Cardiovascular Research Technologies (CRT) 2009, the official meeting of CRM, held March 4–6, 2009, in Washington, DC, was a great success. World-renowned experts offered over 450 scientific presentations, including the latest developments in cell therapy for myocardial regeneration, vulnerable plaque and atherosclerosis, and complex coronary and endovascular intervention, with a focus on management of acute myocardial infarction and acute coronary syndromes. Also presented were more than 35 new technologies and innovations, while meeting attendees and representatives from the Food and Drug Administration exchanged informative discussions regarding the regulatory pathways and requirements for marketing approval in the US. You will find most of these presentations on the meeting's official web site, http://www.crtonline.org. The best abstracts submitted and subsequently presented at the meeting are scheduled for publication in upcoming issues of CRM. It is our hope that many of them will develop into full-length articles and eventually find their way into publication in major cardiology journals.
Meanwhile, we are pleased to present many distinguished manuscripts in this issue of CRM. The first of five clinical original articles comes to us from Ruzsa et al. and compares the outcomes and complication rates between transradial and transfemoral percutaneous coronary interventions in patients with ST-segment elevation myocardial infarction. In their submission, Tsunoda et al. aimed to investigate stent deformation by torsional stress after implantation at the ostium of a model coronary artery. Fuchs et al. investigated the incidence, predictors, and prognostic impact of peri-procedural bleeding in a cohort of unselected patients undergoing contemporary primary percutaneous coronary intervention. Next, Ouldzein et al. aimed to compare mortality at 1 year following drug-eluting and bare-metal stent implantation in patients over 75 years of age. Our final clinical original article, from Varghese et al., aimed to compare the characteristics, procedural, and follow-up clinical outcomes of prior coronary artery bypass surgery patients undergoing native coronary artery vs. bypass graft percutaneous coronary intervention.
Our sole biology original article, from Waksman et al., aimed to determine the effects of peripheral blood-derived endothelial progenitor cells or unfractionated bone marrow cells obtained from inbred siblings on neointimal formation and inflammation in cholesterol fed, balloon denuded, and radiated rabbit iliac arteries. Karthikeyan and Senthamizhchelvan then present a theoretical basis for choosing the optimal site of graft placement on the left anterior descending artery in our only review article. The design of a new vascular support structure (stent) to provide designers with estimates of the critical, essential parameters is described in a novel technology submission from Kumar and Mathew.
Rigatelli et al. present a case of multisite paradoxical embolism (pulmonary, cerebral, upper limb) mediated by a large right-to-left shunt mediated by a patent foramen ovale associated with a redundant Eustachian valve in the first of four case reports. The second, by Cevik et al., reports on the significant coronary artery aneurysms detected in a 41-year-old male with Behçet's disease who had been in remission for 13 years. Pesarini et al. then report three cases of recurrent very late thrombosis of first generation drug-eluting stents in middle-aged patients with different degrees of coronary artery disease, presenting with acute myocardial infarction. Lastly, Prasad et al. report the case of an unstable patient with severe distal left main stem disease in whom cardiac surgery, intra-aortic balloon pumping, and femoral approach were all contraindicated who was successfully treated via a radial approach. Our image of the issue, from Otahbachi et al., presents the left ventriculogram and echocardiogram of a patient who suffered from a very significant pseudoaneurysm secondary to left ventricular free wall rupture during the early postprocedure period.
Finally, with the deepening effects of the global economic recession, serious challenges face our health care system: more and more uninsured patients cannot pay their bills, others defer medical care, and hospitals that are losing money are forced to rein in their expenses by capital freezes and personnel layoffs. The biotechnology industry is in crisis because resources for research and development are dwindling due to a lack of funding and the ability to borrow money, and we have all been called upon to conserve and ‘tighten the belt’ without impacting quality of care. Medical education and data dissemination are also under threat; medical journals have become thinner due to a decline in advertising, readers have chosen not to renew their subscriptions, and medical conferences are reporting significant reductions in attendance. We must collectively figure out what it is we can do to carry on our mission without compromising our charter for patient care, while continuing with research and education programs.
As in previous years, we are continually committed to bringing our readers the best scientific material possible. To that end, we welcome your thoughts and/or experiences regarding ways to preserve solid, effective health care services in these difficult times.
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