1. Practice differences and knowledge gaps in complex and high-risk interventions between Japan and the USA: A case-based discussion.
- Author
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Bavishi C, Davies RE, Matsuno S, Kobayashi N, Katoh H, Obunai K, Maran A, Kearney K, Kohsaka S, and Hirai T
- Subjects
- Male, Female, Humans, Middle Aged, Japan, Coronary Artery Bypass adverse effects, Shock, Cardiogenic etiology, Treatment Outcome, Coronary Artery Disease surgery, Percutaneous Coronary Intervention adverse effects, Myocardial Infarction etiology
- Abstract
Advances in percutaneous coronary intervention (PCI) devices and techniques have expanded the pool of eligible patients for revascularization, including those with comorbidities, reduced left ventricular function, or anatomical complexity (defined as CHIP: complex and high-risk interventions in indicated patients). CHIP interventions are typically performed by selected operators who specialize in complex PCI. This review presents two cases performed in the USA, to discuss the similarities and differences in practice patterns between CHIP operators in Japan and the USA. The first case involves a 58-year-old male presenting with myocardial infarction and cardiogenic shock, and the second case involves a 51-year-old female with a history of coronary artery bypass grafting presenting with a chronic total occlusion and PCI complicated by vessel perforation. The discussion focuses on appropriate patient selection, the role of the heart team approach for decision-making, the use of hemodynamic support devices, and other relevant factors. By comparing practices in Japan and the USA, this review highlights opportunities for knowledge exchange and potential areas for improving patient outcomes., Competing Interests: Declaration of competing interest Dr. Davies reports speaking honoraria from Abiomed, Asahi Intec, Boston Sci, Medtronic, Shockwave, and Teleflex. She also serves on advisory boards for Abiomed, Avinger, Boston Sci, Medtronic, and Rampart. Dr. Kato has received honoraria for speaker from Abbott Medical Japan and Kaneka Medix. Dr. Maran is a consultant for Boston Scientific, Medtronic, and Philips. Dr. Kearney reports consulting fees or honoraria from Asahi Intecc, Abiomed, Boston Scientific, Philips, Medtronic, Teleflex, and Reflow medical. Dr. Kohsaka has received research grants from Novartis and AstraZeneca. Dr. Hirai received speaking honoraria from Abiomed and Asahi Intecc. He received institutional research grant from Abiomed and Asahi Intecc. The remaining authors have nothing to disclose., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
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