Cardiology Commons^™

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 …

Effect Of Perioperative Stroke On Survival After Carotid Intervention, Tommaso Cambiaghi, Alexander Mills, Samuel Leonard, Regina Husman, Syed T Zaidi, Ezra Y Koh, Kourosh Keyhani, S Keisin Wang

Faculty, Staff and Student Publications

OBJECTIVES: Perioperative stroke is the most dreaded complication of carotid artery interventions and can severely affect patients' quality of life. This study evaluated the impact of this event on mortality for patients undergoing interventional treatment of carotid artery stenosis with three different modalities.

METHODS: Patients undergoing carotid revascularization at participating Memorial Hermann Health System facilities were captured from 2003-2022. These patients were treated with either carotid endarterectomy (CEA), transfemoral carotid stenting (TF-CAS), or transcarotid artery revascularization (TCAR). Perioperative outcomes, including stroke and mortality, as well as follow-up survival data at 6-month intervals, were analyzed and stratified per treatment modality.

RESULTS: …

Discordance Interpretation Of Left Ventricular Size Between Echocardiography And Cardiac Magnetic Resonance In Pediatric Patients With Aortic/Mitral Regurgitation, Anastasia Barros, Michelle Udine, Chris Spurney, Laura Olivieri, Yue-Hin Loke

Jefferson Hospital Staff Papers and Presentations

PURPOSE: This study investigated discordance between echocardiography (echo) and cardiac magnetic resonance (CMR) measurements of the left ventricle (LV) in pediatric patients with aortic and/or mitral regurgitation (AR/MR).

METHODS: Retrospective cohort study of pediatric patients. The cohorts were comprised of patients with AR/MR vs. non-AR/MR. Left ventricular end diastolic volume (LVEDV) by CMR and left ventricular internal diameter diastolic (LVIDd) by echo were obtained from clinical reports then echo images were reviewed to remeasure LVEDV by bullet method. Left ventricular internal diameter systolic (LVIDs) and left ventricular ejection fraction (LVEF) measurements by echo and LVEF by CMR were obtained from …

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 …

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

Faculty, Staff and Student 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 …

Echocardiographic Parameters Associated With Less Reverse Left Ventricular Remodeling After Transcatheter Aortic Valve Implant In Subjects With Prosthesis Patient Mismatch, Andrew C. Peters, Fei Fei Gong, Ashvita Ramesh, Adin Andrei, Madeline Jankowski, Eric Cantey, Vincent Chen, James D. Thomas, James D. Flaherty, S. Christopher Malaisrie, Kameswari Maganti

Division of Cardiology Faculty Papers

BACKGROUND: Transaortic valve implant (TAVI) is the treatment of choice for severe aortic stenosis (AS). Some patients develop prosthesis patient mismatch (PPM) after TAVI. It is challenging to determine which patients are at risk for clinical deterioration.

METHODS: We retrospectively measured echocardiographic parameters of left ventricular (LV) morphology and function, prosthetic aortic valve effective orifice area (iEOA) and hemodynamics in 313 patients before and 1 year after TAVI. Our objective was to compare the change in echocardiographic parameters associated with left ventricular reverse modeling in subjects with and without PPM. Our secondary objective was to evaluate echo parameters associated with …

Effects Of Bioprosthetic Valve Fracturing On Valve-In-Valve Transcatheter Aortic Valve Implantation Transvalvular Gradients, Osama Hallak, Karley Fischer, Shaina Ailawadi, Damian Valencia, Yan Yatsynovich, Raja Nazir, Brian Schwartz

The Texas Heart Institute Journal

BACKGROUND: Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) is quickly becoming a routine and effective means by which to treat degenerated bioprosthetic valves. A known complication of ViV-TAVI is patient-prosthesis mismatch, which substantially affects survival. Bioprosthetic valve fracture is a method by which to reduce the risk of patient-prosthesis mismatch and post-ViV-TAVI transvalvular gradients. This study sought to determine the safety and efficacy of post-ViV-TAVI bioprosthetic valve fracture.

