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When conventional NC balloons fail, the new OPN NC dedicated high-pressure balloon provides an effective and safe alternative strategy for the dilatation of resistant coronary lesions.

The diffusion of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) forced the Italian population to restrictive measures that modified patients' responses to non-SARS-CoV-2 medical conditions. We evaluated all patients with acute coronary syndromes admitted in 3 high-volume hospitals during the first month of SARS-CoV-2 Italian-outbreak and compared them with patients with ACS admitted during the same period 1 year before. Hospitalization for ACS R ESUM ELa propagation du coronavirus 2 du syndrome respiratoire aigu s evère (SRAS-CoV-2) a oblig e la population italienne à prendre des mesures contraignantes qui ont modifi e la r eaction des patients face aux affections m edicales non li ees au SRAS-CoV-2. Nous avons evalu e tous les patients atteints de syndromes coronariens aigus (SCA) admis dans 3 hôpitaux à fort volume d'activit e au cours du premier mois de l' epid emie italienne de SRAS-CoV-2 et les avons compar es aux After the first outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in late December 2019, in the Chinese city of Wuhan, Italy soon became the center of a fastgrowing epidemic in late February to March 2020: more severe in some areas of northern and central Italy. 1 After the first confirmed case reported on February 20, 2020, in Codogno, a small town near Milan, the rapid diffusion of the infection prompted the Italian government to proclaim a national lockdown on March 9, 2020, forcing the entire population to severe restrictive isolation measures. These measures, certainly helpful in reducing the diffusion of SARS-CoV-2 infection, significantly modified patients' responses to non-SARS-CoV-2 medical conditions, including acute coronary syndrome (ACS). 2 Because ACS is a life-threatening condition, with outcomes strictly dependent on prompt recognition and treatment, under-or misdiagnosis and late or missed treatment might be deleterious. In the current study, we report data from high-volume hospitals from 3 variably affected regionsdPiedmont, Marche, and Tuscanydto evaluate changes in rate of hospitalization for ACS during the first month of the SARS-CoV-2 Italian outbreak. MethodsThis is a multicentre, observational, retrospective study involving 3 high-volume centres distributed in northern and central Italy. Epidemiologic data of consecutive patients with ACS admitted in March 2019, and March 2020 were anonymously extracted and entered into a dedicated database. Data

No abstract

PCSs were effective in the treatment of friable embolization-prone coronary plaques, sealing of acute iatrogenic vessel rupture and exclusion of large aneurysms with no thrombosis but high target lesion revascularization.

Objective To report our initial experience of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)/acute coronary syndrome (ACS) patients undergoing standard of care invasive management. Background The rapid diffusion of the SARS‐CoV‐2 together with the need for isolation for infected patients might be responsible for a suboptimal treatment for SARS‐CoV‐2 ACS patients. Recently, the group of Sichuan published a protocol for COVID/ACS infected patients that see the thrombolysis as the gold standard of care. Methods We enrolled 31 consecutive patients affected by SARS‐COV‐2 admitted to our emergencies room for suspected ACS. Results All patients underwent urgent coronary angiography and percutaneous coronary intervention (PCI) when required except two patients with severe hypoxemia and unstable hemodynamic condition that were conservatively treated. Twenty‐one cases presented diffuse ST‐segment depression while in the remaining cases anterior and inferior ST‐elevation was present in four and six cases, respectively. PCI was performed in all cases expect two that were diagnosed as suspected myocarditis because of the absence of severe coronary disease and three with apical ballooning at ventriculography diagnostic for Tako‐Tsubo syndromes. Two patients conservatively treated died. The remaining patients undergoing PCI survived except one that required endotracheal intubation (ETI) and died at Day 6. ETI was required in five more patients while in the remaining cases CPAP was used for respiratory support. Conclusions Urgent PCI for ACS is often required in SARS‐CoV‐2 patients improving the prognosis in all but the most advanced patients. Complete patient history and examination, routine ECG monitoring, echocardiography, and careful evaluation of changes in cardiac enzymes should be part of the regular assessment procedures also in dedicated COVID positive units.

No abstract

Apical hypertrophic cardiomyopathy (AHCM) is a relatively rare morphologic variant of HCM in which the hypertrophy of myocardium is localized to the left ventricular apex. Symptoms of AHCM might vary from none to others mimic coronary artery disease including acute coronary syndrome, thus resulting in inappropriate hospitalization. Transthoracic echocardiography is the first-line imaging technique for the diagnosis of hypertrophic cardiomyopathies. However, when the hypertrophy of the myocardium is localized in the ventricular apex might results in missed diagnosis. Aim of this paper is to review the different imaging techniques used for the diagnosis of AHCM and their role in the detection and comprehension of this uncommon disease.