Cardiology Commons^™

One-Year Results Of The Liberty 360 Study: Evaluation Of Acute And Midterm Clinical Outcomes Of Peripheral Endovascular Device Interventions., Jihad Mustapha, William Gray, Brad J Martinsen, Ryan W Bolduan, George L Adams, Gary Ansel, Michael R Jaff

Heart and Vascular Articles

PURPOSE: To report the 1-year results of a multicenter study of peripheral artery disease (PAD) treatment with a variety of endovascular treatment strategies employed in routine practice.

MATERIALS AND METHODS: The LIBERTY trial ( ClinicalTrials.gov identifier NCT01855412) is a prospective, observational, core laboratory-assessed, multicenter study of endovascular device intervention in 1204 subjects (mean age 69.8±10.7 years; 770 men) stratified by Rutherford category (RC): claudicants (RC2,3; n=501) and critical limb ischemia (CLI) with no/minimal tissue loss (RC4,5; n=603) or significant tissue loss (RC6; n=100). Key outcomes included quality of life (QoL) measures (VascuQol and EuroQol) and freedom from major adverse events …

Maximum Iv Tpa Dose For Obese Patients Is Associated With Greater Likelihood Of Hemorrhagic Conversion And Worse Functional Outcome At Discharge, Amy Starosciak, Felipe De Los Rios La Rosa

All Publications

No abstract provided.

Large Coronary Arteries Mean No Chance Of A Heart Attack, Right? An Acute Myocardial Infarction In The Setting Of Holding Anticoagulation For A Routine Colonoscopy, Nathan Brewster Do, Jennifer Nesfeder, Ryan Murphy Do, Brian J. Holahan, Syed Rafay Ali Sabzwari

Department of Medicine

Coronary artery ectasia (CAE) is an uncommon pathology, which is sometimes incidentally found on left heart catheterization (LHC). CAE is occasionally treated with systemic anticoagulation to prevent thrombosis or progression of the clot in the coronary arteries. We present a 63-year-old male with known CAE on warfarin who presented to the hospital with myocardial infarction after a routine colonoscopy for which anticoagulation was held. His myocardial infarction was attributed to a likely coronary thromboembolic event. This case highlights the need for consideration of bridging anticoagulation therapy before and after procedures in patients with CAE to prevent adverse coronary events.

More On Waiting For Test Results: When A Doctor Is The Patient, Herbert L Fred

The Texas Heart Institute Journal

No abstract provided.

Effect Of Percutaneous Suction Thromboembolectomy On Improved Right Ventricular Function, Akbarshakh Akhmerov, Heidi Reich, James Mirocha, Danny Ramzy

The Texas Heart Institute Journal

Venous thromboembolism is a leading cause of cardiovascular death. Historically, surgical intervention has been associated with high morbidity rates. Pharmacologic therapy alone can be inadequate for patients with substantial hemodynamic compromise, so minimally invasive procedures are being developed to reduce clot burden. We describe our initial experience with using the AngioVac system to remove thromboemboli percutaneously. We reviewed all suction thromboembolectomy procedures performed at our institution from March 2013 through August 2015. The main indications for the procedure were failed catheter-directed therapy, contraindication to thrombolysis, bleeding-related complications, and clot-in-transit phenomena. We collected details on patient characteristics, procedural indications, thrombus location, …

An Unusual Case Of Takotsubo Cardiomyopathy In Pheochromocytoma, Paolo Angelini

The Texas Heart Institute Journal

No abstract provided.

Minimally Invasive Endovascular Repair Of Ascending Thoracic Aortic Aneurysm With Use Of Local Anesthesia And Conscious Sedation, Abdelkader Almanfi, Zvonimir Krajcer

The Texas Heart Institute Journal

Ascending thoracic aortic aneurysm (ATAA) is typically treated surgically. No commercially available device has been specifically designed for endovascular ATAA repair, and currently, multiple anatomic and technical challenges affect its feasibility. Previously, such repairs have been performed with the patients under general anesthesia. We describe a novel, minimally invasive approach to endovascular repair of ATAA, involving local anesthesia, conscious sedation, and 24-hour hospitalization. Two consecutive male patients (ages, 79 and 54 yr) who had comorbidities underwent percutaneous transfemoral endovascular ATAA repair with use of commercially available endografts. Patient 1 had a saccular aneurysm, and Patient 2 had a pseudoaneurysm consequent …

