Cardiology Commons^™

Assessing The Safety And Effectiveness Of Endovascular Treatment Vs. Surgical Repair Of Aortic Aneurysms In Patients With Marfan Syndrome: A Literature Review, Noor Baig, Zainab Mubasher, Nassos Tziviskos, Joseph Pernini, Marcus Fariello, Ryan Hickey

Rowan-Virtua Research Day

Background: This review compares the safety and effectiveness of thoracic endovascular aortic repair (TEVAR) versus open surgical repair in patients with Marfan Syndrome (MFS) and thoracic aortic aneurysms. We assessed differences in mortality, length of hospital stay, renal impairment, and stroke incidence between the two techniques. Currently, open surgical repair is the gold standard treatment.

Hypothesis: As the gold standard treatment, we expect open surgical repair to have more favorable outcomes than TEVAR.

Methods: A systematic literature search was performed using studies from 2000-2024 across PubMed, Scopus, Embase, Cochrane, and Web of Science. Studies were included if they involved adult …

On Death And Disease: How Physicians’ Perspectives Compare Across Specialties Through Written Work, Stephanie Anne C. Alkonga

Honors Capstones

Narrative medicine is a tool that the medical field is increasingly utilizing to cultivate patient-centered and culturally competent doctors and to reflect on lived experiences through texts that focus on psychosocial best practices. This study aims to examine the language used in physician-written works that address how physicians in different medical specialties treat the aging and the terminally ill, and how they view the deceased. Qualitative data guided by thematic questions will primarily be used in the analysis and comparison of these texts’ tone, rhetoric, diction, and similar literary devices to uncover if certain patterns arise across such specialties. Findings …

Preliminary Assessment For Quality Improvement Of Hypertension Management In Kenya, Shubhangi Singh

Honors Theses

Hypertension is a leading contributor to cardiovascular disease (CVD) morbidity and mortality worldwide, with a disproportionate burden in low- and middle-income countries (LMICs). Despite relatively low rates of common behavioral risk factors, the Kasigau region of Kenya experiences high prevalence of hypertension and hypertension-related complications. This study explores self-efficacy, health beliefs, and management behaviors among adults in Kasigau to provide pilot quality improvement data for providers and future intervention planning. A cross-sectional, randomized survey of 45 adults was conducted at the Bughuta Clinic in southeastern Kenya. Participants completed a five-question hypertension-specific, self-efficacy assessment and a health belief model-based survey, with …

Pr Novel Hematoma Prevention Device, Nolan Shoukri, Steven Pearl, Nishaki Mehta

Posters

• Hematomas are a common complication in cardiac internal electronic device (CIED) placement procedures, they occur in up to 20-25% of CIED implants.

• Previous RCT tested a novel hematoma compression device (PR) and showed good tolerability, decreased hematoma formation from 15% to 6%, and wound improvement.

• Based on feedback collected from the nurses, physicians, allied health professionals during the randomized control trial, iteration of the PR was done (Gen 2 PR).

• This study evaluated 1) bench testing of the Gen 2 PR device and 2) healthy volunteer testing of Gen 2 PR device.

Early Mobilization In Post-Operative Cardiac Patients, Bailey Robertson, Trey Keesee

Covenant Nurses Week 2025

No abstract provided.

Suture Management Practices In Central Venous Catheters: A Survey Among Healthcare Professionals, Matthew Prevost, Nishaki Mehta

Posters

• Traditional suture methods (Fig. 1) for securing central venous catheters (CVCs) lack standardization, are nonadjustable postsecurement, and require dexterity → increasing risk of catheter micropistoning and central line-associated bloodstream infections (CLABSIs).

• This study examines medical practitioners' experiences and challenges with suturing CVCs

• Our hypothesis predicts that variations in responses and differences in practitioner training may influence experiences and complication rates.

