Jamil Cade

Pregnancy-associated spontaneous coronary artery dissection: insights from a case series of 13 patients.

Aims We sought to present a series of 13 pregnancy-associated spontaneous coronary artery dissection (P-SCAD), their angiographic and multimodal imaging findings, acute phase treatment, and outcomes. Methods and results Between 2005 and 2015, 13 cases of P-SCAD were collected from a database of 11 tertiary hospitals. The mean age was 33.8 ± 3.7 years; most patients had no risk factors for coronary artery disease, and the majority were multiparous. P-SCAD occurred during the puerperium in 12 patients with a median time of 10 days. Only one patient presented with P-SCAD in the 37th week of pregnancy, and she was the only patient who died in this series. Six patients (46%) presented with ST-segment elevation acute myocardial infarction (STEMI), six (46%) presented with non-STEMI, and one presented with unstable angina; one-third of women had cardiogenic shock. In 12 patients, the dissection involved the left anterior descending or circumflex artery, and it extended to the left main coronary artery in 6 patients. Intravascular ultrasound or optical coherence tomography helped to confirm diagnosis and guide treatment in 46% of cases. Seven women were managed clinically; percutaneous coronary intervention was performed in five cases, and coronary artery bypass grafting was performed in one patient. Conclusion In these 13 cases of P-SCAD, clinical presentation commonly included acute myocardial infarction and cardiogenic shock. Multivessel dissections and involvement of the left coronary artery and left main coronary artery were highly prevalent. Clinicians must be aware of angiographic appearances of P-SCAD for prompt diagnosis and management in these high-risk patients.

Spontaneous coronary artery dissection and healing documented by optical coherence tomography

Cardiovascular Research Foundation, New York, NY, USA.Corresponding author: Adriano Caixeta – Avenida Albert Einstein, 627/701 – Morumbi – Zip code: 05652-900 – Sao Paulo, SP, Brazil – Phone: (55 11) 2151-0453 – E-mail: adriano.caixeta@einstein.brReceived on: Oct 9, 2015 – Accepted on: Feb 24, 2016DOI: 10.1590/S1679-45082016AI3551

TCT-438 Telemedicine Increases the Access to Primary Percutaneous Coronary Intervention Saving Costs and Lives in ST-Elevation Myocardial Infarction (STEMI). Three-year Analysis of the Latin America Telemedicine Network (LATIN) Program in Sao Paulo East Zone.

The STEMI remains with high mortality in underserved areas. Patient’s transportation, logistics and treatment to PCI centers require high use of resources. Telemedicine (TM) favors early referral reducing the time to revascularization with the potential to improve outcomes. However the impact of

TCT-49 Transformational Pathways for AMI Management in Developing Countries - Rolling 600,000 Remote Patient Encounters to D2B Interventions

Major disparities exist between developed and developing countries in the outcomes of patients presenting with AMI. Telemedicine has emerged as a powerful, cost-efficient, and scalable tool for population-based AMI management. We propose efficient telemedicine protocols as frontline AMI strategies

TCT-439 Long-term Savings with Telemedicine STEMI Networks

Despite proven benefits of a telemedicine-guided AMI strategy, insurance rebuffs are prodigious reasons for denial of Primary PCI (>50%). Our previous work has demonstrated augmented access, accuracy, and cost-effectiveness of a population-based AMI program. Latin Telemedicine Infarct Network (LATIN

CRT-200.25 Comparison Of Time Exposed To Radiation During Interventional Cardiology Training Between Transradial And Transfemoral Access On Patients Undergoing Coronary Angiography And Interventional Procedures: Experience Of An Interventional Cardiology Training Center On A Developing Country

Few data available between transradial and transfemoral time exposure to fluoroscopy during coronary angiography (CA) and percutaneous coronary intervention (PCI) of radialists training centers. Our study retrospectively analyzed 3.235 patients who underwent to coronary angiogram and intervention

Global Challenges and Solutions: Role of Telemedicine in ST-Elevation Myocardial Infarction Interventions

Major disparities exist between developed and developing countries in the management of acute myocardial infarction (AMI). These pronounced differences result in significantly increased morbidity and mortality from AMI in different regions of the world. Lack of infrastructure, insurance, facilities, and skilled personnel are the major constraints. Primary percutaneous coronary intervention has revolutionized the treatment of AMI; however, its global use is limited by the listed constraints. Telemedicine provides an efficient methodology that can hugely increase access and accuracy of AMI management.

Experiência Inicial com o Uso do Autopulse ® em Sala de Hemodinâmica

The initial experience with the use of AutoPulse® Non-Invasive Cardiac Support Pump in the catheterization laboratory is reported. The device was used in a case of cardiopulmonary arrest in the catheterization laboratory, allowing the percutaneous procedure to move on with simultaneous cardiopulmonary resuscitation. The device provided uninterrupted and effective chest compressions and released a team doctor for other functions during the procedure. There were difficulties related to the setup of the device and regarding the radiopacity of the electronic components, which prevented some angiographic projections from being obtained. The use of mechanical devices for chest compressions during a cardiopulmonary arrest is feasible, however, there is no proof of its benefits when compared to cardiopulmonary resuscitation using manual compressions.

Initial Experience with Autopulse® in a Catheterisation Laboratory

ABSTRACT An initial experience using the AutoPulse® Non-Invasive Cardiac Support Pump in a catheterisation laboratory is reported. The device was used for a case of cardiopulmonary arrest in the catheterisation laboratory, allowing the percutaneous procedure to continue with simultaneous cardiopulmonary resuscitation. The device provided uninterrupted and effective chest compressions and allowed a team physician to perform other functions during the procedure. There were difficulties related to the setup of the device and to the radiopacity of the electronic components, which prevented some angiographic projections from being obtained. The use of mechanical devices for chest compressions during cardiopulmonary arrest is feasible; however, there is no proof of their benefits when compared to cardiopulmonary resuscitation using manual compressions.