TAVR with the 29-mm S3 valve beyond the recommended range by overexpansion is safe, with acceptable PVL and pacemaker rates. Larger LVOTs and more eccentric annuli were associated with more PVL. Longer term follow-up will be needed to determine durability of S3 TAVR in this population.

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Intracoronary urokinase was used to treat flow-limiting intracoronary thrombus accumulation that complicated successful percutaneous transluminal coronary angioplasty (PTCA) during acute ischemic syndromes in 48 patients who were followed up through the acute phase of their illness. The study group with 63% of all patients studied before discharge), and in no patient was there angiographic evidence of reocclusion, although two patients showed angiographic evidence of stenosis; improved vessel percent stenosis persisted, averaging 32±17%. In all patients studied, the coronary flow was TIMI grade 3 at follow-up. Thus, in patients with acute ischemic syndromes with flow-limiting intracoronary thrombus accumulation that complicated PTCA, intracoronary urokinase with repeated PTCA proved to be highly effective in restoring vessel patency and avoiding early complications. (Circulation 1990;82:2052-2060 T he acute ischemic syndromes of unstable angina pectoris, acute myocardial infarction, and postinfarction angina often share a common pathogenesis, with atherosclerotic plaque rup-*All editorial decisions for this article, including selection of reviewers and the final decision, were made by a guest editor. This procedure applies to all manuscripts with authors from the

No abstract