Cardiology Commons^™

Comprehensive Analysis Of Substernal Lead Removal: Experience From Ev Icd Pilot, Pivotal, And Continued Access Studies., Venkata Sagi, Francis Murgatroyd, Lucas V A Boersma, Jaimie Manlucu, Bradley P Knight, Christophe Leclercq, Anish Amin, Ulrika Maria Birgersdotter-Green, Joseph Yat Sun Chan, Henri Roukoz, Mauro Biffi, Haris Haqqani, Russell Denman, Christopher Wiggenhorn, Thomas R Holmes, Thomas Lulic, Paul Friedman, Ian Crozier

Heart and Vascular Articles

AIMS: The extravascular implantable cardioverter-defibrillator (EV ICD) has been shown to be safe and effective for patients at risk of sudden cardiac death, but little is known about EV ICD lead removal in humans. This analysis aimed to characterize the EV ICD lead removal experience thus far.

METHODS AND RESULTS: This was a retrospective analysis of lead removals from the EV ICD Pilot, Pivotal, and Continued Access Studies. Patients with a successful EV ICD implant who underwent lead removal were included. The main objective was lead removal success. Ancillary objectives included characterizing technique used, procedure complications, and reimplantation status. An …

Milvexian Vs Apixaban For Stroke Prevention In Atrial Fibrillation: The Librexia Atrial Fibrillation Trial Rationale And Design, Sneha S Jain, Kenneth W Mahaffey, Karen S Pieper, Wataru Shimizu, Tatjana Potpara, Christian T Ruff, Hooman Kamel, Basil S Lewis, Jan H Cornel, Peter R. Kowey, Jay Horrow, John Strony, Alexei N Plotnikov, Danshi Li, Stephen Weng, Julia Donahue, C Michael Gibson, P Gabriel Steg, Roxana Mehran, Jeffrey I Weitz, S Claiborne Johnston, Graeme J Hankey, Robert A Harrington, Carolyn S P Lam

Department of Medicine Faculty Papers

BACKGROUND: Direct oral anticoagulants are the standard of care for stroke prevention in eligible patients with atrial fibrillation and atrial flutter; however, bleeding remains a significant concern, limiting their use. Milvexian is an oral Factor XIa inhibitor that may offer similar anticoagulant efficacy with less bleeding risk.

METHODS: LIBREXIA AF (NCT05757869) is a global phase III, randomized, double-blind, parallel-group, event-driven trial to compare milvexian with apixaban in participants with atrial fibrillation or atrial flutter. Participants are randomly assigned to milvexian 100 mg or apixaban (5 mg or 2.5 mg per label indication) twice daily. The primary efficacy objective is to …

David Taylor Memorial Lecture: Insights Into The Origins Of Intracardiac Surgery, James K. Kirklin

The VAD Journal

David Taylor was an eminent luminary in the field of advanced heart failure and transplantation. As past president of the International Society for Heart and Lung Transplantation, he significantly impacted the field and was a mentor to many young heart failure cardiologists. In addition to many professional activities, David was an integral part of Brano meetings, including numerous eastern European trips promoting education and training in advanced heart failure, mechanical circulatory support, and transplantation

Utilization Of A Novel Scoring System In Predicting 30-Day Mortality In Acute Pulmonary Embolism, The Clot-5 Pilot Study, Alexandru Marginean, Punit Arora, Kevin Walsh, Elizabeth Bruno, Cathryn Sawalski, Riya Gupta, Frances Greathouse, Jacob Clarke, Quinn Mallery, Myoung Hyun Choi, Waddah Malas, Parth Shah, David Sutherland, Amudha Kumar, Igor Wroblewski, Ahmed Elkaryoni, Parth Desai, Yevgeniy Brailovsky, Amir Darki

Division of Cardiology Faculty Papers

OBJECTIVES: To construct a new scoring system utilizing biomarkers, vitals, and imaging data to predict 30-day mortality in acute pulmonary embolism (PE).

