Cardiology Commons^™

Redo-Transcatheter Aortic Valve Replacement With Self-Expanding Valves: A U.S. Registry Analysis., Toby Rogers, Vinayak N Bapat, Stanley J Chetcuti, Harold L Dauerman, John K Forrest, Sachin S Goel, Kendra J Grubb, Wah Wah Htun, Rishi Puri, Michael J Reardon, Gilbert H L Tang, Amit N Vora, Steven J Yakubov, Ruth Eisenberg, Guilherme F Attizzani

Heart and Vascular Articles

BACKGROUND: Redo-transcatheter aortic valve replacement (TAVR) for failed transcatheter heart valves is expected to increase, but data on outcomes with self-expanding valves remain limited.

OBJECTIVES: The aims of this study were to evaluate procedural, clinical, and quality-of-life outcomes following redo-TAVR using self-expanding Evolut valves and to compare these outcomes with those among a contemporary native TAVR cohort.

METHODS: Outcomes after redo-TAVR with Evolut R, Evolut PRO, and Evolut PRO+ valves in the Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry were analyzed and compared with outcomes after native-valve TAVR using the same valve platform during the …

Risk-Based Nurse-Managed Personalized Heart Failure Interventions: The Alleviate-Hf Trial., Javed Butler, Rami Kahwash, Muhammad Shahzeb Khan, David Zhang, Jonathan W Dukes, Madhu Reddy, Anupam Basuray, Elie Gharib, Bart Gerritse, Aimee Laechelt, Jennifer Wehking, Shantanu Sarkar, Brian Van Dorn, Nirav Patel, Verla Laager, Michael R Zile, Alleviate-Hf Investigators

Heart and Vascular Articles

BACKGROUND: Early identification of worsening heart failure (HF) may improve outcomes.

OBJECTIVES: This study aims to assess if insertable cardiac monitor (ICM)-based high-risk detection combined with centrally managed, nurse-facilitated, individually protocolized diuretic interventions is safe and improves HF outcomes.

METHODS: A Reveal LINQ (Medtronic) ICM with an investigational HF risk-status software was implanted in participants with HF who were randomized 1:1 to an intervention arm (high-risk HF alert triggering protocolized diuretic regimen) or an observation arm (standard care). The primary safety endpoint was intervention-related serious adverse events and the primary efficacy endpoint was a 5-component hierarchical composite including cardiovascular death …

Real-World Outcomes Of Dedicated Leaflet Modification For Bioprosthetic Valve-In-Valve Tavr: A 150-Patient Commercial Experience., Raj R Makkar, Aakriti Gupta, Ignacio Inglessis, Curtiss T Stinis, Pradeep K Yadav, Vinod H Thourani, Stanley J Chetcuti, Matthew Summers, Vivek Patel, Bassem M Chehab, Apurva Patel, Gilbert H L Tang, Sahil Khera, Michael Rinaldi, Trevor Simard, Jeffrey Southard, Benjamin R Stripe, Brian Whisenant, Keith Allen, Yoseph Rozenman, Danny Dvir, Carlos E Sanchez, Jeffrey Popma, Martin B Leon, Philippe Généreux

Heart and Vascular Articles

BACKGROUND: Coronary obstruction during valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) is infrequent but catastrophic. Mechanical splitting of bioprosthetic leaflets may mitigate this risk, but real-world experience remains limited.

OBJECTIVES: The aim of this is to evaluate procedural performance and in-hospital outcomes of a dedicated mechanical leaflet-splitting device in ViV TAVR.

METHODS: Consecutive postapproval cases were performed at 28 centers from February to November 2025. Patients were selected for elevated risk based on preprocedural computed tomography criteria, including virtual valve-to-coronary distance ≤4 mm and/or virtual valve-to-sinotubular junction distance ≤3 mm. Procedural outcomes were assessed among patients in whom splitting was …

Safety Evaluation Of Dofetilide Administration Per Enteral Tube., Megan E Labreck, Katherine Crawford, David M Nemer, Auroa Badin, Anish Amin

Heart and Vascular Articles

No abstract provided.

