Cardiology Commons^™

Isolated Bicuspid Pulmonic Valve: “Forgotten Valve” And A Rare Anomaly, Ghulam Akbar Md, Fnu Vikram Md, Lohit Garg Md, Larry E. Jacobs Md, Matthew W. Martinez Md

Department of Medicine

No abstract provided.

Traumatic Tricuspid Regurgitation: When To Operate, Ghulam Akbar Md, Lohit Garg Md, Syed Rafay Ali Sabzwari, Fnu Vikram Md, Raman Dusaj Md

Department of Medicine

No abstract provided.

Safety And Efficacy Of Very High Dose Furosemide Continuous Infusions, Jessica Wilczynski, Pharmd, Matthew Decaro, Md, Facc, Facp, Gregary Marhefka, Md, Facc, Facp, Brandi Thoma, Pharmd, Bcps, Bccp, Susan Varghese, Pharmd, Bcps, Ryan Watson, Md, Ilya Danelich, Pharmd, Bcps, Bccp

Division of Cardiology Posters

• Fluid overload is treated with loop diuretics in patients with heart failure and in patients with acute kidney injury1,2
• There are sparse data regarding use of very high dose continuous loop diuretic infusions. In some studies, very high doses were only used in outlying patients (maximum160 mg/hour)3, 4
• The use of very high dose furosemide continuous infusions at Thomas Jefferson University Hospital is a rare practice. These infusions range in dose from 40-240 mg/hour, with no limitation on the duration
• The purpose of this study is to examine the efficacy and safety of very high dose furosemide continuous infusions

A Case Of Overlooked Popliteal Artery Entrapment Syndrome., Lisa Saa, Peter K Firouzbakht, Mohammad Otahbachi

Articles, Abstracts, and Reports

Popliteal artery entrapment syndrome (PAES) is an uncommon cause of lower extremity claudication that is often overlooked. It most commonly occurs in young athletes without risk factors for peripheral vascular disease. We present a case of a 47-year-old man who went undiagnosed for over 10 years despite multiple orthopedic, chiropractic, and neurosurgery consults. A definitive diagnosis of PAES was confirmed in the catheterization lab by angiography. The patient underwent popliteal artery bypass surgery and his symptoms completely resolved. PAES must be considered in the differential diagnosis of lower extremity pain, especially in younger patients.

Outcomes Of Catheter Ablation For Atrial Fibrillation In Patients With Hypertrophic Cardiomyopathy, Lohit Garg Md, Syed Rafay Ali Sabzwari Md, Ghulam Akbar Md, Hiwot Ayele Md, Sahil Agrawal Md, Manyoo Agarwal Md, Jeffrey Gordon, Raman Dusaj Md, Talha Nazir Md, Babak Bozorgnia Md, Matthew W. Martinez Md

Department of Medicine

No abstract provided.

Favorable Outcomes With Ventricular Assist Device Exchange, Megan Carroll, Meghan Tooman, Markian Bochan, Christopher Salerno, Ashwin Ravichandran

The VAD Journal

Left ventricular assist device (LVAD) therapy remains a vital therapeutic option for patients with end-stage heart failure. Unfortunately, adverse events can occur and progress to require consideration for device exchange once the failure of medical management becomes evident, especially when heart transplantation is not possible in a timely manner. The aim of this analysis is to describe the incidence and outcomes of LVAD exchanges at our institution. Between April 2008 and May 2017, 397 patients underwent LVAD implantation, with 32 of those patients subsequently receiving exchange upon the recommendation of our multidisciplinary team due to refractory infection (n=12), device malfunction …

Dennd5b Regulates Intestinal Triglyceride Absorption And Body Mass, Scott M. Gordon, Edward B. Neufeld, Zhihong Yang, Milton Pryor, Lita A. Freeman, Xiao Fan, Iftikhar J. Kullo, Leslie G. Biesecker, Alan T. Remaley

Saha Cardiovascular Research Center Faculty Publications

Regulation of lipid absorption by enterocytes can influence metabolic status in humans and contribute to obesity and related complications. The intracellular steps of chylomicron biogenesis and transport from the Endoplasmic Reticulum (ER) to the Golgi complex have been described, but the mechanisms for post-Golgi transport and secretion of chylomicrons have not been identified. Using a newly generated Dennd5b^−/− mouse, we demonstrate an essential role for this gene in Golgi to plasma membrane transport of chylomicron secretory vesicles. In mice, loss of Dennd5b results in resistance to western diet induced obesity, changes in plasma lipids, and reduced aortic atherosclerosis. In …

Gender Differences In Takotsubo Cardiomyopathy As A Secondary Diagnosis: Higher Hospital Charges, More Procedures, And Longer Length Of Stays, Daniel Westerdahl, Hsin-Fang Li, Amir Yazdani, Kateri Spinelli, Tyler J Gluckman

Articles, Abstracts, and Reports

Background

The incidence of Takotsubo Cardiomyopathy (TC) has risen steadily over the past decade, with current estimates of 15-30 cases per 100,000 per year. Historically, men diagnosed with TC have worse outcomes compared to women. The relationship between total hospital charges, number of procedures performed, and length of stay (LOS) between genders has not been previously reported with TC as a secondary diagnosis.

