Cardiology Commons^™

Chiari Network Identified By Ct Imaging: An Uncommon Modality For A Common Incidental Finding, Kyle Admire, Denis Yusupov, Xian Qiao

Eastern Virginia Medical Journal

Chiari networks are anatomical variants that result from incomplete resorption of embryologic tissues and are often discovered incidentally on echocardiography. We describe the case of a large Chiari network we discovered after independent review of the patient’s computed tomography scan showed an unexpected filling defect within the right atrium, prompting further investigation. We also conducted a review of the literature for this anatomic variant of unclear clinical significance.

Mechanical-Medical Convergence In Heart Failure: Artificial Intelligence, Finite-Element Modeling, And 3d Printing For Diagnosis And Prognosis, Quazi Noor E. Sabrina, Quazi Md Zobaer Shah, Quazi Noor E. Sohela, Md Mahabub Hasan Mousum, Md. Moyeen Uddin Chisty, Quazi Md. Akbar Shah

Mechanical & Aerospace Engineering Faculty Publications

Heart failure remains a leading cause of global morbidity and mortality, yet routine clinical indices often miss the regional biomechanical disturbances that drive progression and shape treatment response. This State-of-the-Art review examines how finite-element (FE) modeling, additive manufacturing, and artificial intelligence (AI) are converging to improve the diagnosis, phenotyping, procedural planning, and prognostic assessment of heart failure (HF). Although these technologies have matured in structural heart disease and transcatheter intervention research, their greatest translational potential may lie in HF, where patient-specific ventricular remodeling, myocardial stress–strain heterogeneity, valve-ventricular coupling, and device-tissue interaction are incompletely captured by conventional clinical indices. We synthesize …

Atrial Fibrillation Detection From At-Rest Ppg Signals Using An Sdof-Tf Method, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

At-rest PPG signals have been explored for detecting atrial fibrillation (AF), yet current signal-processing techniques do not achieve perfect accuracy even under low-motion artifact (MA) conditions. This study evaluates the effectiveness of a single-degree-of-freedom time–frequency (SDOF-TF) method in analyzing at-rest PPG signals for AF detection. The method leverages the influence of MA on the instant parameters of each harmonic, which is identified using an SDOF model in which the tissue–contact–sensor (TCS) stack is treated as an SDOF system. In this model, MA induces baseline drift and time-varying system parameters. The SDOF-TF method enables the quantification and removal of MA and …

The Structure Of The Native Cardiac Crossbridge In The Rigor State, Cristina M. Risi, Tyler Nguyen, Betty Belknap, Howard D. White, Jose R. Pinto, Prescott B. Chase, Vitold E. Galkin

Department of Biomedical and Translational Sciences Faculty Publications

Cardiac contraction is driven by double-headed myosin cycling on cardiac thin filaments, where troponin-tropomyosin regulates myosin access to actin. Prior high-resolution structural studies used a single-headed myosin bound to bare actin, thereby limiting insight into coordination between myosin heads and the influence of troponin-tropomyosin on actomyosin interactions. Here, we report a high-resolution structure of the native cardiac rigor cross-bridge formed by heavy meromyosin bound to the thin filament. We show that direct communication between the two bound heads, uneven interactions between the heads and tropomyosin, and spatial constraints imposed by troponin govern myosin placement along the thin filament. Additionally, the …

Combined Snare And Buddy-Balloon Strategy For Failed Valve Crossing In Valve-In-Valve Transcatheter Aortic Valve Replacement, Hira Sarfraz, Muhammad U. Javed, Parth K. Parikh, Joshua A. Cohen, Raymond L. Benza, Matthew R. Summers, Deepak R. Talreja

Department of Medicine Faculty Publications

Background

Retrograde valve crossing during valve-in-valve transcatheter aortic valve replacement (ViV TAVR) may fail despite modern delivery systems.