Risk-Stratified Transitional Care And Cardiovascular Hospitalizations By Sex: A Secondary Analysis Of A Randomized Clinical Trial., Douglas S Lee, Chang Nancy Wang, Peter C Austin, Sharon E Straus, Michael E Farkouh, Alice Chong, Monica Taljaard, Stephanie Poon, Stuart Smith, Robert S Mckelvie, Robert M Iwanochko, Andrea Macdougall, Esam Elbarasi, Peter M Cram, Jiming Fang, Clare L Atzema, Jacob A Udell, Paula A Rochon, Michael J Schull, Susanna Mak, Heather J Ross

Heart and Vascular Articles

IMPORTANCE: Female patients with heart failure (HF) are older and more often present with preserved left ventricular ejection fraction (LVEF), whereas male patients present with more ischemic disease. Despite these differences, an emergency department-based acute HF strategy may be equally applicable to both sexes.

OBJECTIVE: To determine whether the strategy for acute HF management in the Comparison of Outcomes and Access to Care for Heart Failure (COACH) trial differed by sex.

DESIGN, SETTING, AND PARTICIPANTS: This prespecified secondary analysis of the multicenter COACH stepped-wedge, cluster-randomized clinical trial included 10 acute care hospitals in Ontario, Canada. Data were collected from January …

Igg4-Related Disease As An Uncommon Cause Of Myocarditis: A Case Report., Emily Ellis, Sarah Grebennikov, Rodolfo Jose Denadai Benatti

Heart and Vascular Articles

BACKGROUND: IgG-4-related disease (IgG4-RD) is a systemic fibroinflammatory disease that can affect any organ system. Myocarditis is a rare manifestation.

CASE SUMMARY: A 65-year-old woman with clinically diagnosed IgG4-RD, who had recently completed corticosteroid taper, presented with multiple admissions for recurrent chest pain and myocardial injury. Coronary angiography repeatedly showed preserved coronary anatomy, and initial transthoracic echocardiography showed preserved left ventricular systolic function. Subsequent transthoracic echocardiography showed rapid decline in ejection fraction, and cardiac magnetic resonance imaging (MRI) showed myocardial oedema, infarct scar, and patchy non-ischaemic fibrosis. A probable diagnosis of IgG4-RD myocarditis was made clinically based on medical history, …

Same Day Discharge Can Be Performed Safely After Atrial Fibrillation Catheter Ablation Using A Wide-Footprint Lattice-Tip Dual-Energy System., Tyler L Taigen, Devi G Nair, Dinesh Sharma, Erich L Kiehl, Jose Osorio, Petr Neuzil, Josef Kautzner, Stavros E Mountantonakis, Andrea Natale, John D Hummel, Shephal K Doshi, Anish K Amin, Usman R Siddiqui, Kelly A Van Bragt, Jeffrey Cerkvenik, Khaldoun G Tarakji, Vivek Y Reddy, Moussa Mansour, Elad Anter

Heart and Vascular Articles

BACKGROUND: Same-day discharge (SDD) after atrial fibrillation (AF) ablation is generally considered safe, since most complications are identified during (or immediately) after the procedure.

OBJECTIVE: This study aimed to evaluate SDD in the SPHERE Persistent-Atrial Fibrillation trial.

METHODS: Patients with persistent AF were randomized to the dual-energy lattice-tip mapping and ablation catheter (investigational) vs a conventional contact-force radiofrequency ablation system (control). SDD and timing of 30-day procedure- or device-related serious adverse events (SAEs) were assessed in the full cohort. In a subset of centers that performed SDD in the trial, predictors of SDD, 30-day readmissions, and mortality rates were assessed. …

Clinical And Economic Impact Of Vascular Access Teams Utilizing An Ic-Ecg-Based Tip Confirmation System For Peripherally Inserted Central Catheters., Gustavo Rc De Freitas, Sanjay A Patel, Shigeki Fujitani, Yusuke Terasaka, Angel A Sarabia Collazo, Andrew Barton, Leanne Ruegg, Amanda Griffin, Matthew O'Brien, Idal Beer

