Cardiology Commons^™

Concomitant Transcatheter Edge-To-Edge Repair For Mitral And Tricuspid Regurgitation For Polyvalvular Disease, Omar Khan, Matthew Summers

Department of Medicine Faculty Publications

This patient is a 77-year-old male with non-ischemic cardiomyopathy, severe tricuspid regurgitation, and moderate mitral regurgitation who underwent simultaneous transcatheter edge-to-edge repair of both mitral and tricuspid valves. Post-procedure, the patient exhibited significant symptomatic improvement and reduced regurgitation severity, highlighting the feasibility of dual-valve TEER in high-risk patients.

Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement: Incidence, Predictors, And Association With Reduced Ischemic Stroke Risk, Omar Saleh, Nicholas J. Valle, Shinjer Li, Saleh Mostafa, Israa Saleh, Raymond Benza, Deepak R. Talreja, Matthew R. Summers

Department of Medicine Faculty Publications

Background

Development of conduction abnormalities requiring pacing after transcatheter aortic valve replacement (TAVR) is relatively common. The effects of post-TAVR permanent pacemaker (PPM) implantation on mortality, ischemic stroke, and cardiovascular outcomes remain incompletely characterized. AIMS: To evaluate the incidence, predictors, and cardiovascular outcomes of post-TAVR permanent pacemaker implantation, including its association with 1-year ischemic stroke risk.

Methods

Adults undergoing TAVR (2008-2019; n = 1101) were evaluated. Patients with prior PPM (n = 104) and/or valve-in-valve or redo TAVR (n = 11) were excluded. PPM placement was identified post-indexed TAVR admission based on procedure codes, including both in-hospital and post-discharge implantations. …

Complicated Third Sternotomy For Left Ventricular Outflow Tract Obstruction Secondary To Mitral Valve Prosthesis Strut, Rishab Agarwal, Alleabelle Bradshaw, Michelle Carvajal, Jennifer S. Lawton

Department of Medicine Faculty Publications

Introduction: LVOT obstruction after surgical bioprosthetic MVP placement is uncommon and the influence of the MVP strut width has seldom been examined.

Case presentation: A 74-year-old female presented with palpitations, chest pain, and shortness of breath. She had MVR with 31-mm bioprosthetic valve 2 years prior. TEE confirmed LVOT obstruction secondary to a MVP strut, causing a peak gradient of 55 mmHg. The redo operation was complicated by iatrogenic Type A aortic dissection. The patient was immediately cooled for DHCA with RCP and ascending aortic replacement was performed. MVR was then performed with a prosthesis with narrower strut width. Recovery …

Percutaneous Closure Of Ventricular Septal Rupture After Myocardial Infarction:, Thomas A. Cook, Simone K. Schumaecker, Anjani Patibandla, Nicholas J. Valle, Matthew R. Summers

Department of Medicine Faculty Publications

BACKGROUND: Ventricular septal rupture (VSR) following acute myocardial infarction is a rare but deadly complication with mortality rates exceeding 90% when left untreated. Coronary ischaemia leads to myocardial necrosis and friability resulting in septal rupture, most commonly 3-5 days post-infarction. The sudden development of a left-to-right shunt causes volume overload in the right ventricle, pulmonary vasculature, and left atrium, precipitating biventricular failure, and cardiogenic shock. Management requires careful consideration of timing and modality of closure along with stabilization with mechanical circulatory support in severe cases.

