Cardiovascular System Commons^™

Open Transatrial Valve-In-Mitral Annular Calcification Mitral Valve Replacement With An Autologous Anterior Leaflet Sealing Skirt, Omar Saleh, Nicholas Valle, Rishab Agarwal, Israa Saleh, Joshua Dolsen, Connor Mckechnie, Dhruvi Patel, Deepak R. Talreja, Matthew R. Summers, Christopher M. Sciortino

Department of Medicine Faculty Publications

[Central Message] In patients undergoing ViMAC, surgical fixation of the native anterior mitral leaflet to a BEV cuff creates an autologous seal, reducing risk of paravalvular leak and neo-LVOT obstruction.

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 …

Transatrial Balloon-Expandable Valve Implantation For Severe Mitral Annular Calcification With Native Leaflet Sealing, Omar Saleh, Rishab Agarwal, Israa Saleh, Nicholas Valle, Joshua Dolsen, Raymond L. Benza, Deepak R. Talreja, Clinton D. Kemp, Matthew R. Summers, Christopher M. Sciortino

Department of Medicine Faculty Publications

Background: Severe mitral annular calcification (MAC) limits mitral intervention options. Transseptal valve-in-MAC (ViMAC) transcatheter mitral valve replacement (TMVR) risks neo-left ventricular outflow tract (neo-LVOT) obstruction and paravalvular leak, while surgical replacement requires extensive annular reconstruction.

Case Summary: We report 3 high-risk patients with severe MAC (computed tomography [CT]-based MAC scores 7-10) who underwent open transatrial valve-in-MAC TMVR via a balloon-expandable valve after CT-based simulation and multidisciplinary heart review identified increased risk of valve malapposition or neo-LVOT obstruction precluding transseptal approach. Native anterior mitral leaflet tissue was preserved, everted, and fixed to the bioprosthetic valve cuff, creating a seal to address …

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 …

Redo Tavr With Asymmetric Coronary Risk: Interpreting Borderline Ct Findings, Connor J. Mckechnie, Nicolas J. Valle, Omar A. Saleh, Matthew R. Summers, Deepak R. Talreja

Department of Medicine Faculty Publications

Image(s)

Computed tomography (CT) and computational modeling (DASI) in redo transcatheter aortic valve replacement (TAVR) planning.

Case Summary

A 77-year-old woman presented with severe symptomatic aortic stenosis due to degeneration of a prior transcatheter valve. CT demonstrated leaflet calcification with borderline left-sided valve-to-coronary distance (3.27 mm). Geometric assessment suggested low right coronary obstruction risk, but higher left main risk. Computational modeling demonstrated adequate leaflet-coronary clearance (distance from displaced leaflet cusp to coronary ostium normalized to coronary diameter >0.7). Redo TAVR with a 26-mm Evolut FX was performed without leaflet modification and no coronary obstruction.

Take-Home Message

Borderline CT findings in …

Current Insight Into Ldlr And Pcsk9 Genetic Variants: Investigating Genetic Keys To Cholesterol In A Cohort Of Stroke Patients From Yogyakarta, Indonesia, Loury Priskila, Lenggana Relung Atmadi, Arya Taksya Bagaskara, Andreas Mercyan Anggitama

Makara Journal of Health Research

Background: Stroke is the second leading cause of mortality worldwide. In Yogyakarta, Indonesia, the incidence of stroke (14%) is higher than the national average. We therefore investigated the roles of LDLR rs688 (C/T) and PCSK9 rs562565 (A/G) polymorphisms in familial hypercholesterolemia as predictors of first-time ischemic stroke.

Methods: In this case-control study, 119 first-time ischemic stroke patients were divided into dyslipidemia (N = 71) and non-dyslipidemia groups (N = 48). The DNA of the nucleotide polymorphisms LDLR rs688 (C/T) and PCSK9 rs562556 (A/G) was extracted and analyzed using the PCR-RFLP method, and statistical analyses were performed to evaluate …

Investigating The Cardiovascular And Autonomic Responses To Energy Drink Consumption: The Role Of Energy And Calorie Content, Sophia Schmidt

Honors Theses

Energy drinks (EDs) are among the most consumed functional beverages, often marketed to enhance focus, alertness, and physical performance. Despite their popularity, the combined cardiovascular and autonomic effects of caffeine and sugar during exercise remain poorly understood. The purpose of this study was to examine the acute cardiovascular, metabolic, and autonomic responses to sugar-sweetened (ED-S), non-nutritive sweetened (ED-NNS), and placebo beverages during submaximal cycling in healthy young males.