Heart and Vascular Articles

INTRODUCTION: Peripherally inserted central catheters (PICCs) are commonly used in clinical practice. Historical PICC placement methods (e.g. fluoroscopy-guided placement or blind insertion with confirmatory chest X-ray) have many limitations and are associated with longer wait times, treatment delays, and potential risks to patient safety. One such way of addressing some of these issues is the use of dedicated systems that integrate ultrasound vessel selection and PICC insertion, magnetic catheter tip navigation, and intracavitary electrocardiogram-based tip confirmation (IC-ECG). The uptake of these systems has been slow in some parts of the world. This narrative review aims to assess the clinical and …

Comparison Of Integrated 3d Electroanatomic Mapping And Conventional Mapping Systems For Pentaspline Pulsed Field Ablation Of Atrial Fibrillation., Auroa Badin, Andrea K Robinson, Allyson Farrah, Saanvi Billakanty, David M Nemer, Ankur N Shah, Jaret D Tyler, Eugene Y Fu, Nagesh Chopra, Anish K Amin

Heart and Vascular Articles

INTRODUCTION: Pulsed field ablation (PFA) is an established therapy for atrial fibrillation (AF), yet optimal mapping strategies during pentaspline PFA remain uncertain. We compared procedural characteristics and material costs of an integrated 3D electroanatomic mapping (EAM) platform with conventional mapping systems.

METHODS AND RESULTS: In a multicenter observational study of 448 consecutive AF ablations done using pentaspline catheter (62 integrated mapping; 386 conventional mapping) performed between February 2024 and August 2025, baseline characteristics were similar between groups. Compared with conventional mapping, the integrated platform was associated with shorter total procedure time (49 ± 16 vs. 66 ± 26 min, p …

Postdilation Of Evolut Transcatheter Heart Valves: Insights From Bench Testing., Ole De Backer, Ryan Stublaski, Hatem Tadros, Arif Khokhar, Gintautas Bieliauskas, Steven J Yakubov, Michael Deeb, Kendra J Grubb, John K Forrest, Michael J Reardon

Heart and Vascular Articles

No abstract provided.

Six-Year Outcomes After Transcatheter Vs Surgical Aortic Valve Replacement In Low-Risk Patients With Aortic Stenosis., John K Forrest, Steven J Yakubov, G Michael Deeb, Michael J Reardon

Heart and Vascular Articles

BACKGROUND: The Evolut Low Risk trial enrolled patients with severe aortic stenosis at low surgical risk. Annual follow-up is planned for 10 years, evaluating the composite of all-cause mortality or disabling stroke and key secondary endpoints.

OBJECTIVES: Our prespecified objective was to report the 6-year clinical outcomes of transcatheter aortic valve replacement (TAVR) vs surgery from the Evolut Low Risk trial. Given an increase in reintervention rates at 6 years, we performed additional analyses in available 7-year data.

METHODS: Low-risk patients with severe symptomatic aortic stenosis were randomized to TAVR or surgery from 2016-2019. Prespecified analyses at 6 years included …

Right Ventricular Thrombus Presenting With Right Ventricular Failure In Septic Shock: A Case Report., Micah Harris

Heart and Vascular Articles

We present a case report of refractory multifactorial shock initially managed as septic shock, requiring multidisciplinary collaboration when the diagnostic pathway was limited by acute kidney injury; the primary learning objective is to highlight clinical decision-making in shock when standard contrast imaging is contraindicated. Echocardiography revealed right ventricular failure with right ventricular thrombus, and pulmonary embolism was strongly suspected but could not be confirmed due to the inability to obtain contrast imaging. Persistent shock prompted a transition from a septic shock-directed strategy to cardiogenic and obstructive shock management. The patient was treated with anticoagulation but was not a candidate for …

Health Plan-Based Atherosclerosis Imaging For Members With Diabetics: Utilization And Impact On Subsequent Episodes Of Care., Subha V Raman, Alexander V Smolensky, Juhi Ramchandani, Purva Patel, Xin He, Tarek Aridi, John Salvas, Wasi Khatri, Jack Tiahnybik, Nihanth Damera, Keyur Vora, Rohan Dharmakumar

Heart and Vascular Articles

BACKGROUND: Quantitative coronary CT angiography plaque analysis (QCCTA) is a novel tool for atherosclerosis detection.

