with absent or atypical complaints.