Proteomic Alterations Of Hdl In Youth With Type 1 Diabetes And Their Associations With Glycemic Control: A Case-Control Study, Evgenia Gourgari, Junfeng Ma, Martin P. Playford, Nehal N. Mehta, Radoslav Goldman, Alan T. Remaley, Scott M. Gordon

Saha Cardiovascular Research Center Faculty Publications

Background: Patients with type 1 diabetes (T1DM) typically have normal or even elevated plasma high density lipoprotein (HDL) cholesterol concentrations; however, HDL protein composition can be altered without a change in cholesterol content. Alteration of the HDL proteome can result in dysfunctional HDL particles with reduced ability to protect against cardiovascular disease (CVD). The objective of this study was to compare the HDL proteomes of youth with T1DM and healthy controls (HC) and to evaluate the influence of glycemic control on HDL protein composition.

Methods: This was a cross-sectional case–control study. Blood samples were obtained from patients with T1DM and …

Treating Postpartum Refractory Long Qt Syndrome With Cervical Ganglion Sympathectomy, Nikhil A. Mehta Mbbs, Mario Caruso Do, Syed Rafay Ali Sabzwari Md, Lohit Garg Md, Jeffrey Gordon Md, Talha Nazir Md

Department of Medicine

No abstract provided.

Appropriateness Of Tavr In The Chronic Liver Patient Undergoing Liver Transplant Evaluation, Rebecca Marcantuono, Msn, Crnp, Nicholas Ruggiero, Md, Alec Vishnevsky, Md, John Entwistle, Md, Praveen Mehrotra, Md, Kiran Mahmood, Md, Wisam Alfay, Md

Division of Cardiology Posters

As the indications for Transcatheter Aortic Valve Replacement (TAVR) continue to expand, understanding appropriate patient selection is becoming an area of growing interest. The presence of Liver cirrhosis has been previously proven to increase perioperative morbidity and mortality in patients undergoing general surgical procedures. However, there is limited research articulating clinical outcomes in TAVR patients with known liver disease who are actively undergoing orthotopic liver transplant evaluation (OLT).

A Rare Case Of Minocycline Induced Eosinophilic Myocarditis, Tarick Sheikh Md, Anam Malik Md, Paul Secheresiu Do, James R. Kimber Do, Hiwot Ayele Md, Lekha Racharla Do

Department of Medicine

No abstract provided.

Atresia Of The Coronary Sinus Ostium With Anomalous Drainage Into Innominate Vein: Implications For Crt, Syed Rafay Ali Sabzwari Md, Lohit Garg Md, Nikhil A. Mehta Md, Hiwot Ayele Md, Nghia Hoang Md

Department of Medicine

No abstract provided.

Sudden Cardiac Death Associated With Malignant Mitral Valve Prolapse, Damon Mcenroe Md, Fnu Vikram Md, Kailyn Mann Do, Lohit Garg Md, Syed Rafay Ali Sabzwari, Nael Hawwa Md

Department of Medicine

No abstract provided.

Aortoduodenal Fistula Forms From Primary Aortic Stump Graft In A Two-Time Multi-Visceral Transplant Patient With Presentation Of Gastrointestinal Bleed And Bowel Perforation: A Case Report, Brielle Corrente

Graduate Student Research Symposium

Usually not diagnosed until open laparotomy, aortoduodenalfistulas (ADF) are one of the rarest complications of intestinal transplant surgery. With an incidence rate of only 0.04% at autopsy and only 250 documented cases since the early 1800’s, aortoduodenal fistulas are the most deadly complications of intestinal transplantation with a mortality rate of 100% without surgical intervention. A 39 year old, two-time multi-visceral transplant African American female patient suffered from a primary aortoduodenal fistula formation in a primary modified multi-visceral transplant aortic stump graft site. With emergency open laparotomy repair, revascularization of the secondary multi-visceral transplant was performed, saving the life of …

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.

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.

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 …