Cardiology Commons^™

The Impact Of Severe Obesity On Image Quality And Ventricular Function Assessment In Echocardiography And Cardiac Mri., Akash Goyal, Christopher D Crabtree, Bryan C Lee, Thura T Harfi, Saurabh Rajpal, Vedat O Yildiz, Orlando P Simonetti, Matthew S Tong

Heart and Vascular Articles

This study sought to evaluate the impact of severe obesity on image quality and ventricular function assessment in cardiovascular magnetic resonance (MRI) and trans-thoracic echocardiography (TTE). We studied 100 consecutive patients who underwent clinically indicated cardiac MRI and TTE studies within 12 months between July 2017 and December 2020; 50 (28 females and 22 males; 54.5 ± 18.7 years) with normal body mass index (BMI) (18.5-25 kg/m

Three-Year Outcomes Of The Abre Venous Self-Expanding Stent System In Patients With Symptomatic Iliofemoral Venous Outflow Obstruction., Stephen Black, Marc Sapoval, David J Dexter, Kathleen Gibson, Raghu Kolluri, Mahmood Razavi, Dorian J Defreitas, Hong Wang, Stephanie Brucato, Erin Murphy

Heart and Vascular Articles

PURPOSE: To report 36-month outcomes and subgroup analysis of the ABRE study evaluating the safety and effectiveness of the Abre venous self-expanding stent system for the treatment of symptomatic iliofemoral venous outflow obstruction disease.

METHODS: The ABRE study was a prospective, multicenter, nonrandomized study that enrolled and implanted Abre venous stents in 200 participants (mean age 51.5 years [SD ± 15.9], 66.5% women) with symptomatic iliofemoral venous outflow obstruction at 24 global sites. Outcomes assessed through 36 months included patency, major adverse events, stent migration, stent fracture, and quality-of-life changes. Adverse events and imaging studies were adjudicated by independent clinical …

Real-World Outcomes For The Fifth-Generation Balloon Expandable Transcatheter Heart Valve In The United States., Curtiss T Stinis, Amr E Abbas, Paul Teirstein, Raj R Makkar, Christine J Chung, Vijay Iyer, Philippe Généreux, Robert M Kipperman, John K Harrison, G Chad Hughes, Jefferson M Lyons, Ayaz Rahman, Nikolaos Kakouros, Jennifer Walker, David K Roberts, Pei-Hsiu Huang, Biswajit Kar, Abhijeet Dhoble, Daniel P Logsdon, Puneet K Khanna, Joseph Aragon, James M Mccabe

Heart and Vascular Articles

BACKGROUND: The fifth-generation SAPIEN 3 Ultra Resilia valve (S3UR) incorporates several design changes as compared with its predecessors, the SAPIEN 3 (S3) and SAPIEN 3 Ultra (S3U) valves, including bovine leaflets treated with a novel process intended to reduce structural valve deterioration via calcification, as well as a taller external skirt on the 29-mm valve size to reduce paravalvular leak (PVL). The clinical performance of S3UR compared with S3 and S3U in a large patient population has not been previously reported.

OBJECTIVES: The aim of this study was to compare S3UR to S3/S3U for procedural, in-hospital, and 30-day clinical and …

Pulmonary Vein Isolation With Or Without Left Atrial Appendage Ligation In Atrial Fibrillation: The Amaze Randomized Clinical Trial., Dhanunjaya R Lakkireddy, David J Wilber, Suneet Mittal, David Tschopp, Christopher R Ellis, Abdi Rasekh, Troy Hounshell, Rudy Evonich, Sheetal Chandhok, Ronald D Berger, Rodney Horton, Michael H Hoskins, Hugh Calkins, Steven J Yakubov, Pamela Simons, Benjamin R Saville, Randall J Lee

Heart and Vascular Articles

IMPORTANCE: Left atrial appendage elimination may improve catheter ablation outcomes for atrial fibrillation.

