Medicine and Health Sciences Commons^™

Microcurrent-Mediated Modulation Of Myofibroblasts For Cardiac Repair And Regeneration, Dipthi Bachamanda Somesh, Karsten Jürchott, Thomas Giesel, Thomas Töllner, Alexander Prehn, Jan-Peter Richters, Dragana Kosevic, J. Eduardo Rame, Peter Göttel, Johannes Müller

Division of Cardiology Faculty Papers

Cardiovascular diseases are a significant cause of illness and death worldwide, often resulting in myofibroblast differentiation, pathological remodeling, and fibrosis, characterized by excessive extracellular matrix protein deposition. Treatment options for cardiac fibrosis that can effectively target myofibroblast activation and ECM deposition are limited, necessitating an unmet need for new therapeutic approaches. In recent years, microcurrent therapy has demonstrated promising therapeutic effects, showcasing its translational potential in cardiac care. This study therefore sought to investigate the effects of microcurrent therapy on cardiac myofibroblasts, aiming to unravel its potential as a treatment for cardiac fibrosis and heart failure. The experimental design involved …

Microvascular Vasoregulatory Dysfunction In African Americans - An Enhanced Opportunity For Early Prevention And Treatment Of Atherosclerotic Cardiovascular Disease, Renee Bullock-Palmer, Panithaya Chareonthaitawee, Ervin Fox, Garth Beache

Division of Cardiology Faculty Papers

Atherosclerotic cardiovascular disease and its risk factors and precursors are a major driver of disparities in cardiovascular health. This review examines reported evidence that vascular endothelial dysfunction, and its manifestation as coronary microvascular dysfunction, underlies observed excess morbidity and mortality in African Americans. Advanced imaging insights that reveal patho-mechanisms, along with population evidence from the Jackson Heart Study, and the growing evidence emanating from national and international clinical trials and registries are presented. We examine a physiological framework that recognizes insulin-resistant cardiometabolic underpinnings of the conditions of the American Heart Associations' Life's Essential Eight construct of cardiovascular health as a …

Sex Differences In Revascularization, Treatment Goals, And Outcomes Of Patients With Chronic Coronary Disease: Insights From The Ischemia Trial, Harmony R Reynolds, Derek D Cyr, C Noel Bairey Merz, Leslee J Shaw, Bernard R Chaitman, William E Boden, Karen P Alexander, Yves D Rosenberg, Sripal Bangalore, Gregg W Stone, Claes Held, John Spertus, Kaatje Goetschalckx, Olga Bockeria, Jonathan D Newman, Jeffrey S Berger, Ahmed Elghamaz, Renato D Lopes, James K Min, Daniel S Berman, Michael H Picard, Raymond Y Kwong, Robert A Harrington, Boban Thomas, Sean M O'Brien, David J Maron, Judith S Hochman, Ischemia Research Group

Student and Faculty Publications

BACKGROUND: Women with chronic coronary disease are generally older than men and have more comorbidities but less atherosclerosis. We explored sex differences in revascularization, guideline-directed medical therapy, and outcomes among patients with chronic coronary disease with ischemia on stress testing, with and without invasive management.

METHODS AND RESULTS: The ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial randomized patients with moderate or severe ischemia to invasive management with angiography, revascularization, and guideline-directed medical therapy, or initial conservative management with guideline-directed medical therapy alone. We evaluated the primary outcome (cardiovascular death, myocardial infarction, or hospitalization for …

Percutaneous Coronary Intervention In Unprotected Left Main Coronary Artery Stenosis Patients. A Retrospective Study From Palestine, Yunis Daralammouri, Hamza Hamayel, Raya Yassin, Ameer Kittaneh, Aya Asaly, Zaher Nazzal, Yahya Ismail

