Nr 3 JIM Today Saturday - page 1

Issue
3
Saturday
11 February 2017
Thinking ‘out of the box’ in
mitral valve-in-ring case
T
he audience packed into Main Hall
Washington on Friday morning
for a series of live cases from the
Interventional Cardiology Unit at
the San Raffaele Scientific Institute
in Milan. Kicking off the first case
were operators Antonio Colombo, Azeem Latib,
Matteo Montofano and the rest of their team,
who were gearing up to address severe mitral
regurgitation (MR).
The patient, a 72-year-old man, had a medical
history of hypertension, dyslipidaemia, paroxysmal
atrial fibrillation (treated with warfarin), COPD and
severe chronic kidney disease. In 2014, he was
diagnosed with severe left ventricular dysfunction,
with normal coronary arteries and severe MR.
As such, he underwent mitral valve repair with a
Medtronic (USA) Profile 3D Annuloplasty System
– a 28 mm fully rigid ring designed to repair the
mitral valve annulus.
Having had ‘frequent’ >1-month admissions
for heart failure in the last year, at the time of the
case the patient was still symptomatic, with effort
dyspnoea (NYHA III). Echo showed recurrence of
C
erebral
embolic
protection
devices
:
joining the mainstream?
Page 11
OCT
brings
atherosclerosis
into sharp focus
Page 6
L
ithoplasty
runs circles around
calcium
Page 7
E
vidence
to
date
 on
no-predilatation TAVI
Page 10
The official
newspaper
of the Joint
Interventional
Meeting
T
he first of two ‘Pro/Con’ de-
bates took place on Thursday
morning at JIM, with Franc-
esco Prati (San Giovanni Hosp, Rome,
Italy / CLI Foundation) and Michael
Haude (Director of Medical Clinic
I Lukas Hospital, Neuss, Germany)
addressing the question: ‘Is imaging
during PCI so important?’.
Stepping up to the podium first
was Dr Prati, who gave his opening
gambit for the audience. “First of all,
it is very important indeed to use an
imaging modality, particularly OCT,
when we want to really understand
what is going on in patients with
ambiguous lesions in the setting of
acute coronary syndromes.”
He added that given OCT has
such a high resolution, it gives
superior ability to identify thrombi
– thereby allowing the pinpointing
of ruptured vessels and lesions that
could cause acute events. Clinically,
it allows better understanding of
what syndrome the patient has, and
therefore aids in drug choice.
Importantly, Dr Prati also stressed
that imaging modalities can be used
to help decide when best not to
treat a patient. Similarly, he added: “I
think it is very important sometimes
to use IVUS, to use OCT, to decrease
the Syntax score: i.e. to be less ag-
gressive. It is difficult, however, to
Continued on page 12
DEBATE: Is imaging during PCI so important? 
Main Hall Washington 
Thursday 
09:45–10:15
Great debates at JIM 2017
Continued on page 2
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