Case Summary

A 67-year-old man with a degenerated 27-mm Magna Ease bioprosthesis and unfavorable aortic geometry (kinked ascending aorta at a prior surgical graft site) underwent ViV TAVR, where retrograde valve crossing failed despite multiple stiff guidewires and snare traction alone. Successful delivery of a 29-mm Evolut FX+ was ultimately achieved by combining gooseneck-snare traction for coaxial realignment with a partially inflated Tyshak buddy balloon acting as a mechanical ramp across the surgical valve frame.

Discussion

This case demonstrates a structured, stepwise …

Balloon Aortic Valvuloplasty As A Bridge Therapy In Acute Valve Syndrome: A Narrative Review Of Evidence Gaps And Future Directions, Omar Saleh, Omar Jafar, Nicholas Valle, Shirish Yasa, Saleh Mostafa, Raymond L. Benza, Deepak R. Talreja, Benjamin D. Peterson, Matthew R. Summers

Department of Medicine Faculty Publications

Acute valve syndrome (AVS) represents a high-acuity, decompensated presentation of severe aortic stenosis (AS), often manifesting as acute heart failure, cardiogenic shock, or cardiac arrest. Transcatheter aortic valve replacement (TAVR) remains the only durable therapy for severe AS in patients with prohibitive surgical risk, yet AVS patients may be too unstable for standard preprocedural planning. Balloon aortic valvuloplasty (BAV) has re-emerged as a bridge strategy that can provide rapid hemodynamic stabilization and permit subsequent valve replacement. Registry analyses report lower mortality in emergent TAVR compared with BAV, but these comparisons are confounded by procedural indication and unmatched AS severity. Smaller …

Endovascular Arch Repair Using A Novel Single Branch Arch Stent Graft: 30-Day Results From The Chronic Dissection Arm Of The Nexus Aortic Arch Clinical Study To Evaluate Safety And Effectiveness Investigational Device Exemption Study, Bradley G. Leshnower, Jean Panneton, Himanshu J. Patel, Adam W. Beck, Mathew Wooster, Kyle W. Eudailey, Shinichi Fukuhara, Jae Cho, Sanford Zeigler, Westley Ohman, Puja Kachroo, Derek Brinster, Shahab Toursavadkohi, Mehrdad Ghoreishi, Brandley Taylor, Frank Arko, Paul Hayes, Ross Milner

Department Surgery Faculty Publications

Objective

Moderate levels of frailty or a previous sternotomy make open repair of aortic arch pathology high risk or even preclude any treatment. This study examined 30-day outcomes from the NEXUS Aortic Arch Clinical Study to Evaluate Safety and Effectiveness investigational device exemption (TRIOMPHE IDE) study of an off-the-shelf stent-graft system for Zone 0 endovascular aortic arch repair in patients with high-risk chronic dissection.

Methods

TRIOMPHE IDE is a prospective, multicenter study evaluating the NEXUS system (Endospan) in chronic aortic dissection (n = 54). Following cervical debranching, NEXUS was delivered into the arch first, followed by an ascending aortic stent-graft. …

Impact Of Social Determinants Of Health On Perioperative And Interstage Outcomes In Congenital Heart Surgery A Systematic Review, Sara Sakowitz, Jennifer S. Nelson, Justin Robinson, Camilla S. Rossi, David M. Shahian, David T. Cooke, Jeffrey P. Jacobs, Shelby Aughtman, Megan Schultz, Meena Nathan, Claude Beaty, Michal Shafer, Deborah Kozik, Glenn J. Pelletier

Department Surgery Faculty Publications

Importance: Social determinants of health (SDoH)- conditions in which patients live, grow, and age, - are increasingly recognized to influence the health of patients with congenital heart disease (CHD).

Objective: To explore the impact of SDoH on short-term mortality and morbidity, interstage outcomes, and resource utilization, among patients following congenital heart surgery.

