BookTimothy J Watson, Paul JL Ong, James E Tcheng, editors.
Summary: This book is open access under a CC BY 4.0 license. This quick-reference handbook offers a concise and practical review of key aspects of the treatment of ST-segment elevation myocardial infarction (STEMI) in the era of primary percutaneous coronary intervention (PPCI). In the context of STEMI, PPCI is the preferred mode of emergency revascularization. Access to PPCI is rapidly increasing and is now routinely practiced in both general and specialist hospitals and there has been a recent emphasis on developing STEMI networks to enhance and expedite the referral pathway. This coupled with concurrent developments to enhance the safety and efficacy of the PPCI procedure has heralded an era where STEMI interventions are increasingly considered an important subspecialty within interventional cardiology. Written by leading cardiologists who have been instrumental in the adoption of PPCI in their respective institutions, the book provides junior and senior cardiologists alike with insightful and thought-provoking tips and tricks to enhance the success of PPCI procedures, which may in turn translate into direct improvements in outcomes. The book is also relevant for healthcare providers and emergency department physicians.
Contents:
Foreword
Historical perspectives on management of acute myocardial infarction
Pre-hospital diagnosis and management of acute myocardial infarction
STEMI network and logistics - rural vs. urban
Cath lab design, staffing, training
Patient preparation and vascular access for primary PCI
Management of intra-coronary thrombus
Culprit only artery versus multi-vessel disease
Pharmacologic therapies in primary PCI - antiplatelet agents
Pharmacologic therapies in primary PCI - glycoproteins, heparins, bivalirudins, etc
Pharmacologic therapies in primary PCI - inotropes, etc
Drug-eluting stents vs. bare-metal stents in Primary PCI
Is there still a debate?
Drug-eluting balloons in primary PCI
High bleeding risk scenarios in primary PCI
Mechanical complications of myocardial infarction - free-wall rupture, VSD, acute MR
The role of mechanical circulatory support in primary PCI - IABP, ECMO, IMPELLA, LUCAS?
Methods of reducing infarct size and reperfusion injury in primary PCI
Time to reperfusion, door to balloon times, and how to reduce them
Utilization of facilitated and rescue angioplasty in primary PCI
Primary angioplasty: the economics
Role of bypass surgery in acute myocardial infarction: indications, timing, outcome
Role of intravascular imaging in emergency PCI
Patients ineligible for primary PCI .