Methods

National Inpatient Sample (NIS) data from 2009-2015 was used to identify encounters of adult patients (≥18 years) undergoing coronary angiography that were ultimately given a secondary diagnosis of TC (International Classification of Diseases – 9 code …

Prevalence, Patterns And Factors Associated With Hypertensive Crises In Mulago Hospital Emergency Department; A Cross-Sectional Study, Martha Sajatovic

Faculty Scholarship

Background: Hypertension is increasing in sub-Saharan Africa (SSA) and it’s the single most important modifiable stroke risk factor, yet it’s control is not routinely emphasized. The prevalence, pattern and factors associated with hypertensive urgencies and emergencies in Uganda is not well established. A cross-sectional study, was conducted between November 2015 and February 2016, using a complete clinical examination and pre-tested standardized questionnaire subjects were enrolled. The prevalence of hypertensive crises and associations of demographic and clinical factors determined using logistic regression. Results: The prevalence of hypertensive crises was 5.1%, (203/4000) of all admissions at the medical section of the accident …

Heart Failure Symptom Biology In Response To Ventricular Assist Device Implantation., Christopher S Lee, James O Mudd, Karen S Lyons, Quin E Denfeld, Corrine Y Jurgens, Bradley E Aouizerat, Jill M Gelow, Christopher V Chien, Emily Aarons, Kathleen L Grady

Articles, Abstracts, and Reports

BACKGROUND: We have a limited understanding of the biological underpinnings of symptoms in heart failure (HF), particularly in response to left ventricular assist device (LVAD) implantation.

OBJECTIVE: The aim of this study was to quantify the degree to which symptoms and biomarkers change in parallel from before implantation through the first 6 months after LVAD implantation in advanced HF.

METHODS: This was a prospective cohort study of 101 patients receiving an LVAD for the management of advanced HF. Data on symptoms (dyspnea, early and subtle symptoms [HF Somatic Perception Scale], pain severity [Brief Pain Inventory], wake disturbance [Epworth Sleepiness Scale], …

Differential Impact Of Bleeding Avoidance Strategies On Risk-Adjusted Pci-Related Bleeding Rates Within A Large Multistate Health System, Tyler J Gluckman, L Wang, Kateri Spinelli, Jl Petersen, P Huang, Sv Rao

Articles, Abstracts, and Reports

No abstract provided.

Femoral Vein Transposition Arteriovenous Fistula Is A Feasible Option In "Selected" Patients As Hemodialysis Access, Zia Ur Rehman, Asfia Arham, Ziad Sophie

Section of Cardiothoracic Surgery

Introduction: Lower extremity hemodialysis access is offered to the patients who have severe central venous stenosis. Femoral vein transposition arteriovenous fistula (FV tAVF) is an alternative to lower leg arteriovenous prosthetic grafts. Its safety and patency is under observation.
Materials and Methods: This is a retrospective review of patients who had FV tAVF between January 2011 and March 2016. Preoperative clinical findings, intraoperative findings, postoperative complications, and patency of the AVF were noted and analyzed.
Results: There were 7 patients who underwent FV tAVF during this study period. Most patients were female (6 : 1), with mean …

Inferior Vena Cava Filter Clinic And Hospital Registry: One Year Review, Emily Keltner Bs, Ma, T. Eric White Md, Lisa Hollister

Parkview Heart Institute

Poster Presentation-

Background: Inferior vena cava (IVC) filters are small, cage-like devices placed percutaneously into the inferior vena cava to prevent propagation of thrombus into the pulmonary arteries. Currently, there are two available types of filters, permanent and temporary. Retrievable inferior vena cava (IVC) filter use has increased over 115% since the Food and Drug Administration (FDA) approval in 2009. Likewise, there has been a marked increase in complications related to their increased use. In 2014, the FDA initiated a comprehensive analysis of filter placement and issued the following recommendation: “The FDA recommends that implanting physicians and clinicians responsible for …

Data Integration And Interoperability For Patient-Centered Remote Monitoring Of Cardiovascular Implantable Electronic Devices, Carly Daley, Tammy Toscos Phd, Michael Mirro

