Invasive Cardiology Research Articles

The head of invasive cardiologists as a target of professional exposure to ionizing radiation

Exposure to ionizing radiation has recognized detrimental cancer and non-cancer health effects. These effects are now well-proven not only for high doses > 1,000 millisieverts (mSv) associated with head radiotherapy but also for moderate (100–1,000 mSv) and even low (< 100 mSv) doses, of interest for professionally exposed cardiologists. The head of interventional cardiologists is highly exposed to ionizing radiation, with possible damage to the eye and brain. Unprotected interventional cardiologists experience head radiation doses up to ten times greater than chest doses below lead aprons, with marked exposure to the left hemisphere of the brain reaching up to 2 Sv—equivalent to 10,000 chest X-rays over a professional lifetime. This narrative review aims to provide an overview of the background of radioprotection, the biological mechanisms involved, and the epidemiological evidence regarding the health effects of head exposure to ionizing radiation in invasive cardiologists. These health effects include cataracts, brain cancer, cerebrovascular diseases, neurodegeneration, and mood disorders. The evidence gathered from other exposed populations, which experienced similar eye and brain doses, has also been reviewed. This is important because the doses, risks, and effects are consistent in cases of repeated exposures, which occur more frequently for patients, and in situations involving chronic low doses, as seen with interventional cardiologists. Despite these risks, effective protective measures—such as suspended lead ceilings, curtains, and specialized eyewear—can reduce radiation exposure to near-zero levels. In some fields, like interventional cardiac electrophysiology, a groundbreaking near-zero radiation approach using non-fluoroscopic methods has been created, eliminating radiation exposure and alleviating orthopedic stress and operational discomfort. The race to zero radiation in interventional cardiology is ongoing.

Age stratified differences in coronary artery plaque phenotype in women and men with non-obstructive coronary artery disease

Abstract Background Development of coronary artery disease (CAD) and risk of acute cardiac events differ between women and men during the life span. The aim of this study was therefore to characterize sex differences in coronary artery plaque phenotype among patients with symptomatic non-obstructive CAD in different age groups. Methods Advanced coronary artery plaque phenotyping by coronary computed tomography angiography was performed in 606 patients (31% women) with symptomatic non-obstructive CAD from the Norwegian Registry of Invasive Cardiology. A 1:1 sex-matched study design ensured equal distribution of the sexes in the different age groups. We assessed total plaque burden adjusted for vessel volume and plaque composition consisting of dense calcium, fibrous, fibro-fatty, and necrotic core. Patients were further stratified into age groups of ≤50, 51-64, and ≥65 years to explore the relationship between age and sex on coronary artery plaque phenotype. Results In the study population, patients ≥65 years had a higher prevalence of hypertension, higher calcium score, coronary artery segment involvement score and total plaque burden, whereas the prevalence of obesity was lower compared to patients aged 51-64 and ≤50 years (all p<0.05). The prevalence of smoking, diabetes and statin treatment was similar between groups. A two-way analysis of variance demonstrated an interaction between sex and age group on total plaque burden (F [2, 600] =3.431, p=0.33), where women aged 51-64 and ≥65 years had a higher total plaque burden compared to men (p=0.002 and p<0.001, respectively, Figure 1). Plaque composition in women ≥65 years was characterized by an increased proportion of stable dense calcified plaques compared to men and younger women (all p<0.05), whereas men ≥65 years had a higher proportion of vulnerable necrotic core plaque phenotype (p<0.001). Women showed consistently lower proportions of more vulnerable fibro-fatty plaques compared to men across all age groups (all p<0.05, Figure 2). Conclusions In non-obstructive CAD, higher total plaque burden was associated with older age and female sex. Women had a lower proportion of vulnerable fibro-fatty plaques across all age groups and a higher proportion of stable dense calcified plaques at an older age compared to men. Future longitudinal studies on coronary artery plaque phenotype during the life span will increase the understanding of sex differences in CAD development and may contribute to customise risk stratification in women and men.Figure 1.Total plaque burdenFigure 2.Compositional plaque burden

TCT-742 Radiation Hazards and Safety Among Physicians and Allied Health Practitioners (AHP) in Invasive Cardiology Procedures

TCT-742 Radiation Hazards and Safety Among Physicians and Allied Health Practitioners (AHP) in Invasive Cardiology Procedures

Analysis of Compliance with Proper Nutrition Principles in Patients with a History of Myocardial Infarction.