Evidence Review: A systematic review was completed according to PRISMA guidelines. Relevant studies evaluating the association of SDoH with surgical outcomes of pediatric and adult CHD patients were identified from five databases queried including PubMed, SCOPUS, CINAHL, PYSCINFO, and Cochrane between January 1999 and February 2024. Inclusion criteria …

An Analysis Of Heart Failure Among Cancer Patients In The United States Between 1999 And 2020, Abes A. Bautista Neughebauer, Deepak Talreja, Apostolos Gaitanidis

Department of Medicine Faculty Publications

Background: Cancer and heart failure (HF) are highly prevalent in the population and can co-exist, due to shared risk factors and an aging population. The HF-related mortality burden in cancer patients across in the United States (US) remains poorly understood. The goal of this study is to evaluate the patterns of HF-related deaths among cancer patients in the United States.

Methods: A retrospective analysis was performed using the Centers for Disease Control and Prevention (CDC) WONDER Multiple Cause of Death database between years 1999 and 2020. HF-related deaths were defined as death certificates listing HF as a contributing cause of …

Defining Clinically Meaningful Within-Patient Changes In Heart Failure: Jacc Heart Failure Position Statement, Amin Yehya, Rebecca Hahn, Barry Borlaug, Victoria Delgado, Andrew Ambrosy, Ross Arena, Nosheen Reza, Gregory Lewis, Natalie Tapaskar, Salvatore Carbone, Cynthia Chauhan, Mitchell A. Psotka, Norman Stockbridge, James Januzzi, Javed Butler, Jennifer Cowger, Biykem Bozkurt, John Spertus

Department of Medicine Faculty Publications

Heart failure (HF) clinical trials increasingly rely on diverse endpoints beyond mortality, including hospitalizations, imaging, hemodynamic status, biomarkers, functional capacity, and patient-reported outcomes. Although statistically significant differences between treatment groups are commonly reported, interpreting whether these changes are clinically meaningful for individual patients remains challenging. This JACC: Heart Failure position statement proposes a pragmatic framework for defining clinically meaningful within-patient change across commonly used HF outcomes by integrating measurement variability, prognostic associations, and patient-anchored evidence where available. Relative and absolute risk reductions should both inform interpretation of clinical events, while imaging, hemodynamic, biomarker, and functional measures require changes exceeding measurement …

The Treatment Of Obesity In The Context Of The Obesity Paradox In Patients With Heart Failure: A Narrative Review, Pamela L. Alebna, Sarah Martey, Anurag Mehta, Carl J. Lavie, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Purpose of review

While excess adiposity is a known risk factor for incident heart failure ( HF), once the condition is established, observational data suggest that increased body mass index (BMI) may confer a survival advantage. This paradox has emphasized the underlying roles of cardiorespiratory fitness (CRF), and body composition, particularly lean mass (LM), in influencing clinical outcomes.

Recent findings

In this review, we explore the multifaceted nature of the obesity paradox in HF, with a focus on emerging anti-obesity incretin-mimetic therapies, such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. These agents …

Physiologic Markers Of Mortality In Acute Valve Syndrome: An Ischemic Physiology Score Stratifies Patient Risk, Omar Saleh, Nicholas J. Valle, Israa Saleh, Raymond Benza, Deepak R. Talreja, Matthew R. Summers

Department of Medicine Faculty Publications

Background: Acute valve syndrome (AVS) represents a high-risk phenotype of advanced valvular disease with largely uncharacterized risk heterogeneity. We aimed to validate an expanded AVS definition and develop a physiology-dependent risk stratification tool using available clinical markers.

Methods: This retrospective study analyzed 2380 patients undergoing aortic valve replacement for severe aortic stenosis and classified them as AVS (n = 1556) or progressive valvular disease (n = 824). The primary outcome was 1-year all-cause mortality. An L2-regularized logistic regression model was developed to predict 1-year mortality using admission laboratory markers and comorbidity burden. Model performance was assessed using nested cross-validation with …

Concomitant Transcatheter Edge-To-Edge Repair For Mitral And Tricuspid Regurgitation For Polyvalvular Disease, Omar Khan, Matthew Summers

Department of Medicine Faculty Publications

This patient is a 77-year-old male with non-ischemic cardiomyopathy, severe tricuspid regurgitation, and moderate mitral regurgitation who underwent simultaneous transcatheter edge-to-edge repair of both mitral and tricuspid valves. Post-procedure, the patient exhibited significant symptomatic improvement and reduced regurgitation severity, highlighting the feasibility of dual-valve TEER in high-risk patients.

Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement: Incidence, Predictors, And Association With Reduced Ischemic Stroke Risk, Omar Saleh, Nicholas J. Valle, Shinjer Li, Saleh Mostafa, Israa Saleh, Raymond Benza, Deepak R. Talreja, Matthew R. Summers

Department of Medicine Faculty Publications

Background

Development of conduction abnormalities requiring pacing after transcatheter aortic valve replacement (TAVR) is relatively common. The effects of post-TAVR permanent pacemaker (PPM) implantation on mortality, ischemic stroke, and cardiovascular outcomes remain incompletely characterized. AIMS: To evaluate the incidence, predictors, and cardiovascular outcomes of post-TAVR permanent pacemaker implantation, including its association with 1-year ischemic stroke risk.

Methods

Adults undergoing TAVR (2008-2019; n = 1101) were evaluated. Patients with prior PPM (n = 104) and/or valve-in-valve or redo TAVR (n = 11) were excluded. PPM placement was identified post-indexed TAVR admission based on procedure codes, including both in-hospital and post-discharge implantations. …

Complicated Third Sternotomy For Left Ventricular Outflow Tract Obstruction Secondary To Mitral Valve Prosthesis Strut, Rishab Agarwal, Alleabelle Bradshaw, Michelle Carvajal, Jennifer S. Lawton

Department of Medicine Faculty Publications

Introduction: LVOT obstruction after surgical bioprosthetic MVP placement is uncommon and the influence of the MVP strut width has seldom been examined.

Case presentation: A 74-year-old female presented with palpitations, chest pain, and shortness of breath. She had MVR with 31-mm bioprosthetic valve 2 years prior. TEE confirmed LVOT obstruction secondary to a MVP strut, causing a peak gradient of 55 mmHg. The redo operation was complicated by iatrogenic Type A aortic dissection. The patient was immediately cooled for DHCA with RCP and ascending aortic replacement was performed. MVR was then performed with a prosthesis with narrower strut width. Recovery …

Percutaneous Closure Of Ventricular Septal Rupture After Myocardial Infarction:, Thomas A. Cook, Simone K. Schumaecker, Anjani Patibandla, Nicholas J. Valle, Matthew R. Summers

Department of Medicine Faculty Publications

BACKGROUND: Ventricular septal rupture (VSR) following acute myocardial infarction is a rare but deadly complication with mortality rates exceeding 90% when left untreated. Coronary ischaemia leads to myocardial necrosis and friability resulting in septal rupture, most commonly 3-5 days post-infarction. The sudden development of a left-to-right shunt causes volume overload in the right ventricle, pulmonary vasculature, and left atrium, precipitating biventricular failure, and cardiogenic shock. Management requires careful consideration of timing and modality of closure along with stabilization with mechanical circulatory support in severe cases.

CASE SUMMARY: A 65-year-old female presented with anterior ST-segment elevation myocardial infarction complicated by VSR …

Platypnea-Orthodeoxia Syndrome Caused By A Patent Foramen Ovale And Interatrial Septal Aneurysm: A Case Report, Abes A. Bautista Neughebauer, Raymond L. Benza, Deepak Talreja

Department of Medicine Faculty Publications

Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by positional hypoxemia, often due to right-to-left shunting across a patent foramen ovale (PFO) despite normal right-sided pressures. Early recognition is essential as symptoms may be subtle and imaging is often unrevealing. A 78-year-old female patient with a known PFO presented with one week of lower abdominal pain and mild exertional dyspnea without chest pain. She was profoundly hypoxic to 76% on room air, with improvement when supine and worsening when upright. Initial labs were unremarkable, and arterial blood gas revealed primary respiratory alkalosis with severe hypoxemia. Despite unremarkable chest radiography, CT …

