Question 1

What is Charles Dotter’s nickname and what is he credited with achieving?

A : Smart Charlie, brachial technique
B : Crazy Charlie, first arterial angioplasty
C : Clever Charlie, first coronary angiography

Answer B : Crazy Charlie, first arterial angioplasty

Charlie Dotter performed the first arterial dilatation in 1964 with stiff coaxial Teflon catheters. He became known as ¨Crazy Charlie¨ because little credit was given to his unconventional, innovative ideas.

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Question 2

What was Geoffrey Hartzler’s biggest contribution in PTCA?

A : First PTCA in Acute Myocardial Infarctions
B : First stent in saphenous bypass grafts
C : First kissing balloons for bifurcations

Answer A : First PTCA in Acute Myocardial Infarctions

Geoffrey Hartzler expanded the indications of balloon angioplasty. In 1980, he performed the world’s first PTCA for AMI and recommended PTCA as the treatment of choice in AMI.

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Question 3

The monorail system was invented by?

A : John Simpson
B : Bernhard Meier
C : Tassilo Bonzel

Answer C : Tassilo Bonzel

In 1986, Tassilo Bonzel invented the monorail system, where the guide wire was coaxial for only the last 10 cm of the balloon catheter. John Simpson invented the steerable system and Bernhard Meier performed the first kissing balloon for bifurcations.

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Question 4

The first coronary angiography was performed accidentally by?

A : Melvin Judkins
B : Sven Seldinger
C : Mason Sones

Answer C : Mason Sones

Mason Sones accidentally performed the first coronary arteriography during an aortography. After this incident, he designed a braided catheter with a tapered tip and developed the brachial selective coronary arteriography technique.

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Question 5

Who said about Andreas Grüntzig: “He will either go to jail or win the Nobel Prize!”

A : Geoffrey Hartzler
B : Julio Palmaz
C : John Simpson

Answer C : John Simpson

When John Simpson heard Andreas Grüntzig’s presentation in 1977 at Stanford, John though that Andreas was either going to revolutionize the treatment of coronary artery disease or go to jail. In those days, it just made no sense to take a balloon catheter and put it into a critical vessel, to inflate it and believe that suddenly everything would be okay.

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Question 6

Who implanted the first endoprosthesis in a vessel with success?

A : Alexis Carrel
B : Charles Dotter
C : Hans Wallsten

Answer B : Charles Dotter

In 1969, Charles Dotter published a paper about long term patency in popliteal dog arteries, using uncoated coil springs. Of the three coil springs that were implanted, two remained patent at two years. The idea came from Alexis Carrel, but his first experiences in 1912 with permanent intubations in canine aortas were a failure. Hans Wallsten and Ake Senning were involved from the beginning of the first expandable endoprosthesis which would later be implanted in peripheral arteries in 1985 and coronary arteries in 1986.

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Question 7

The indication for the world’s first human coronary artery endoprosthesis implantation was to treat:

A : an abrupt closure occurring during PTCA
B : an acute myocardial infarction
C : a restenosis

Answer C : a restenosis

Jacques Puel implanted the world’s first coronary endoprosthesis on March 28, 1986, to treat a restenosis of a proximal LAD. Ulrich Sigwart implanted the first in man endoprosthesis for the treatment of an acute dissection following a PTCA of a proximal LAD on June 12, 1986. Acute myocardial infarction was initially a contraindication for stenting, but became feasible and successful in the 1990s with stent optimization implantation and dual platelet therapy.

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Question 8

The concept of a balloon-expandable stent was invented by:

A : Julio Palmaz
B : Gary Roubin
C : John Simpson

Answer A : Julio Palmaz

To avoid risk of dissection and elastic recoil, Julio Palmaz had a hunch that it could potentially be done by placing an intraluminal tubular structure which could then be expanded at one time within the stenotic lesion. He is the inventor of the balloon-expandable stent. Julio Palmaz was working with Richard Schatz who proposed to modify the initial device with a bridge permitting it to be implanted in coronary arteries. Gary Roubin and Cesare Gianturco were able to capitalize on Julio Palmaz’ ‘balloon’ idea to enable for better navigation and expansion of their Cook Gianturco-Roubin stent, which needed a better delivery system. John Simpson was the originator of directional atherectomy in 1985, as the first alternative interventional technique after balloon angioplasty.

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Question 9

Who validated the concept of dual platelet therapy to prevent stent thrombosis?

A : Paul Barragan
B : Raffaele De Caterina
C : Marie-Claude Morice

Answer C : Marie-Claude Morice

To prevent stent thrombosis observed in about 25 % at the beginning of bare metal stent use, the French study, conducted by Marie-Claude Morice from 1992 to 1995, validated the concept of dual antiplatelet therapy. Edgar Benveniste, a biologist from Lyon involved in this study, personally suggested combining aspirin and ticlopidine to achieve beneficial, synergistic effects to combat platelets responsible for stent thrombosis. Paul Barragan was the first to use ticlopidine alone, with a pre-treatment, for all his balloon angioplasty since 1986 and, later, for all his stent implantations. Raffaele De Caterina was the first to demonstrate in 1991 that the combination of aspirin and ticlopidine was more effective than either of these 2 agents taken separately.

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Question 10

What was the first new device used to reduce restenosis observed in bare metal stents?

A : bioresorbable stent
B : drug-coated balloon
C : drug-eluting stent

Answer A : bioresorbable stent

Hideo Tamai implanted the first bioresorbable stent in 1998 with the hope of eliminating chronic inflammation caused by the presence of a permanent stent and to permit restoration of normal arterial wall motion after the resorption of this new device. The first drug-eluting stent was implanted in December 1999 by Eduardo Sousa, with the hope of reducing restenosis by reversing the neointimal hyperplasia due to smooth-muscle cell proliferation. Drug-coated balloons were used to treat restenosis of bare metal or drug-eluting stents since 2003.

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Question 11

When and where did Henning Andersen present his poster on “Transluminal Catheter Implantation of a New Expandable Artificial Heart Valve in pigs”?

A : AHA 1990, Dallas
B : ESC 1992, Barcelona
C : TCT 1995, Washington

Answer B : ESC 1992, Barcelona

Andersen presented his animal experiments at ESC 1992 in Barcelona

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Question 12

How well attended was the very first PVT TAVI lecture given by Alain Cribier at TCT 2000 in Washington?

A : Standing room only
B : Very sparsely attended
C : Moderately attended (half of the seats taken)
 

Answer B : Very sparsely attended

Just friends and a few lecturers

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Question 13

Who performed the first TAVI case in US in 2005?

A : Martin Leon
B : Peter Block
C : Bill O’Neill

Answer C : Bill O’Neill

Bill O’Neill in an investigator-sponsored IDE

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Question 14

What valve material was utilized in the first generation of CoreValve in 2004?

A : Equine pericardium
B : Porcine pericardium
C : Bovine pericardium

Answer C : Bovine pericardium

Bovine pericardium, then later changed to porcine in current CoreValve systems

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*Multiple choice

Question 15

What frame materials have been implanted in TAVR cases?

A : Stainless steel, nitinol, cobalt-chromium, epoxy-based polymer, platinum-iridium
B : Nitinol, cobalt-chromium, platinum-iridium
C : Stainless steel, nitinol, cobalt-chromium

Answer A, B, C : All the above

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