OBJECTIVES: The authors examined utilization of a health plan offering of QCCTA to diabetic members and the impact of utilization on health plan costs.

METHODS: Diabetic health plan members ≥40 years without prior myocardial infarction were offered QCCTA as a pilot benefit. Benefit utilizers were compared to eligible nonutilizers for incident cardiovascular episodes of care post-notification of eligibility.

RESULTS: Over 14 months, 2,064 of 38,079 health plan members were identified as eligible. Utilizers (19.1%) were predominantly White (76.4%) and female (72.6%) residing in communities with …

Leadless Versus Transvenous Dual-Chamber Pacemakers: Real-World Evidence From Aveir Dr Coverage With Evidence Development Study., Monica Lo, Anish K Amin, Marcin Kowalski, Anne Kroman, Dilip Mathew, Valay Parikh, Stanislav Weiner, Jennifer M Joseph, Leonard Ganz, Mohammed Mortada

Heart and Vascular Articles

BACKGROUND: AVEIR DR, an industry-first dual-chamber leadless pacemaker (LP), provides continuous atrioventricular synchrony through implant-to-implant (i2i) communication between atrial and ventricular LP devices. It is important to evaluate the early real-world comparative safety of AVEIR DR LP.

OBJECTIVE: To compare complications and mortality between AVEIR DR LP and dual-chamber transvenous pacemakers (TP).

METHODS: De novo LP and TP patients were identified in Medicare Fee-for-Service claims (October 2023 and December 2024). Outcomes were 30-day and 6-month complications, reinterventions, heart failure hospitalizations, and all-cause mortality. Comparisons were adjusted for demographics, comorbidities, and hospital encounter characteristics.

RESULTS: Compared to TP (N = 77 …

Sequential Tav-In-Tav Resolves Lvot Pseudoaneurysm-Related Paravalvular Leak., Zeryab A Khan, Steven J Yakubov, Laura D Flannery, Carlos E Sanchez

Heart and Vascular Articles

No abstract provided.

Contemporary Chronic Limb-Threatening Ischemia Care In The United States-Part 1: A Path Toward Multispecialty Collaboration., Eric A Secemsky, Ehrin J Armstrong, Venita Chandra, Raghu Kolluri, Parag J Patel, Peter A Schneider, Niten Singh

Heart and Vascular Articles

Care for patients with chronic limb-threatening ischemia (CLTI) is complex, and it is most effective when conducted with collaboration across multiple specialties. A recent upward trend in major limb amputation among patients with CLTI warrants a renewed effort to optimize care for this multifaceted condition. The Vascular InterVentional Advances (VIVA) Foundation, a not-for-profit 501(c)(3) organization, convened a Vascular Leaders Forum in 2024 to initiate an open, multispecialty discussion about the state of CLTI care in the United States and current challenges around delivery and access to such care. The forum comprised representatives from vascular surgery, interventional cardiology, interventional radiology, vascular …

Scai Position Statement On Intracardiac Echocardiography To Guide Structural Heart Disease Interventions., Mackram F Eleid, Christine J Chung, Matthew J Daniels, V Vivian Dimas, Andrew M Goldsweig, Harsh Golwala, Eric M Horlick, Matthew J Price, Carlos E Sanchez, John T Saxon, Markus D Scherer, Gilbert H L Tang, Dee Dee Wang, Omar K Khalique