Differential Impact Of Catheter Ablation Across Heart Failure Phenotypes In Atrial Fibrillation: A Grade Assessed Systematic Review And Meta-Analysis, Faizan Ahmed, Ayesha Zulfiqar, Mohamed Nasser Elshabrawi, Omama Ayatullah, Sheraz Qasim, Hira Sarfraz, Haris Bin Tahir, Faseeh Haider, Maryam Fatima, Syed Ahmed Ali Shah, Ameema Kaleem, Muhammad Taha Altaf, Muhammad Bin Aslam Zahid, Nazila Dalir, Manal Zia, Amro Taha, Abdul Qadeer, Bhavin Patel, Khurram Arshad

Department of Medicine Faculty Publications

Introduction: Atrial fibrillation (AF) is highly prevalent in heart failure (HF) and is linked to increased mortality and hospitalization in both preserved (HFpEF) and reduced ejection fraction (HFrEF). Catheter ablation (CA) has emerged as an effective rhythm-control strategy beyond medical therapy (MT), but phenotype-specific differences remain unclear. We compared the efficacy and safety of CA versus MT in AF with HFpEF or HFrEF.

Methods: PubMed, Embase, Scopus, and Cochrane databases were searched through December 2025. Random-effects meta-analyses were conducted in R (version 4.5.3), reporting risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs).

Results: Fifteen studies involving …

Stim1-Dependent Treg Dysfunction Promotes Cardiometabolic Hfpef: Insights From Patients And Animal Studies, Balaji Srinivas, Alluri Kiran, Hongmei Peng, Jiang Xu, Paula Fortuno, Jennifer May, Ismail El Moudden, Nour-Eddine Rhaleb, John M. Herre, Raymond L. Benza, Khalid Matrougui

Department of Biomedical and Translational Sciences Faculty Publications

Background

Heart failure with preserved ejection fraction (HFpEF) arises from chronic cardiometabolic and vascular stress and is increasingly recognized as an inflammatory syndrome with immune dysregulation. Regulatory T cells (Tregs) are critical modulators of cardiovascular inflammation, yet the mechanisms driving Treg dysfunction in HFpEF remain poorly defined. stromal interaction molecule 1 (STIM1)-dependent calcium signaling is a key stress-responsive pathway in immune cells; however, its role in Treg maladaptation during HFpEF remains unknown.

Methods

Circulating Tregs from patients with and without HFpEF were analyzed for abundance, STIM1 expression, and stress-associated signaling pathways. To establish causality, mice with Treg-specific deletion of STIM1 …

Racial Differences In Adverse Pregnancy Outcomes And Incident Hypertension: A Mediation Analysis, Lucia C. Petito, Xiaoning Huang, C. Noel Bairey, Natalie Bello, Janet Catov, Ernesto Licon, Abbi Lane, David M. Haas, Lisa D. Levine, Rebecca B. Mcneil, Eliza Miller, Uma M. Reddy, Bethany Barone Gibbs, George Saade, Lauren Theilen, Laura E. Wiener, Brian M. Mercer, Hyagriv N. Simhan, Lynn M. Yee, Philip Greenland, William A. Grobman, Sadiya S. Khan

Department of Obstetrics & Gynecology Faculty Publications

Background

Adverse pregnancy outcomes (APOs) are associated with increased hypertension risk. Black women experience higher rates of APOs and hypertension compared with White women, but whether APOs contribute to Black-White hypertension disparities remains unknown.