BACKGROUND: Acute PE, a well-known manifestation of venous thromboembolic disease, is responsible for over 100,000 deaths worldwide yearly. Contemporary management algorithms rely on a multidisciplinary approach to care via PE response teams (PERT) in the identification of low, intermediate, and high-risk patients. The PESI and sPESI scores have been used as cornerstones of the triage process in assigning risk of 30-day mortality for patients presenting with acute PE; however, the specificity of these scoring systems has often come …

Intraoperative Remifentanil Use Reduces Atrial Fibrillation After Coronary Artery Bypass Surgery, Yasuhiko Imashuku, Susumu Hiraoka, Motoi Inoue, Takayoshi Mizuno, Misuzu Oyagi, Hirotoshi Kitagawa

Journal of the Saudi Heart Association

Objectives:

Atrial fibrillation after coronary artery bypass grafting is a relatively well known complication that has been observed for a long time. Though the management and drugs in the perioperative period have changed, their impact on the generation of postoperative atrial fibrillation remains unclear. Therefore, we investigated various perioperative management methods and the occurrence of postoperative atrial fibrillation.

Methods

The patients underwent off-pump coronary artery bypass grafting between January 2010 and October 2019. The study was a retrospective observational study, and we investigated the incidence of atrial fibrillation during all 5 postoperative days. Patient factors included age, sex, height, …

“Two Is Company, Three Is A Crowd” – A Case Presentation Of Cardiac Amyloidosis, Hypertrophic Cardiomyopathy Plus Coronary Heart Disease, ​Carolina Miguel Gonçalves, Mariana Carvalho, Celia Domingues, Fatima Saraiva, ​​Joao ​ ​​Morais​

Journal of the Saudi Heart Association

A 76-year-old man was referred to our appointment with complaints of exertional dyspnea. He had a medical history consisting of chronic coronary syndrome, hypertrophic cardiomyopathy, and an implantable cardioverter-defibrillator for primary prevention. A transthoracic echocardiogram revealed features suspicious for cardiac amyloidosis. Haematologic and genetic tests were negative, and scintigraphy was positive, confirming wild-type transthyretin amyloidosis, not eligible for tafamidis. Several months later with optimized medical therapy, he had two worsening heart failure events.

This clinical case highlights the importance of differential diagnosis. Our patient had both hypertrophic cardiomyopathy and transthyretin amyloidosis, a rare association that constitutes a diagnostic and treatment …

Heartmate 3 As A Bridge To Transplant In An Adult With Failing Fontan Circulation, Kengo Z. Soghoyan, Stephen Cook, Maya Guglin

The VAD Journal

Mechanical circulatory support devices have demonstrated efficacy in adult congenital patients with biventricular repairs. The off-label use of ventricular assist devices may be invaluable for managing end-stage single ventricle failure. We present the case of a 27-year-old male who developed heart failure, congestive hepatopathy, and, ultimately, cardiogenic shock. He received a HeartMate 3 (Abbott, Chicago, IL, USA) without complications one year after the surgery.

Perceptions Of Hiv-Related Comorbidities And Usability Of A Virtual Environment For Cardiovascular Disease Prevention Education In Sexual Minority Men With Hiv: Formative Phases Of A Pilot Randomized Controlled Trial, S Raquel Ramos, Harmony Reynolds, Constance Johnson, Gail Melkus, Trace Kershaw, Julian F Thayer, Allison Vorderstrasse

Faculty, Staff and Student Publications

Background: Sexual minority men with HIV are at an increased risk of cardiovascular disease (CVD) and have been underrepresented in behavioral research and clinical trials.

Objective: This study aims to explore perceptions of HIV-related comorbidities and assess the interest in and usability of a virtual environment for CVD prevention education in Black and Latinx sexual minority men with HIV.

