Clinical Guide to Primary Angioplasty

Primary angioplasty is a life-saving, minimally invasive emergency procedure increasingly used in the treatment of acute myocardial infarction. As the procedure further proves its effectiveness, it is imperative that all cardiologists have a comprehensive understanding of the major issues surrounding primary angioplasty. This easy-to-use, clinically focused text is an essential reference for those hoping to achieve this understanding. A valuable educational tool, this text fully explores the vital concepts of primary angioplasty. Key features include: # Fundamental examination of acute myocardial infarction—specifically looks at symptoms, diagnosis, and pre-hospital care # Assessment of various Primary PCI techniques—explores stenting options, balloon angioplasty and multivessel intervention # An exploration of mechanical aspects of primary angioplasty that includes chapters on possible mechanical complications and circulatory support # Specialty chapters on adjunctive pharmacologic therapies, stem cell therapy, the treatment of diabetic patients, and the role of surgery in acute myocardial infarction # An in-depth discussion of heart attack treatment networks—looks at North American and European models and economic factors Stephen Brecker, M.D He is a Consultant Cardiologist at St. George’s Hospital, London, UK and is an Honorary Senior Lecturer at St. George’s University of London. He is the Care Group Lead for Cardiology and Director of Cardiac Catheterisation Laboratories at St. George’s Hospital in London. He received his medical degree from St. Thomas' Hospital Medical School, University of London. A highly experienced specialist in interventional cardiology, Dr. Brecker is a frequent speaker at national and international meetings. He is a fellow of the Royal College of Physicians, European Society of Cardiology, and American College of Cardiology. The author of over 70 scientific papers, Dr. Brecker is a frequent reviewer for many prestigious medical journals including Circulation, Journal of the American College of Cardiology, and Heart. His research interests include use of echocardiography to assess ventricular function, and the role and efficacy of transcatheter aortic valve implantation. Martin Rothman, M.D., Consultant Cardiologist He is the Director of Cardiac Research and Development at Barts and the London NHS Trust. Dr. Rothman received his medical degree from the University of Manchester Medical School and is an Honorary Professor of Interventional Cardiology at Queen Mary, University of London. A pioneering figure in the field of interventional cardiology, he helped to establish Europe’s largest heart attack center. He also co-founded the British Cardiovascular Intervention Society. Dr. Rothman, author of several books and numerous peer-reviewed journal articles, serves on the editorial board of several medical journals including the International Journal of Cardiovascular Intervention, Intravascular Imaging, and Catheterization and Cardiovascular Intervention. Dr. Rothman is committed to the innovation of new intravascular cardiovascular devices; he has been instrumental in the development and advancements of intravascular ultrasound and helped to develop a novel abdominal aortic aneurysm percutaneous device. CONTENTS Foreword by Martin Leon 1. Epidemiology and Historical Perspectives Peter Clemmensen, Kari Saunamäki 2. Pre-hospital Diagnosis and Management of Acute Myocardial Infarction Gilles Montalescot, Patrick Goldstein 3. Presentation of AMI – Symptoms, Examination, Biomarkers and Atypical Presentations Christopher P. Moriates, Kabir J. Singh, Alan S. Maisel 4. The Definition of Myocardial Infarction Kristian Thygesen, Joseph S. Alpert, and Allan S. Jaffe 5. Optimal Reperfusion Therapy: Clinical trial evidence of primary angioplasty and (prehospital) fibrinolysis Freek W.A. Verheugt 6. Adjunctive Pharmacologic Therapies Gregory Ducrocq, Philippe Gabriel Steg 7. Primary Percutaneous Coronary Intervention: Role of Stenting versus Balloon Angioplasty and Drug-Eluting Stents versus Bare Metal Stents. Trial Evidence and Current Concepts Robert A. Byrne, Adnan Kastrati 8. Primary Percutaneous Coronary Intervention: Culprit-Lesion Only versus Multivessel Intervention Thomas Pilgrim, Stephan Windecker 9. Management of Mechanical Complications of Myocardial Infarction: Ventricular Septal Defect, Mitral Regurgitation, Free-Wall Rupture Imran Saeed, Marjan Jahangiri 10. Primary Coronary Angioplasty: The Role of Mechanical Circulatory Support Luiz Alberto Mattos, Pedro Beraldo de Andrade 11. Primary Angioplasty: Methods of Reducing Infarct Size and Reperfusion Injury Michael Gick, Jan Minners, Franz-Josef Neumann 12. Primary Angioplasty: The Importance of Time to Reperfusion, Door to Balloon Times and How to Reduce Them Atman P. Shah, William J. French 13. Systems of Care for Primary Percutaneous Coronary Intervention Abhiram Prasad 14. Utilization of Facilitated and Rescue Angioplasty Rajiv Gulati, Bernard J. Gersh 15. Opportunities and Challenges of Stem Cell Therapy: Is there a role in AMI Barry H. Trachtenberg, Joshua M. Hare 16. (A) Primary Angioplasty in Health Care Delivery: The North American Model Jacob Thorsted Sorensen, Christian Juhl Terkelsen, Steen Dalby Kristensen 16. (B) Primary Angioplasty in Healthcare Delivery: The North American Model Faisal Latif, Kintur Sanghvia, Cindy L. Grines MD 17. Special Management of the Diabetic Patients with STEMI Salvatore Brugaletta, Manel Sabaté 18. Role of Surgery in Acute Myocardial Infarction Yasir Abu-Omar, David P. Taggart