Palestinian Medical and Pharmaceutical Journal

Objective: The study aimed to assess the results of stenting in unprotected left main coronary artery disease (uLMCAD) at a tertiary hospital center. Methods: We assessed all patients who received stenting for uLMCAD, including stable patients who underwent elective, urgent, or emergent procedures. Data were gathered by reviewing hospital records and coronary angiograms and calculating SYNTAX scores. Patient follow-up was conducted via clinic visits and phone calls. Results: Percutaneous coronary intervention (PCI) was performed on seventy patients with uLMCAD, all of whom had successful revascularization. During their hospital stay, only one patient (1.4%) died from a noncardiac cause and no …

Venovenous Extracorporeal Membrane Oxygenation Usage Following Bullet Embolism To The Pulmonary Artery, Jonathan E. Schoen, Brian Carr, Murtuza Ali, Brett Chapman, Alan Marr, Lance Stuke, Patrick Greiffenstein, John P. Hunt, Paige Deville, Alison Smith

School of Medicine Faculty Publications

Background: Pulmonary artery embolus is a rare complication following gunshot wounds that creates a unique and serious challenge for trauma surgeons. While the majority of bullets that embolize through the vascular system end in the peripheral circulation, approximately one-third enter the central venous circulation. Case Report: We present the case of a bullet embolus to the left pulmonary artery following gunshot wounds to the right chest and the abdomen, with the abdominal ballistic traversing the liver before entering the vena cava and embolizing. The patient’s course was complicated by the development of severe acute respiratory distress syndrome that was successfully …

Chronic Glp1 Therapy Reduces Postprandial Il6 In Obese Humans With Prediabetes, Vala Hamidi, Hongyu Wang, Vi Pham, Karla Bermudez Saint Andre, Heinrich Taegtmeyer, Absalon D Gutierrez

Faculty and Staff Publications

Single-dose glucagon-like peptide 1 (GLP1) therapy increases postprandial plasma IL6 levels in prediabetic, obese humans. GLP1-IL6 interactions underly multiple antidiabetic effects, but these may differ after acute versus chronic therapy. This study examines postprandial effects of GLP1 after chronic therapy. Seven humans (six Black) with prediabetes and obesity completed 6 weeks of exenatide extended release therapy. Then subjects returned for pre- and post-meal measurements of plasma IL6, GLP1, glucagon, and related inflammatory markers. Weight, which was measured before and after therapy, did not change. Plasma IL6 decreased from baseline to postmeal state ( = 0.016), with decreases in free fatty …

Clinicopathological Evaluation Of Papillary Thyroid Microcarcinoma, Ando Takahito, Kimihito Fujii, Hirona Banno, Masayuki Saito, Yukie Ito, Mirai Ido, Manami Goto, Yukako Mouri, Junko Kousaka, Tsuneo Imai, Shogo Nakano

Faculty and Staff Publications

BACKGROUND AND AIMS: Clinicians sometimes encounter papillary thyroid microcarcinoma (PMC) that is less than 10 mm, associated with lymph node metastasis. In this study, we assessed PMC clinicopathologically to clarify risk factors for poor prognosis.

PATIENTS AND METHODS: Fifty-one patients who underwent thyroid surgery at Aichi Medical University from September 2009 to October 2016 were included. Patients were divided into two groups, pEX-positive (23 patients) and pEX-negative (28 patients), based on the pathological finding of thyroid capsule invasion. The former indicates that the tumor infiltrated the thyroid capsule and spread to the neighboring tissue, and the latter indicates no capsule …

Implementation Of A Home Blood Pressure Monitoring Program For The Management Of Hypertensive Disorders Of Pregnancy, An Observational Study In British Columbia, Canada, Karen C Tran, Sabina Freiman, Tessa Chaworth-Musters, Susan Purkiss, Colleen Foster, Nadia A Khan, Wee Shian Chan

Student and Faculty Publications

BACKGROUND: COVID-19 pandemic has influenced health care delivery. We conducted an observational study to understand how obstetric medicine (ObM) physicians utilized home blood pressure monitoring (HBPM) to manage hypertension in pregnancy.

