Cardiovascular Diseases Commons^™

Reverse Takotsubo-Like Cardiomyopathy And Pheochromocytoma, Patryk Purta, Dmitriy Scherbak Do, Michael Gruber Md, Oliwier Dziadkowiec

Cardiology

No abstract provided.

Phlegmasia Cerulea Dolens In May Thurner Syndrome: A Threat To Life & Limb, Matt Mcmaster, Rage Geringer Md, Gregory Hicks Md, Oliwier Dziadkowiec

Internal Medicine

No abstract provided.

High-Sensitivity C-Reactive Protein Discordance With Atherogenic Lipid Measures And Incidence Of Atherosclerotic Cardiovascular Disease In Primary Prevention: The Aric Study, Renato Quispe, Erin D. Michos, Seth S. Martin, Rishi Puri, Peter P. Toth, Jassim Al Suwaidi, Maciej Banach, Salim S. Virani, Roger S. Blumenthal, Steven R. Jones

Office of the Provost

Background: Inflammation is an independent causal risk factor for atherosclerotic cardiovascular diseases (ASCVDs). However, whether hsCRP (high‐sensitivity C‐reactive protein) is prognostic across various levels of atherogenic lipid measures such as low‐density lipoprotein cholesterol, non–high‐density lipoprotein cholesterol, apolipoprotein B and total cholesterol/high‐density lipoprotein cholesterol in primary prevention is unknown.
Methods and Results: We studied 9748 ARIC (Atherosclerosis Risk in Communities) study participants who were free of ASCVD at baseline (visit 4, 1996–1998) and had measurements of lipids, apolipoprotein B, and hsCRP. We used multivariable adjusted Cox models to estimate the risk of incident ASCVD events associated with hsCRP levels (less than/greater …

Iatrogenic Trauma Following Percutaneous And Minimally Invasive Surgical Interventions, M Hammad Ather, Tashfeen Ahmad, Shabbir Akhtar, Tabish Chawla, Aneela Darbar, Wardah Rafaqat, Syed Shahabuddin, Noman Shahzad, Shahid Ahmed Sami

Section of Urology

Technological progress has changed the landscape of surgical practice. Minimally invasive surgery (MIS) and percutaneous interventions (PC) are constantly replacing open procedures. This reduces hospital stay and allows quicker recovery. The application of MIS should follow the good medical practice dictum by Hippocrates i.e. "First do no harm". To remain abreast with new procedures, the medical personnel are required to update and enhance their knowledge and skill. To ensure safety, the innovations are rigorously tested and tried. The learning curve of MIS is shortened by simulator training and proctorship. Credentialing processes are in place to enhance safe delivery of care. …

Modified Pull-Through Technique For Cardiac Resynchronization Therapy Upgrades In Patients With Occluded Access Veins, Guram Imnadze, Khaled Awad, Wolfgang Kranig, Irakli Giorgberidze

The Texas Heart Institute Journal

The number of procedures for upgrading implantable devices for cardiac resynchronization therapy has increased considerably during the last decade. A major challenge that operators face in these circumstances is occlusion of the access vein. We have modified a pull-through method to overcome this obstacle. Six consecutive patients with occluded access veins and well-developed collateral networks underwent a procedure in which the occluded vein was recanalized by snaring the existing atrial lead via transfemoral access. Upgrading the device was successful in all patients; none had intraprocedural complications. Our experience shows that our modified pull-through technique may be a feasible alternative for …

Prognostic Value Of 6-Minute Walk Distance In Patients Undergoing Percutaneous Coronary Intervention: A Veterans Affairs Prospective Study, Tarun W Dasari, Bhavin Patel, Siddharth A Wayangankar, David Alexander, Yan D Zhao, Joann Schlegel, Cheuk Leung, Pedro Lozano, Faisal Latif, Udho Thadani

The Texas Heart Institute Journal

The 6-minute walk distance (6MWD) test is a useful prognostic tool in chronic heart failure. Its usefulness after percutaneous coronary intervention is unknown.

In a prospective observational study, patients underwent a 6MWD test within 2 weeks after percutaneous coronary intervention. The primary endpoint was major adverse cardiovascular events (MACE) (death, acute coronary syndrome, and heart failure admission) at one year. Receiver operating characteristic curves and area under the curve were used to determine the 6MWD test's predictive power, and the Youden index was used to measure its effectiveness.