Adherence to dietary recommendations and the implementation of appropriate dietary habits after myocardial infarction (MI) can significantly improve health and reduce mortality from cardiac causes. The aim of this study was to analyse the adherence of patients with a history of MI to a healthy diet, which is one of the primary methods of cardiovascular disease (CVD) prevention. Following a proper diet involves limiting the consumption of saturated fats, salt, alcohol, and simple sugars. It is recommended to follow the Mediterranean diet, which is based on whole grains, fruits, vegetables, and fish. This study involved 120 patients hospitalised in the Invasive Cardiology and Cardiac Intensive Care Unit at the Independent Public Voivodship Hospital in Szczecin from August to December 2019. A self-designed questionnaire and the Questionnaire of Eating Behaviour (QEB) were used. The majority of respondents were hospitalised for a first-time MI (88.33%), and 65% of them reported adherence to the recommendations. The vast majority (78.33%) considered their diet good, with 50.83% of the respondents eating four meals a day and never eating fast food (49.17%). The analysis showed that although the respondents' diets did not contain many unhealthy foods, they did not consume enough vegetables, fruits, fish, nuts, or fibre, which have a protective effect, lowering the risk of cardiovascular diseases and death. Furthermore, patients with a better education had a higher level of knowledge. Respondents' knowledge of proper post-MI nutrition was sufficient, and their index of unhealthy diets was low, but they still made dietary mistakes and did not consume enough health-protective foods. These results indicate a need for further education.

Risk factors of cardiac arrest during a percutaneous coronary intervention performed with rotational atherectomy - analysis based on a Large National Registry.

Rotational atherectomy (RA) is traditionally administered for patients with heavily calcified lesions and is thereby characterized by a high risk of the performed intervention. However, the prevalence characteristics of cardiac arrest are poorly studied in this group of patients. We aimed to evaluate the frequency and risk factors of cardiac arrest during percutaneous coronary interventions (PCI) performed with RA and preceding coronary angiography (CA). Based on the data collected in the Polish Registry of Invasive Cardiology Procedures (ORPKI) from 2014 to 2021, we included 6522 patients who were treated with RA-assisted PCI. We scrutinized patient and procedural characteristics, as well as periprocedural complications, subsequently comparing groups in terms of cardiac arrest incidence with the use of univariable and multivariable analyses. Thirty-five (0.5%) patients suffered from cardiac arrest during RA-PCI or preceding CA. They were characterized by significantly higher rates of prior stroke, acute coronary syndromes (ACS) as indications and higher Killip class (P < 0.001) at the admission time. Among the confirmed independent predictors of in-procedure cardiac arrest, the following can be noted: factors related to patients' clinical characteristics (e.g., older age, female sex, and disease burden), periprocedural characteristics (e.g., PCI within left main coronary artery [LMCA]), and periprocedural complications (e.g., coronary artery perforation and no-reflow phenomenon). Severe clinical condition at baseline, expressed by ACS presence and Killip class IV, as well as RA-PCI performed within LMCA and other periprocedural complications, were the strongest predictors of cardiac arrest during RA-assisted PCI and CA.

Drug-Eluting Balloons and Drug-Eluting Stents in Diabetic Patients Undergoing Percutaneous Coronary Intervention Due to Restenosis-DM-Dragon Registry.

Background: The rate of in-stent restenosis (ISR) is decreasing; however, it is still a challenge for contemporary invasive cardiologists. Therapeutic methods, including drug-eluting balloons (DEBs), intravascular lithotripsy, excimer laser coronary atherectomy, and imaging-guided percutaneous coronary intervention (PCI) with drug-eluting stents (DES), have been implemented. Patients with diabetes mellitus (DM) are burdened with a higher risk of ISR than the general population. Aims: DM-Dragon is aimed at evaluating the clinical outcomes of ISR treatment with DEBs vs. DES, focusing on patients with co-existing diabetes mellitus. Methods: The DM-Dragon registry is a retrospective study comprising data from nine high-volume PCI centers in Poland. A total of 1117 patients, of whom 473 individuals had DM and were treated with PCI due to ISR, were included. After propensity-score matching (PSM), 198 pairs were created for further analysis. The primary outcome of the study was target lesion revascularization (TLR). Results: In DM patients after PSM, TLR occurred in 21 (10.61%) vs. 20 (10.1%) in non-diabetic patients, p = 0.8690. Rates of target vessel revascularization (TVR), target vessel myocardial infarction, device-oriented composite endpoint (DOCE), and cardiac death did not differ significantly. Among diabetic patients, the risk of all-cause mortality was significantly lower in the DEB group (2.78% vs. 11.11%, HR 3.67 (95% confidence interval, CI) [1.01-13.3), p = 0.0483). Conclusions: PCI with DEBs is almost as effective as DES implantation in DM patients treated for ISR. In DM-Dragon, the rate of all-cause death was significantly lower in patients treated with DEBs. Further large-scale, randomized clinical trials would be needed to support these findings.