Global Results From The Optimize Pro Study: Standardized Tavr Technique And Care Pathway., Kendra J Grubb, Hemal Gada, Douglas Fraser, Josep Rodes-Cabau, Tamim M Nazif, Suneet Mittal, Danny Dvir, Emmanuel Teiger, Lang Lin, Joshua D Rovin, Ramzi F Khalil, Ibrahim Sultan, Matias B Yudi, Blake Gardner, David Lorenz, Stanley Chetcuti, Nainesh C Patel, James Harvey, Paul Mahoney, Deepak Talreja, Carlo Trani, Darren Mylotte, Brian Schwartz, Zubair Jafar, Jan Van Der Heyden, Diego Maffeo, Gerald Yong, Cesar Moris, John Wang, Robert Gooley, Katie Flor, Yu Jung Yeh, Steven J Yakubov

OhioHealth Research Institute Articles

BACKGROUND: The safety and efficacy of utilizing standardized implant protocols and care pathways are limited in large global prospective studies of transcatheter aortic valve replacement (TAVR), and institutional variability remains. This analysis aims to report 30-day outcomes from the global Optimize PRO study evaluating valve performance and procedural outcomes using an "optimized" TAVR care pathway and the cusp overlap technique (COT) in patients receiving Evolut PRO/PRO+ valves.

METHODS: The Optimize PRO study is a multicenter, postmarket, prospective study conducted in 50 centers in the United States, Canada, Europe, the Middle East, and Australia. Patients with symptomatic severe aortic stenosis and …

Serendipitous Supernormality, Behzad B. Pavri, Eitan Frankel

Division of Cardiology Faculty Papers

We describe a patient who underwent AV node modification to create complete heart block in the setting of incessant, ablation-and-drug-refractory, symptomatic atypical atrial flutter. His dual chamber defibrillator (previously implanted for resuscitated cardiac arrest) was programmed to the VVIR mode at a faster pacing rate of 85 bpm. Serendipitously, this rate was an almost exact factorial of his flutter rate of 250-260 bpm. This resulted in every 6th flutter wave falling in the supernormal period, resulting in fixed-coupled supraventricular bigeminy and trigeminy in the setting of complete heart block. Reprogramming the pacing rate to 75 bpm abolished bigeminy and trigeminy.

Novel Application Of Orthopedic Suture Tape For Sternal Closure After Upper Hemisternotomy, Vishal N. Shah, Joshua R. Chen, Konstadinos A. Plestis

Department of Surgery Faculty Papers

The FiberTape (FT) System (Arthrex, Naples, FL, USA), initially developed for orthopedic surgery, is a new, nonmetallic, suture-based alternative to standard stainless-steel wires for sternal reapproximation. Publications on FT use after cardiothoracic surgery are limited. The FT System has not been used in upper hemisternotomy (UHS) closure. Consequently, we report the use of the FT System for sternal closure in a 70-year-old man after UHS aortic valve replacement and discuss several advantages of its application.

Macrophage-Mediated Il-6 Signaling Drives Ryanodine Receptor-2 Calcium Leak In Postoperative Atrial Fibrillation, Joshua A Keefe, Yuriana Aguilar-Sanchez, J Alberto Navarro-Garcia, Isabelle Ong, Luge Li, Amelie Paasche, Issam Abu-Taha, Marcel A Tekook, Florian Bruns, Shuai Zhao, Markus Kamler, Ying H Shen, Mihail G Chelu, Na Li, Dobromir Dobrev, Xander Ht Wehrens

Faculty, Staff and Students Publications

Postoperative atrial fibrillation (poAF) is AF occurring days after surgery, with a prevalence of 33% among patients undergoing open-heart surgery. The degree of postoperative inflammation correlates with poAF risk, but less is known about the cellular and molecular mechanisms driving postoperative atrial arrhythmogenesis. We performed single-cell RNA-seq comparing atrial nonmyocytes from mice with and without poAF, which revealed infiltrating CCR2+ macrophages to be the most altered cell type. Pseudotime trajectory analyses identified Il-6 as a gene of interest driving in macrophages, which we confirmed in pericardial fluid collected from human patients after cardiac surgery. Indeed, macrophage depletion and macrophage-specific Il6ra …

Identification Of Frailty Clusters Using Cross-Sectional Frailty And Frailty Trajectory: Cohort Of Heart Failure Veterans, Javad Razjouyan, Saeed Tofighi, Ariela R Orkaby, Biykem Bozkurt, Amir Sharafkhaneh, Molly J Horstman, Parag Goyal, Christopher I Amos, Orna Intrator, Aanand D Naik

Faculty, Staff and Student Publications

BACKGROUND: Frailty is a syndrome associated with increased vulnerability and diminished physiological reserves. Three-quarters (78%) of heart failure (HF) patients are frail. Traditional frailty indices (FIs) assess cross-sectional deficits, while frailty trajectories (FTs) measure changes over time.