Methods

The nuMoM2b-HHS (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be-Heart Health Study) prospectively recruited nulliparous pregnant people at 8 US centers (2010-2013) with follow-up 2 to 7 years postpartum (2014-2017). Race, which represents a social construct, was self-identified. The primary outcome was incident hypertension at follow-up. APOs included hypertensive disorders of pregnancy, preterm birth, and small-for-gestational age birth. Potential confounders (psychological health, social factors, and health behaviors) …

Challenging Case: Acute Type A Aortic Dissection With Multi-Organ Malperfusion, Rishab Agarwal, Allebelle Bradshaw Md, Jennifer S. Lawton Md

Cardiovascular Research Symposium

Description of case: A 57-year-old male with hypertension and obesity presented with acute, severe chest pain. He developed a cold, numb right leg with motor deficits. He was hypotensive with a lactate of 7.4. CT imaging revealed an acute Type A aortic dissection (TAAD) with malperfusion involving the right internal carotid, right subclavian, and right coronary arteries, as well as the superior mesenteric artery, and right iliac artery (Fig 1A/B). He was transferred to our tertiary center for emergent surgery.

Five hours after presentation, he underwent emergent ascending aortic replacement, deep hypothermic circulatory arrest, and retrograde cerebral perfusion. The …

Association Between Cardiovascular Risk And Kidney Function In A Real-World Peruvian Cohort, Juan Munoz-Moreno, Gina Sanchez, Johanna Contreras

Cardiovascular Research Symposium

Background: Cardiovascular risk and kidney function are interrelated, with variations by sex and age. Middle-aged women often have slightly lower kidney function than men, increasing susceptibility to early renal effects of elevated cardiovascular risk, but data from Latin America remain limited.

Methods: Cross-sectional study of adults aged 40-79 years evaluated at a tertiary hospital in Peru between January and June 2024. We excluded individuals with established cardiovascular disease, statin use, LDL >190 mg/dL, or incomplete ASCVD risk data. Ten-year ASCVD risk was estimated using the 2013 Pooled Cohort Equations with race set as “Other” and classified as low, borderline, intermediate, …

Six-Year Survival Following Liver Transplant In Val30met Hereditary Transthyretin Amyloidosis, Juan Munoz-Moreno, Johanna Contreras

Cardiovascular Research Symposium

Background: Hereditary transthyretin amyloidosis (ATTRv) is a progressive, multisystem disorder caused by pathogenic TTR mutations affecting the heart and peripheral nerves. While disease-modifying agents such as tafamidis are available, liver transplantation (LTx) remains an option in selected genotypes, with over 50% of Val30Met carriers surviving up to 20 years post-transplant.

Case: A 53-year-old male with a permanent pacemaker for complete atrioventricular block presented with NYHA class II dyspnea, syncope, and lower extremity paresthesias. ECG showed atrial fibrillation. Transthoracic echocardiography revealed preserved ejection fraction, biventricular wall thickening with granular appearance, moderate left atrial dilation, and moderate mitral regurgitation. Speckle-tracking echocardiography demonstrated …

Mechanical Circulatory Support As A Bridge To Early Recovery Of Left Ventricular Function In Fulminant Myocarditis, Juan Munoz-Moreno, Gina Sanchez, Johanna Contreras

Cardiovascular Research Symposium

Background: Fulminant myocarditis (FM) is a rare cause of acute heart failure that can lead to a rapid left ventricular ejection fraction (LVEF) decline within four weeks. With in-hospital mortality up to 18.2%, timely mechanical circulatory support (MCS) is essential to stabilize hemodynamics and bridge to recovery or transplantation.

Case: A 49-year-old Japanese man with hypertension and diabetes presented with two weeks of dyspnea and angina after a flu-like illness. On admission, he developed ventricular fibrillation requiring advanced CPR. Physical exam revealed pulmonary congestion. ECG showed repolarization abnormalities. TTE demonstrated severe biventricular dysfunction (LVEF 9%, RVFAC 9%). Labs showed elevated …

Characteristics And Outcomes Of Axillary And Subclavian Artery Injuries, Benjamin Samberg, Nicholas Bandy, Michael Martyak

Cardiovascular Research Symposium

INTRODUCTION: Subclavian and axillary artery injuries are rare but life-threatening. Optimal management strategies remain debated. This study compares injury characteristics and outcomes.

METHODS: Retrospective analysis was conducted on 181 PROOVIT Database patients categorized by injury location, mechanism, and treatment (open, endovascular, nonoperative). Collected data includes ISS, PRBC, mortality, hospital and ICU LOS, and hard signs.