CASE SUMMARY: A 65-year-old female presented with anterior ST-segment elevation myocardial infarction complicated by VSR …

Platypnea-Orthodeoxia Syndrome Caused By A Patent Foramen Ovale And Interatrial Septal Aneurysm: A Case Report, Abes A. Bautista Neughebauer, Raymond L. Benza, Deepak Talreja

Department of Medicine Faculty Publications

Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by positional hypoxemia, often due to right-to-left shunting across a patent foramen ovale (PFO) despite normal right-sided pressures. Early recognition is essential as symptoms may be subtle and imaging is often unrevealing. A 78-year-old female patient with a known PFO presented with one week of lower abdominal pain and mild exertional dyspnea without chest pain. She was profoundly hypoxic to 76% on room air, with improvement when supine and worsening when upright. Initial labs were unremarkable, and arterial blood gas revealed primary respiratory alkalosis with severe hypoxemia. Despite unremarkable chest radiography, CT …

Differential Impact Of Catheter Ablation Across Heart Failure Phenotypes In Atrial Fibrillation: A Grade Assessed Systematic Review And Meta-Analysis, Faizan Ahmed, Ayesha Zulfiqar, Mohamed Nasser Elshabrawi, Omama Ayatullah, Sheraz Qasim, Hira Sarfraz, Haris Bin Tahir, Faseeh Haider, Maryam Fatima, Syed Ahmed Ali Shah, Ameema Kaleem, Muhammad Taha Altaf, Muhammad Bin Aslam Zahid, Nazila Dalir, Manal Zia, Amro Taha, Abdul Qadeer, Bhavin Patel, Khurram Arshad

Department of Medicine Faculty Publications

Introduction: Atrial fibrillation (AF) is highly prevalent in heart failure (HF) and is linked to increased mortality and hospitalization in both preserved (HFpEF) and reduced ejection fraction (HFrEF). Catheter ablation (CA) has emerged as an effective rhythm-control strategy beyond medical therapy (MT), but phenotype-specific differences remain unclear. We compared the efficacy and safety of CA versus MT in AF with HFpEF or HFrEF.

Methods: PubMed, Embase, Scopus, and Cochrane databases were searched through December 2025. Random-effects meta-analyses were conducted in R (version 4.5.3), reporting risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs).

Results: Fifteen studies involving …

Validity Assessment Of Resting Heart Rate Variability From The Garmin Health Snapshot, Kayla M. Porter, Andrew Flatt

Honors College Theses

Purpose: To assess the agreement between the Garmin Forerunner 265 (a commercially available sports watch) and a single-channel electrocardiographic (ECG) chest strap for determining resting heart rate variability (HRV). Secondary aims were to assess the impact of skin tone and body position on measurement accuracy.

Methods: Young adults (n = 30, 57% women) aged 18–39 years without known cardiovascular conditions and without tattooing or scarring on the dorsal left wrist were recruited. HRV was recorded simultaneously using ECG and the Forerunner 265’s optical sensor during Garmin’s 2-minute “Health Snapshot.” Measurements were obtained in three standardized positions: supine, seated, and standing. …

Impact Of Rapid Response Team On In-Hospital Cardiac Arrest Events, Sara Everard Tucker, Julie Gale Bell, Stephanie Pigg, Shelby Austin, Kelsey Sawyer, Stephan Smith, Michelle Bradberry, Jonathan Ortegon, Matt Mitchell

Covenant Nurses Week 2026

No abstract provided.

Outcomes And Implications Of Patients Included Vs. Excluded For Extracorporeal Cardiopulmonary Resuscitation After Initial Activation, Kevin George, Joshua B. Wiener, Michael Zacharias, Frank Forde, Yasir Abu-Omar, Colin Mccloskey

Division of Cardiology Faculty Papers

BACKGROUND: The aim of this study is to describe the implementation of a new Extracorporeal Cardiopulmonary Resuscitation (ECPR) program in Cleveland, Ohio, USA. We also provide a novel comparison of outcomes between patients cannulated vs excluded from cannulation for ECPR after initial field activation.