METHODS: Patients with a history of surgical aortic valve replacement undergoing ViV-TAVI bioprosthetic valve fracture (N = 25) at the corresponding institution from 2015 to 2022 were cataloged for a retrospective analysis. …

Association Between Remote Monitoring And Interstage Morbidity And Death In Patients With Single-Ventricle Heart Disease Across Socioeconomic Groups., Bianca Cherestal, Lori A. Erickson, Janelle R. Noel-Macdonnell Phd, Girish S. Shirali, Hayley S. Hancock, Doaa Aly, Matthew Files, Sarah Clauss, Natalie Jayaram

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Despite improvements in survival over time, the mortality rate for infants with single-ventricle heart disease remains high. Infants of low socioeconomic status (SES) are particularly vulnerable. We sought to determine whether use of a novel remote monitoring program, the Cardiac High Acuity Monitoring Program, mitigates differences in outcomes by SES.

METHODS AND RESULTS: Within the Cardiac High Acuity Monitoring Program, we identified 610 infants across 11 centers from 2014 to 2021. All enrolled families had access to a mobile application allowing for near-instantaneous transfer of patient information to the care team. Patients were divided into SES tertiles on the …

A Multicenter Retrospective Cohort Study To Characterize Patients Hospitalized With Multisystem Inflammatory Syndrome In Adults And Coronavirus Disease 2019 In The United States, 2020-2021, Michael Melgar, Joseph Y Abrams, Shana Godfred-Cato, Ami B Shah, Amit Garg, Andrew Strunk, Mangala Narasimhan, Jonathan Koptyev, Alexandra Norden, David Musheyev, Fahmida Rashid, Rachel Tannenbaum, Rosa M Estrada-Y-Martin, Bela Patel, Siddharth Karanth, Chad J Achenbach, Gavin T Hall, Sara M Hockney, Matthew Caputo, Lilian M Abbo, Laura Beauchamps, Stephen Morris, Renzo O Cifuentes, Annabelle De St Maurice, Douglas S Bell, Kavitha K Prabaker, Fernando J Sanz Vidorreta, Evan Bryant, David K Cohen, Rohith Mohan, Christopher P Libby, Spencer Soohoo, Tristel J Domingo, Angela P Campbell, Ermias D Belay

Faculty, Staff and Student Publications

Background: The diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated multisystem inflammatory syndrome in adults (MIS-A) requires distinguishing it from acute coronavirus disease 2019 (COVID-19) and may affect clinical management.

Methods: In this retrospective cohort study, we applied the US Centers for Disease Control and Prevention case definition to identify adults hospitalized with MIS-A at 6 academic medical centers from 1 March 2020 to 31 December 2021. Patients MIS-A were matched by age group, sex, site, and admission date at a 1:2 ratio to patients hospitalized with acute symptomatic COVID-19. Conditional logistic regression was used to compare demographic characteristics, …

A Case Report: A Patient Rescued By Va-Ecmo After Cardiac Arrest Triggered By Trigeminocardiac Reflex After Nasal Surgery, Xu Zhang, Bin Sun, Chen Pac-Soo, Daqing Ma, Liwei Wang

Faculty, Staff and Student Publications

Rationale:

Cardiac arrest (CA) caused by trigeminocardiac reflex (TCR) after endoscopic nasal surgery is rare. Hence, when a patient suffers from TCR induced CA in the recovery room, most doctors may not be able to find the cause in a short time, and standard cardiopulmonary resuscitation and resuscitation measures may not be effective. Providing circulatory assistance through venous-arterial extracorporeal membrane oxygenation (VA-ECMO) can help healthcare providers gain time to identify the etiology and initiate symptom-specific treatment.

Patient concerns:

We report a rare case of CA after endoscopic nasal surgery treated with VA-ECMO.