A total of 212 patients were enrolled (98% men; mean age, 65 …

Obstruction Of 2 Coronary Arteries From Different Causes Immediately After Transapical Transcatheter Aortic Valve Replacement, Umihiko Kaneko, Ryuji Koshima, Hirosato Doi, Tsutomu Fujita

The Texas Heart Institute Journal

Coronary obstruction, a rare complication of transcatheter aortic valve replacement, can be fatal. Few data exist on this phenomenon, and, to date, authors have reported only single coronary lesions. We present a case in which 2 coronary arteries obstructed immediately after transapical transcatheter aortic valve replacement. The patient was an 81-year-old woman with symptomatic severe aortic stenosis who underwent transapical transcatheter aortic valve replacement. Immediately after an Edwards Sapien XT valve was deployed, she experienced sudden cardiogenic shock resulting from obstruction of the left main coronary artery ostium and the distal left anterior descending coronary artery. The left main obstruction …

Unusual Cause Of Heart Failure In A Patient With Marfan Syndrome: A Late Complication Of Bioprosthetic Valved Graft Replacement, Prerna B Bansal, Hari P Chaliki, Kantha R Kolla, Roger L Click, Alberto Pochettino

The Texas Heart Institute Journal

A high-velocity gradient across the left ventricular outflow tract is most often caused by aortic valve stenosis. We describe the unusual case of a high-velocity gradient caused by a kinked ascending aortic graft in a 69-year-old man who had Marfan syndrome. The patient had a history of ascending aortic aneurysm and had previously undergone replacement of the aortic root and ascending aorta with use of a bioprosthetic valved graft. The kinking was caused by dilation of the native aortic arch. The patient underwent successful hemi-arch replacement and repair of the kinked graft. Late complications and reoperation after proximal aortic surgery …

Benefit Of Contact Force-Guided Catheter Ablation For Treating Premature Ventricular Contractions, Ziming Zhao, Xiaowei Liu, Lianjun Gao, Yutao Xi, Qi Chen, Dong Chang, Xianjie Xiao, Jie Cheng, Yanzong Yang, Yunlong Xia, Xiaomeng Yin

The Texas Heart Institute Journal

We evaluated whether an irrigated contact force–sensing catheter would improve the safety and effectiveness of radiofrequency ablation of premature ventricular contractions originating from the right ventricular outflow tract.

We retrospectively reviewed the charts of patients with symptomatic premature ventricular contractions who underwent ablation with a contact force–sensing catheter (56 patients, SmartTouch) or conventional catheter (59 patients, ThermoCool) at our hospital from August 2013 through December 2015. During a mean follow-up of 16 ± 5 months, 3 patients in the conventional group had recurrences, compared with none in the contact force group. Complications occurred only in the conventional group (one steam …

Knowledge Gain Of The Non-Vascular Surgeons After Attending A Course On Traumatic Vascular Emergencies, Zia Ur Rehman, Muhammad Asad Moosa, Qamar Riaz

Department of Surgery Docs

Objective: To measure the effectiveness of the workshop in enhancing the knowledge and skills of the non-vascular surgeons in dealing with traumatic vascular emergencies.
Methodology: It was a Quasi-experimental pre-post design study conducted at Section of Vascular Surgery, Aga Khan University Hospital, Karachi (Pakistan) in February 2019. One-day workshop was conducted to enhance the knowledge and operative skills of the non-vascular surgeons in managing traumatic vascular emergencies. A written test and course evaluation survey were used to evaluate the effectiveness of the course in achieving the desired objectives.
Results: Total of 21 participants attended the workshop with mean age of …

Heritability Of 596 Lipid Species And Genetic Correlation With Cardiovascular Traits In The Busselton Family Heart Study, Gemma Cadby, Phillip E. Melton, Nina S. Mccarthy, Corey Giles, Natalie A. Mellett, Kevin Huynh, Joseph Hung, John Beilby, Marie-Pierre Dube, John Blangero

School of Medicine Publications

Introduction: Cardiovascular disease (CVD) is the leading cause of death worldwide, and genetic investigations into the human lipidome may provide insight into CVD risk. The aim of this study was to estimate the heritability of circulating lipid species and their genetic correlation with CVD traits.

Methods: Targeted lipidomic profiling was performed on 4492 participants from the Busselton Family Heart Study to quantify the major fatty acids of 596 lipid species from 33 classes. We estimated narrow-sense heritabilities of lipid species/classes, and their genetic correlations with eight CVD traits – body mass index, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, triglycerides, …

Assessment Of Guideline Recommended Anti-Coagulation Rates For Atrial Fibrillation In An Outpatient Resident Clinic, Kanav Gupta Md, Emily Langnas Do, Zahra Khaled, Travis Tagami Do, Alexandra Halalau Md

Internal Medicine

No abstract provided.

Giant 75mm Intracranial Aneurysm Masquerading As Primary Malignancy, Andrew W. Hwang, Satvir Dhillon Md, Remus Popa

Internal Medicine

No abstract provided.

Catch 22 : To Anticoagulate Or Not To Anticoagulate, Muhammad Madkour, Patrick Hu

Internal Medicine

No abstract provided.

