Surgical Aortic Valve Replacement to Treat Prosthetic Valve Endocarditis After Valve-in-Valve Transcatheter Aortic Valve Replacement.

Prosthetic valve endocarditis (PVE) is an uncommon complication after heart valve replacement surgery that can result in increased morbidity and mortality. Current guidelines for management of PVE recommend antibiotic therapy followed by surgical valve replacement. The number of aortic valve replacements is expected to rise in the coming years with the expanded indications for use of transcatheter aortic valve replacement (TAVR) in patients with low, intermediate, and high surgical risk, as well as in patients with a failed aortic bioprosthetic valve.

SARS-COV-ATE risk assessment model for arterial thromboembolism in COVID-19.

Patients with SARS-CoV-2 infection are at an increased risk of cardiovascular and thrombotic complications conferring an extremely poor prognosis. COVID-19 infection is known to be an independent risk factor for acute ischemic stroke and myocardial infarction (MI). We developed a risk assessment model (RAM) to stratify hospitalized COVID-19 patients for arterial thromboembolism (ATE).

3D-PAST: Risk Assessment Model for Predicting Venous Thromboembolism in COVID-19.

Hypercoagulability is a recognized feature in SARS-CoV-2 infection. There exists a need for a dedicated risk assessment model (RAM) that can risk-stratify hospitalized COVID-19 patients for venous thromboembolism (VTE) and guide anticoagulation. We aimed to build a simple clinical model to predict VTE in COVID-19 patients.

Venous thromboembolism in COVID-19 patients and prediction model: a multicenter cohort study.

Background: Patients with COVID-19 infection are commonly reported to have an increased risk of venous thrombosis. The choice of anti-thrombotic agents and doses are currently being studied in randomized controlled trials and retrospective studies. There exists a need for individualized risk stratification of venous thromboembolism (VTE) to assist clinicians in decision-making on anticoagulation.

Data of atrial arrhythmias in hospitalized COVID-19 and influenza patients.

Atrial arrhythmias (AA) are common in hospitalized COVID-19 patients with limited data on their association with COVID-19 infection, clinical and imaging outcomes. In the related research article using retrospective research data from one quaternary care and five community hospitals, patients aged 18 years and above with positive SARS-CoV-2 polymerase chain reaction test were included. 6927 patients met the inclusion criteria.

Incidence, Mortality, and Imaging Outcomes of Atrial Arrhythmias in COVID-19.

Atrial arrhythmias (AAs) are common in hospitalized patients with COVID-19; however, it remains uncertain if AAs are a poor prognostic factor in SARS-CoV-2 infection. In this retrospective cohort study from 2014 to 2021, we report in-hospital mortality in patients with new-onset AA and history of AA. The incidence of new-onset congestive heart failure (CHF), hospital length of stay and readmission rate, intensive care unit admission, arterial and venous thromboembolism, and imaging outcomes were also analyzed.

A case report of successful intravascular shockwave lithotripsy and directional venous atherectomy of extensive chronic femoral deep venous thrombosis.

Background: Conventional treatment for chronic deep venous thrombosis (DVT) is anticoagulation. However, limited interventional endovascular options exist for patients with non-healing venous ulcers secondary to chronic DVT.

Case Summary: We present a case of 67-year-old man with severely symptomatic post-thrombotic syndrome (PTS) with persistent high-grade femoral DVT despite prior compressive therapy and chronic oral anticoagulation.

Impella-Assisted Intracoronary Lithotripsy of Severely Calcified Left Main Coronary Artery Bifurcation for NSTEMI With Cardiogenic Shock.

High calcification of coronary artery plaque is a frequent cause of suboptimal stent expansion, which can result in stent thrombosis and restenosis. Shockwave intravascular lithotripsy (S-IVL) represents a new frontier in the treatment of highly calcified coronary lesions. It can be an excellent alternative to intracoronary atherectomy in extremely high-risk lesions.

A Single Coronary Artery Anomaly: Right Coronary Artery as a Branch From the Left Anterior Descending Artery.

An anomalous origin of the right coronary artery (RCA) from the left anterior descending artery (LAD), also known as a single coronary artery, is an extremely rare finding in clinical practice. It is usually a benign anomaly; however, symptoms are highly dependent on the course that the anomalous RCA takes after branching off of the LAD. We present a case of a patient who had decompensated heart failure and was detected to have a single coronary artery.