OBJECTIVES: This study aims to examine the interaction between FI and FT to enhance risk stratification in hospitalized adults with HF.

METHODS: This retrospective cohort study utilized data from the Veterans Health Administration, including 143,687 veterans aged >50 admitted for HF from 2005 to 2019. FT measurements were derived from FI calculations for each of the 3 years before index hospitalization. Unsupervised clustering …

Double-Edged Sword: Troubleshooting "Wide-Complex Tachycardia" And "Palpitations" Caused By Gastric Neurostimulator., Tori Hensley, Ankur Shah, Jennifer J Miller, Jason R Foreman, Allen C Brown, Asim S Ahmed

Heart and Vascular Articles

No abstract provided.

Sealing The Leak: Transcatheter Repair Of Anterior Mitral Leaflet Perforation With Amplatzer Vascular Plug 4., Zeryab A Khan, Cody Carter, Jordan Luli, Nathan Marzlin, Johnathan Hatanelas, Lindsay Castle, Kevin Stiver, Laura Flannery, Steven J Yakubov, Carlos Sanchez

Heart and Vascular Articles

We document the first reported use of the Amplatzer Vascular Plug 4 for anterior mitral leaflet perforation repair in a 56-year-old male who had undergone valve-in-valve transcatheter aortic valve replacement. Previously reported cases involving the use of other occluder devices for mitral leaflet perforation repair either required guide catheter or delivery sheath exchanges, arteriovenous wire loop for deployment, or use of mitral transcatheter edge-to-edge repair for leaflet stability. Our case highlights the efficacy of the bilobar-designed Amplatzer Vascular Plug 4 for precise occlusion in anterior mitral leaflet perforation through antegrade-only delivery and safety through the simplification of procedural steps.

A Case Of A Massive Right Atrial Thrombus Removal Under Transesophageal Echocardiographic Guidance, Justin Phillips, Max Kabolowsky, Alex M. Hendon, Samantha Arzillo

HCA Healthcare Journal of Medicine

Background

With the advent of catheter guided interventions, practitioners have added another tool alongside chemical lysis and surgical removal to reduce the clot burden of patients with large emboli and thrombi. Due to comorbid conditions, many patients are poor candidates for surgical or chemical clot treatment but may present optimally for catheter-based thromboembolectomy. In this case, we highlight the benefits of mechanical thrombectomy with transesophageal echocardiographic guidance to reduce the clot burden of a patient who would otherwise be considered a poor candidate for surgical or chemical treatment.

Case Presentation

This case follows a 78-year-old man with a past medical …

Utility Of Incorporating Radiological Findings Of Right Heart Strain In Patients With Acute Pulmonary Embolism For Risk Stratification Of Adverse Outcomes: A Retrospective Analysis, Joshua Amaya, Sameer Allahabadi, Daniel L. Habenicht, John Hunton, Amal M. Khan, Subhash Venigalla, Curran Reddy, Jeremy V. Doan, Grace Wang, Daniel R. Eickenhorst, Shovendra Gautam

HCA Healthcare Journal of Medicine

Background

Right heart (RH) strain in the setting of pulmonary embolisms can significantly increase the risk of mortality. Thus, screening for risk of complications in these patients is crucial. The goal of our study was to assess the strength of specific diagnostic findings of RH strain for predicting adverse outcomes including mortality, hospital length of stay, and the requirement of advanced interventions.