METHODS: Pregnant participants with risk factors or diagnosis of hypertensive disorders of pregnancy (HDP) were enrolled, May 2020-December 2021, and provided with validated home blood pressure (BP) monitor. ObM physicians completed questionnaires to elicit how home BP readings were interpreted to manage HDP.

RESULTS: We enrolled 103 people: 44 antepartum patients (33.5 ± 5 years, gestational age of 24 ± 5 weeks); 59 postpartum patients (35 ± 6 years, …

The Curious Case Of Kounis Syndrome: Exploring Clinical Manifestations And Management In The Presence Of Nonobstructive Coronary Arteries, Darren Drittel, Dylan Deyar, Eric Boxer, Hussam Al Hennawi, Margaret Mack

Abington Jefferson Health Papers

Kounis syndrome, an allergic hypersensitivity coronary disorder, is a rare but potentially life-threatening condition triggered by various allergens, including medications. We present the case of a 41-year-old male with no prior cardiac history, who developed Kounis syndrome following vancomycin administration for suspected cellulitis. The patient initially presented with rash, fever, and malaise, which progressed to chest discomfort associated with diaphoresis and elevated troponin levels. Diagnostic evaluations, including electrocardiographic changes and coronary angiography, confirmed a diagnosis of type I Kounis syndrome. This case adds to the limited literature on vancomycin-induced Kounis syndrome, and underscores the importance of considering this diagnosis in …

Diagnostic And Therapeutic Challenge: A Case Of Right Ventricular Thrombus, Angad Bedi, Muhammad Sabri, Prerana Sevella, Hussam Al Hennawi, Gregory Pirolli

Abington Jefferson Health Papers

Right ventricular thrombus is a rare finding found in 4% of people diagnosed with pulmonary embolism. Although right ventricular thrombi are usually associated with atrial fibrillation, deep venous vein thrombi, or intracardiac procedures, isolated right ventricular thrombi are rare. Right ventricular thrombus has also been reported in patients with right ventricular infarction, as hypokinesis of the right ventricle causes blood stasis and promotes thrombosis as per Virchow’s triad. However, we present a case of isolated RV thrombus in a patient without evidence of deep vein thrombosis or right ventricular hypokinesis who presented with dyspnea on exertion.

What Did We Learn About Vads In 2023?, Maya Guglin

The VAD Journal

This is our 10^th annual literature review on mechanical circulatory support (MCS) devices. All of our previous reports were well received by the readers.^1-9

In this paper, we summarized the most interesting and important, from our standpoint, publications from 2023. There may be some slight overlap with the end of 2022, because some papers were published online first, and the year of publication changed when they became available in print.

For the seventh time this year, we wrote a section on extracorporeal membrane oxygenation (ECMO), which primarily addresses new developments in veno-arterial ECMO.

Readers who wish to supplement …

Covid-19-Associated Myocarditis: Screening For Early Diagnosis, Yousuf Khan, Salmman Ahmed, Samuel John Wlasowicz, Ronald G. Lott Iii, Xavier C. Zonna

Advances in Clinical Medical Research and Healthcare Delivery

The SARS-CoV-2 virus (causing COVID-19), has infected about 770 million people, and caused the death of about 6.9 million people worldwide in the span of three years (John Hopkins Resource Center). Common symptoms of a patient infected with the virus include shortness of breath, fever, chills, fatigue, loss of taste or smell, and muscle aches. However, recent studies have also shown a prevalence of patients presenting with cardiac inflammation (endocarditis, myocarditis or pericarditis) as a potential comorbidity, both during the infectious stage as well as after the infection has subsided. A pattern of specific clinical markers may be indicative of …

Late Cardiotoxicity From The Tyrosine Kinase Inhibitor, Dasatinib: Pleural Effusions, Pulmonary Arterial Hypertension, And Right Heart Failure, Mark Jay Zucker, Andrew M. Zucker