Diagnoses:

We excluded myocardial infarction, pulmonary embolism, allergies, …

The Characterization And Evaluation Of The Soluble Triggering Receptor Expressed On Myeloid Cells-Like Transcript-1 In Stable Coronary Artery Disease, Zaida Bayrón-Marrero, Siobhan Branfield, Javier Menéndez-Pérez, Benjamín Nieves-López, Laura Ospina, Yadira Cantres-Rosario, Loyda M Melendez, Robert Hunter, Angelia Gibson, Gerónimo Maldonado-Martínez, A Valance Washington

Faculty, Staff and Student Publications

Platelets play crucial roles in the development and progression of coronary artery disease (CAD). The triggering receptor expressed in myeloid cells-like transcript-1 (TLT-1) is stored in platelet α granules, and activated platelets release a soluble fragment (sTLT-1). We set out to better characterize the constituent amino acids of sTLT-1 and to evaluate sTLT-1 for use as a biomarker in patients with stable CAD. We evaluated sTLT-1 release using immunoprecipitation and mass spectrometry and employed statistical methods to retrospectively correlate sTLT-1 concentrations, utilizing ELISA in plasma samples from 1510 patients with documented stable CAD. We identified TLT-1 residues to 133 in …

Incidence, Risk Score Performance, And In-Hospital Outcomes Of Postoperative Atrial Fibrillation After Cardiac Surgery, Matthew W Segar, Alexander Marzec, Mehdi Razavi, Karen Mullins, Joanna E Molina-Razavi, Subhasis Chatterjee, Alexis E Shafii, Jennifer R Cozart, Marc R Moon, Abdi Rasekh, Mohammad Saeed

The Texas Heart Institute Journal

BACKGROUND: Postoperative atrial fibrillation (POAF) frequently complicates cardiac surgery. Predicting POAF can guide interventions to prevent its onset. This study assessed the incidence, risk factors, and related adverse outcomes of POAF after cardiac surgery.

METHODS: A cohort of 1,606 patients undergoing cardiac surgery at a tertiary referral center was analyzed. Postoperative AF was defined based on the Society of Thoracic Surgeons' criteria: AF/atrial flutter after operating room exit that either lasted longer than 1 hour or required medical or procedural intervention. Risk factors for POAF were evaluated, and the performance of established risk scores (POAF, HATCH, COM-AF, CHA2DS2-VASc, and Society …

Advanced Perioperative Echocardiography In Venoarterial Extracorporeal Membrane Oxygenation Weaning Trial-Off, José L Díaz-Gómez, Alec A Hendon

The Texas Heart Institute Journal

No abstract provided.

Women With Large Vessel Occlusion Acute Ischemic Stroke Are Less Likely To Be Routed To Comprehensive Stroke Centers, Muhammad Bilal Tariq, Iman Ali, Sergio Salazar-Marioni, Ananya S Iyyangar, Hussain M Azeem, Swapnil Khose, Victor Lopez, Rania Abdelkhaleq, Louise D Mccullough, Sunil A Sheth, Youngran Kim

Faculty, Staff and Student Publications

Background Prehospital routing of patients with large vessel occlusion (LVO) acute ischemic stroke (AIS) to centers capable of performing endovascular therapy may improve clinical outcomes. Here, we explore whether distance to comprehensive stroke centers (CSCs), stroke severity, and sex are associated with direct-to-CSC prehospital routing in patients with LVO AIS. Methods and Results In this cross-sectional study, we identified consecutive patients with LVO AIS from a prospectively collected multihospital registry throughout the greater Houston area from January 2019 to June 2020. Primary outcome was prehospital routing to CSC and was compared between men and women using modified Poisson regression including …

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 …

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

Heart and Vascular Articles

No abstract provided.

Assessment Of Predictors Of Early Postoperative Complications After Primary Robotically Assisted Roux-En-Y Gastric Bypass: A Multicenter, Retrospective Cohort Study, Pouya Iranmanesh, Shinil K Shah, Mickael Chevallay, Christian Toso, Stefan P Mönig, Monika E Hagen, Erik B Wilson, Minoa K Jung

Faculty, Staff and Student Publications

BACKGROUND: Robotic Roux-en-Y gastric bypass (RRYGB) is performed in an increasing number of bariatric centers worldwide. Previous studies have identified a number of demographic and clinical variables as predictors of postoperative complications after laparoscopic Roux-en-Y gastric bypass (LRYGB). Some authors have suggested better early postoperative outcomes after RRYGB compared to LRYGB. The objective of the present study was to assess potential predictors of early postoperative complications after RRYGB.