Role of 3D transoesophageal echocardiography in the study of infective endocarditis. Demonstration in a case collection.

Infective endocarditis (IE) is a condition that predominantly affects native or prosthetic heart valves, which is currently on the rise due to the increase in invasive cardiology procedures, such as the utilization of cardiac implantable electronic devices and transcatheter interventions. The recommended imaging tests for diagnosis are 2D transthoracic echocardiography (2D TTE) and 2D transoesophageal echocardiography (2D TOE). However, these modalities present limitations in detecting vegetations and estimating their dimensions. These disadvantages can be overcome by 3D transoesophageal echocardiography (3D TOE), particularly with the multiplanar reconstruction tool, which allows for the visualization of infinite valve planes, thus optimizing the detection of lesions and precise measurements. Furthermore, the volume rendering provides insight into the anatomical relationships between lesions, which is particularly useful for surgical planning. In this review, we aim to discuss the role of this recent imaging modality in the diagnosis, prognosis, and therapeutic of IE. Finally, we present a collection of images that illustrate the use of 3D TOE tools.

The Correlation Between Interleukin-6 (IL-6) Levels and the Extent of Coronary Lesions Based on SYNTAX Scores in Patients with Acute Coronary Syndrome (ACS)

&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Atherosclerosis plays an important role in the pathogenesis of acute coronary syndrome (ACS). Inflammation plays a causal role in atherosclerosis. There are many inflammatory markers related to ACS, including C-reactive protein (CRP), homocysteine, matrix metal loproteinases, interleukin (IL)-6, IL-8, and IL-27. IL-6 is the sign of synthesis of acute phase proteins. Recently, the clinical trials related to ACS showed that IL-6 may be an indicator of increased risk for ACS. An Interleukin-6 (IL-6) examination is can be used to assess risk factors for acute coronary syndrome (ACS). Interleukin-6 is a marker of local inflammation of coronary plaque and peripheral blood circulation which increases the occurrence of coronary heart disease causing plaque instability and rupture. The SYNTAX scoring system has correlation assessed through angiography assessing the complexity of the severity of coronary artery stenosis. This study aims to determine the between Interleukin-6 (IL-6) levels and the extent of coronary lesions based on the SYNTAX score in patients with acute coronary syndrome (ACS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a cross-sectional study of 45 patients with acute coronary syndrome (ACS) who were treated at H. Adam Malik General Hospital, Medan (February 2023 – May 2023). IL-6 levels were examined using the Electrochemiluminescent Immunoassay (ECLIA) method using Cobas e 411. The extent of the coronary lesion was calculated based on the SYNTAX score from coronary angiography which was calculated by two invasive cardiologist as suggested before using an online calculator. We used the Spearman correlation test and Mann Whitney test to analyze the data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The were 39 male subjects (86.7%) total.&lt;strong&gt; &lt;/strong&gt; The mean age of the subjects was 54.89 ± 10.3 years old. Most of the subjects experienced STEMI in total 28 people (62.2%). The Median IL-6 levels was 19.22 pg/mL while the median of SYNTAX score level was 13.00. By using &lt;em&gt;cross-sectional&lt;/em&gt; study and the spearman correlationa test, there is a significant correlation between IL-6 and the SYNTAX score with the correlation value obtained r = 0.343 (p = 0.021).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;There is a significant relationship between IL-6 and the extent of coronary lesions based on the SYNTAX score in patients with acute coronary syndrome.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Clinical characteristics and predictors of in-hospital mortality of patients hospitalized with myocardial infarction before and during COVID-19 pandemic.

