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 .
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.
Dr. Timothy Watson is a board certified interventional cardiologist with a keen interest in novel technologies and research. He qualified at the University of London and completed his internship and residency in various hospitals in London and across the West Midlands region. After becoming a member of the Royal College of Physicians of London, he joined a clinical research training programme where he led a study investigating mechanisms of blood clot formation in atrial fibrillation, a common irregular heartbeat which can increase the risk of stroke. For this work, he has been awarded a Doctor of Medicine (MD) degree from the University of Birmingham. Dr. Watson trained in general and interventional cardiology, primarily at Addenbrooke's and Papworth Hospitals in Cambridge. He has subsequently undertaken a fellowship in interventional and structural cardiology at the renowned Green Lane Cardiovascular Unit in Auckland, New Zealand, where he has been involved in various first-in-human studies using exciting and novel technologies, some of which are now being introduced into clinical mainstream practice. He has worked as a consultant (interventional) cardiologist in New Zealand, Malaysia and in Singapore. In addition to his work as a clinical cardiologist, he continues to undertake various research projects as an investigator and maintains active research collaborations with the University of Auckland.