Heart and Vascular Articles

As structural heart disease interventions rapidly evolve, demand for minimally invasive intraprocedural imaging techniques has increased. Intracardiac echocardiography (ICE) has emerged as a valuable imaging modality, offering real-time, high-resolution visualization of cardiac structures without the need for general anesthesia. This position statement from the Society for Cardiovascular Angiography & Interventions outlines the clinical applications, advantages, limitations, and implementation strategies for ICE in guiding transcatheter structural heart disease procedures. The document details standardized ICE imaging protocols and views for interventions involving the mitral, tricuspid, and pulmonary valves, as well as left atrial appendage occlusion atrial septal defect, and patent foramen ovale …

Novel Leadless Atrial And Ventricular Pacing System With Subcutaneous Implantable Cardiac Defibrillator: A Case Of Cross-Platform Device Compatibility., Nicholas Bradley, Ankur Shah, Anish Amin

Heart and Vascular Articles

No abstract provided.

Contemporary Chronic Limb-Threatening Ischemia Care In The United States-Part 2: Designing Clinical Device Trials., Eric A Secemsky, Ehrin J Armstrong, Venita Chandra, Raghu Kolluri, Saher S Sabri, Niten Singh

Heart and Vascular Articles

Head-to-head research comparing invasive revascularization strategies for chronic limb-threatening ischemia (CLTI) is sparse, partly due to challenges in conducting randomized controlled trials in the CLTI space. These include the expense of head-to-head trials, optimizing patient selection criteria for real-world applicability, and identifying optimal study end points. The Vascular InterVentional Advances (VIVA) Foundation, a 501(c)(3) not-for-profit organization, convened a Vascular Leaders Forum to initiate an open, multispecialty collaborative discussion of these challenges and ways to optimize the design of medical device trials in CLTI. This article summarizes the current landscape of clinical studies of CLTI revascularization strategies and options for designing …

Association Of Acute Kidney Injury Risk And Same-Day Discharge Practices After Percutaneous Coronary Intervention., Anezi Uzendu, Rayan El Zein, Jennifer A Rymer, Dan D Nguyen, R Angel Garcia, Nobuhiro Ikemura, Neel Butala, Howard M Julien, Saket Girotra, Dharam J Kumbhani, Oladipupo Olafiranye, Rebecca Young, Leo Brothers, John A Spertus

Heart and Vascular Articles

BACKGROUND: Same-day discharge (SDD) after percutaneous coronary intervention (PCI) may be altered when complications occur. We sought to determine whether risk of the most common complication, acute kidney injury (AKI), is associated with SDD in practice.

METHODS: Using the NCDR (National Cardiovascular Data Registry) CathPCI registry, we calculated the AKI risk for elective PCIs from 2018 to 2022 using the NCDR prediction model. Hierarchical logistic regression models were constructed to predict SDD with AKI risk and procedural variables as fixed effects, and site as a random effect. Trends in SDD rate across AKI risk categories were described and variability across …

Drug-Eluting Resorbable Scaffold Versus Balloon Angioplasty For Below-The-Knee Peripheral Artery Disease: 2-Year Results From The Life-Btk Trial., Brian G Derubertis, Ramon L Varcoe, Prakash Krishnan, Marc P Bonaca, David J O'Connor, Richard Pin, David C Metzger, Andrew Holden, Jen-Kuang Lee, Osamu Iida, Ehrin J Armstrong, Steven W C Kum, Raghu Kolluri, Danielle R Bajakian, Lawrence A Garcia, Mehdi H Shishehbor, Shawn Yu, Karine Ruster, Brad J Martinsen, Zsuzsanna Igyarto, Sahil A Parikh

Heart and Vascular Articles

BACKGROUND: Limited treatment options exist for infrapopliteal disease in patients with chronic limb-threatening ischemia (CLTI), a condition associated with a high risk of limb loss. Interventional management of diseased infrapopliteal vessels with percutaneous transluminal angioplasty (PTA) is associated with high rates of restenosis and reintervention. In the LIFE-BTK randomized controlled trial (Pivotal Investigation of Safety and Efficacy of BRS Treatment-Below the Knee), the drug-eluting resorbable scaffold (DRS) demonstrated superior 12-month efficacy compared with PTA in a selected CLTI population with predominantly noncomplex, mildly to moderately calcified lesions. This report presents the 2-year safety and efficacy outcomes of the Esprit BTK …