Methods: This is a 3-phase pilot behavioral randomized controlled trial. We report on formative phases 1 and 2 that informed virtual environment content and features using qualitative interviews, usability testing, and beta testing with a total of 25 individuals. In phase …

Saudi Heart Association / National Heart Center / Saudi Arabian Cardiac Interventional Society / Saudi Society For Cardiac Surgeons / Saudi Cardiac Imaging Group 2023 Tavi Guidelines, Turki Albacker, Adel Tash, Hussein Alamri, Mirvat Alasnag, Wail Alkashkari, Fawaz Almutairi, Faisal Alqoofi, Ahmed Alsaileek, Uthman Aluthman, Ghormallah Alzahrani, Mohammed Balghith, Fahd Makhdom

Journal of the Saudi Heart Association

Saudi Arabia has seen a significant improvement in its healthcare system over the past four decades resulting in an increase in life-expectancy. Transcatheter aortic valve implantation (TAVI) has spread widely in Saudi Arabia and has become a routine procedure in many centers. The expanding clinical indications and the availability of the technology have made it possible for many large and intermediate centers all over the country to commence their own TAVI programs. So, the aim of this document is to standardize TAVI practices in different Saudi Arabian centers through reasonable guidelines based on the evaluation and summarization of the best …

Influence Of Pathophysiologic Patterns Of Coronary Artery Disease On Immediate Percutaneous Coronary Intervention Outcomes, Carlos Collet, Daniel Munhoz, Takuya Mizukami, Jeroen Sonck, Hitoshi Matsuo, Toshiro Shinke, Hirohiko Ando, Brian Ko, Simone Biscaglia, Fernando Rivero, Thomas Engstrøm, Ketina Arslani, Antonio Maria Leone, Lokien X Van Nunen, William F Fearon, Evald Høj Christiansen, Stephane Fournier, Liyew Desta, Andy Yong, Julien Adjedj, Javier Escaned, Masafumi Nakayama, Ashkan Eftekhari, Frederik M Zimmermann, Koshiro Sakai, Tatyana Storozhenko, Bruno R Da Costa, Gianluca Campo, Nick E J West, Tom De Potter, Ward Heggermont, Dimitri Buytaert, Jozef Bartunek, Colin Berry, Damien Collison, Thomas Johnson, Tetsuya Amano, Divaka Perera, Allen Jeremias, Ziad Ali, Nico H J Pijls, Bernard De Bruyne, Nils P Johnson

Faculty, Staff and Student Publications

Background: Diffuse coronary artery disease affects the safety and efficacy of percutaneous coronary intervention (PCI). Pathophysiologic coronary artery disease patterns can be quantified using fractional flow reserve (FFR) pullbacks incorporating the pullback pressure gradient (PPG) calculation. This study aimed to establish the capacity of PPG to predict optimal revascularization and procedural outcomes.

Methods: This prospective, investigator-initiated, single-arm, multicenter study enrolled patients with at least one epicardial lesion with an FFR ≤0.80 scheduled for PCI. Manual FFR pullbacks were used to calculate PPG. The primary outcome of optimal revascularization was defined as an FFR ≥0.88 after PCI.

Results: A total of …

The Why, The Who, And The How: Launching The Society Of Critical Care Cardiology, Balimkiz Senman, David M. Dudzinski, Ann Gage, P. Elliott Miller, Jason N. Katz

Journal of Shock and Hemodynamics

None.

Thigh Perforator Exchange: Intraflap Perforator Augmentation Of Anterolateral Thigh Free Flaps, Patrick A. Palines, Matthew E. Nungesser, Morgan E. Baudoin, Devin M. Melancon, Mark W. Stalder

School of Medicine Faculty Publications

Peripheral perfusion in large anterolateral thigh flaps may be inadequate if perforator zones are not properly planned during flap design and harvest, and variations in vascular anatomy can contribute to operative difficulty and morbidity. Intraflap anastomosis of extrinsic perforators may allow for augmentation of perfusion while avoiding significant intramuscular dissection. Adaptation of the perforator exchange technique, previously described in autologous breast reconstruction, optimizes vascular flow in anterolateral thigh flaps. Here, we present a technique for intraflap perforator anastomosis (the thigh perforator exchange) and illustrate its use in a subset of patients. This technique is relatively simple and rapid to perform …

