Medicine and Health Sciences Commons^™

Successful Percutaneous Management Of Lvad Outflow Graft Stenosis: Role Of Invasive Hemodynamics In Decision Making, Tarun Dalia, Amandeep Goyal, Harsh Mehta, Henedine C. Foster, Eric Hockstad, Aaron Rohr, Philip Johnson, Travis Abicht, Bhanu Gupta

The VAD Journal

Left ventricular assist device (LVAD) outflow graft stenosis (OGS) is a rare but lethal complication. We present a case of a 79-year-old male with pertinent past medical history of an LVAD implanted as destination therapy, stage III chronic kidney disease, and hypertension. He was admitted for low-flow alarms, and the echocardiogram showed stable right ventricle function and no pericardial effusion. Invasive hemodynamic assessments demonstrated a peak-to-peak gradient of 90 mm Hg in the outflow graft between the mid and distal ends of the graft on pullback. Contrast angiography confirmed OGS. The OGS was successfully treated with a VBX-covered stent (Gore). …

Stent Or Shunt, What Could Be Better For Children With Duct Dependent Pulmonary Circulation?, Ghassan A. Shaath, Abdulraouf Mz Jijeh, Mohammed Fararjeh, Fahad Alhabshan, Mansour B. Almutairi, Ahmed Alomrani, Omar Tamimi

Journal of the Saudi Heart Association

Background: Systemic to pulmonary shunt (Shunt) is offered for children with duct dependent pulmonary circulation to augment pulmonary flow. Recently patent ductus arteriosus (PDA) stent (Stent) is widely used as an alternative method. We aimed to compare post intervention outcomes in children underwent either procedure. Methods: Infants under 3 months who had an initial palliation by Shunt or Stent were retrospectively reviewed between 2008-2016, then followed till the second intervention or 1 year whichever earlier. Results: 187 patients (110 Shunt and 77 Stent) were included. Initial weight and pulmonary artery (PA) branches size were similar between the groups. Shunt patients …

Entrapment Of A Partially Degloved Stent In The Radial Artery: Is There Any Way Out?, Nooraldaem Yousif, Husam A. Noor

Journal of the Saudi Heart Association

Stent loss during percutaneous coronary intervention (PCI) is uncommon but may lead to serious adverse events. Here we describe a challenging case of stent loss in the radial artery during primary PCI. There, a long stent failed to cross the culprit lesion, and an attempt to pull back the undeployed stent into the guiding catheter resulted in eversion of the stent, partially stripping it off the stent balloon and rendering the stent irretrievable. Retrieval of the stent at all costs might have led to major complications; hence stent deployment in the radial artery bailed us out of this precarious situation.

Continuous-Flow Left Ventricular Assist Device Outflow Graft Stenting: Indications And Outcomes, Chelsey T. Wood, Mfa, Elizabeth J. Maynes, Md, Thomas J. O'Malley, Md, Rohinton J. Morris, Md, Louis E. Samuels, Md, H. Todd Massey, Md, Vakhtang Tchantchaleishvili

Phase 1

Introduction: Stenosis in the continuous-flow left ventricular assist device (CF-LVAD) outflow graft can be caused by various mechanical and anatomical factors. Increasingly, percutaneous management has been utilized to re-establish adequate CF-LVAD flow. We sought to evaluate indications for such interventions and their outcomes.

Methods: An electronic search was performed to identify all studies in the English literature reporting CF-LVAD outflow graft stenting for various etiologies. Twenty-one studies consisting of 26 patients were included in the analysis.

Results: Median patient age was 59 years [45.8-67.0] and 65.4% (17/26) were male. 58.3% (14/24) of patients had HeartWare HVAD, 37.5% (9/24) had HeartMate …

Evaluating Wall Shear Stress Indices To Uncover Stimuli For Restenosis And Malapposition In Stented Coronary Arteries, Ali A. Aleiou

Master's Theses (2009 -)

The cause of coronary artery neointimal thickening leading to restenosis in ~10% of drug-eluting stents is unknown. Although research suggests adverse values of traditional wall shear stress (WSS) indices may contribute, studies to date have not accounted for stent geometry, which dictates local WSS patterns influencing drug concentration. Recently proposed WSS indices such as WSS variability and WSS exposure time (WSSET) may shed further light on restenosis or, the opposite effect, resorption. The objective of this investigation was to locally evaluate traditional and recently proposed post-stenting metrics and their respective impact on restenosis or resorption. This study used de-identified data …

The Use Of Wallstent And Smart Stents Incarotid Stent-Supported Angioplasty, Steven Siu-Lung Li

Journal of the Hong Kong College of Cardiology

In the endovascular approach of carotid stenosis treatment, stent-supported angioplasty is current state-of-the-art technique. Self-expandable stents are preferable to balloon-expandable stents due to the potential risk of deformation of the latter by external pressure. Wallstents and SMART stents are the more commonly used self-expandable stents. They appear to be of similar efficacy and safety but due to their different characteristics, their applications may be different according to different lesion characteristics.