30-Day And 1-Year Outcomes From The Optimize Pro Tavr Evolut Fx Addendum Study., Hemal Gada, Ramzi F Khalil, Stanley J Chetcuti, G Michael Deeb, Kendra J Grubb, Adam B Greenbaum, David Lorenz, Robert D Jumper, Ibrahim Sultan, Dustin Kliner, Paul Mahoney, Deepak R Talreja, Mustafa I Ahmed, Joshua D Rovin, Lang Lin, Paul Sorajja, Douglas G W Fraser, Suneet Mittal, Tamim Nazif, Josep Rodes-Cabau, Amit N Vora, Kathleen Ertelt, Amanda C Tenhoff, Yu Jung Yeh, Steven J Yakubov

Heart and Vascular Articles

BACKGROUND: Primary results from the Optimize PRO study demonstrated that transcatheter aortic valve replacement (TAVR) with the cusp overlap technique (COT) resulted in low 30-day permanent pacemaker implantation (PPI) rates and no moderate or greater aortic regurgitation (AR).

OBJECTIVES: The aim of this study was to evaluate outcomes after Evolut FX implantation using the COT and postprocedural computed tomography (CT).

METHODS: The Optimize PRO FX Addendum study is a postmarket, prospective, multicenter, nonrandomized study. Patients with severe aortic stenosis underwent TAVR with the Evolut FX using the COT protocol. Postprocedurally, COT adherence was evaluated to identify key steps, and CT-assessed …

Characteristics Of Extravascular Implantable Cardioverter-Defibrillator Implantation., Sreedhar R Billakanty, Auroa G Badin, Matthew J Cline, Bridget A Cavanagh, Andrea K Robinson, Nagesh X Chopra, Eugene Y Fu, Jaret D Tyler, Anish K Amin

Heart and Vascular Articles

No abstract provided.

Criteria For The Establishment Of An Atrial Fibrillation Center Of Excellence And Key Operational Standards., T Jared Bunch, Elliott Antman, John N Catanzaro, Thomas Deneke, James V Freeman, M Edip Gurol, Colleen J Johnson, Paulus Kirchhof, Melissa E Middeldorp, Sanghamitra Mohanty, Andrea Natale, Jonathan P Piccini, Sean D Pokorney, Andrea K Robinson, Andrea M Russo, Roopinder K Sandhu, Joshua Silverstein, Jennifer M Wright, Thomas F Deering

Heart and Vascular Articles

No abstract provided.

Pulsed Field Ablation Of Persistent Atrial Fibrillation With Continuous Electrocardiographic Monitoring Follow-Up: Advantage Af Phase 2., Vivek Y Reddy, Edward P Gerstenfeld, Boris Schmidt, Jason G Andrade, Devi Nair, Andrea Natale, Walid Saliba, Philipp Sommer, Andreas Metzner, Atul Verma, Troy Hounshell, Anish Amin, Philip Gentlesk, Stanislav Weiner, Frank A Cuoco, Jamie Kim, Mohit K Turagam, Gery Tomassoni, Chinmay Patel, Ziad Issa, Michael Shehata, Allison M Anderson, Thomas J Stoltz, Jonathan D Raybuck, Torri Schwartz, Brad S Sutton, Moussa Mansour

Heart and Vascular Articles

BACKGROUND: There are sparse high-quality safety and effectiveness data for pulsed field ablation (PFA) of persistent atrial fibrillation (PerAF), in which lesions beyond pulmonary vein isolation (PVI) are often placed. In addition, no large trials have used insertable cardiac monitors for continuous rhythm monitoring after ablation in patients with PerAF or after PFA in any atrial fibrillation population. In Phase 2 of the ADVANTAGE AF study (A Prospective Single Arm Open Label Study of the FARAPULSE Pulsed Field Ablation System in Subjects With Persistent Atrial Fibrillation), patients with PerAF underwent PFA for PVI and posterior wall ablation (PWA) and, in …