Epigenetic Mechanisms Differentially Regulate Blood Pressure And Renal Dysfunction In Male And Female Npr1 Haplotype Mice, Prerna Kumar, Kandasamy Neelamegam, Chandramohan Ramasamy, Ramachandran Samivel, Huijing Xia, Daniel R. Kapusta, Kailash N. Pandey

School of Graduate Studies Faculty Publications

We determined the epigenetic mechanisms regulating mean arterial pressure (MAP) and renal dysfunction in guanylyl cyclase/natriuretic peptide receptor-A (GC-A/NPRA) gene-targeted mice. The Npr1 (encoding NPRA) gene-targeted mice were treated with class 1 specific histone deacetylase inhibitor (HDACi) mocetinostat (MGCD) to determine the epigenetic changes in a sex-specific manner. Adult male and female Npr1 haplotype (1-copy; Npr1+/−), wild-type (2-copy; Npr1+/+), and gene-duplicated heterozygous (3-copy; Npr1++/+) mice were intraperitoneally injected with MGCD (2 mg/kg) for 14 days. BP, renal function, histopathology, and epigenetic changes were measured. One-copy male mice showed significantly increased MAP, renal dysfunction, and fibrosis than 2-copy and 3-copy mice. …

Spontaneous Interatrial Hematoma: Still An Unresolved Critical Conundrum, Fayaz Mohammed Khazi, Imthiaz Manoly, Nayyer R Siddiqi, Tarek Abdel Aziz, Obaid Aljassim

Journal of the Saudi Heart Association

Spontaneous interatrial hematoma is a rare clinical entity leading to the obliteration of the left atrial cavity and causing haemodynamic compromise, necessitating immediate surgical intervention. Herein, we report a patient with acute chest pain with normal coronaries and echocardiographic evidence of left atrial mass. The investigations revealed the mass to be a thrombus rather than tumour. The patient underwent surgery to remove a large thrombus completely enclosed within the interatrial septum. The septum was then repaired using a pericardial patch. No apparent etiological factor was found. Spontaneous atrial wall dissection should be considered in the differential diagnosis of acute chest …

Improved Robustness For Deep Learning-Based Segmentation Of Multi-Center Myocardial Perfusion Mri Datasets Using Data Adaptive Uncertainty-Guided Space-Time Analysis., Dilek M Yalcinkaya, Khalid Youssef, Bobak Heydari, Janet Wei, Noel Bairey Merz, Robert Judd, Rohan Dharmakumar, Orlando P Simonetti, Jonathan W Weinsaft, Subha V Raman, Behzad Sharif

Heart and Vascular Articles

BACKGROUND: Fully automatic analysis of myocardial perfusion MRI datasets enables rapid and objective reporting of stress/rest studies in patients with suspected ischemic heart disease. Developing deep learning techniques that can analyze multi-center datasets despite limited training data and variations in software (pulse sequence) and hardware (scanner vendor) is an ongoing challenge.

METHODS: Datasets from 3 medical centers acquired at 3T (n = 150 subjects; 21,150 first-pass images) were included: an internal dataset (inD; n = 95) and two external datasets (exDs; n = 55) used for evaluating the robustness of the trained deep neural network (DNN) models against differences in …

Left Atrial Venoarterial Extracorporeal Membrane Oxygenation Strategy In Postcardiotomy Cardiogenic Shock: A Case Series, Daniel Manzur-Sandoval Md, Gian Manuel Jiménez-Rodríguez Md, José Luis Elizalde-Silva Md, Meredith Fernanda Sánchez-Torres Md, Uriel Encarnación-Martínez Md, Cristhian Josué Gaytán-García Md, José Octavio Salazar-Delgado Md, Guadalupe Lisseth Hernández-González Md, Gustavo Rojas-Velasco Md