The VAD Journal

Despite the remarkable progress made over the past few decades in the management of patients with both solid and hematologic malignancies, radiation- and chemotherapy-related cardiotoxicity remains an ongoing problem. This is true even for newer highly targeted therapies, including tyrosine kinase inhibitors (TKIs). This report presents a case of late/severe right heart dysfunction secondary to pulmonary hypertension, developed after ten years of therapy with dasatinib. We also review the history of this known, but often unrecognized, and potentially reversible complication, and we suggest treatment options. Additionally, this case highlights the remarkable effectiveness of TKIs in patients with chronic myelogenous leukemia …

" Does Educational Level Affect The Outcome Of Myocardial Infarction? ", Ahmed Magdy Ahmed Elsayed

Theses and Dissertations

Background: Heath awareness plays a major role in determining the outcomes of serious medical conditions specially when response time is crucial. STEMI patients are prone to serious compilations if they didn’t receive the appropriate treatment on time. Raising the health awareness of the community would result in seeking medical help at earlier stage of the disease. Earlier presentation to the medical center would result in better health outcomes. Certain factors form the health awareness of the community. This includes educational level, previous exposure to similar situations, and exposure to health awareness materials.

Methods: This is a cohort study in …

Early Renal Denervation Attenuates Cardiac Dysfunction In Heart Failure With Preserved Ejection Fraction, Jake E. Doiron, Zhen Li, Xiaoman Yu, Kyle B. Lapenna, Heather Quiriarte, Timothy D. Allerton, Kashyap Koul, Andrew Malek, Sanjiv J. Shah, Thomas E. Sharp, Traci T. Goodchild, Daniel R. Kapusta, David J. Lefer

School of Graduate Studies Faculty Publications

BACKGROUND: The renal sympathetic nervous system modulates systemic blood pressure, cardiac performance, and renal function. Pathological increases in renal sympathetic nerve activity contribute to the pathogenesis of heart failure with preserved ejection fraction (HFpEF). We investigated the effects of renal sympathetic denervation performed at early or late stages of HFpEF progression. METHODS AND RESULTS: Male ZSF1 obese rats were subjected to radiofrequency renal denervation (RF-RDN) or sham procedure at either 8 weeks or 20 weeks of age and assessed for cardiovascular function, exercise capacity, and cardiorenal fibrosis. Renal norepinephrine and renal nerve tyrosine hydroxylase staining were performed to quantify denervation …

Relationship Between Periodontal Disease And Coronary Heart Disease: A Bibliometric Analysis, Xiaowen Bo, Wenpeng Song

Annual Research Symposium

Periodontal disease (PD) and coronary heart disease (CHD) are both prevalent diseases worldwide and cause patients physical and mental suffering and a global burden. Recent studies have suggested a link between PD and CHD, but there is less research in this field from the perspective of bibliometrics. This study aimed to quantitatively analyze the literature on PD and CHD to summarize intellectual bases, research hotspots, and emerging trends and pave the way for future research.

Insights From The Histopathologic Analysis Of Acquired And Genetic Thoracic Aortic Aneurysms And Dissections, L Maximilian Buja, Bihong Zhao, Humaira Sadaf, Michelle Mcdonald, Ana M Segura, Li Li, Alana Cecchi, Siddharth K Prakash, Rana O Afifi, Charles C Miller, Anthony L Estrera, Dianna M Milewicz

Student and Faculty Publications

OBJECTIVE: The purpose of this study was to apply contemporary consensus criteria developed by the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology to the evaluation of aortic pathology, with the expectation that the additional pathologic information may enhance the understanding and management of aortic diseases.

METHODS: A scoring system was applied to ascending aortic specimens from 42 patients with heritable thoracic aortic disease and known genetic variations and from 86 patients from a single year, including patients with known genetic variations (n = 12) and patients with sporadic disease (n = 74).

