Pub Date : 2011-08-01DOI: 10.1177/2150133511415808
T. Meskan
The Patient Protection and Affordable Care Act (PPACA), signed into law in March 2010, has significantly altered our discussions about the future role of cardiovascular (CV) care in the evolving health care landscape. New terms such as accountable care organization and payment bundling have permanently entered the vernacular, whereas traditional concepts such as quality have taken on greater importance given the federal government’s intent to drive behavior with a quality-based carrot-and-stick rewards system for health care providers. This is particularly relevant to CV care as the Centers for Medicare and Medicaid Services (CMS) and others involved in the health policy discussion often use CV examples to show the opportunities for care process improvement. This article will briefly examine the changing landscape by defining three important new features of health care reform, highlighting real-world experience with these concepts, and offering some suggestions on how we might move forward in this new environment.
{"title":"The Evolving Health Care Landscape","authors":"T. Meskan","doi":"10.1177/2150133511415808","DOIUrl":"https://doi.org/10.1177/2150133511415808","url":null,"abstract":"The Patient Protection and Affordable Care Act (PPACA), signed into law in March 2010, has significantly altered our discussions about the future role of cardiovascular (CV) care in the evolving health care landscape. New terms such as accountable care organization and payment bundling have permanently entered the vernacular, whereas traditional concepts such as quality have taken on greater importance given the federal government’s intent to drive behavior with a quality-based carrot-and-stick rewards system for health care providers. This is particularly relevant to CV care as the Centers for Medicare and Medicaid Services (CMS) and others involved in the health policy discussion often use CV examples to show the opportunities for care process improvement. This article will briefly examine the changing landscape by defining three important new features of health care reform, highlighting real-world experience with these concepts, and offering some suggestions on how we might move forward in this new environment.","PeriodicalId":320506,"journal":{"name":"Cardiac Cath Lab Director","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117163969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-08-01DOI: 10.1177/2150133511427249
Chuck R Williams, N. H. Pevsner, M. Viamonte, J. Lepage, Daniel R. Mabie, Theresa Lehto, Heidi L. Miller, Brian A. Wood, C. Gibaut, P. C. Williams, Tressie D. Brooks, A. Carney
{"title":"Radiation Safety Series","authors":"Chuck R Williams, N. H. Pevsner, M. Viamonte, J. Lepage, Daniel R. Mabie, Theresa Lehto, Heidi L. Miller, Brian A. Wood, C. Gibaut, P. C. Williams, Tressie D. Brooks, A. Carney","doi":"10.1177/2150133511427249","DOIUrl":"https://doi.org/10.1177/2150133511427249","url":null,"abstract":"","PeriodicalId":320506,"journal":{"name":"Cardiac Cath Lab Director","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114656232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-08-01DOI: 10.1177/2150133511419494
Jonathan D. McDivitt, Rolf E. Graning, M. Ferguson
Fractional flow reserve (FFR) is a well-established method to assess the hemodynamic and clinical significance of intermediate coronary artery stenoses. Ostial coronary lesions present a particular challenge to FFR measurements, as the guide needs to be positioned outside the artery during normalization and hyperemia measurements. Utilization of a “buddy wire” can help maintain stability of the coronary guide to facilitate FFR measurements of ostial coronary lesions.
{"title":"Buddy Wire Technique to Facilitate Fractional Flow Reserve of an Ostial Right Coronary Artery Lesion","authors":"Jonathan D. McDivitt, Rolf E. Graning, M. Ferguson","doi":"10.1177/2150133511419494","DOIUrl":"https://doi.org/10.1177/2150133511419494","url":null,"abstract":"Fractional flow reserve (FFR) is a well-established method to assess the hemodynamic and clinical significance of intermediate coronary artery stenoses. Ostial coronary lesions present a particular challenge to FFR measurements, as the guide needs to be positioned outside the artery during normalization and hyperemia measurements. Utilization of a “buddy wire” can help maintain stability of the coronary guide to facilitate FFR measurements of ostial coronary lesions.","PeriodicalId":320506,"journal":{"name":"Cardiac Cath Lab Director","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132513105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-07-27DOI: 10.1177/2150133511415843
A. Lupi, Gioel Gabrio Secco, A. Rognoni, M. Lazzero, M. Sansa, A. Sante Bongo
Transradial percutaneous coronary interventions (PCIs) have gained popularity because of reduced vascular complications and increased patient acceptability. However, safety and efficacy of transradial PCI in ST elevation myocardial infarction has been questioned. Anomalous radial artery anatomy is a relatively common cause of transradial PCI failure. The authors describe a case of a primary PCI performed by transradial approach through a very small caliper and tortuous superficial brachioradial artery (a rare variant). The use of miniaturized and hydrophilic apparels allowed procedure success without significant delay. To the authors’ knowledge, this is the first report of a primary PCI performed through an abnormal superficial brachioradial artery with final success.
{"title":"Transradial Primary Angioplasty in a Patient With Congenital Abnormality of the Forearm Circulation and Increased Bleeding Risk","authors":"A. Lupi, Gioel Gabrio Secco, A. Rognoni, M. Lazzero, M. Sansa, A. Sante Bongo","doi":"10.1177/2150133511415843","DOIUrl":"https://doi.org/10.1177/2150133511415843","url":null,"abstract":"Transradial percutaneous coronary interventions (PCIs) have gained popularity because of reduced vascular complications and increased patient acceptability. However, safety and efficacy of transradial PCI in ST elevation myocardial infarction has been questioned. Anomalous radial artery anatomy is a relatively common cause of transradial PCI failure. The authors describe a case of a primary PCI performed by transradial approach through a very small caliper and tortuous superficial brachioradial artery (a rare variant). The use of miniaturized and hydrophilic apparels allowed procedure success without significant delay. To the authors’ knowledge, this is the first report of a primary PCI performed through an abnormal superficial brachioradial artery with final success.","PeriodicalId":320506,"journal":{"name":"Cardiac Cath Lab Director","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128734018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-04-01DOI: 10.1177/2150133511407629
A. Yehya, M. Mandawat
Coronary angiography is the gold standard for evaluating coronary atherosclerotic heart disease, yet it has well-known limitations. Intravascular ultrasound (IVUS) is an invasive technique that is used to improve the assessment and management of coronary artery disease. IVUS is a readily available imaging modality that is easy to learn and interpret with low complication rates. In this literature review, the authors will review the technique and discuss the various current usages of IVUS and its limitations, safety, and complications.
{"title":"Intravascular Ultrasound","authors":"A. Yehya, M. Mandawat","doi":"10.1177/2150133511407629","DOIUrl":"https://doi.org/10.1177/2150133511407629","url":null,"abstract":"Coronary angiography is the gold standard for evaluating coronary atherosclerotic heart disease, yet it has well-known limitations. Intravascular ultrasound (IVUS) is an invasive technique that is used to improve the assessment and management of coronary artery disease. IVUS is a readily available imaging modality that is easy to learn and interpret with low complication rates. In this literature review, the authors will review the technique and discuss the various current usages of IVUS and its limitations, safety, and complications.","PeriodicalId":320506,"journal":{"name":"Cardiac Cath Lab Director","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125408078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-04-01DOI: 10.1177/2150133511407034
S. Hancock
{"title":"The Value of Credentials","authors":"S. Hancock","doi":"10.1177/2150133511407034","DOIUrl":"https://doi.org/10.1177/2150133511407034","url":null,"abstract":"","PeriodicalId":320506,"journal":{"name":"Cardiac Cath Lab Director","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127934276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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