The VAD Journal

Postcardiotomy cardiogenic shock is a rare complication with high mortality. When patients do not respond to the placement of an intra-aortic balloon pump or pharmacological treatment, therapy with peripheral venoarterial extracorporeal membrane is a viable option that allows active resuscitation. The adjunct use of Impella® (Abiomed, Danvers, MA, USA) allows active unloading of the dysfunctional left ventricle. However, left atrial venoarterial extracorporeal membrane oxygenation (LAVA-ECMO) is an appealing and effective strategy in cases of aortic dissection, aortic valve replacement, or bioprosthesis of the aorta. Insertion of an extraction cannula that can discharge both atria or only the left atrium allows …

Consensus Of National Heart Center And The Saudi Arabian Cardiac Interventional Society On The Current Landscape Of The Management Of Intracoronary Calcification In Saudi Arabia, Khaled Al-Shaibi, Mirvat Alasnag, Owayed Alshemmari, Ayman Alsaleh, Wail Alkashkari, Fawaz Almutairi, Nouf Alanazi, Mognee Alameer, Adel Tash

Journal of the Saudi Heart Association

Objectives

We aimed to develop a streamlined algorithm for the management of intracoronary calcification that includes guidance on intracoronary imaging and the appropriate selection of atherectomy devices.

Methods

National experts representing both the National Heart Center (NHC) and the Saudi Arabian Cardiac Interventional Society (SACIS) met to develop a consensus document on the assessment and management of intracoronary calcification in Saudi Arabia. The nominal group technique was utilized; a number of statements on the assessment and management of coronary artery calcification were developed based on a systematic review of the literature. Th authors discussed the developed statements until a consensus …

The Michigan Procedure: Mass Extraction From The Heart Facilitated By Onocor Global Embolic Protection Device, Hussam Al Hennawi, Shaurya Srivastava, Ahmad Abulshamat, Mohammed Qintar

Abington Jefferson Health Papers

Intracardiac masses present a challenging diagnostic and therapeutic dilemma and are associated with an increased risk of complications, such as embolic events and obstructive symptoms. We report a novel procedure using an ŌNŌCOR device through subclavian access that acted as a full-body protection device as well as a retrieval device.

Enhancing Clinical Relevance Of Pretrained Language Models Through Integration Of External Knowledge: Case Study On Cardiovascular Diagnosis From Electronic Health Records, Qiuhao Lu, Andrew Wen, Thien Nguyen, Hongfang Liu

Faculty, Staff and Student Publications

Background: Despite their growing use in health care, pretrained language models (PLMs) often lack clinical relevance due to insufficient domain expertise and poor interpretability. A key strategy to overcome these challenges is integrating external knowledge into PLMs, enhancing their adaptability and clinical usefulness. Current biomedical knowledge graphs like UMLS (Unified Medical Language System), SNOMED CT (Systematized Medical Nomenclature for Medicine-Clinical Terminology), and HPO (Human Phenotype Ontology), while comprehensive, fail to effectively connect general biomedical knowledge with physician insights. There is an equally important need for a model that integrates diverse knowledge in a way that is both unified and compartmentalized. …

An Unusual Case Of Refractory Hypoxia: The Many Ways Of Providing Oxygen, Saliha Erdem, Mir Babar Basir

Journal of Shock and Hemodynamics

This case report outlines the complex clinical course of a 26-year-old female patient who presented with altered mental status after an N-methyl-3,4-methylenedioxy-amphetamine overdose. The patient exhibited profound hemodynamic instability and respiratory failure. She subsequently developed shock, necessitating advanced life support measures, including veno-venous extracorporeal membrane oxygenation with a dual lumen right atrium to pulmonary artery cannula (ProtekDuo; LivaNova, London, UK) and Quadrox Oxygenator (Getinge, Wayne, NJ) system. This resulted in worsening hypoxemia, which was attributed to an increased left ventricular preload. In response, an intra-aortic balloon pump was used to decrease the left ventricle’s afterload. After balloon placement, the patient’s …

Cardioprotective Efficacy Of Sevoflurane In Patients With Rheumatic Heart Disease Undergoing Heart Valve Surgery Under Cardiopulmonary Bypass, Vu Thanh Lam, Nguyen Quoc Kinh, Nguyen Minh Ly

Journal of the Saudi Heart Association

Objectives

In this study, we investigated whether cardioprotective properties of sevoflurane were expressed in patients with rheumatic heart disease undergoing heart valve surgery under cardiopulmonary bypass (CPB).