OBJECTIVE: To assess the safety and effectiveness of percutaneous left atrial appendage ligation adjunctive to catheter pulmonary vein isolation for nonparoxysmal atrial fibrillation.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter, prospective, open-label, randomized clinical trial evaluated the safety and effectiveness of percutaneous left atrial appendage ligation adjunctive to planned pulmonary vein isolation for nonparoxysmal atrial fibrillation present for less than 3 years. Eligible patients were randomized in a 2:1 ratio to undergo left atrial appendage ligation and pulmonary vein isolation or pulmonary vein isolation alone. Use of a …

Simplifying Transcatheter Tricuspid Valve Replacement With 3-Dimensional Intracardiac Echocardiography., Carlos E Sanchez, Steven J Yakubov

Heart and Vascular Articles

Transcatheter tricuspid valve replacement (TTVR) offers the potential for improved outcomes for the significant number of patients with severe tricuspid valve regurgitation relative to current treatment options. Imaging is a critical component of the success of this procedure. Here we describe strategies and techniques for the use of 3-dimensional intracardiac echocardiography as an adjunct to standard transesophageal echocardiography during TTVR procedure.

The Time Is Now For Vascular Medicine, Heather L Gornik, Raghu Kolluri, Herbert Aronow, Bruce Gray, Geno Merli, Ido Weinberg, Joshua A Beckman

Heart and Vascular Articles

No abstract provided.

Clinical Care For Life's Essential 8 By Medical Specialty In The United States, An Observational Cohort Study., Michael E Johansen, Madeline R Sterling, Jeremy B Sussman

Heart and Vascular Articles

No abstract provided.

Successful Extravascular Implantable Cardioverter-Defibrillator Implantation In A Patient With Recurrent Transvenous Implantable Cardioverter-Defibrillator Erosion., Andrea Robinson, Sreedhar Billakanty, Eugene Fu, Anish Amin

Heart and Vascular Articles

No abstract provided.

Atrial Fibrillation Symptom Reduction And Improved Quality Of Life Following The Hybrid Convergent Procedure: A Converge Trial Subanalysis., Jaswinder Gill, Karl J Crossen, Christopher Blauth, Faraz Kerendi, Saumil R Oza, Anthony R Magnano, Mark A Mostovych, Michael E Halkos, David Tschopp, Jose Osorio, Paul Tabereaux, William Boedefeld, Kenneth Civello, Syed Ahsan, John Yap, Sreedhar Billakanty, Steve Duff, Otto Costantini, Eric Espinal, Andy Kiser, Christian Shults, David Pederson, James Garrison, David M Gilligan, Michael G Link, Marcin Kowalski, Christopher Stees, Jason S Sperling, Israel Jacobowitz, Felix Yang, Yisachar J Greenberg, David B De Lurgio

Heart and Vascular Articles

BACKGROUND: CONVERGE was a prospective, multicenter, randomized controlled trial that evaluated the safety of Hybrid Atrial Fibrillation Convergent (HC) and compared its effectiveness to endocardial catheter ablation (CA) for the treatment of persistent atrial fibrillation (PersAF) and longstanding PersAF (LSPAF). In 2020, we reported that CONVERGE met its primary safety and effectiveness endpoints. The primary objective of the present study is to report CONVERGE trial results for quality of life (QOL) and Class I/III anti-arrhythmic drug (AAD) utilization following HC.

METHODS: Eligible patients had drug-refractory symptomatic PersAF or LSPAF and a left atrium diameter ≤6.0 cm. Enrolled patients were randomized …

Transcatheter Aortic Valve Replacement In Discordant Aortic Stenosis: The Time Is Now., Vikrant Jagadeesan, Carlos Sanchez, Steven Yakubov

Heart and Vascular Articles

No abstract provided.

Celiac Artery Occlusion From Median Arcuate Ligament Compression Complicating A Hemorrhagic Duodenal Ulcer Repair., Anthony N Rizzo, Marc Seligson, William O'Brien, David Laczynski, Anthony Rizzo

Heart and Vascular Articles

We present a case of a hemorrhagic duodenal ulcer complicated by occlusion of the celiac artery (CA) by acute median arcuate ligament (MAL) compression. Angiography revealed retrograde flow through the gastroduodenal artery (GDA) to the hepatic artery, with occlusion at the CA origin. This unique presentation required coordinated release of the MAL to reestablish antegrade CA flow before pyloroplasty and GDA ligation. The presence of preexisting MAL compression of the CA should be considered during the repair of bleeding duodenal ulcers through embolization or ligation of the GDA, because impaired CA perfusion could result in foregut ischemia.