RESULTS: The various types …

Cannula Placement For Cerebral Protection Without Circulatory Arrest In Patients Undergoing Hemiarch Aortic Aneurysm Repair, Joseph C Sweeney, Jaimin R Trivedi, Toyokazu Endo, Akhila Ankem, Siddharth V Pahwa, Mark S Slaughter, Brian L Ganzel

The Texas Heart Institute Journal

BACKGROUND: Aortic aneurysms involving the proximal aortic arch, which require hemiarch-type repair, typically require circulatory arrest with antegrade cerebral perfusion. Left carotid antegrade cerebral perfusion (LCP) via distal arch cannulation without circulatory arrest was used in this study's patient population. The goal was to assess the operative efficiency and clinical outcomes of using a distal arch cannulation technique that would not require any hypothermic circulatory arrest (HCA) time compared with more traditional brachiocephalic artery cannulation with right-sided unilateral antegrade cerebral perfusion (RCP) and HCA.

METHODS: A single-center retrospective review of patients with replacement of the distal ascending aorta involving the …

Factors Associated With Early Mortality In Acute Type A Aortic Dissection-A Single-Centre Experience, Panagiotis Doukas, Nicola Dalibor, András Keszei, Jelle Frankort, Julia Krabbe, Rachad Zayat, Michael J Jacobs, Alexander Gombert, Payam Akhyari, Arash Mehdiani

Student and Faculty Publications

BACKGROUND: Acute aortic dissection type A (AADA) is a surgical emergency with relevant mortality and morbidity despite improvements in current management protocols. Identifying patients at risk of a fatal outcome and controlling the factors associated with mortality remain of paramount importance.

METHODS: In this retrospective observational study, we reviewed the medical records of 117 patients with AADA, who were referred to our centre and operated on between 2005 and 2021. Preoperative, intraoperative, and postoperative variables were analysed and tested for their correlation with in-hospital mortality.

RESULTS: The overall survival rate was 83%. Preoperatively, factors associated with mortality were age ( …

Differing Radiation Exposure In Scrub Technicians And Rotating Staff In Cardiac Catheterization Laboratory: Occupation Matters, Nasir Rahman, Maleeha Javed, Ghufran Adnan, Maria Khan, Zeenat Nizar, Izat Shah

Section of Cardiology

Background: Radiation exposure is a significant hazard associated with invasive Cardiology, with most studies based on primary operator exposure. This prospective, observational study aimed to find out over lead radiation exposure as effective dose acquired by non-physician staff comprising scrub technicians and rotating staff in the cath laboratory. Effective dose (ED) measured per procedure via Raysafe i2®dosimeter badges worn by both rotating staff and scrub technicians over lead aprons along with dose area product (DAP), fluoroscopy time (FT) and procedure time (PT) in minutes was collected prospectively over forty-six invasive Cardiology procedures.
Results: This study shows that rotating staff acquire …

Recent Studies In The Surgical Treatment Of Tetralogy Of Fallot, Emma C. Gardner

Mako: NSU Undergraduate Student Journal

No abstract provided.

Association Of Cardiovascular Risk Profile With Premature All-Cause And Cardiovascular Mortality In Us Adults: Findings From A National Study, Ryan T. Nguyen, Vardhmaan Jain, Isaac Acquah, Safi U. Khan, Tarang Parekh, Mohamad Taha, Salim S. Virani, Michael J. Blaha, Khurram Nasir, Zulqarnain Javed Zulqarnain Javed

Office of the Provost

Objective: To assess the association between cardiovascular risk factor (CRF) profile and premature all-cause and cardiovascular disease (CVD) mortality among US adults (age < 65).
Methods: This study used data from the National Health Interview Survey from 2006 to 2014, linked to the National Death Index for non-elderly adults aged < 65 years. A composite CRF score (range = 0-6) was calculated, based on the presence or absence of six established cardiovascular risk factors: hypertension, diabetes, hypercholesterolemia, smoking, obesity, and insufficient physical activity. CRF profile was defined as "Poor" (≥ 3 risk factors), "Average" (1-2), or "Optimal" (0 risk factors). Age-adjusted mortality rates (AAMR) were reported across CRF profile categories, separately for all-cause and CVD mortality. Cox proportional hazard models were used to evaluate the association between CRF profile and all-cause and CVD mortality.
Results: Among 195,901 non-elderly individuals (mean age: 40.4 ± 13.0, 50% females and 70% Non-Hispanic (NH) White adults), 24.8% had optimal, 58.9% average, and 16.2% poor CRF profiles, respectively. Participants with poor CRF profile were more likely to be NH Black, have lower educational attainment and lower income compared to those with …

