Cardiovascular Diseases Commons^™

Right Ventricle-Pulmonary Artery Conduit Replacement Resolves Anomalous Single Coronary Stenosis In Repaired Tetralogy Of Fallot, Karl Kristian Lundin, Edward Hickey, Prakash Masand, Vivian Dimas, Katherine Bohard Salciccioli

Faculty, Staff and Students Publications

A 41-year-old man with repaired tetralogy of Fallot and a single coronary artery (CA) arising anteriorly presented with dyspnea in the setting of moderate right ventricle-pulmonary artery conduit (RV-PAC) stenosis and moderate-to-severe extrinsic left main CA compression between the aorta and RV-PAC. His CA stenosis resolved after successful RV-PAC replacement.

Reducing The Incidence Of Frequent Hospital Readmissions In Veterans Population, Dasari Reddy

Student Scholarly Projects

Practice Problem: Veterans hospital readmission problems are challenging, specifically in the heart failure department, which severely impacts the patient's health, mortality, family, and quality of life. Frequent readmissions increase the usage cost, hospital budget, and loss of time from providers to other veterans, and failure to meet the key guidelines of the Center for Medicare and Medicaid for improvement.

PICOT: The PICOT question that guided this project was, in veterans with heart failure and one or more frequent hospital readmissions discharged in the last 30 days(P), does the appointment of a dedicated discharge nurse practitioner as a coordinator(I), compared to …

Improving Firefighter Health Through Education In Sleep Science, Elisabeth J. Filiss

Master's Projects and Capstones

Sleep impacts all aspects of life, from mental health to physical well-being to job performance. Nowhere is this more important than in the fire service, where extreme working conditions are the norm. One of 44 stations in a large fire department (XFD), Firehouse X, has 21 full-time members, six on duty per shift. A microsystem assessment of Firehouse X revealed poor sleep habits and environmental factors that are not conducive to quality sleep. The role of sleep in the fire service has recently been examined, and interventions aimed at improving firefighters’ sleep have been recommended.

This quality improvement project implemented …

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.

Unraveling The Complex Dynamics Of Cardiac Fibrosis: Ccn1 As A Novel Regulator Of Scar Collagen Architecture And Structural Integrity In Myocardial Infarction., Annalara Garland Fischer

Electronic Theses and Dissertations

Expansion of the extracellular matrix (ECM), known as fibrosis, accompanies nearly all forms of cardiac disease; however, its most significant and complex manifestations arise following a myocardial infarction (MI). This process, principally led by fibroblasts, constitutes a necessary and adaptive response acutely to fill the void from cardiomyocyte necrosis following ischemic injury due to the heart’s lack of regenerative capacity. This acute response never fully resolves and contributes to ongoing collagen accumulation in non-infarcted regions, leading to diminished ventricular compliance, ongoing myocyte loss, and attrition in function—culminating in heart failure. Further, recent research demonstrates that concomitant with progressive increases in …

The Athero-Af Study: A Need To Optimize Af Management In An Environment Of Medical Advancement, Michael D. Ezekowitz, Ibrahim Alameh, Mohammed Kamareddine

Department of Medicine Faculty Papers

No abstract provided.

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.

Effect Of Cvd Education On The Perception And Modifiable Health Behaviors Of College Students, Sanitha Douglas

Doctor of Nursing Practice Projects

Background

Research reports that cardiovascular disease (CVD) has been a national and global health problem for many years, and that knowledge has increased regarding its prevention (Hennekens, 2020). However, according to Hennekens (2020), CVD remains the number one cause of death in America and most developed countries worldwide. The lack of perception and knowledge of actual CVD risk in the young adult population may be contributing to this deadly disease. This project evaluated the effectiveness of education on CVD risk perception and modifiable health behaviors of college students.

Purpose

This project’s purpose was to assess college students' perception of their …

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.

Image-Guided Aspiration Of A Cystic Mediastinal Teratoma: A Case Report And Literature Review, Craig R Kym, Anoop P Ayyappan, Babith J Mankidy, Mohammad Ghasemi-Rad

Faculty, Staff and Students Publications

A 51-year-old male presented to our tertiary referral hospital with progressive shortness of breath and orthopnea. A computed tomography (CT) of the chest was performed that showed a large cystic middle mediastinal mass. Magnetic resonance imaging (MRI) of the chest demonstrated a large, well-circumscribed, T2-hyperintense cystic middle mediastinal mass resulting in significant compression of the trachea, brachiocephalic artery, superior vena cava, and azygos vein. The patient subsequently developed a right hemispheric stroke due to compression of the brachiocephalic artery and was too clinically unstable to undergo or definitive operative management of the mediastinal cyst. Percutaneous CT-guided aspiration of the cystic …

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.