The COVID-19 pandemic has impacted many acute coronary syndrome (ACS) care aspects. The aim was to compare the patient profile, ACS characteristics, and the outcomes in patients referred to the invasive cardiology department before (March 2019 - February 2020) and during the COVID-19 pandemic (March 2020 - February 2021). Clinical and demographic features, comorbidities, laboratory parameters at admission, and periprocedural data were recorded. The relationship of these parameters with in-hospital mortality was assessed. Before the COVID-19 pandemic, 664 patients were admitted due to ACS (mean age 67.16 ± 11.94 years, females 32.1%), and during the COVID-19 pandemic 545 ACS patients were recorded [mean age 66.02 ± 12.02 years (p = 0.463), females 31% (p = 0.706)]. A 17.8% decrease in the ACS rate was observed. During the pandemic, there were more STEMI patients (44.3% vs. 52.1%, p < 0.001) and fewer patients treated conservatively (24.9% vs. 8%, p < 0.001). Most lesions were located in the left anterior descending artery (53.4% vs. 54.7%), but post-percutaneous coronary intervention TIMI 3 was observed more frequently before the pandemic (83.9% vs. 75.1%, p < 0.001). Periprocedural complication rates did not differ between the groups. In-hospital outcomes did not differ between analyzed periods regarding all-cause death nor cardiac death rates, 5.3% vs. 4.6% (p = 0.598) and 4.5% vs. 3.7% (p = 0.473), respectively. Based on the analysis of 1209 patients, a decrease in ACS patients admitted during the pandemic was recorded, but in-hospital mortality remained similar.

A 25-year-long journey into interventional cardiology: looking back, and rushing forward.

Cardiovascular disease remains decade after decade a leading cause of mortality, morbidity and resource use globally as well as locally. We have had the opportunity of being involved in several iterative breakthroughs in invasive cardiovascular procedures, ranging from the advent of coronary stents to transcatheter mitral valve repair. Building up such extensive clinical and research experience, we hereby present 25 years of cardiovascular interventions at Pineta Grande Hospital and Casa di Salute S. Lucia, respectively in Castel Volturno, and S. Giuseppe Vesuviano, both in the Italian Campania region, where the same team of interventional cardiologists has managed to adopt and master several cardiovascular innovations for the benefit of thousands of patients. Our experience showcases the evolution of invasive cardiology, especially in diagnostic and therapeutic practices. Key highlights include advancements in coronary procedures, with the introduction of bare-metal stents, drug-eluting stents and drug-coated balloons, despite the setback of bioresorbable vascular scaffolds, as well as transcatheter aortic valve implantation and innovative approaches to mitral regurgitation. Furthermore, this overview scrutinizes procedural challenges, patient outcomes, and quality of life improvements, providing a rich tapestry of clinical experiences and research insights. It serves as a testament to the dynamic nature of interventional cardiology, offering a forward-looking perspective on future trends and technologies. We hope that this overview will prove an informative and insightful read for those seeking to understand the intricate journey of invasive cardiovascular care over the past decades and its trajectory into the future.

Radiation Awareness and X-Ray Use in Cardiology: An International Independent Web-Based Survey

Background. Cardiologists are today exposed to a growing dose of ionising radiation in their practice. Radiation awareness and correct management of X-ray use are the cornerstone to comply with the principles of exposure optimization and justification. Methods and Results. An investigator-initiated international voluntary-based survey including 28 questions was conducted across 19 European countries. 228 cardiologists participated in the survey. Invasive cardiology subspecialties were the most represented (83.6%). Radiation exposure is the cause of personal protective equipment-related orthopaedic injuries (personally or in coworkers) or anxiety in 68.5% and 62.9% of cases, respectively. 38.4% of participants have encountered difficulties in having their institutions recognizing periods off work for exceeding radiation exposure limit (16.3% usually and 22.1% on rare occasions). Gender was not associated with any difference in the answers. Age older than 40 years old was associated with an increased knowledge of personal dosimeter data (71.6% vs. 51.3%, p=0.008). Invasive cardiologists more frequently suffer from orthopaedic injuries (73.0% vs. 44.8%, p=0.006) and show greater participation to radioprotection courses (78.4 vs. 27.6%, p&lt;0.001). Conclusion. European cardiologists show appropriate awareness of the risks associated with X-ray use in medical practice and of the principles guiding a proper management of radiation hazard. However, there is still room for improvement, and institutions should promote risk education policies, which are the basis for the creation and diffusion of a community consciousness on radiation hazard.

Occupational Risks of Radiation Exposure to Cardiologists.

