3D Stent Reconstruction Using CMCT: A Novel Method to Assess Stent Expansion.

Stent underexpansion in calcified coronary stenosis is an important predictor of major short- and long-term adverse cardiovascular events. In this case, we describe a novel method for assessing stent expansion using 3-dimensional stent reconstruction with C-arm motion compensated computed tomography.

[Cardiac magnetic resonance imaging and coronary optical coherence tomography : Acquisition techniques, interpretation and integration in diagnostic algorithms for MINOCA]. / Imagerie par résonance magnétique et imagerie endocoronaire par tomographie par cohérence optique : acquisition, interprétation et intégration dans le diagnostic étiologique des MINOCA.

MINOCA is a heterogeneous entity with many possible etiologies that need to be clarified to optimize therapeutic interventions. Common causes include plaque disruption, plaque erosion, spontaneous coronary artery dissection, coronary artery spasm, coronary thromboembolism. Most of the time, coronary angiography is inadequate to obtain the proper identification of these underlying pathophysiological mechanisms. Within this context, myocardial tissue characterization with magnetic resonance imaging is key investigation to assess and locate recent myocardial infarctions and to exclude differential diagnostics such as myocarditis or takotsubo cardiomyopathy. In addition, optical coherence tomography is a powerful tool to visualize coronary intraluminal and superficial coronary artery structures in detail including the detection of plaque disruption signs, thrombus or dissections. The use of appropriate diagnostic algorithms combining both OCT and CMR seems to provide a clear substrate or diagnosis to many of the cases. This narrative review aims to expose both imaging modalities focusing on their contributions in the setting of MINOCA.

[Diagnostic and prognostic utility of cardiac magnetic resonance imaging in myocarditis]. / Apports diagnostique et pronostique de l'imagerie par résonance magnétique cardiaque dans la myocardite.

Cardiac magnetic resonance imaging (CMR) became over the last 30 years an essential tool in the management of patients with myocarditis. Noninvasive diagnosis of acute myocarditis relies on a clinical picture compatible with myocarditis and fulfilling of the updated 2018 Lake Louise criteria. These criteria include highlights of myocardial edema by conventional T2-weighted sequences or by T2 mapping in one hand and evidence of myocardial injury using late gadolinium enhancement sequences, T1 mapping or extra-cellular volume measurement in the other hand. It is recommended to perform basal examination in the 2 or 3 weeks following acute episode and to repeat CMR during follow-up. The literature reports excellent diagnostic accuracy, between 80% and 90%, making CMR a robust and reliable noninvasive alternative to endomyocardial biopsy. Besides, beyond its diagnostic performance, CMR can also help to identify patients with unfavourable long-term outcome. For instance, medio-ventricular and septal location of late gadolinium enhancement, degree of late gadolinium enhancement extent or high T2 mapping values are independent predictive factors of major cardio-vascular events.

Transcatheter Occlusion of Coronary-Pulmonary Fistula With a Liquid Embolic Agent After Evaluation by FFR.

A 58-year-old man was admitted for stable angina. The coronary angiogram revealed a coronary-pulmonary fistula with a nonsignificant atheroma. We decided to perform percutaneous embolization of the fistula in view of the symptoms and the hemodynamic assessment findings. Embolization was performed using a liquid embolic agent with no residual flow. (Level of Difficulty: Intermediate.).