METHODS: A retrospective analysis of two prospective databases containing patients who underwent RRYGB between 2006 and 2019 at two high volumes, accredited bariatric centers was performed. Primary outcome was rate of 30 …

Developing A Parsimonious Frailty Index For Older, Multimorbid Adults With Heart Failure Using Machine Learning, Javad Razjouyan, Molly J Horstman, Ariela R Orkaby, Salim S Virani, Orna Intrator, Parag Goyal, Christopher I Amos, Aanand D Naik

Faculty, Staff and Student Publications

Frailty is associated with adverse outcomes in heart failure (HF). A parsimonious frailty index (FI) that predicts outcomes of older, multimorbid patients with HF could be a useful resource for clinicians. A retrospective study of veterans hospitalized from October 2015 to October 2018 with HF, aged ≥50 years, and discharged home developed a 10-item parsimonious FI using machine learning from diagnostic codes, laboratory results, vital signs, and ejection fraction (EF) from outpatient encounters. An unsupervised clustering technique identified 5 FI strata: severely frail, moderately frail, mildly frail, prefrail, and robust. We report hazard ratios (HRs) of mortality, adjusting for age, …

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 …

The Impact Of Bicuspid Aortic Valve Leaflet Fusion Morphology On The Ascending Aorta And On Outcomes Of Aortic Valve Replacement, Steve Bibevski, Mark Ruzmetov, Juan F Plate, Frank G Scholl

The Texas Heart Institute Journal

BACKGROUND: Patients with bicuspid aortic valves (BAVs) tend to develop dilation of the ascending aorta. The aim of this study was to analyze the impact of leaflet fusion pattern on aortic root diameter and outcomes in patients undergoing surgery for BAV vs tricuspid aortic valve (TAV) disease.

METHODS: This is a retrospective review of 90 patients with aortic valve disease (mean [SD] age, 51.5 [8.2] years) who underwent aortic valve replacement for BAV (n = 60) and TAV (n = 30). Fusion of right-left (R/L) coronary cusps was identified in 45 patients, whereas the remaining 15 patients had right-noncoronary (R/N) …

Recovery From The Impact Of Covid-19 On Treatment Times And Clinical Outcomes Of Patients With St-Segment Elevation Myocardial Infarction: An Interim Analysis, Abdelrahman Ali, Thomas Schirmer, Francis J Kiernan, Bryan Piccirillo, Joseph Ingrassia, Talhat Azemi, Immad Sadiq, Daniel B Fram, Asad Rizvi, Saurabh Joshi, Jeffrey Mather, Raymond G Mckay

The Texas Heart Institute Journal

BACKGROUND: Previous studies have documented a negative impact of the COVID-19 pandemic on emergent percutaneous treatment of patients with ST-segment elevation myocardial infarction (STEMI), but few have examined recovery of healthcare systems in restoring prepandemic STEMI care.

METHODS: Retrospective analysis was performed of data from 789 patients with STEMI from a large tertiary medical center treated with percutaneous coronary intervention between January 1, 2019, and December 31, 2021.

RESULTS: For patients with STEMI presenting to the emergency department, median time from door to balloon was 37 minutes in 2019, 53 minutes in 2020, and 48 minutes in 2021 (P < .001), whereas median time from first medical contact to device changed from 70 to 82 to 75 minutes, respectively (P = .002). Treatment time changes in 2020 and 2021 correlated with median emergency department evaluation time (30 to 41 to 22 minutes, respectively; P = .001) but not median catheterization laboratory revascularization time. For transfer patients, median time from first medical contact to device changed from 110 to 133 to 118 minutes, respectively (P = .005). In 2020 and 2021, patients with STEMI had greater late presentation (P = .028) and late mechanical complications (P = .021), with nonsignificant increases in yearly in-hospital mortality (3.6% to 5.2% to 6.4%; P = .352).