Invasive cardiologists are exposed to large amounts of ionizing radiation. This review aims to summarize the main occupational risks in a radiation-exposed cardiology practice. We carried out a literature review on the subject. The studies reviewed allowed us to list six main health risk categories possibly associated with radiation exposure among cardiologists: deoxyribonucleic acid (DNA) and biochemical damages; cancers; ocular manifestations; olfaction, vascular, and neuropsychological alterations; musculoskeletal problems; and reproductive risks. Our descriptive analysis demonstrates higher risks of DNA damage and lens opacities among radiation-exposed cardiology staff. Surveys and questionnaires have demonstrated a higher risk of musculoskeletal disease in exposed workers. Studies reported no difference in cancer frequency between radiation-exposed workers and controls. Changes in olfactory performance, neuropsychological aspects, and vascular changes have also been reported. Limited literature supports the security of continuing radiation-exposed work during pregnancy. Therefore, there is an urgent need to increase knowledge of the occupational risks of radiation exposure and to adopt technologies to reduce them.

Differing radiation exposure in scrub technicians and rotating staff in Cardiac catheterization laboratory: occupation matters

BackgroundRadiation exposure is a significant hazard associated with invasive Cardiology, with most studies based on primary operator exposure. This prospective, observational study aimed to find out over lead radiation exposure as effective dose acquired by non-physician staff comprising scrub technicians and rotating staff in the cath laboratory. Effective dose (ED) measured per procedure via Raysafe i2®dosimeter badges worn by both rotating staff and scrub technicians over lead aprons along with dose area product (DAP), fluoroscopy time (FT) and procedure time (PT) in minutes was collected prospectively over forty-six invasive Cardiology procedures.ResultsThis study shows that rotating staff acquire higher ED in comparison with their scrub technician colleagues in diagnostic, interventional and electrophysiology cases. However, a statistically significant difference in radiation exposure of both staff groups was demonstrated in diagnostic and interventional Cardiology procedures, with p values of 0.04 and 0.01, respectively.ConclusionsThese findings highlight occupational role and mobility around fluoroscopic sources as major factors in radiation exposure, which should be addressed within current radiation protection practices.

Using registry data to determine actual cardiac rehabilitation participation after percutaneous coronary intervention

Abstract Background Comprehensive cardiac rehabilitation (CR) has proven beneficial effects, and is a class 1A recommendation in European Society of Cardiology guidelines. Still, CR is grossly underused globally. In Norway, few studies on CR participation exist, and the extent to which CR is underused is more uncertain. Using data from national quality registries provides an opportunity to estimate actual CR participation, and whether there are some groups that participate less often than others do. Aim To determine actual use of CR, comprehensive or single component, in patients after percutaneous coronary intervention (PCI), with a special attention on women, older people, patients with comorbidities and education level. Methods CONCARDPCI is a prospective multicentre cohort study including 1970 patients after PCI at three Norwegian university hospitals during 2017-2019. Socio-demographic characteristics were self-reported during the index hospitalization for PCI. Clinical data were collected from patients’ medical records and the Norwegian Registry on Invasive Cardiology. Data on CR participation were extracted from the Norwegian Control and Payment of Health Reimbursements Database, and measured at 2-, 6- and 12 months after index hospitalisation. Results One year after PCI, one out of six patients (16%) had received single- or multicomponent CR. At 2 months, 7% had participated in CR, from 2–6 months, 12% participated in CR and from 6–12 months, 2% participated in CR. Most patients were men (78%) with a mean age of 66 years (SD 11, range 20-96 years). At 6 months, fewer women than men had participated in CR (9% vs. 13%, p=0.020). During the 12 month period, 12% of women and 17% of men participated in CR (p=0.019). The patients participating in CR were significantly younger (60 vs. 67, p&amp;lt;0.001) at all measuring points. A sizeable proportion had previous cardiovascular comorbidities including hypertension (52%) and hypercholesterolemia (47%). Patients with hypercholesterolemia participated significantly less than those without at 2 months (6% vs. 8%, p=0.031) and 6 months (9% vs. 14%, p=0.001). Those with hypertension also participated less than those without at 2 months (5% vs. 9%, p=0.002) and 6 months (9% vs. 15%, p&amp;lt;0.001). Further, 26% had previous PCI, and those with a history of PCI participated less than those with no history at 2 months (3% vs. 9%, p&amp;lt;0.001) and 6 months (6% vs. 14%, p&amp;lt;0.001). Finally, those with a lower educational level participated less at 2 months (primary school 4% vs. college/university 10%, p=0.034) and 6 months (primary school 9% vs. college/university 15%, p=0.050). Conclusion Very few patients participated in comprehensive or single component CR. Those with a lower educational level and women participated less often in CR, and the proportion was even lower in patients with comorbidities. New modes of delivery for CR is needed to meet the large group of patients not receiving follow-up according to guidelines.