The Clinical And Economic Impact Of Extended Battery Longevity Of A Substernal Extravascular Implantable Cardioverter Defibrillator., Bradley P Knight, Nicolas Clémenty, Anish Amin, Ulrika M Birgersdotter-Green, Henri Roukoz, Reece Holbrook, Jaimie Manlucu

Heart and Vascular Articles

INTRODUCTION: The extravascular implantable cardioverter defibrillator (EV ICD) has extended projected battery longevity compared to the subcutaneous implantable cardioverter defibrillator (S-ICD). This study used modeling to characterize the need for generator changes, long-term complications, and overall costs for both the EV ICD and S-ICD in healthcare systems of various countries.

METHODS: Battery longevity data were modeled using a Markov model from averages reported in device labeling for the S-ICD and with engineering estimates based on real life usage from EV ICD Pivotal Study patient data to introduce variability. Clinical demographic data were derived from published literature. The primary outcomes were …

Management Of Postprocedural Conduction Disturbances Using A Prespecified Algorithm In The Optimize Pro Study., Kendra J Grubb, Steven J Yakubov, Tamim M Nazif, Suneet Mittal, Hemal Gada, Douglas G W Fraser, Joshua D Rovin, Ramzi Khalil, Robert T Pyo, Samin K Sharma, Mustafa Ahmed, Jian Huang, Josep Rodes-Cabau

Heart and Vascular Articles

BACKGROUND: Lack of standardization in posttranscatheter aortic valve replacement (TAVR) conduction disturbance (CD) identification and treatment may affect permanent pacemaker implantation (PPI) rates and clinical outcomes. The safety and efficacy of a standardized TAVR CD algorithm has not been analyzed. This study analyzes the Optimize PRO post-TAVR CD management algorithm with Evolut PRO/PRO

METHODS: Optimize PRO is a prospective, postmarket study implementing 2 strategies to reduce pacemaker rates: TAVR with cusp overlap technique and a post-TAVR CD algorithm. The 2-hour postprocedural electrocardiogram (ECG) stratified patients to early discharge in the absence of new ECG changes or to CD algorithms for …

Cardiovascular Disease In Thymic Cancer Patients., Abhishek Khemka, Suparna C Clasen, Patrick J Loehrer, Anna R Roberts, Lilian Golzarri-Arroyo, Sunil S Badve, Subha V Raman, Siu L Hui, Titus K L Schleyer

Heart and Vascular Articles

INTRODUCTION: Cancer patients may have increased risk for adverse cardiac events, but our understanding of cardiovascular risk in thymic cancer patients is not clear. We sought to characterize baseline cardiometabolic risk factors before thymic cancer diagnosis and the potential association between cancer treatment and subsequent cardiac events.

METHODS: This was a retrospective cohort study evaluating patients with thymic cancer from 2003 to 2020 compared to age- and sex-matched controls without cancer. Baseline cardiovascular risk factors, cancer characteristics, and incidence of cardiac events were collected from the health information exchange. Multivariable regression was used to examine the impact of cardiovascular risk …

Profound First-Degree Atrioventricular Block In A High-Level Basketball Athlete., Justin D Stumph, William K Cornwell, Michael A Rosenberg, Morteza Khodaee

Heart and Vascular Articles

First-degree atrioventricular (AV) block (PR interval >200 ms) is commonly observed among screening electrocardiogram (ECG) in athletes. Profound first-degree AV block (PR interval >400 ms) and Mobitz type I (Wenckebach) second-degree AV block are generally uncommon and often require further workup on a case-by-case basis, particularly when there is concern for a structural cardiac abnormality. In this case, we present an example of an asymptomatic profound first-degree AV block with Mobitz type I (Wenckebach) second-degree AV block. Transthoracic echocardiogram and stress echocardiogram were unremarkable and the patient was cleared to participate in sports without any restriction. Physicians managing athletes should …