Methods

A single-center, retrospective cohort study of 81 patients diagnosed with acute pulmonary embolism with RH strain on computed tomography pulmonary angiogram (CTPA) from September 12, 2019, to August 30, 2023. Data were collected on patient computed tomography …

Evaluating The Efficacy Of Htk (Histidine-Tryptophan-Ketoglutarate) And Potassium-Based Cardioplegia Solutions In Adult Cardiac Surgery: A Scoping Review Of Postoperative Outcomes, Efficiency, And Complications, Lauren Ryan

Student Works

Background/Introduction: Cardioplegia solutions are integral to myocardial protection during cardiac surgery, particularly during ischemic periods induced by cardiopulmonary bypass (CPB). Histidine-Tryptophan-Ketoglutarate (HTK) solution and potassium-based solutions such as Del Nido, St. Thomas, 4:1, and Microplegia are widely utilized for their distinct biochemical mechanisms and protective properties. Despite their widespread application, variability in clinical outcomes and procedural contexts has led to uncertainty about the optimal choice of cardioplegia solution. This scoping review aims to compare HTK and potassium-based solutions, focusing on their efficacy, postoperative outcomes, and complications in adult patients undergoing coronary artery bypass graft (CABG) and valve surgeries, including minimally …

A Deadly Case Of Encephalopathy, Brenna Ostertag, Md, Gita D Gelfer, Andrea Roast

Providence Portland Medical Center Internal Medicine 2025

Introduction: Human prion disease are heterogenous groups of neurodegenerative disorders characterized by spongiform degeneration, astrogliosis, and neuronal loss in the central nervous system from misfolding and subsequent spread of the prion protein. This disease manifests rapidly and is often accompanied by visual and speech abnormalities, gait changes, and progressive encephalopathy. It is always fatal. Around 400 people are diagnosed with prion disease in the United States annually. Recent innovations in diagnostics using Real-Time Quaking Induced Conversion (RT-QuIC) has allowed for antemortem diagnosis of prion disease. Case Presentation: A 66-year-old male with a history of alcohol use disorder in remission and …

Endocarditis Prophylaxis In Vulnerable Valve; Antibiotic Stewardship Or Suboptimal Care?, Zachary Taylor, Andrea Roast, Michael Layoun

Providence Portland Medical Center Internal Medicine 2025

Introduction Infective endocarditis (IE) is a relatively uncommon disease with an annual incidence of 5 per 100,000 people in the U.S.. Dental procedures are an exceptionally rare cause of IE. Amidst a global emphasis on antibiotic stewardship, U.S. and European guidelines only recommend antibiotic prophylaxis for dental procedures in high-risk groups. Having a bicuspid aortic valve (BAV) confers an 11-fold risk of endocarditis compared to the general public, and yet, is not classified as high-risk per AHA/IDSA guidelines. We present a patient with BAV who developed IE following a noninvasive dental procedure and review whether patients with BAV are under-classified …

Comparing The Effectiveness Of Digital 3d Pdf Vs. 3d-Printed Heart Models As Learning Aids For Echocardiography In Medical Students, Kunaal S. Sarnaik, Vishnu Ramasamy, Kelli Qua, Robert A. Jones, Susanne Wish-Baratz

Student Scholarship

Background: Reconciling echocardiographic images with heart anatomy in sonographic cross-sections is challenging. We compared use of 3D-printed heart models to 3D Portable Document Format (PDFs) heart models as learning aids in understanding echocardiography. Methods: 3D heart models were printed in five echocardiographic cross-sections: parasternal long axis, parasternal base short axis, parasternal ventricular short axis, apical four-chamber, and bicaval. Models were also reproduced as 3D PDFs on handheld tablets. Medical students were assigned to use 3D PDFs (control) or 3D-printed models (experimental) while performing transthoracic echocardiograms on standardized patients. Students were given immediate (after one session) and delayed (after four sessions …

A Rare Case Of Anomalous Left Coronary Artery From Right Cusp In A Young Athlete, Brittany Hooper, Michael J. Nolan

2025 Student Academic Showcase

This case report evaluates a 15-year-old male diagnosed with Anomalous Left Coronary Artery from Right Cusp. This rare condition often goes unnoticed until a tragic event occurs. In March 2022, a teenage athlete was completing practice when he suddenly collapsed. Fortunately, a police officer was already in the parking lot when teammates and coaches flagged them down. Emergency medical services arrived, and the athlete was transported to a nearby hospital. Despite extensive medical interventions and spending 35 days in a coma, he unfortunately succumbed to the condition. This case report aims to raise awareness of Anomalous Left Coronary Artery from …