Mirro Center Articles

Abstract: The prevalence of cardiovascular implantable electronic devices with remote monitoring capabilities continues to grow, resulting in increased volume and complexity of biomedical data. These data can provide diagnostic information for timely intervention and maintenance of implanted devices, improving quality of care. Current remote monitoring procedures do not utilize device diagnostics to their potential, due to the lack of interoperability and data integration among proprietary systems and electronic medical record platforms. However, the development of a technical framework that standardizes the data and improves interoperability shows promise for improving remote monitoring. Along with encouraging the implementation of this framework, we …

Adipose-Derived Autotaxin Regulates Inflammation And Steatosis Associated With Diet-Induced Obesity, J. Anthony Brandon, Maria Kraemer, Julia Vandra, Suchismita Halder, Margo F. Ubele, Andrew J. Morris, Susan S. Smyth

Gill Heart & Vascular Institute Faculty Publications

Autotaxin (ATX) is a secreted enzyme that generates the bioactive lipid lysophosphatidic acid (LPA). We generated mice with global inducible post-natal inactivation or adipose-specific loss of the Enpp2 gene encoding ATX. The animals are phenotypically unremarkable and exhibit differences in adipocyte size and adipose tissue expression of inflammatory genes after high fat feeding without gross differences in fat distribution or body mass. Surprisingly, both models of Enpp2- deficiency exhibited marked protection from high fat diet-induced hepatic steatosis. This phenotype was not associated with differences in dietary fat absorption but may be accounted for by differences in hepatic expression of …

A Nurse Navigator-Driven Program To Increase Palliative Care Referrals For Advanced Heart Failure Patients, Margaret Richter, Linda Desitter, Adam Mizgajski, Deborah Strohecker

Articles, Abstracts, and Reports

No abstract provided.

Does Concomitant Cabg Influence The Outcomes Of Post-Myocardial Infarction Ventricular Septal Defect Repair?, Dylan P. Horan, Jae Hwan Choi, Matthew P. Weber, Elizabeth Maynes, Sinal Patel, Jothika Challapalli, Jessica G.Y. Luc, John W. Entwistle, H. Todd Massey, Rohinton J. Morris, Vakhtang Tchantchaleishvili

Phase 1

Introduction: Ventricular septal defect (VSD) following myocardial infarction (MI) is a relatively infrequent complication with high mortality. Over time, understanding of the pathology and its management has resulted in improved outcomes; however, controversies remain.

Objective: We sought to investigate the effect of concomitant coronary artery bypass graft (CABG) on outcomes following post-MI VSD repair.

Methods: Electronic search was performed to identify all relevant studies published from 2000 to 2018. After assessment for inclusion and exclusion criteria, 66 studies were selected for the analysis. Data were extracted and pooled for systematic review and meta-analysis.

Results: Average age was 68.7 years …

Why Did Coapt Win While Mitra-Fr Failed? Defining The Appropriate Patient Population For Mitraclip., Kimberly Atianzar, Ming Zhang, Zachary Newhart, Sameer Gafoor

Articles, Abstracts, and Reports

In 2018, the world of functional mitral regurgitation changed with the presentation of two trials - Multicentre Study of Percutaneous Mitral Valve Repair MitraClip Device in Patients With Severe Secondary Mitral Regurgitation (MITRA-FR) and Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT). The trials, which seemed to point in two different directions, raised significant questions for the field. This article looks at the differences in effective regurgitant area, guideline-directed medical therapy, patient selection, technical clues and other reasons why the trials had similar aims but very different findings.

Process To Ensure Correct Classification Of Myocardial Infarction-Related Deaths, Renee Swanson, Hannah Berg, Joanna Herzog, Curt Kandra, Cindy Keithley, Daniel Westerdahl, Adam Mizgajski, Tyler J Gluckman

Articles, Abstracts, and Reports

No abstract provided.

Clinical Evaluation Of Exercise Capacity In Adults With Systemic Right Ventricle, Beata Rog, Kinga Salapa, Magdalena Okolska, Natalia Dluzniewska, Piotr Werynski, Piotr Podolec, Lidia Tomkiewicz-Pajak

The Texas Heart Institute Journal

The right ventricle provides systemic circulation in individuals with congenitally corrected transposition of the great arteries (CCTGA) and in those with complete transposition who have had an atrial switch repair (DTGA). The aim of this study was to evaluate how the systemic right ventricle adapts to increased workload and oxygen demand during exercise. From November 2005 through December 2015, 3,358 adult patients with congenital heart disease were treated at our institution; we identified 48 (26 females, 22 males; median age, 25.4 ± 8.1 yr) who met the study criteria; 37 had DTGA and atrial switch repair, and 11 had CCTGA. …