The 2023 Society For Vascular Surgery, American Venous Forum, And American Vein And Lymphatic Society Clinical Practice Guidelines For The Management Of Varicose Veins Of The Lower Extremities. Part Ii: Endorsed By The Society Of Interventional Radiology And The Society For Vascular Medicine., Peter Gloviczki, Peter F Lawrence, Suman M Wasan, Mark H Meissner, Jose Almeida, Kellie R Brown, Ruth L Bush, Michael Di Iorio, John Fish, Eri Fukaya, Monika L Gloviczki, Anil Hingorani, Arjun Jayaraj, Raghu Kolluri, M Hassan Murad, Andrea T Obi, Kathleen J Ozsvath, Michael J Singh, Satish Vayuvegula, Harold J Welch

Heart and Vascular Articles

The Society for Vascular Surgery, the American Venous Forum, and the American Vein and Lymphatic Society recently published Part I of the 2022 clinical practice guidelines on varicose veins. Recommendations were based on the latest scientific evidence researched following an independent systematic review and meta-analysis of five critical issues affecting the management of patients with lower extremity varicose veins, using the patients, interventions, comparators, and outcome system to answer critical questions. Part I discussed the role of duplex ultrasound scanning in the evaluation of varicose veins and treatment of superficial truncal reflux. Part II focuses on evidence supporting the prevention …

Randomized Controlled Trial Of Mechanical Thrombectomy Vs Catheter-Directed Thrombolysis For Acute Hemodynamically Stable Pulmonary Embolism: Rationale And Design Of The Peerless Study., Carin F Gonsalves, C Michael Gibson, Stefan Stortecky, Roger A Alvarez, Daren M Beam, James M Horowitz, Mitchell J Silver, Catalin Toma, John H Rundback, Stuart P Rosenberg, Craig D Markovitz, Thomas Tu, Wissam A Jaber

Heart and Vascular Articles

BACKGROUND: The identification of hemodynamically stable pulmonary embolism (PE) patients who may benefit from advanced treatment beyond anticoagulation is unclear. However, when intervention is deemed necessary by the PE patient's care team, data to select the most advantageous interventional treatment option are lacking. Limiting factors include major bleeding risks with systemic and locally delivered thrombolytics and the overall lack of randomized controlled trial (RCT) data for interventional treatment strategies. Considering the expansion of the pulmonary embolism response team (PERT) model, corresponding rise in interventional treatment, and number of thrombolytic and nonthrombolytic catheter-directed devices coming to market, robust evidence is needed …

Supraventricular Tachycardia Associated With Repeat Cesarean Section Under Spinal Anesthesia., Mihir Patel, Matthias Franzen, Camille D Hawkins, Matthew Brown, Samir Patel

Heart and Vascular Articles

Supraventricular tachycardia (SVT) is the most common tachyarrhythmia of pregnancy. Catecholamine surges, the use of vasoactive agents during delivery, and increased cardiac output during pregnancy are the most common contributing factors to developing SVT. SVT is usually benign in presentation but can lead to more serious arrhythmias in patients with a history of mitral stenosis secondary to rheumatic heart disease. When an SVT is detected, organic heart causes should be ruled out first. Symptoms of SVT include shortness of breath, palpitations, syncope, sweating, chest pain, and dizziness. In patients who are refractory to pharmacologic management and hemodynamically unstable, electrical cardioversion …

Outcomes In High-Risk Pulmonary Embolism Patients Undergoing Flowtriever Mechanical Thrombectomy Or Other Contemporary Therapies: Results From The Flame Study., Mitchell J Silver, C Michael Gibson, Jay Giri, Sameer Khandhar, Wissam Jaber, Catalin Toma, Bushra Mina, Terry Bowers, Lee Greenspon, Herman Kado, David M Zlotnick, Mithun Chakravarthy, Aaron R Ducoffe, Paul Butros, James M Horowitz

Heart and Vascular Articles

BACKGROUND: Hemodynamically unstable high-risk, or massive, pulmonary embolism (PE) has a reported in-hospital mortality of over 25%. Systemic thrombolysis is the guideline-recommended treatment despite limited evidence. The FLAME study (FlowTriever for Acute Massive PE) was designed to generate evidence for interventional treatments in high-risk PE.