CONCLUSION: …

Mortality And Major Adverse Cardiovascular Events In Hospitalized Patients With Atrial Fibrillation With Covid-19, Lucas Wang, Lawrence Hoang, Kristopher Aten, Mujahed Abualfoul, Victor Canela, Sri Prathivada, Michael Vu, Yi Zhao, Manavjot Sidhu

Faculty, Staff and Student Publications

COVID-19 results in increased incidence of cardiac arrhythmias, including atrial fibrillation (AF). However, little is known about the combined effect of AF and COVID-19 on patient outcomes. This study aimed to determine if AF, specifically new-onset AF (NOAF), is associated with increased risk of mortality and major adverse cardiovascular events (MACEs) in hospitalized patients with COVID-19. This multicenter retrospective analysis identified 2,732 patients with COVID-19 admitted between March and December 2020. Data points were manually reviewed in the patients' electronic health records. Multivariate logistic regression was used to assess if AF was associated with death or MACE. Patients with AF …

Association Of Metformin With The Development Of Age-Related Macular Degeneration, Amitha Domalpally, Samuel A Whittier, Qing Pan, Dana M Dabelea, Christine H Darwin, William C Knowler, Christine G Lee, Jose A Luchsinger, Neil H White, Emily Y Chew

Faculty, Staff and Student Publications

IMPORTANCE: Age-related macular degeneration (AMD) is a leading cause of blindness with no treatment available for early stages. Retrospective studies have shown an association between metformin and reduced risk of AMD.

OBJECTIVE: To investigate the association between metformin use and age-related macular degeneration (AMD).

DESIGN, SETTING, AND PARTICIPANTS: The Diabetes Prevention Program Outcomes Study is a cross-sectional follow-up phase of a large multicenter randomized clinical trial, Diabetes Prevention Program (1996-2001), to investigate the association of treatment with metformin or an intensive lifestyle modification vs placebo with preventing the onset of type 2 diabetes in a population at high risk for …

Inter-Observer Variability Of Expert-Derived Morphologic Risk Predictors In Aortic Dissection, Martin J Willemink, Domenico Mastrodicasa, Mohammad H Madani, Marina Codari, Leonid L Chepelev, Gabriel Mistelbauer, Kate Hanneman, Maral Ouzounian, Daniel Ocazionez, Rana O Afifi, Joan M Lacomis, Luigi Lovato, Davide Pacini, Gianluca Folesani, Ricarda Hinzpeter, Hatem Alkadhi, Arthur E Stillman, Anna M Sailer, Valery L Turner, Virginia Hinostroza, Kathrin Bäumler, Anne S Chin, Nicholas S Burris, D Craig Miller, Michael P Fischbein, Dominik Fleischmann

Faculty, Staff and Student Publications

OBJECTIVES: Establishing the reproducibility of expert-derived measurements on CTA exams of aortic dissection is clinically important and paramount for ground-truth determination for machine learning.

METHODS: Four independent observers retrospectively evaluated CTA exams of 72 patients with uncomplicated Stanford type B aortic dissection and assessed the reproducibility of a recently proposed combination of four morphologic risk predictors (maximum aortic diameter, false lumen circumferential angle, false lumen outflow, and intercostal arteries). For the first inter-observer variability assessment, 47 CTA scans from one aortic center were evaluated by expert-observer 1 in an unconstrained clinical assessment without a standardized workflow and compared to a …

Diabetes-Related Major And Minor Amputation Risk Increased During The Covid-19 Pandemic., Dominick J Casciato, Sara Yancovitz, John Thompson, Steven Anderson, Alex Bischoff, Shauna Ayres, Ian Barron

Heart and Vascular Articles

BACKGROUND: Along with significant case transmission, hospitalizations, and mortality experienced during the global severe acute respiratory syndrome coronavirus 2 pandemic, there existed a disruption in the delivery of health care across multiple specialties. We studied the effect of the pandemic on inpatients with diabetic foot problems in a Level I trauma center in central Ohio.