Nine male participants (age 22.2 ± 2.4 yrs; BMI 26.2 ± 2.9 kg/m²) completed three experimental visits in a randomized, repeated-measures design. Each visit involved ingestion of one drink (ED-S, ED-NNS, or …

Use Of Calcium Modification In Percutaneous Coronary Intervention: A Comprehensive Review, Noyan Ramazani, Ala W. Abdallah, Michael V. Dicaro, Divyansh Sharma, Aditi Singh, Kachon Lei

Department of Internal Medicine Faculty Research

Calcified coronary lesions remain a challenge in percutaneous coronary intervention (PCI) in both situations of acute myocardial infarction (MI) and stable coronary syndrome. It significantly increases the risk of procedural complications due to difficulty in equipment delivery, balloon expansion, and stent delivery. Furthermore, stent thrombosis, dissection, perforation, and future in-stent restenosis occur more frequently in calcified coronary lesions, impacting repeat target vessel revascularization and increasing the risk of future MI. With intracoronary imaging (intravascular ultrasound and optical coherence tomography), peri-procedural success for treating calcified lesions has increased significantly. Different modalities of calcium modification techniques have since been introduced. This review …

A Rare Variation In The Branching Pattern Of The Axillary Artery, Preethi Umanath, Sutha Selvaraj

Chulalongkorn Medical Journal

ABSTRACT:

BACKGROUND: This study aims to elucidate a previously unreported rare variation in the branching pattern of the third part of the axillary artery.

Results and discussion: During the routine dissection of a male cadaver, it was observed that the third part branches of the left axillary artery, specifically the anterior and posterior circumflex humeral arteries, were completely absent. To compensate for the missing branches, an unusual ascending branch emerged from the arteria profunda brachii (a branch of the brachial artery). This branch later divided into two: the deltoid branch, which accompanied the axillary nerve, entered in to …

The Science Of Sound: Studying The Cognitive, Emotional, And Physiological Effects Of Frequency, Genre, And Music, Jett Yarborough

Senior Honors Theses

Music influences emotion, physiology, and cognition, yet little is known about how the frequency it is tuned to affects these influences. Prior research has shown that music tuned to 432 Hz can reduce stress, lower blood pressure, and improve sleep. My colleagues and I conducted two studies to investigate this. Our research found that music tuned to 432 Hz promotes a significant increase in memory retention and induces a state of focus and relaxation. These results suggest that shifting from the standard tuning frequency of 440 Hz to 432 Hz could have a profoundly positive impact on our daily lives. …

Structural Variation Of The Right Coronary Ostium And Its Implications To Cardiac Medicine, Jessica L. Hensley, Joseph X. Anders, Timothy Robinson, William Srinivasan, Donald G. Matz, Ethan L. Snow

The Journal of Integrative Physiology

Introduction: The high oxygen demand of the heart’s myocardium is met via perfusion through the coronary arterial system. During embryological development, the right (RCA) and left (LMCA) coronary arteries fuse onto the aortic root, creating right (RCO) and left (LCO) ostial openings respectively to join the closed circulatory system. Regardless of their widely variable branching patterns, the ability of the RCA and LMCA to perfuse the myocardium initially relies on the functional patency of the coronary ostia. The objective of this study is to examine a unique extra-ostial tissue structure found overlying an RCO and provide a literature-based discussion of …

Interplay Between Admission And Early Postpartum Blood Pressure And Risk Of Postpartum Readmission For Hypertension, Juan C. Naranjo, J. Hunter Collins, Elizabeth F. Sutton

School of Medicine Faculty Publications

No abstract provided.

Standardizing Assessment Of Open Vascular Skills: National Roll-Out And Early Impact Of The Fundamentals Of Vascular Surgery Curriculum, Yana Etkin, Kristyn Mannoia, Pail Dimusto, Libby Weaver, Khalil Qato, Gabriela Velazquez, Malachi Sheahan

School of Medicine Faculty Publications

Background: Exposure to open vascular case is declining in surgical training, creating a need for standardized, objective assessment of fundamental open skills. The Association of Program Directors in Vascular Surgery developed the Fundamentals of Vascular Surgery (FVS) curriculum to teach and assess three core skills—end-to-side anastomosis, patch angioplasty, and clockface precision suturing. This study describes FVS development and validation, nationwide rollout, and early implementation experience across U.S. training programs. Methods: A multiphase project was conducted: (1) validation (2012–2019) of the 3 FVS tasks with 313 trainees scored by trained raters using OSATS checklists and global rating scales; reliability and construct …

Utilization Of The Fundamentals Of Vascular Surgery Symposium In Surgical Curricula, Priscilla Tanamal, Amit Chawla, Amanda Tullos, Claudie Sheahan, Malachi Sheahan