Registre CARDIO-ARSIF - Base de données sur les coronarographies et angioplasties coronaires réalisées en Île-de-France

The CARDIO-ARSIF registry has been continuously collecting comprehensive data on coronary angiography and percutaneous coronary interventions (PCI) performed in the 36 catheterization laboratories across the Île-de-France region since 2000. Over the period from 2003 to 2022, this registry has recorded information from more than 330,000 patients, encompassing more than one million procedures. Among these procedures, 58% consisted of coronary angiography, 13% were percutaneous coronary interventions (PCI), and the remaining 28% were PCI performed on an ad-hoc basis.This extensive dataset serves as a valuable resource for both qualitative and quantitative assessments of practices and the relevance of procedures in the field of coronary invasive cardiology. The results of these analyses undergo annual validation by a dedicated scientific committee and are shared with the teams of investigators. The exploitation of this data has led to scientific publications, with one notable finding being a consistent reduction in the radiation doses received by patients, regardless of the type of procedure.

Completeness of intervention description in invasive cardiology trials: an observational study of ClinicalTrials.gov registry and corresponding publications.

Non-pharmacological invasive interventions in cardiology are complex and often inadequately reported. Template for Intervention Description and Replication (TIDieR) checklist and guide were developed to aid reporting and assessment of non-pharmacological interventions. The aim of our study was to assess the completeness of describing invasive cardiology interventions in clinical trials at the level of trial registration and corresponding journal article publication. We searched for clinical trials in invasive cardiology registered in Clinicaltrials.gov and corresponding journal publications. We used the 10-item TIDieR checklist for registries and 12-item checklist for journal publications. Out of 7,017 registry items retrieved by our search, 301 items were included in the analysis. The search for corresponding published articles yielded 192 journal publications. The majority of trials were funded by the industry and were medical device trials. The median number of reported TIDieR items was 4.5 (95% CI 4.49-4.51) out of 10, and while the corresponding journal articles reported 6.5 (95% CI 6.0-6.5) out of 12 TIDieR items. Registration and reporting of invasive cardiology trials is often incomplete and adequate detailed description of the interventions is not provided. TIDieR checklist is an important tool which should be used to ensure rigorous reporting of non-pharmacological interventions in cardiology.

Enhancing safety in invasive cardiology procedures through checklist implementation: a 6-month follow up

Enhancing safety in invasive cardiology procedures through checklist implementation: a 6-month follow up

Robotic-Assisted Solutions for Invasive Cardiology, Cardiac Surgery and Routine On-Ward Tasks: A Narrative Review.

Robots are defined as programmable machines that can perform specified tasks. Medical robots are emerging solutions in the field of cardiology leveraging recent technological innovations of control systems, sensors, actuators, and imaging modalities. Robotic platforms are successfully applied for percutaneous coronary intervention, invasive cardiac electrophysiology procedures as well as surgical operations including minimally invasive aortic and mitral valve repair, coronary artery bypass procedures, and structural heart diseases. Furthermore, machines are used as staff-assisting tools to support nurses with repetitive clinical duties i.e., food delivery. High precision and resolution allow for excellent maneuverability, enabling the performance of medical procedures in challenging anatomies that are difficult or impossible using conventional approaches. Moreover, robot-assisted techniques protect operators from occupational hazards, reducing exposure to ionizing radiation, and limiting risk of orthopedic injuries. Novel automatic systems provide advantages for patients, ensuring device stability with optimized utilization of fluoroscopy. The acceptance of robotic technology among healthcare providers as well as patients paves the way for widespread clinical application in the field of cardiovascular medicine. However, incorporation of robotic systems is associated with some disadvantages including high costs of installation and expensive disposable instrumentations, the need for large operating room space, and the necessity of dedicated training for operators due to the challenging learning curve of robotic-assisted interventional systems.

Patients reporting to be healthy and not needing to change lifestyle after percutaneous coronary intervention - a cause for action?