METHODS: The FLAME study was a prospective, multicenter, nonrandomized, parallel group, observational study of high-risk PE. Eligible patients were treated with FlowTriever mechanical thrombectomy (FlowTriever Arm) or with other contemporary therapies (Context Arm). The primary end point was an in-hospital composite of all-cause mortality, bailout to an alternate thrombus removal strategy, clinical deterioration, and major …

Transcarotid Versus Transaxillary Access For Transcatheter Aortic Valve Replacement With A Self-Expanding Valve: A Propensity-Matched Analysis., Keith B Allen, Daniel Watson, Amit N Vora, Paul Mahoney, Adnan K Chhatriwalla, Jonathan G Schwartz, Antoine Keller, Nishtha Sodhi, Daniel Haugan, Michael Caskey

Heart and Vascular Articles

UNLABELLED: Transaxillary access has been the most frequently used nonfemoral access route for transcatheter aortic valve replacement (TAVR) with a self-expanding valve. Use of transcarotid TAVR is increasing; however, comparative data on these methods are limited. We compared outcomes following transcarotid or transaxillary TAVR with a self-expanding, supra-annular valve.

METHODS: The Transcatheter Valve Therapy Registry was queried for TAVR procedures using transaxillary and transcarotid access between July 2015 and June 2021. Patients received a self-expanding Evolut R, PRO, or PRO + valve (Medtronic) and had 1-year follow-up. Thirty-day and 1-year outcomes were compared in transcarotid and transaxillary groups after 1:2 …

Delphi Consensus On Reporting Standards In Clinical Studies For Endovascular Treatment Of Acute Iliofemoral Venous Thrombosis And Chronic Iliofemoral Venous Obstruction., Suresh Vedantham, Peter Gloviczki, Teresa L Carman, Sandra Zelman Lewis, Peter A Schneider, Saher S Sabri, Raghu Kolluri

Heart and Vascular Articles

Acute iliofemoral deep vein thrombosis and chronic iliofemoral venous obstruction cause substantial patient harm and are increasingly managed with endovascular venous interventions, including percutaneous mechanical thrombectomy and stent placement. However, studies of these treatment elements have not been designed and reported with sufficient rigor to support confident conclusions about their clinical utility. In this project, the Trustworthy consensus-based statement approach was utilized to develop, via a structured process, consensus-based statements to guide future investigators of venous interventions. Thirty statements were drafted to encompass major topics relevant to venous study description and design, safety outcome assessment, efficacy outcome assessment, and topics …

Case Report: Large Left Ventricular Aneurysm With Contained Rupture And Haemopericardium., Aimee Willett, Zachary Glenn, Madison Rose-Malkamäki, Arash Arshi

Heart and Vascular Articles

BACKGROUND: Recent advancements in cardiology have significantly decreased the incidence of post-myocardial infarction mechanical complications. When these sequelae occur, they can have high morbidity and mortality and may require aggressive intervention.

CASE SUMMARY: We describe a case of contained rupture of a large left ventricular aneurysm (LVA) presenting with syncope in a 60-year-old male with late presentation myocardial infarction (MI) 6 weeks prior on home triple antithrombotic therapy (TAT). Urgent pericardiocentesis along with imaging techniques including ultrasound, computed tomography angiography (CTA), and cardiac magnetic resonance imaging (MRI) were used for initial diagnosis. Definitive treatment was achieved with excision and repair …

Effects Of Atrioventricular Optimization On Left Ventricular Reverse Remodeling With Cardiac Resynchronization Therapy: Results Of The Smart-Crt Trial., Michael R Gold, Kenneth A Ellenbogen, Christophe Leclercq, Jonathan Lowy, Seth J Rials, Morio Shoda, Gery Tomassoni, Ziad Issa, Jean-Francois Sarrazin, John M Jennings, Devi G Nair, Nicholas Wold, Patrick Yong, Michelle M Harbin, Kenneth M Stein, Angelo Auricchio

Heart and Vascular Articles

BACKGROUND: The role of atrioventricular optimization (AVO) to improve cardiac resynchronization therapy outcomes remains controversial. Previous post hoc analyses of a multicenter trial showed that measures of electrical dyssynchrony (right ventricular-left ventricular [LV] or LV electrical delay durations) are associated with patients who benefit from AVO.