Corrigendum To 'Scai Expert Consensus Statement On Alternative Access For Transcatheter Aortic Valve Replacement' [Journal Of The Society For Cardiovascular Angiography & Interventions 4 (2025) 102514]., Matthew Sherwood, Keith B Allen, Thom G Dahle, Chandan M Devireddy, Jeffrey Gaca, Santiago Garcia, Kendra J Grubb, Tsuyoshi Kaneko, Chad A Kliger, Robert J Lederman, John C Messenger, Puja B Parikh, Marie-France Poulin, Carlos Sanchez, Anene Ukaigwe, James J Yun, Paul D Mahoney

Heart and Vascular Articles

[This corrects the article DOI: 10.1016/j.jscai.2024.102514.].

Atrial Fibrillation In An Elite Athlete: Continuous Ecg Monitoring Guiding Therapy And Return To Play., Sean M Muir, Auroa Badin, Anne R Albers, Kanny Grewal

Heart and Vascular Articles

BACKGROUND: The diagnosis of atrial fibrillation (AF) is increasing among elite athletes. This case highlights the novel use of an implantable loop recorder to guide treatment decisions for AF in an elite soccer player.

CASE SUMMARY: A 25-year-old professional soccer player who had received a diagnosis of asymptomatic AF during routine screening underwent cardioversion and continuous monitoring with an implantable loop recorder. A rising AF burden prompted ablation.

DISCUSSION: This case demonstrates the potential utility of advanced monitoring technologies for managing AF in athletes, particularly when symptoms are absent or minimal. Additional studies are needed to confirm whether continuous monitoring …

Silent But Deadly: A Case Of Obtuse Marginal Artery Occlusion., Austin M Miller, Vishal Tharani, Erin Fraser, Howard W Levitin

Heart and Vascular Articles

The obtuse marginal artery (OMA) is a key branch of the left circumflex coronary artery, supplying blood to the lateral wall of the left ventricle. OMA occlusions can result in myocardial ischemia and serious cardiac events, often presenting with subtle or atypical electrocardiogram (EKG) changes, unlike the more pronounced alterations observed with left anterior descending artery occlusions. This case report discusses a 57-year-old female presenting with chest pain and shortness of breath, indicative of acute coronary syndrome. The patient's initial EKG showed occasional premature ventricular contractions (PVCs), T-wave flattening in aVL, and 1 mm ST elevation in V6, but otherwise, …

Sealing The Leak: Transcatheter Repair Of Anterior Mitral Leaflet Perforation With Amplatzer Vascular Plug 4., Zeryab A Khan, Cody Carter, Jordan Luli, Nathan Marzlin, Johnathan Hatanelas, Lindsay Castle, Kevin Stiver, Laura Flannery, Steven J Yakubov, Carlos Sanchez

Heart and Vascular Articles

We document the first reported use of the Amplatzer Vascular Plug 4 for anterior mitral leaflet perforation repair in a 56-year-old male who had undergone valve-in-valve transcatheter aortic valve replacement. Previously reported cases involving the use of other occluder devices for mitral leaflet perforation repair either required guide catheter or delivery sheath exchanges, arteriovenous wire loop for deployment, or use of mitral transcatheter edge-to-edge repair for leaflet stability. Our case highlights the efficacy of the bilobar-designed Amplatzer Vascular Plug 4 for precise occlusion in anterior mitral leaflet perforation through antegrade-only delivery and safety through the simplification of procedural steps.

Double-Edged Sword: Troubleshooting "Wide-Complex Tachycardia" And "Palpitations" Caused By Gastric Neurostimulator., Tori Hensley, Ankur Shah, Jennifer J Miller, Jason R Foreman, Allen C Brown, Asim S Ahmed

Heart and Vascular Articles

No abstract provided.