Left Atrial Function: Basic Physiology
INTRODUCTION A resurgence of interest in atrial function has enhanced our understanding of the atrial contributions to cardiovascular performance in health and disease (see Chapter 13 ). The reasons for…
Role of Pericardium in Diastolic Dysfunction and Diastolic Heart Failure
INTRODUCTION Pericardologists were concerned almost exclusively with diastole (for good reasons of pericardial constriction and cardiac tamponade) before the late 1980s, when diastolic dysfunction (DD) started to attract widespread attention…
Molecular, Gene, and Cellular Mechanisms
INTRODUCTION Heart failure is an ancient diagnosis. Some of the earliest known descriptions are attributed to Hippocrates, circa 460–370 BCE. He reported dozens of clinical case histories with examples of…
Complications
Abstract Complications of chronic total occlusion (CTO) percutaneous coronary interventions (PCI) can be classified according to timing (as acute and long-term) and according to location (cardiac coronary, cardiac noncoronary, and…
The Retrograde Approach
Abstract The retrograde approach to chronic total occlusion (CTO) crossing differs from the antegrade approach because the occlusion is approached from the distal vessel. The retrograde approach can be divided…
Complex Lesion Subsets
Abstract There are several complex subsets of chronic total occlusion (CTO) lesions, such as CTOs with proximal cap ambiguity, impenetrable proximal or distal cap, flush aortoostial CTOs, ostial circumflex and…
Antegrade Dissection/Reentry
Abstract Dissection/reentry can be achieved either in the antegrade or the retrograde direction. Antegrade dissection can be achieved using knuckled guidewires or using the CrossBoss catheter. Antegrade reentry can be…
The Basics: Timing, Dual Injection, Studying the Lesion, Access, Anticoagulation, Guide Support, Trapping, Pressure and Electrocardiogram Monitoring
Abstract Knowledge and application of eight basic principles and techniques are critical for safely and successfully performing chronic total occlusion (CTO) percutaneous coronary interventions (PCIs). First, CTO PCIs should be…
Putting It All Together: The Hybrid Approach
Abstract The hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention provides guidance on selection of the optimal CTO crossing strategy in a stepwise fashion. First, dual injection is…