Dynamic Prognosis Prediction For Patients On Dapt After Drug-Eluting Stent Implantation: Model Development And Validation, Fang Li, Laila Rasmy, Yang Xiang, Jingna Feng, Ahmed Abdelhameed, Xinyue Hu, Zenan Sun, David Aguilar, Abhijeet Dhoble, Jingcheng Du, Qing Wang, Shuteng Niu, Yifang Dang, Xinyuan Zhang, Ziqian Xie, Yi Nian, Jianping He, Yujia Zhou, Jianfu Li, Mattia Prosperi, Jiang Bian, Degui Zhi, Cui Tao

Student and Faculty Publications

BACKGROUND: The rapid evolution of artificial intelligence (AI) in conjunction with recent updates in dual antiplatelet therapy (DAPT) management guidelines emphasizes the necessity for innovative models to predict ischemic or bleeding events after drug-eluting stent implantation. Leveraging AI for dynamic prediction has the potential to revolutionize risk stratification and provide personalized decision support for DAPT management.

METHODS AND RESULTS: We developed and validated a new AI-based pipeline using retrospective data of drug-eluting stent-treated patients, sourced from the Cerner Health Facts data set (n=98 236) and Optum's de-identified Clinformatics Data Mart Database (n=9978). The 36 months following drug-eluting stent implantation were …

Relationship Between Obesity And Global Longitudinal Strain In The Pediatric Single Ventricle Fontan Population Across Ventricular Morphologies., Nitin Madan, Doaa Aly, Melanie Kathol, Amulya Buddhavarapu, Thomas Rieth, Ashley K. Sherman, Daniel Forsha

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Obesity is associated with diminished myocardial function as measured by strain echocardiography in children and young adults with normal cardiac anatomy. Data are lacking about the effect of obesity on myocardial strain in patients with a single ventricle. In this study, the relationship between body mass index (BMI) and single ventricle myocardial strain in the Fontan population was assessed.

METHODS AND RESULTS: Thirty-eight abnormal BMI Fontan cases (21 overweight and 17 obese) and 30 normal BMI Fontan controls matched based on single ventricular morphology, age, and sex were included in the study. Ventricular morphology was categorized as single right …

Transcatheter Aortic Valve Replacement Across Hemodynamic Subtypes Of Severe Aortic Valve Stenosis: A Network Meta-Analysis, Waqas Ullah, Muhammad Khawar Sana, Maryam Mukhtar, Sohaib Hasan Syed, Salman Zahid, Mohamad Alkhouli, Alec Vishnevsky

Division of Cardiology Faculty Papers

Background: Studies assessing outcomes of transcatheter aortic valve replacement (TAVR) in patients with severe aortic valve stenosis (AS) with hemody- namic subtypes have demonstrated mixed results with respect to outcomes and periprocedural complications. This study aimed to assess the outcomes of TAVR in patients across various hemodynamic subtypes of severe AS. Methods: PubMed, Embase, and Cochrane databases were searched through September 2023 to identify all observational studies comparing outcomes of TAVR in patients with paradoxical low flow low gradient (pLFLG), classic LFLG, and high gradient AS (HGAS). The primary outcome was major adverse cardiovascular events (MACE). The secondary outcomes were …

Prenatal Diagnosis Of A Ductal-Dependent Branch Pulmonary Artery: Extra Vessels In The 3-Vessel And Trachea View., Anmol Goyal, Maria Kiaffas, Tara Swanson, Melanie Kathol, Sanket Shah, Nitin Madan

Manuscripts, Articles, Book Chapters and Other Papers

Obtaining a three-vessel (3V) and three-vessel and trachea (3VT) view from the fetal upper mediastinum is now considered to be part of standard imaging protocol for routine obstetric cardiac screening examinations. We report two fetal cases of an anomalous pulmonary artery origin, utilizing the standard 3V and 3VT views. Further imaging led to a rare diagnosis of bilateral ductus arteriosus with discontinuous branch pulmonary arteries in the absence of any other congenital heart defect. We briefly discuss the imaging features, differential diagnoses, and management of this rare entity.