METHODS: A prospective observational study of ECPR activations between September 2021 and February 2025. Patients meeting initial eligibility criteria for out-of-hospital cardiac arrest (OHCA)-namely based on age, bystander-CPR, and initial shockable rhythm-were transported to the emergency department where the ECPR team completed cannulation based on further biochemical criteria. Medical records were used to collect data after …

Microgravity-Induced Alterations In Left Atrial Hemodynamics And Thrombogenic Risk: Insights From Healthy And Atrial Fibrillation Models, Grace M. Hoeppner

Dissertations, Master's Theses and Master's Reports

Background: Microgravity exposure alters cardiovascular loading, yet its impact on left atrial flow dynamics and thrombotic risk remains poorly understood. This study investigates how spaceflight-relevant microgravity-induced changes in cardiac outflow affect left atrial hemodynamics in healthy individuals and patients with atrial fibrillation.

Methods: Patient-specific left atrial models were generated for three healthy individuals and three AF patients. Computational fluid dynamics (CFD) simulations were performed using each patient’s baseline mitral outflow waveform and two modified waveforms representing short- and long-duration post-flight cardiac loading changes derived from echocardiographic observations. Hemodynamic metrics included left atrial velocity, time averaged wall shear stress, oscillatory shear …

Stim1-Dependent Treg Dysfunction Promotes Cardiometabolic Hfpef: Insights From Patients And Animal Studies, Balaji Srinivas, Alluri Kiran, Hongmei Peng, Jiang Xu, Paula Fortuno, Jennifer May, Ismail El Moudden, Nour-Eddine Rhaleb, John M. Herre, Raymond L. Benza, Khalid Matrougui

Department of Biomedical and Translational Sciences Faculty Publications

Background

Heart failure with preserved ejection fraction (HFpEF) arises from chronic cardiometabolic and vascular stress and is increasingly recognized as an inflammatory syndrome with immune dysregulation. Regulatory T cells (Tregs) are critical modulators of cardiovascular inflammation, yet the mechanisms driving Treg dysfunction in HFpEF remain poorly defined. stromal interaction molecule 1 (STIM1)-dependent calcium signaling is a key stress-responsive pathway in immune cells; however, its role in Treg maladaptation during HFpEF remains unknown.

Methods

Circulating Tregs from patients with and without HFpEF were analyzed for abundance, STIM1 expression, and stress-associated signaling pathways. To establish causality, mice with Treg-specific deletion of STIM1 …

Optimal Local Impedance Parameters For Catheter Ablation Of The Cavo-Tricuspid Isthmus In Atrial Flutter Patients: A Retrospective Analysis, Yamann Sahlool, Yann Dacquay, Saro Avedikian, Jeong Hwan J. Kim, Ali Sovari

HCA Healthcare Journal of Medicine

Background

Atrial flutter is a common arrhythmia, and catheter ablation offers a potentially curative intervention. However, there is a continued desire to enhance the procedure’s efficiency and safety to optimize patient outcomes. Recently, local impedance (LI) has garnered attention as a novel approach to optimizing ablation procedures. The parameters of LI change when associated with durable ablation lesions for cavo-tricuspid isthmus (CTI) which remains poorly defined. This study aims to address this gap through analysis of gathered data.

Methods

We conducted a retrospective data analysis of 121 consecutive patients who underwent local impedance-guided catheter ablation of the CTI for typical …

Sequential Tav-In-Tav Resolves Lvot Pseudoaneurysm-Related Paravalvular Leak., Zeryab A Khan, Steven J Yakubov, Laura D Flannery, Carlos E Sanchez

Heart and Vascular Articles

No abstract provided.