METHODS: This was a global, multicenter, prospective, randomized trial of de novo cardiac resynchronization therapy implant patients with an right ventricular-LV duration ≥70 ms to determine whether AVO results in greater reverse remodeling. Patients were randomized 1:1 for either an AVO algorithm (SmartDelay) that determines atrioventricular delay and pacing chamber, biventricular or LV only, …

Pacing After Tavr: Just Give Me The Beat, But Improve The Instruments., Steven J Yakubov, Anish Amin

Heart and Vascular Articles

No abstract provided.

3-Year Outcomes After Transcatheter Or Surgical Aortic Valve Replacement In Low-Risk Patients With Aortic Stenosis., John K Forrest, G Michael Deeb, Steven J Yakubov, Hemal Gada, Mubashir A Mumtaz, Basel Ramlawi, Tanvir Bajwa, Paul S Teirstein, Michael Defrain, Murali Muppala, Bruce J Rutkin, Atul Chawla, Bart Jenson, Stanley J Chetcuti, Robert C Stoler, Marie-France Poulin, Kamal Khabbaz, Melissa Levack, Kashish Goel, Didier Tchétché, Ka Yan Lam, Pim A L Tonino, Saki Ito, Jae K Oh, Jian Huang, Jeffrey J Popma, Neal Kleiman, Michael J Reardon

Heart and Vascular Articles

BACKGROUND: Randomized data comparing outcomes of transcatheter aortic valve replacement (TAVR) with surgery in low-surgical risk patients at time points beyond 2 years is limited. This presents an unknown for physicians striving to educate patients as part of a shared decision-making process.

OBJECTIVES: The authors evaluated 3-year clinical and echocardiographic outcomes from the Evolut Low Risk trial.

METHODS: Low-risk patients were randomized to TAVR with a self-expanding, supra-annular valve or surgery. The primary endpoint of all-cause mortality or disabling stroke and several secondary endpoints were assessed at 3 years.

RESULTS: There were 1,414 attempted implantations (730 TAVR; 684 surgery). Patients …

Clinical Impact Of Standardized Tavr Technique And Care Pathway: Insights From The Optimize Pro Study., Kendra J Grubb, Hemal Gada, Suneet Mittal, Tamim Nazif, Josep Rodés-Cabau, Douglas G W Fraser, Lang Lin, Joshua D Rovin, Ramzi Khalil, Ibrahim Sultan, Blake Gardner, David Lorenz, Stanley J Chetcuti, Nainesh C Patel, James E Harvey, Paul Mahoney, Brian Schwartz, Zubair Jafar, John Wang, Srinivasa Potluri, Amit N Vora, Carlos Sanchez, Amy Corrigan, Shuzhen Li, Steven J Yakubov

Heart and Vascular Articles

BACKGROUND: Procedural success and clinical outcomes after transcatheter aortic valve replacement (TAVR) have improved, but residual aortic regurgitation (AR) and new permanent pacemaker implantation (PPI) rates remain variable because of a lack of uniform periprocedural management and implantation.

OBJECTIVES: The Optimize PRO study evaluates valve performance and procedural outcomes using an "optimized" TAVR care pathway and the cusp overlap technique (COT) in patients receiving the Evolut PRO/PRO+ (Medtronic) self-expanding valves.

METHODS: Optimize PRO, a nonrandomized, prospective, postmarket study conducted in the United States, Canada, Europe, Middle East, and Australia, is enrolling patients with severe symptomatic aortic stenosis and no pre-existing …

Incidence And Predictors Of Acute Limb Ischemia In Acute Myocardial Infarction Complicated By Cardiogenic Shock., Carlos M Romero, Irfan Shafi, Aadhar Patil, Eric Secemsky, Ido Weinburg, Raghu Kolluri, Huaqing Zhao, Vladimir Lakther, Riyaz Bashir

Heart and Vascular Articles

OBJECTIVE: To describe the incidence and predictors of acute limb ischemia (ALI) in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS).

