Coronary Physiology

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‘Combat’ Approach to Cardiogenic Shock

Considering the unacceptably high mortality rate of patients with cardiogenic shock (CS) and the absence of widespread improvements in survival over recent decades, the time has arrived for the cardiovascular community to embrace a ‘combat’ approach to CS.1 In the past 20 years we have witnessed a revolution in the management of combat polytrauma towards a goal of zero preventable battlefield death.

Delayed Coronary Obstruction After Transcatheter Aortic Valve Implantation is not the Structural Equivalent of Late Stent Thrombosis After Percutaneous Coronary Intervention

Reports of late stent thrombosis following percutaneous coronary intervention (PCI) with drug-eluting stents started to emerge in 2005 and 2006, causing widespread alarm and a substantial reduction in their use.1,2 Research-led advances in pharmacology and stent design have done much to allay this alarm, but nevertheless late stent thrombosis (LST) remains a concern for coronary interventionists and a focus for ongoing research.

Advances in Coronary Physiology: Update for 2017

Coronary artery disease (CAD), the most common cause of morbidity and mortality in the US, is frequently identified by coronary angiography. Decisions for treatment are often based on angiography alone, absent other clinical indicators for intervention. However, by angiography alone, conventional wisdom has suggested that a coronary stenosis is significant if there is at least a 50 % diameter reduction in the left main coronary artery, or at least a 70 % diameter reduction in any other epicardial artery.