Methods

Fifty patients with rheumatic heart disease undergoing heart valve surgery under CPB were randomly assigned to receive total anesthesia with sevoflurane or propofol during surgery. Except for this, anesthetic and surgical management was the same in all patients. The primary outcomes were postoperative high-sensitive cardiac troponin T (hs-cTnT) and creatine kinase-myocardial band (CK-MB) release. The secondary outcomes were hemodynamic events and short-term clinical outcomes (within 30 days after surgery).

Results

The plasma …

Cardiac Mass In A 78-Year-Old Patient With A History Of Cancer: Diagnostic And Treatment Challenges, Bihong Zhao, Ayah Zaqqa, Michelle M Mcdonald, Ismael A Salas De Armas, Igor D Gregoric, L Maximilian Buja

The Texas Heart Institute Journal

Primary cardiac angiosarcoma is a rare, aggressive malignancy that commonly metastasizes to various organs. The presenting symptoms are typically nonspecific, so a comprehensive examination is required to confirm the diagnosis promptly. This case report describes the presentation of an older patient with a history of neoplasms. Echocardiography and biopsy were performed, but despite surgical intervention to resect a large right atrial mass, the patient died. A final diagnosis of primary angiosarcoma was made based on the resected specimen.

Factors Associated With Non-Uptake Of Implantable Cardioverter-Defibrillator (Icd) Among Eligible Patients At A Tertiary Hospital In Kenya, Emmanuel Oluoch, Jasmit Shah, Jeilan Mohamed, Mohamed Varwani, Mzee Ngunga

Internal Medicine, East Africa

Background: Efficacy of Implantable Cardioverter-Defibrillator (ICD) implantation in both primary and secondary prevention of Sudden Cardiac Death (SCD) in at-risk population is well established. ICD implantation rates remain low particularly in Africa with a paucity of data regarding factors associated with non-uptake.

Objectives:The primary study objective was to determine the factors associated with non-uptake of ICD among heart failure (HF) patients with reduced ejection fraction (EF

Methods: This was a retrospective study among HF patients eligible for ICD implantation evaluated between 2018 to 2020. Comparison between ICD recipient and non-recipient categories was made to establish determinants of non-uptake.

Results: …

A Case Of Propafenone Toxicity In The Setting Of Dehydration And Acute Kidney Injury, Enad Haddad, Matthew Collins

Abington Jefferson Health Papers

Propafenone is a class 1C antiarrhythmic and is one of the first-line drugs used in the management of atrial fibrillation. Its toxicity is rare, yet potentially life-threatening. Common clinical findings could range from hypotension, dysrhythmias, and conduction disturbances to cardiac arrest. We present a case of an 80-year-old male who presented with generalized weakness and polyuria secondary to over-diuresis leading to dehydration. Electrocardiogram on admission showed a first-degree atrioventricular block, QRS complex widening, and QTC interval prolongation. These findings were attributed to propafenone toxicity in the setting of dehydration and increased serum propafenone concentration. In the case described the optimization …

Modern Perspectives On Hypertrophic Cardiomyopathy-No One Size Fits All, Brett Doliner, Hadeel Gaddar, Ramsey Kalil, Alexander Postalian

The Texas Heart Institute Journal

Despite substantial advances in the management of hypertrophic cardiomyopathy, advanced heart failure remains a major cause of morbidity in this patient population. This narrative review presents the case of a patient with hypertrophic obstructive cardiomyopathy who underwent alcohol septal ablation to frame a discussion of modern therapies for hypertrophic cardiomyopathy. The current treatment landscape includes medications, both old and new, and surgical and procedural interventions to relieve mechanical obstruction. Several promising new modalities for relieving obstruction are in the nascent stages of development.