Iatrogenic Atrial Septal Defect After Mitraclip Transcatheter Edge-To-Edge Repair: To Close Or Not To Close??, Mariem Abdelsalam, Raghad Younus, Lamis F Abdalla, Abdelkader Almanfi

The Texas Heart Institute Journal

The evolution of percutaneous procedures that use transseptal puncture to treat left-sided structural heart disease has led to the emergence of iatrogenic atrial septal defects as a potential complication. These defects can result in hemodynamic decompensation and worsening clinical outcomes. Some iatrogenic atrial septal defects require immediate closure, others do not. This case report presents 2 patients who underwent transcatheter edge-to-edge mitral valve repair with transseptal puncture and required iatrogenic atrial septal defect closure (1 immediate and 1 delayed). The goal of this report is to highlight iatrogenic atrial septal defect assessment and the possible need for closure after transseptal …

A Rare Case Of Cardiac Angiosarcoma Presenting As Recurrent Atrial Flutter/Fibrillation, Muhammad Umer Riaz Gondal, Luke Rovenstine, Muhammad Asad Hanif, Nayab Mirza, Arjun Basnet, Fawwad Ansari, Muhammad Ibraiz Bilal, Zainab Kiyani, Rohail Azhar, Arun Kundra

Transformative Medicine

Introduction

Cardiac angiosarcomas are extremely rare, with an incidence of only 0.056%. They can have various presentations, including arrhythmias.

Case

A 65-year-old male presented to an outside hospital one year ago with palpitations. Heart rates were 130 bpm, and EKG revealed new-onset atrial flutter with 2-1 block. Apixaban and metoprolol tartrate were started, with plans for a TEE and cardioversion in 4 weeks. He went to the emergency department twice the following month with rapid atrial fibrillation and had TEE and cardioversion twice one week apart. A 2.5 cm mass in the right atrium was noted on the TEE.

The …

Annular Rupture During Transcatheter Aortic Valve Replacement Without A Surgical Option–The Double-Edged Sword Of Mechanical Circulatory Support, Aishah Matar, Corey Adams, Anna Bizios, Rosaleen Chun, Jillian Colbert, Daniel Holloway, Ayaaz K. Sachedina

Journal of Shock and Hemodynamics

Transcatheter aortic valve replacement (TAVR) has become a well-established treatment option for patients with severe aortic stenosis. With advances in the field and positive outcomes in clinical trials, TAVR use has expanded from being limited to older patients with prohibitive surgical risk to younger patients with intermediate and low surgical risk. As operators’ experiences have grown and technology has evolved, there are fewer TAVR complications. However, when complications do occur, they remain associated with significant morbidity and mortality. Aortic annulus rupture is a catastrophic complication of TAVR. Risk factors for annulus rupture include valve oversizing, female gender, a large calcification …

Sutureless Valves, A "Wireless" Option For Patients With Aortic Valve Disease: Jacc State-Of-The-Art Review, Cristiano Spadaccio, Antonio Nenna, Angelo Pisani, Grzegorz Laskawski, Francesco Nappi, Marc R Moon, Fausto Biancari, Arminder S Jassar, Kevin L Greason, Malakh L Shrestha, Nikolaos Bonaros, David Rose

Faculty, Staff and Students Publications

Transcatheter technologies triggered the recent revision of the guidelines that progressively widened the indications for the treatment of aortic stenosis. On the surgical realm, a technology avoiding the need for sutures to anchor the prosthesis to the aortic annulus has been developed with the aim to reduce the duration of cardiopulmonary bypass and simplify the process of valve implantation. In addition to a transcatheter aortic valve replacement (TAVR)-like stent that exerts a radial force, these so-called "rapid deployment valves" or "sutureless valves" for aortic valve replacement also have cuffs to improve sealing and reduce the risk of paravalvular leak. Despite …

Roles Of Hydrogen Sulfide (H2s) As A Potential Therapeutic Agent In Cardiovascular Diseases: A Narrative Review, Kazi N. Islam, Ivan D. Nguyen, Rahib Islam, Humza Pirzadah, Hassan Malik