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): The Western Norway Health Authority, The Norwegian Nurses Association Background A substantial proportion of patients with coronary artery disease do not achieve risk factors control, and are subsequently readmitted to hospital. In addition to decreased longevity, this increases the burden to the healthcare system and already strained resources. Aim To determine lifestyle and clinical characteristics of patients reporting to be healthy and not needing to change their lifestyle after percutaneous coronary intervention (PCI). Methods CONCARDPCI is a prospective multicentre cohort study including 3417 patients after PCI at seven Norwegian and Danish university hospitals during 2017-2019. Socio-demographic characteristics were obtained by self-report during the index hospitalization for PCI, and self-report on perceived health and the need to do lifestyle changes were repeated after 12 months. Clinical data were collected from patients’ medical records and the Norwegian Registry on Invasive Cardiology. Descriptive statistics, as well as t-test and chi-square test, scrutinized the aim. Results At baseline, 18% reported to be healthy and not needing to change their lifestyle. This increased to 28% (p&amp;lt;0.001) at 12 months. Most patients were men (78%) with a mean age of 66 years (SD 11, range 20-96 years). A sizeable proportion had previous cardiovascular comorbidities, including history of myocardial infarction (21%), hypertension (52%) and hypercholesterolemia (47%). Further, 27 % were obese (BMI &amp;gt;=30), 17% were smoking, 26% had previous PCI, and 9% previous coronary artery bypass grafting (CABG). Patients reporting to be healthy and not needing to change their lifestyle were older (69 vs 65, p&amp;lt;0.001). At baseline, compared to the total study population, significantly fewer patients with history of: hypercholesterolemia 13% (p = 0.002), hypertension 12% (p = 0.001), previous PCI 11% (p&amp;lt;0.001), previous CABG 9% (p&amp;lt;0.001), obesity 6% (p&amp;lt;0.001) and smoking 4% (p&amp;lt;0.001) reported to be healthy and asserted not needing to change lifestyle. After 12 months, more patients with risk factors reported to be both healthy and not needing to change lifestyle: those having hypercholesterolemia 25% (p&amp;lt;0.001), hypertension 25% (p&amp;lt;0.001), obesity 17% (p&amp;lt;0.001) and smoking 11% (p&amp;lt;0.001), as well as those with history of previous PCI 19% (p&amp;lt;0.001) or CABG 18% (p&amp;lt;0.001). Although the proportion was less for those with history of risk factors than for the total study population at 12 months, the increase in this group was large and significant. Conclusion The proportion of patients reporting to be healthy and not needing to change their lifestyle increased significantly in the longer term. This applied especially to patients with risk factors such as hypercholesterolemia, hypertension, obesity and current smoking, as well as those with history of previous PCI or CABG. For patients to better understand the seriousness and implications of their disease, patient education and increased health literacy is important.

Changes in the Cath Lab in the Treatment of Adult Patients with Congenital Heart Disease: A 12-Year Experience in a Single Referral Center with the Establishment of a Dedicated Working Group.

Adults with congenital heart disease (ACHD) are a growing population needing ongoing care. The aim of this study was to investigate if a dedicated ACHD team impacted the timing and indication of invasive cardiology procedures in these patients at our hospital. Our retrospective single-center study enrolled adult patients with moderate or complex congenital heart disease and with at least one cardiac catheterization between January 2010 and December 2021. According to the period, procedures were labeled as group A (2010 to 2015) or group B (2016 to 2021) and further divided into diagnostic (DCC) and interventional cardiac catheterizations (ICC). 594 patients were eligible for the study. Both DCC (p < 0.05) and ICC increased between groups A and B (p < 0.05). In group B: Fontan patients accounted for the majority of DCC (p < 0.001), while DCC decreased in arterial switch repair (p < 0.001). In Fontan patients, conduit stenting was prevalent (p < 0.001), while fenestration closures dropped (p < 0.01). In patients with tetralogy of Fallot and native outflow tract, percutaneous pulmonary valve implantations (PPVI) increased, with a concurrent reduction in pulmonary valve replacements (p < 0.001 vs. surgical series). In right ventricular conduits, ICC increased (p < 0.01), mainly due to PPVI. Among Mustard/Senning patients, baffle stenting increased from Group A to Group B (p < 0.001). In patients with pulmonary atresia and biventricular repair, ICC often increased for pulmonary artery stenting. A dedicated working group could improve ACHD patients' indications for interventional procedures, leading to tailored treatment, better risk stratification and optimizing time until heart transplantation.