background: Percutaneous coronary intervention (PCI) has become one of the most commonly performed cardiac procedures in clinical practice. Due to improvement in outcomes, reduced acute complication rates, the need to reduce costs and the limited availability of hospital beds, elective PCI with same-day discharge has become an interesting option. Methods: Singlecenter registry with a retrospective evaluation of all patients undergoing elective PCI who were discharged on the same day, from January 2009 to March 2012. The rates of major adverse cardiac events (death, myocardial infarction, target-vessel revascularization and stroke), in addition to stent thrombosis, vascular complications and re-hospitalization between hospital discharge and the first 30 days of follow-up were determined. results: Sixty-nine patients were evaluated with mean age of 64.5 ± 11.2 years, most of them were male (82%), and 28% were diabetics. All patients had stable coronary artery disease and type A or B1 lesions (36% and 36% respectively). Radial access was the most commonly used approach (89%), with 5 F introducer sheaths in 56% and 6 F in the remaining patients. Procedure success was obtained in 98.5%. No clinical events were observed at the 30-day follow-up. Conclusions: Our results demonstrated that same-day discharge was safe for patients with low clinical and angiographic risk undergoing elective PCI with no procedurerelated complications.

Objective In the clinical scenario of ST-segment elevation acute myocardial infarction, several patients with multivessel coronary atherosclerotic disease are discharged without a defined strategy to monitor the residual atherosclerotic lesions. The clinical endpoints evaluated were cardiovascular death, symptoms of angina pectoris, rehospitalization for a new acute coronary syndrome, and the necessity of reintervention during the two-year follow-up. MethodsThis observational, prospective, and historical study included multivessel coronary atherosclerotic disease patients who were admitted to a tertiary care university hospital with ST-segment elevation acute myocardial infarction and underwent primary percutaneous coronary intervention with stent implantation only at the culprit lesion site; these patients were monitored in the outpatient clinic according to two treatments: the Clinical Group - CG (optimized pharmacological therapy associated with counseling for a healthy diet and cardiac rehabilitation) or the Intervention Group - IG (new staged percutaneous coronary intervention or surgical coronary artery bypass graft surgery combined with the previously prescribed treatment). Results Of 143 patients consecutively admitted with ST-segment elevation acute myocardial infarction, 57 were eligible for the study (CG=44 and IG=13). Regarding the clinical endpoints, the cardiovascular death rate did not differ between the CG and IG. The symptom of angina pectoris and the rehospitalization rate for a new episode of acute coronary syndrome were accentuated in the CG (P=0.020 and P=0.049, respectively) mainly in individuals with evidence of ischemia evidenced by myocardial scintigraphy (P<0.001 and P=0.001, respectively) which culminated in an even greater need for reintervention (P=0.001) in this subgroup of patients. Conclusion The staged intervention was demonstrated to be safe and able to reduce angina pectoris and rehospitalization for a new episode of acute coronary syndrome. In addition, it decreases the likelihood of unplanned reinterventions of patients without ischemia evidenced by myocardial scintigraphy.

In patients with the obstructive variant of hypertrophic cardiomyopathy, when symptomatic despite the medical therapy, septal reduction is a common treatment option. Among all the percutaneous approaches, therapeutic septal alcoholization is the most commonly used technique. Non-alcoholic septal reduction techniques have recently emerged as an additional treatment option, generating procedures with more predictable outcomes and lower complication rates. In this report, we describe a case of therapeutic septal reduction with embolization of the target branch using coils with excellent immediate results.

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Background: As the population ages, the prevalence of diseases has increased, particularly that of coronary artery disease requiring treatment. The objective of this study was to assess the temporal evolution of percutaneous coronary intervention in octogenarians in Brazil. Methods: Based on data from the Central Nacional de Intervenções Cardiovasculares (CENIC), we analyzed procedures carried out in patients aged 80 years and over,

Background. Splenic infarction is a rare clinical condition. It is generally attributed to hematologic, vascular, cardioembolic, and infectious diseases or trauma. Case Presentation. We describe a rare case in an otherwise asymptomatic 41-year-old overweight woman with acute abdominal pain. Imaging work-up revealed splenic infarction. Common etiologies were excluded. A transesophageal echocardiography (TEE) revealed a patent foramen ovale (PFO). The patient was sent to closure with good outcome. Conclusion. Paradoxical embolism due to PFO can be a cause of splenic infarction, and its investigation and subsequent closure may be considered when there are no other causative disorders.

Background Same-day discharge for percutaneous coronary interventions is an attractive and safe strategy. Observational and randomized data show equivalent results as compared to overnight observation. In addition, it ensues great savings for the healthcare system. Nevertheless, in Brazil, this approach is underused. The objective of this study was to describe the characteristics and outcomes of patients undergoing percutaneous coronary intervention with same-day discharge. Methods A single-center study with patients who underwent selected procedures, uneventful, discharged on the same day. Clinical and angiographic characteristics were described. Major cardiovascular events and complications were analyzed, reported, and compared to a historical cohort. Results A total of 413 patients were included, mean age of 64±10 years. After a 30-day follow-up, no major cardiovascular event was observed in selected patients submitted to the same-day discharge strategy. In addition, we found an increase in clinical and angiographic complexity as compared to the previous series, which did not translate to rise in adverse outcomes. Conclusion Uncomplicated percutaneous coronary interventions, with same-day discharge, are safe among appropriately selected patients, encouraging further adoption of this approach.