School of Medicine Faculty Publications

Cardiovascular disease (CVD) stands as one of the leading causes of morbidity and mortality worldwide, and the continued search for novel therapeutics is vital for addressing this global health challenge. Over the past decade, hydrogen sulfide (H₂S) has garnered significant attention in the field of medical research, as it has been proven to be a cardioprotective gaseous signaling molecule. It joins nitric oxide and carbon monoxide as endogenously produced gasotransmitters. As for its mechanism, H₂S functions through the posttranslational addition of a sulfur group to cysteine residues on target proteins in a process called sulfhydration. As a result, the observed …

Minimally Invasive Mitral Valve Surgery Using A Cold Fibrillatory Cardiac Arrest Technique In Patients With Prior Cardiac Surgery, Ahmed Ali, Zachary Gray, Gabriel Loor, Alexis E Shafii, Todd K Rosengart, Kenneth K Liao

The Texas Heart Institute Journal

OBJECTIVE: Minimally invasive mitral valve surgery (mini-MVS) is typically reserved for patients who have not undergone open cardiac surgery. In the reoperative setting, using intrapericardial dissection for crossclamping the aorta through a minimally invasive approach can be difficult and, at times, risky. Cold fibrillatory cardiac arrest (CFCA) with systemic cardiopulmonary bypass without cross-clamping is a well-described technique; however, data about its safety for patients who undergo reoperative mini-MVS are limited.

METHODS: Data for 34 patients who underwent reoperative mini-MVS with CFCA from March 2017 to March 2022 were reviewed retrospectively. A mini right thoracotomy (n = 30) or robotic (n …

Artificial Chordae Implantation Vs Posterior Leaflet Preservation: A Comparison Of Midterm Results After Mitral Valve Replacement, Salih Salihi, Bilhan Özalp, Fatih Toptan, Ibrahim Kara

The Texas Heart Institute Journal

BACKGROUND: Various techniques have been proposed for the preservation of the subvalvular apparatus (SVA) in mitral valve replacement. This study aimed to compare the midterm results of posterior leaflet preservation with the results of selective preservation of the SVA involving artificial chordae implantation in terms of left ventricular performance in patients undergoing mitral valve replacement.

METHODS: In total, 127 patients were included in this study. Patients were allocated to 1 of 2 groups according to the techniques used to preserve the SVA. Patients in group 1 underwent posterior leaflet preservation: The anterior leaflet was completely resected, and the posterior leaflet …

Dietary Acculturation Is Associated With Altered Gut Microbiome, Circulating Metabolites, And Cardiovascular Disease Risk In Us Hispanics And Latinos: Results From Hchs/Sol, Yi Wang, Guo-Chong Chen, Zheng Wang, Kai Luo, Yanbo Zhang, Yang Li, Amanda C Mcclain, Marta M Jankowska, Krista M Perreira, Josiemer Mattei, Carmen R Isasi, Maria M Llabre, Bharat Thyagarajan, Martha L Daviglus, Linda Van Horn, David Goldsztajn Farelo, Luis E Maldonado, Steven R Levine, Bing Yu, Eric Boerwinkle, Rob Knight, Robert D Burk, Robert C Kaplan, Qibin Qi, Brandilyn A Peters

Faculty, Staff and Student Publications

Background: Dietary acculturation, or adoption of dominant culture diet by migrant groups, influences human health. We aimed to examine dietary acculturation and its relationships with cardiovascular disease (CVD), gut microbiota, and blood metabolites among US Hispanic and Latino adults.

Methods: In the HCHS/SOL (Hispanic Community Health Study/Study of Latinos), US exposure was defined by years in the United States (50 states and Washington, DC) and US nativity. A dietary acculturation pattern was derived from 14 172 participants with two 24-hour dietary recalls at baseline (2008-2011) using least absolute shrinkage and selection operator regression, with food groups as predictors of US …

Cholesterol Drugs May Improve Periodontal Disease

New Orleans Dental Association News

Recently, statin treatment applied locally into tissues during both surgical and nonsurgical procedures exhibiting a positive effect on various parameters of periodontal tissue health. When looking at this novel, not yet commonly utilized approach to the local application of statins as an adjunct to periodontal treatment, early studies have shown significant improvement in clinical parameters, such as probing depth and clinical attachment levels. This method of local statin delivery into the tissue shows promise, and should be explored by further research.