Safety And Timing Of Early Therapeutic Anticoagulation Therapy After Craniotomy, John M. Wilson, Kierany B. Shelvin, Sarah E. Lawhon, George A. Crabill, Ellery A. Hayden, Alan J. Velander

School of Medicine Faculty Publications

Background: To date, there are few guidelines and studies to guide the timing of initiation of therapeutic anticoagulation (AC) after craniotomy. The goal of this study was to assess the timing, safety, and outcomes of patients following the administration of therapeutic AC after craniotomy. Methods: A retrospective case–control study was performed evaluating all craniotomy patients from August 2017 to July 2021. Cases were selected if they received therapeutic AC within ten days of craniotomy. Nineteen out of 1013 craniotomy patients met the inclusion criteria. Indications for therapeutic AC were diverse, including deep venous thrombosis, pulmonary embolism, dural venous sinus thrombosis, …

Improving Time To Defibrillation​, Jonathan Eyestone, Dana Gilbreth, Amanda Maloney, Tina Pham

Articles, Abstracts, and Reports

"ABSTRACT TITLE: Improving Time to Defibrillation

Background: Providence St. Vincent Medical Center (PSVMC) Medical Surgical units are not meeting the American Heart Association requirement of less than 3 minutes to defibrillation. Time to defibrillation in codes with shockable rhythms averages 4.2 minutes. In Mock Codes, only one met the time less than 3 minutes; four Mock Codes had times over 5 minutes. Resuscitation Quality Improvement CPR (RQI) training is required quarterly. Defibrillator practice with overall Code Blue competency is annual.

Purpose: Combine the hands-on practice of the defibrillator with the hands-on training for RQI.

Methods: The Medical Surgical unit 6 …

Transposition Of The Great Arteries With Intramural Left Main Coronary Artery: Salient Imaging Findings And Description Of Two Operative Techniques, Joshua Holbert, Manasa Gadiraju, Sanket Shah, Edo Bedzra

Posters

Background: Transposition of the great arteries (TGA) is a common cyanotic critical congenital heart disease, with a feasible prenatal diagnosis. Arterial switch operation (ASO) with/without VSD closure is the preferred surgical approach with added challenge when an intramural coronary artery (IMC) is present. ASO is technically quite demanding with IMC, and incidence of post-operative complications and mortality are potentially higher. We present our recent TGA-IMC experience focusing on salient features identified on echocardiography, CT and invasive angiograms, as well as variations in ASO surgical techniques for repair. Methods: Our echo imaging acquisition required high frequency transducers and shallow image depth …

Double Aortic Arch With Atresia Of The Left Aortic Arch Proximal To The Left Common Carotid Artery In A Patient With Phace Syndrome – A Management Conundrum, Mohamed Aashiq Abdul Ghayum, Anmol Goyal, Aliessa P. Barnes, Sanket Shah

Posters

Background Cardiac anomalies in PHACE syndrome (P: posterior fossa anomalies, H: hemangiomas, A: arterial lesions, C: cardiac abnormalities, E: abnormalities of the eye) often consists of complex aortic arch anomalies with double aortic arch (DAA) being an uncommon association. Atresia of the proximal segment of the left arch in DAA is extremely rare and can pose a diagnostic and management conundrum due to formation of a loose vascular ring and asymptomatic nature as seen in our case. Case Description A 5-year-old male, diagnosed with PHACE syndrome, at a different center was noted to have an incidental finding on head imaging …