A Rare Culprit Or An Elusive Culprit In Disguise? Unraveling Wild-Type Attr Cardiac Amyloidosis In Heart Failure With Reduced Ejection Fraction, Jose J. Loayza Pintado, Taiwo Ajani, Daniela Hernandez, Everardo Cobos

School of Medicine Publications

Cardiac amyloidosis (CA) is a rare disorder caused by the deposition of abnormal proteins called amyloid in the myocardium, leading to dysfunction. The 2 most common forms of amyloidosis are AL (light chain) and ATTR (transthyretin). Diagnosing amyloidosis is challenging, especially in its early stages, due to its nonspecific symptoms and overlap with other conditions. Recent studies suggest that the incidence of wild-type transthyretin amyloidosis is rising, likely due to improved diagnostic techniques and an aging population. We present the case of a 72-year-old male with lower extremity edema, progressive shortness of breath, and worsening renal function. He had a …

Efficacy And Safety Of Transcatheter Mitral Valve Repair (Mitraclip) Compared To Medical Therapy And Surgery In Patients With Secondary Mitral Regurgitation: A Systematic Review & Pairwise Meta-Analysis, Salma Younas, Aditya Rana, Mirza Faizan Ali Beig, Sweta Sahu, Cynthia Esohe Emanemua, Aisha Ashiq Reshie, Lamees Kaukab, Dileep Duggineni, S K S S P Ashish Gokavarapu, Padamati Bhavani, Afrasayab Khan, Peter G. Fattal

Journal of the Saudi Heart Association

Background: Secondary mitral regurgitation (SMR) is a frequent complication of heart failure, associated with high morbidity and mortality. While surgery is the standard for primary MR, many SMR patients are poor surgical candidates. Transcatheter mitral valve repair (TMVr) using the MitraClip offers a less invasive alternative, but its comparative efficacy and safety remain under active investigation and controversial. Methods: A systematic search of MEDLINE®, Embase®, and the Cochrane Library was conducted per PRISMA guidelines (PROSPERO ID: CRD420251016943). Eligible studies were randomized controlled trials (RCTs) comparing TMVr (MitraClip) with guideline-directed medical therapy (GDMT) or surgical repair in adult patients with SMR. …

Sex Differences In The Association Of Vascular Risk And Apoe Genotype With Cognitive Decline And Dementia: Evidence From A U.S. Longitudinal Study, Longjian Liu, Jintong Hou, Saishi Cui, Xiaopeng Zhao, Zuolu Liu, J. Craig Longenecker, Nathalie S May, Jin Jun Luo, Rose Ann Dimaria-Ghalili, Howard J. Eisen

Division of Cardiology Faculty Papers

BACKGROUND: Sex differences in the association between vascular factors and cognitive outcomes remain unclear. We aimed to investigate the associations of blood pressure metrics (hypertension, systolic blood pressure [SBP), pulse pressure, ankle and brachial pressures, and ankle to brachial pressure index [ABI]) with the risk of cognitive decline and dementia.

METHODS: We conducted a population-based longitudinal analysis using data from the Atherosclerosis Risk in Communities (ARIC) study (begun in 1987-1989) in the United States. We analyzed a total of 12,268 participants aged 45-64 years who had validated exposure measurements, cognitive function tests (first administrated 1990-1992), and followed up for incidence …

Saudi Heart Association Position Statement On Nt-Probnp For Cardiovascular Risk Screening In Asymptomatic Adults With Type 2 Diabetes Mellitus, Waleed Alhabeeb, Adel , Tash, Abdullah Mohammed Abdullah Arabe, Lamya Alzubaidi, Ayman Al Hayek, Mohammed Ridha Al Safi, Malak Atallah Almashali

Journal of the Saudi Heart Association

Background: Type 2 diabetes mellitus (DM) is a chronic disease with a rapidly increasing prevalence, posing a significant public health challenge worldwide and in Saudi Arabia. Cardiovascular disease (CVD) is the leading cause of death among patients with T2DM, necessitating early detection and intervention to prevent disease progression. Elevated natriuretic peptide levels, particularly N-terminal pro–B-type natriuretic peptide (NT-proBNP), are promising biomarkers for CVD risk stratification in individuals with T2DM. However, the integration of these biomarkers in clinical management remains limited.