Modern Perspectives On Hypertrophic Cardiomyopathy-No One Size Fits All, Brett Doliner, Hadeel Gaddar, Ramsey Kalil, Alexander Postalian

The Texas Heart Institute Journal

Despite substantial advances in the management of hypertrophic cardiomyopathy, advanced heart failure remains a major cause of morbidity in this patient population. This narrative review presents the case of a patient with hypertrophic obstructive cardiomyopathy who underwent alcohol septal ablation to frame a discussion of modern therapies for hypertrophic cardiomyopathy. The current treatment landscape includes medications, both old and new, and surgical and procedural interventions to relieve mechanical obstruction. Several promising new modalities for relieving obstruction are in the nascent stages of development.

Consensus Statement On The Management Of Nonthrombotic Iliac Vein Lesions From The Viva Foundation, The American Venous Forum, And The American Vein And Lymphatic Society., Kush R Desai, Saher S Sabri, Steve Elias, Paul J Gagne, Mark J Garcia, Kathleen Gibson, Misaki M Kiguchi, Santhosh J Mathews, Erin H Murphy, Eric A Secemsky, Windsor Ting, Raghu Kolluri

Heart and Vascular Articles

A nonthrombotic iliac vein lesion is defined as the extrinsic compression of the iliac vein. Symptoms of lower extremity chronic venous insufficiency or pelvic venous disease can develop secondary to nonthrombotic iliac vein lesion. Anatomic compression has been observed in both symptomatic and asymptomatic patients. Causative factors that lead to symptomatic manifestations remain unclear. To provide guidance for providers treating patients with nonthrombotic iliac vein lesion, the VIVA Foundation convened a multidisciplinary group of leaders in venous disease management with representatives from the American Venous Forum and the American Vein and Lymphatic Society. Consensus statements regarding nonthrombotic iliac vein lesions …

Dual-Energy Lattice-Tip Ablation System For Persistent Atrial Fibrillation: A Randomized Trial., Elad Anter, Moussa Mansour, Devi G Nair, Dinesh Sharma, Tyler L Taigen, Petr Neuzil, Erich L Kiehl, Josef Kautzner, Jose Osorio, Stavros Mountantonakis, Andrea Natale, John D Hummel, Anish K Amin, Usman R Siddiqui, Doron Harlev, Paul Hultz, Shufeng Liu, Birce Onal, Khaldoun G Tarakji, Vivek Y Reddy

Heart and Vascular Articles

Clinical outcomes of catheter ablation for atrial fibrillation (AF) are suboptimal due, in part, to challenges in achieving durable lesions. Although focal point-by-point ablation allows for the creation of any required lesion set, this strategy necessitates the generation of contiguous lesions without gaps. A large-tip catheter, capable of creating wide-footprint ablation lesions, may increase ablation effectiveness and efficiency. In a randomized, single-blind, non-inferiority trial, 420 patients with persistent AF underwent ablation using a large-tip catheter with dual pulsed field and radiofrequency energies versus ablation using a conventional radiofrequency ablation system. The primary composite effectiveness endpoint was evaluated through 1 year …

Repair Of Thoracic Aortic Aneurysm With Bilateral Aberrant Subclavian Artery, Yuki Ikeno, Akiko Tanaka, Francesco Brandini, Anthony L Estrera

Faculty, Staff and Student Publications

We present a rare anatomical configuration of a 19-year-old woman, characterized by descending thoracic aortic aneurysm with right aberrant subclavian arteries with a Kommerell's diverticulum in a left aortic arch. The complexity of this vascular anomaly was accompanied by an anomalous origin of left subclavian artery. The patient underwent a single-stage open surgical repair via left thoracotomy under deep hypothermic circulatory arrest. The bilateral aberrant subclavian arteries were separately reconstructed in situ using hand-sewn branched grafts.

Feasibility And Efficacy Of Extravascular Implantable Cardioverter-Defibrillators In Two Patients With Class Iii Obesity., Omar Gutierrez, Matthew Cline, Anish K Amin

Heart and Vascular Articles

No abstract provided.