RESULTS: Subclavian injuries had higher ISS (μ=25, 19; p=0.004) and mortality (18%, 3.4%; p=0.004), but fewer hard signs (41%, 63%; p=0.004) than axillary. Axillary injuries were more frequently treated with open repair (51%, 32%; p=0.016), while subclavian injuries were more often managed nonoperatively (45%, 29%; …

B Cell Subset Specific Regulation Via Desmosterol In An Atherosclerotic Environment, Shelby Ma, Alina Morty, Kathleen Coleman, Basudha Habisyasi, Elena Galkina

Cardiovascular Research Symposium

No abstract provided.

New Onset Heart Failure Of Sodium-Glucose Cotransporter 2 (Sglt2) Inhibitors In Patients With End-Stage Renal Disease (Esrd) And Dialysis, Daiwik Munjwani, Amin Yehya

Cardiovascular Research Symposium

Introduction: Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardioprotective and renoprotective benefits in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). However, the effects of these agents in patients with end-stage renal disease (ESRD) or on dialysis remain underexplored, as previous clinical trials often excluded this population. With the recent removal of ESRD as a contraindication by the U.S. Food and Drug Administration, understanding the cardiovascular risks of SGLT2 inhibitors in this group is imperative. This study aimed to assess the incidence of new onset heart failure (HF), including HF with reduced ejection fraction (HFrEF) and …

"Lost To Follow Up:" A Case Of An Adult Congenital Heart Defect Patient Who Faced Morbidity In Adulthood After Lacking Transitional Care Following Medical Intervention In Childhood, Mackenzie Kelley, Ashish Saini

Cardiovascular Research Symposium

CASE PRESENTATION: This patient is a 40 y.o. male with a BMI of 46.2 kg/m2 who presented to the ED with fluid overload, shortness of breath, and orthopnea. The patient was tachycardic and physical exam revealed anasarca and ascites. The patient reported chronic lower extremity and scrotal edema so severe that he had been unable to walk and was mainly homebound for the past two years. The patient’s past medical history was significant for hypertension, alcohol use disorder with history of withdrawal, and a cardiac murmur which the patient attributed to a “hole in the heart” for which he had …

Ice Guided Percutaneous Pseudoaneurysm Coil Embolization, Moudar Jano, Amir M. Hassani, Matthew R. Summers

Cardiovascular Research Symposium

Background: Pseudoaneurysm formation following cardiac procedures can be a significant complication due to the high risk of rupture. Traditionally managed through sternotomy and cardiac surgery, innovative percutaneous interventions have shown promise for high-risk patients. This case report highlights the successful application of ICE-guided percutaneous coil embolization for the treatment of aortic pseudoaneurysms, presenting a less invasive alternative for patients for whom traditional surgery poses significant risks.

Case Summary: A patient with a complex cardiovascular history, including aortic root and ascending aorta replacement and CABG x2, developed two pseudoaneurysms below the right coronary button and at the distal aortic graft-native aorta …

Using Atrial Pacing Trials After Tavr To Assess Conduction Abnormalities And Predict Need For Pacemaker Implantation, Hemish M. Philip, Matthew R. Summers, Shirish R. Yasa, Hasani Amir, Daiwik P. Munjwani, Thomas A. Cook, Matthew G. Jackson

Cardiovascular Research Symposium

Abstract:

Background: Transcatheter Aortic Valve Replacement (TAVR) is the standard of care for many patients with severe aortic stenosis who cannot undergo surgical intervention. However, conduction disturbances remain a frequent complication, particularly with self-expanding valves. This often leads to permanent pacemaker implantation (PPI). At Sentara Heart Hospital, atrial pacing at 140 bpm is standard practice during TAVR to assess AV conduction.

Objective: This study aims to evaluate whether preserved 1:1 atrioventricular (AV) conduction during routine atrial pacing at 140 bpm after self-expanding TAVR predicts a low likelihood of requiring PPI, thus yielding a high negative predictive value (NPV).

Methods: We …