School of Medicine Faculty Publications

Objective: Simulation is a helpful adjunct to vascular surgery training, in which high-volume surgical experience portends better patient outcomes. Louisiana State University Health New Orleans hosts a 3-day program, the Fundamentals of Vascular Surgery (FVS) Symposium, during which vascular trainees from across the nation can participate in didactic and hands-on lessons with an emphasis on procedures less frequently performed during residency, taught by attending surgeons from various institutions. The objective of this study was to examine the effect of the FVS Symposium on participant confidence in endovascular and open procedures and evaluate any differences between junior and senior level residents. …

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 …

Bradycardia Associated With Remdesivir Treatment In Coronavirus Disease 2019 Patients: A Propensity Score-Matched Analysis, Salman Mohammed, Justin Bauzon, Kavita Batra, Celina Cosome, Kim Inciong, Elli Tian, Fadi Azar, Kevin Lee, Nazanin Houshmand, Uyen Pham, Ariyon Schreiber, Aditi Singh

School of Medicine Faculty Research

Remdesivir is an antiviral drug recommended for the treatment of COVID-19. The therapeutic benefits of remdesivir remain under investigation, with further literature emerging regarding its cardiac side-effect profile. The objective of this study was to investigate the association of remdesivir with bradycardia using a propensity score-matched analysis. Secondary outcomes included assessing in-patient mortality and hospital length of stay following remdesivir treatment for COVID-19. A single-institution retrospective study investigating treatment with and without remdesivir in 645 patients admitted for COVID-19 management was performed. Following treatment with remdesivir, patients were analyzed for episodes of bradycardia, defined in this study as 2 consecutive …

Summary Of The 2024 Brano Heart Failure Forum, Igor D. Gregoric, Milovan Bojic, Bojan Vrtovec, Rajko Radovancevic

The VAD Journal

Since 2007, the Branislav “Brano” Radovancevic Heart Failure Forum (BHFF) has been held annually to provide a venue for experts to present and discuss “Innovations and New Treatment Strategies in Heart Failure.” Clinicians and researchers gather yearly in a different Eastern European city to discuss the latest in heart failure diagnostics and therapeutics. The 2024 BHHF was held on the 18^th through the 20^th of September 2024 in Belgrade, Serbia. It was attended by over 100 faculty from 16 countries. In addition, participation through online streaming was available. Throughout the forum, 17 sessions focused on challenges and solutions …

Temporomandibular Joint Osteoarthritis And Systemic Inflammation: A Cadaveric Study For Dental Insights, Nathan Kent Bs, David Patterson Bs, Alyssa Luu Bs, Samantha Pipkin Bs, Jason Ciccotelli Dpt, Phd, Jeremy James Dmd, Ms, Jessica Immonen Phd, Ms

The Journal of Integrative Physiology

The objective of this study was to determine if gross signs of cadaveric osteoarthritis (OA) have

a tendency to present systemically and if this presentation includes pathology found at the

temporomandibular joint (TMJ). Signs of OA were then correlated to gross alterations of the aorta and common carotid arteries seen with atherosclerotic cardiovascular disease. Ipsilateral synovial joints including the TMJ, knee joint, radiocarpal joint and trapeziometacarpal (TMC) joint were all assessed for signs of OA in 4 cadaveric donors (3 males; 72, 82 and 92 years-old / 1 female; 89 years-old) using a validated scale of disease severity. A Grade …

Cholesterol Crystal Embolization Induced Kidney Disease, Shohan Pervaze, Shreya Mohandas, Pushkas Gopalan, Stephen A. Morse, Siddhartha Bajracharya, Landon A. Krone, Farshid Yazdi

School of Medicine Faculty Publications

Cholesterol crystal embolization (CCE) results from the release of cholesterol crystals from ruptured atherosclerotic plaques into circulation, resulting in the occlusion of small arteries and arterioles in various organs. Ischemia triggers a systemic inflammatory response resulting in vascular obstruction and organ dysfunction. Kidneys are often involved because of the proximity to the aorta and CCE in the kidneys can result in acute, sub-acute, or chronic kidney disease. There are many known risk factors for renal involvement of CCE, including iatrogenic and spontaneous causes. The pathophysiology of CCE includes complex pathways that lead to acute and chronic effects that can have …

Concurrent Presentation Of An Anomalous Right Coronary Artery And An Unusual Bovine Arch: Case Report, Vasiliki Tasouli-Drakou, Jasmine Dugal, Divuansh Sharma, Kachon Lei, Chowdhury Ahsan

Department of Internal Medicine Faculty Research

Anomalous coronary arteries from the opposite sinus of Valsalva are rare but can increase the risk for life-threatening complications. We present the case of a 59-year-old man who was found to have an anomalous right coronary artery and a rare bovine arch variant with a single common brachiocephalic trunk, along with severe proximal left anterior descending artery stenosis on left heart catheterization. The patient underwent a minimally invasive coronary artery bypass graft and unroofing of the anomalous coronary artery. To our knowledge, this is the first reported case of these concurrent anomalies in an individual without tetralogy of Fallot.