An Atypical Presentation Of Ivc Thrombosis, Samantha Gelman Md, Gregory Shimizu Md, Rajesh Gulati Md

Internal Medicine

No abstract provided.

Is The Thomas Ring An Effective Approach To Prevent Recurrence Of Persistent Atrial Fibrillation With Advanced Atrial Fibrosis?, Ruifang Yang Md, Jose Luis Henao Md, David Goldgrab Do, Sokol Kalaveshi Md, Stephen Mester Md, Christian Perzanowski Md

Cardiology

Introduction | Objectives: Pulmonary vein isolation (PVI) with the Thomas ring (TR, single ring posterior wall isolation) has been shown to reduce recurrence of primarily paroxysmal atrial fibrillation (AF). Atrial fibrosis, as an important pathophysiological contributor, is directly linked to AF recurrence and resistance to therapy. The effect of TR ablation on outcomes of persistent AF (peAF) with advanced atrial fibrosis has not been adequately studied.

Methods: Observational series of three peAF patients (Tab.) who underwent TR. The degree of atrial fibrosis was determined by electroanatomic bipolar voltage mapping (CARTO, Diamond Bar, CA, USA). The reduced voltage areas (Fig.) reflected …

Ablation Of Persistent Atrial Fibrillation Substrate In Sinus Rhythm Does Not Lead To An Underestimation Of Fibrotic Atrial Myopathy: A Pilot Study, David Goldgrab Do, Sokol Kalaveshi Md, Jose Luis Henao Md, Ruifang Yang Md, Jearim Craig, Stephen Mester Md, Christian Perzanowski Md

Cardiology

Introduction | Objectives: Ablation of persistent atrial fibrillation (peAF) is associated with a worse outcome. Fibrotic atrial myopathy (FAM) is thought to play a role in the progression of AF. Estimation of left atrial voltage can vary significantly based on whether mapping is performed in fibrillatory conduction or sinus rhythm (SR). Selection of a voltage scale (VS) may lead to an over/under estimation of FAM. We determined the prevalence of advanced atrial myopathy (FAM > = 2) in SR compared to historical cohort ablated in peAF.

Methods: A homogenous group of peAF patients who underwent ablation in SR following cardioversion were …

Cardioversion Of Persistent Atrial Fibrillation Before High Energy Ablation Does Not Improve Outcomes In Short Term Follow Up: Preliminary Analysis, Ruifang Yang Md, Sokol Kalaveshi Md, David Goldgrab Do, Jose Luis Henao Md, Stephen Mester Md, Christian Perzanowski Md

Cardiology

Introduction | Objectives: The optimal approach of ablating persistent Atrial Fibrillation (peAF) has yet to be defined. By convention, mapping/ablation of peAF is most often performed in AF. The success of ablation hinges on catheter contact and achieving lesion transmurality. We theorized that ablation efficacy would improve during sinus rhythm (SR) given stability and predictability of catheter contact.

Methods: Non‐randomized comparison of peAF patients who underwent ablation in SR under a new practice protocol versus a cohort of peAF ablated in AF. The lesion set was the same for both groups, WACA ± BOX. Study group was treated with higher …

Retrospective Study Of Fmol Health System Utilization Using Geospatial Information, Deekshith Mandala

LSU Master's Theses

Medicaid Expansion and closing of Emergency Departments (ED) like Earl K. Long, Baton Rouge General Mid-City ED, and Champion Medical Center changed the health care landscape in East Baton Rouge Parish (EBRP). In this research study, a Geographical Information System (GIS) is used to analyze the impact of the expansion of Medicaid and the inauguration of Our Lady of the Lake North Baton Rouge ED (OLOL NBR ED) over the utilization of Franciscan Missionaries of our Lady Health System (FMOLHS) for both emergency and non-emergency health care services. This study is performed across the 58 neighborhoods of EBRP. Overutilization of …

Spotlight On Icosapent Ethyl For Cardiovascular Risk Reduction: Evidence To Date, Xiaoming Jia, Stephanie Koh, Mahmoud Al Rifai, Roger S. Blumenthal, Salim S. Virani

Office of the Provost

Icosapent ethyl is a highly purified formulation of eicosapentaenoic acid, a type of omega-3 fatty acid contained in fish oil. While omega-3 fatty acids have long been thought to have cardioprotective benefits, the Reduction of Cardiovascular Events with EPA-Intervention Trial (REDUCE-IT) has helped to establish icosapent ethyl as an evidence-based therapy for risk reduction of atherosclerotic cardiovascular disease (ASCVD). REDUCE-IT, however, was by no means an overnight success story. Close examination of the evidence shows that the trial was a culmination of many lessons learned from previous studies. The purpose of this manuscript is to review contemporary evidence of icosapent …