Methods: Published evidence and existing guidelines/consensuses related to the use of NT-proBNP for CVD risk stratification in T2DM patients were …

A Prospective Observational Study On Role Of Intraoperative Renal & Muscle Oxygen Saturation On Post-Operative Serum Creatinine Level In Patients Undergoing Cardiac Surgery On Cardiopulmonary Bypass, Bhakti Banerjee, Haripada Das, Lini Srivastava, Snigdha . Pramanik, Diptimay Majumder

Journal of the Saudi Heart Association

Objective Near Infra-Red Spectroscopy (NIRS), can be used to monitor renal tissue oxygenation (SrO2), as well as thenar muscle oxygenation (SmO2). In this study, we have examined the ability of SrO2 and SmO2 in predicting cardiac surgery related change in serum creatinine level (ΔsCr) and explored any correlation between these two parameters.

Methods This study included 55 adult patients (18 to 60 years), who were scheduled for elective cardiac surgery with cardiopulmonary bypass (CPB), having no pre-existing renal impairment, with skin-to-kidney depth ofSmO2, preoperatively. ΔsCr was investigated at 24, 48 and 72 hours post-operatively. Relative thresholds of SrO2 and SmO2 …

Adjudicated Cardiovascular Events In Patients With Covid-19: Association With Vaccination Status And Changes Over Time, Behnood Bikdeli, Darsiya Krishnathasan, Antoine Bejjani, Candrika D. Khairani, Nada Hamade, Umberto Campia, Julia Davies, Nicole Porio, Ali Assi, Andre Armero, Anthony Tristani, Marcos D. Ortiz-Rios, Victor Nauffal, Zaid I. Almarzooq, Eric Q. Wei, Bridget Mcgonagle, Mariana Pfeferman, Sina Rashedi, Alyssa Sato, Giovanni Scimeca, Valeria Zuluaga-Sánchez, Mehrdad Zarghami, Aditya Achanta, Sirus Jesudasen, Bruce C. Tiu, Geno J. Merli, Orly Leiva, John Fanikos, Aditya M. Sharma, Samantha M. Rizzo, Ruth B. Morrison, Alec Vishnevsky, Shiavax J. Rao, Sivan Naveh, Abdelghani El Rafei, James Welker, Marc P. Bonaca, Brett J. Carroll, Samuel Z. Goldhaber, Zhou Lan, Gregory Piazza, The Corona-Vte Network Investigators

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Patients with COVID-19 are at risk of thrombotic and cardiovascular complications. Existing risk estimates derive from early COVID-19 experiences. More recent event rates, temporal trends, and the association between vaccination status and cardiovascular outcomes remain unclear.

METHODS: The CORONA-VTE Network (COVID-19 Registry to Assess Frequency, Risk Factors, Management, and Outcomes of Arterial and Venous Thromboembolic Complications) multicenter registry included patients with COVID-19 from March 2020 to February 2024. A composite of venous and arterial thrombotic events and a composite of adjudicated cardiovascular events were assessed at 90 days after COVID-19 diagnosis. Time-to-first-event analyses were stratified by inpatients and outpatients …

Treating Atrial Fibrillation: Cryoballoon Vs. Radiofrequency Ablation, Nile A. Latowsky, Jordan E. Andre

Physician Assistant Capstones, 2020-current

Objective: Assess the effectiveness of pulmonary vein isolation (PVI) by cryoballoon ablation (CBA) compared to the current gold standard of care, radiofrequency ablation (RFA), for the treatment of paroxysmal and persistent atrial fibrillation in a symptomatic population. Design: Literature review. Methods: Searches were done in PubMed and Cochrane Library, utilizing the terms atrial fibrillation, cryoballoon ablation, and radiofrequency. In PubMed, the following limits and terms were used: published in the last 10 years, humans, randomized controlled trial, and English. Results: Search results revealed four studies meeting the inclusion/exclusion criteria. Conclusion: Cryoballoon ablation (CBA) is as efficacious in treating atrial fibrillation …