METHODS: Patients with index hospitalizations for AMI complicated by cardiogenic shock from 2016 to 2019 in the US National Readmission Database were identified. We evaluated the incidence of ALI and its associated mortality, length of stay, and cost of hospitalization. We used multivariable logistic regression to determine independent predictors of ALI in this population.

RESULTS: A total of 84,615 patients had AMI complicated by cardiogenic shock and 1302 (1.54%) developed ALI. The rates of ALI increased …

Hybrid Epicardial-Endocardial Ablation For Long-Standing Persistent Atrial Fibrillation: A Subanalysis Of The Converge Trial., David B Delurgio, Christopher Blauth, Michael E Halkos, Karl J Crossen, David Talton, Saumil R Oza, Anthony R Magnano, Mark A Mostovych, Sreedhar Billakanty, Steven Duff, Christopher Stees, Jason Sperling, Syed Ahsan, John Yap, Christian Shults, David Pederson, James Garrison, Paul Tabereaux, David M Gilligan, Graham Bundy, Otto Costantini, Eric Espinal, Angelo La Pietra, Felix Yang, Yisachar Greenberg, Israel Jacobowitz, Jaswinder Gill

Heart and Vascular Articles

BACKGROUND: Favorable clinical outcomes are difficult to achieve in long-standing persistent atrial fibrillation (LSPAF) with catheter ablation (CA). The CONVERGE (Convergence of Epicardial and Endocardial Ablation for the Treatment of Symptomatic Persistent Atrial FIbrillation) trial evaluated the effectiveness of hybrid convergent (HC) ablation vs endocardial CA.

OBJECTIVE: The study sought to evaluate the safety and effectiveness of HC vs CA in the LSPAF subgroup from the CONVERGE trial.

METHODS: The CONVERGE trial was a prospective, multicenter, randomized trial that enrolled 153 patients at 27 sites. A post hoc analysis was performed on LSPAF patients. The primary effectiveness was freedom from …

Structural Valve Deterioration After Self-Expanding Transcatheter Or Surgical Aortic Valve Implantation In Patients At Intermediate Or High Risk., Daniel O'Hair, Steven J Yakubov, Kendra J Grubb, Jae K Oh, Saki Ito, G Michael Deeb, Nicolas M Van Mieghem, David H Adams, Tanvir Bajwa, Neal S Kleiman, Stanley Chetcuti, Lars Søndergaard, Hemal Gada, Mubashir Mumtaz, John Heiser, William M Merhi, George Petrossian, Newell Robinson, Gilbert H L Tang, Joshua D Rovin, Stephen H Little, Renuka Jain, Sarah Verdoliva, Tim Hanson, Shuzhen Li, Jeffrey J Popma, Michael J Reardon

Heart and Vascular Articles

IMPORTANCE: The frequency and clinical importance of structural valve deterioration (SVD) in patients undergoing self-expanding transcatheter aortic valve implantation (TAVI) or surgery is poorly understood.

OBJECTIVE: To evaluate the 5-year incidence, clinical outcomes, and predictors of hemodynamic SVD in patients undergoing self-expanding TAVI or surgery.

DESIGN, SETTING, AND PARTICIPANTS: This post hoc analysis pooled data from the CoreValve US High Risk Pivotal (n = 615) and SURTAVI (n = 1484) randomized clinical trials (RCTs); it was supplemented by the CoreValve Extreme Risk Pivotal trial (n = 485) and CoreValve Continued Access Study (n = 2178). Patients with severe aortic valve …

Case Report: It's Not Always About The Veins; Intervention Of Bilateral May-Thurner Syndrome Secondary To Iliac Aneurysm., Syed H Haq, Sidra R Shah, Jaya Chandra, Pavithra Kannan, Sandeep M Patel

Heart and Vascular Articles

May-Thurner Syndrome (MTS) remains evasive because of the insidiousness and variable etiologies by which it can manifest. In this study, we examine a unique presentation of MTS resulting from compression of both common iliac veins by a right common iliac artery aneurysm that required complex endovascular venous and arterial intervention.