METHODS: A retrospective chart review of patients necessitating a consultation by the foot and ankle surgery service were reviewed from the first 8 months of 2020. A total of 270 patients met the inclusion criteria and were divided into prepandemic (n = 120) and pandemic …

Sex-Biased Autophagy As A Potential Mechanism Mediating Sex Differences In Ischemic Stroke Outcome, Brian Noh, Louise D Mccullough, Jose F Moruno-Manchon

Faculty, Staff and Student Publications

Stroke is the second leading cause of death and a major cause of disability worldwide, and biological sex is an important determining factor in stroke incidence and pathology. From childhood through adulthood, men have a higher incidence of stroke compared with women. Abundant research has confirmed the beneficial effects of estrogen in experimental ischemic stroke but genetic factors such as the X-chromosome complement can also play an important role in determining sex differences in stroke. Autophagy is a self-degrading cellular process orchestrated by multiple core proteins, which leads to the engulfment of cytoplasmic material and degradation of cargo after autophagy …

Open Treatments For Thoracoabdominal Aortic Aneurysm Repair, Akiko Tanaka, Holly N Smith, Hazim J Safi, Anthony L Estrera

Faculty, Staff and Student Publications

Thoracoabdominal aortic aneurysms (TAAA) represent a unique pathology that is associated with considerable mortality if untreated. While the advent of endovascular technologies has introduced new modalities for consideration, the mainstay of TAAA treatment remains open surgical repair. However, the optimal conduct of open TAAA repair requires careful consideration of patient risk factors and a collaborative team effort to mitigate the risk of perioperative complications. In this chapter, we briefly outline the history of treating TAAA, preoperative preparation and postoperative care, and our operative techniques for treatment.

Feasibility Of Mediastinal Radiation Use In Heartmate 3 Lvad Recipients With Cancer., Nausharwan Butt, Farooq H Sheikh

Division of Cardiology Faculty Papers

The HeartMate 3 left ventricular assist device possesses the unique feature of having its electronics and software located within the housing of the pump, which may predispose it to malfunction from radiation exposure during cancer treatment. We investigated this association in a case series of two patients at our institution.

Validity And Diagnostic Performance Of Computing Fractional Flow Reserve From 2-Dimensional Coronary Angiography Images, Vahid Mohammadi, Massoud Ghasemi, Reza Rahmani, Maryam Mehrpooya, Hamidreza Babakhani, Akbar Shafiee, Mohammad Sadeghian

The Texas Heart Institute Journal

BACKGROUND: Measurement of fractional flow reserve (FFR) is the gold standard for determining the physiologic significance of coronary artery stenosis, but newer software programs can calculate the FFR from 2-dimensional angiography images.

METHODS: A retrospective analysis was conducted using the records of patients with intermediate coronary stenoses who had undergone adenosine FFR (aFFR). To calculate the computed FFR, a software program used simulated coronary blood flow using computational geometry constructed using at least 2 patient-specific angiographic images. Two cardiologists reviewed the angiograms and determined the computational FFR independently. Intraobserver variability was measured using κ analysis and the intraclass correlation coefficient. …

Cardiovascular Outcomes In Patients With Chronic Kidney Disease And Covid-19: A Multi-Regional Data-Linkage Study, Emilie J Lambourg, Peter J Gallacher, Robert W Hunter, Moneeza Siddiqui, Eve Miller-Hodges, James D Chalmers, Dan Pugh, Neeraj Dhaun, Samira Bell

Faculty, Staff and Student Publications

BACKGROUND: Data describing cardiovascular outcomes in patients with coronavirus disease 2019 (COVID-19) and chronic kidney disease (CKD) are lacking. We compared cardiovascular outcomes of patients with and without COVID-19, stratified by CKD status.

METHODS: This retrospective, multi-regional data-linkage study utilised individual patient-level data from two Scottish cohorts. All patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Cohort 1 between 1 February 2020 and 31 March 2021 and in Cohort 2 between 28 February 2020 and 8 February 2021 were included.

RESULTS: Overall, 86 964 patients were tested for SARS-CoV-2. There were 36 904 patients (mean±sd age 61±21 …