Periprocedural and long-term outcomes of endovascular abdominal aortic aneurysm repair in cardiology practice.

Background: Endovascular repair of abdominal aortic aneurysm (AAA) has recently been made a class I indication in the treatment of AAA. In comparison to the conventional open surgical treatment, endovascular AAA repair (EVAR) is associated with equivalent long-term morbidity and mortality rates. Vascular surgeons perform majority of EVAR.

Decreased readmissions and improved quality of care with the use of an inexpensive checklist in heart failure.

Providing effective discharge instructions, appropriate dose uptitration, education regarding heart failure (HF) monitoring, and strict follow-up have all been shown to decrease readmissions for HF but are all underutilized. The authors developed and evaluated the impact of a quality-improvement HF checklist as a tool to remind physicians to improve quality of care in HF patients. The checklist was used in randomly selected patients admitted with a primary diagnosis of acute decompensated HF.

No Racial Disparities in the Treatment of ST Elevation Myocardial Infarction - A Community-based Experience.

Whether racial disparities exist in the treatment of ST elevation myocardial infarction (STEMI) is not exactly known. We report a retrospective chart review of patients with first event of STEMI, in two groups separated by one decade. Results revealed that hospital mortality in the 2007 and 1997 groups for African Americans versus Caucasians was one of 22 versus 21 of 170, 95 % confidence interval (CI) -0.

Minimally invasive retrieval of patent foramen ovale closure device after device migration to the descending aorta.

Percutaneous treatment of patent foramen ovale with a septal closure device has become a common procedure, but it is associated with various complications. Migration of the device is uncommon, and migration through the aortic valve into the aorta is rare. Managing the migration of a patent foramen ovale occluder can be challenging; it usually requires surgical retrieval of the foreign body.

High prevalence of obesity in young patients with ST elevation myocardial infarction.

Background: There is growing concern about increasing rates of obesity in young people, and increasing ST elevation myocardial infarction (STEMI) at a younger age. There are only a few studies performed to study the risk factors in STEMI among young populations.

Methods: Retrospective chart reviews on all first event STEMI patients between December 2005 and July 2007 were performed.

Endovascular abdominal aortic aneurysm repair by interventional cardiologists--a community-based experience.

Introduction: Endovascular repair of abdominal aortic aneurysm (AAA) is a relatively recent technology. In comparison to the conventional open surgical treatment for AAA, endovascular AAA repair (EVAR) combines a less-invasive approach with lower morbidity and mortality. There have been few studies regarding the performance of this procedure in a community-based setting.

Moxifloxacin-induced QT prolongation and torsades: an uncommon effect of a common drug.

Torsade de pointes (TdP) or "twisting of the points" represents polymorphic ventricular tachycardia in the setting of prolonged QT interval and is characterized by QRS complexes that change in morphology and amplitude. We report a rare case of TdP, associated with QT interval prolongation, caused by intravenous moxifloxacin given for pneumonia in a 71-year-old African American man. Electrocardiogram initially revealed QT interval prolongation that led to torsades de pointes.

Documented traditional cardiovascular risk factors and mortality in non-ST-segment elevation myocardial infarction.

Background: Although documented traditional cardiovascular risk factors (hypertension, diabetes, smoking, and dyslipidemia) increase the risk of developing coronary artery disease, their influence on the treatments and outcomes of patients with non-ST-segment elevation myocardial infarction (NSTEMI) has not been fully elucidated.

Methods: Using data from the CRUSADE Quality Improvement Initiative, we sought to characterize the effect that the absence of documented traditional risk factors has on inhospital treatments and outcomes in a population of patients with NSTEMI treated in routine practice. We compared clinical characteristics and inhospital outcomes according to the presence and number of risk factors in 74,220 patients with NSTEMI (defined as creatine kinase-MB and/or troponin I/T values above the local upper limit of normal) treated in 476 US hospitals from January 2001 through March 2004.

Impact of on-site cardiac catheterization on resource utilization and fatal and non-fatal outcomes after acute myocardial infarction.

Background: Patterns of care for acute myocardial infarction (AMI) strongly depend on the availability of on-site cardiac catheterization facilities. Although the management found at hospitals without on-site catheterization does not lead to increased mortality, little it known about its impact on resource utilization and non-fatal outcomes.

Methods: We identified all patients (n = 35,289) admitted with a first AMI in the province of Quebec between January 1, 1996 and March 31, 1999 using population-based administrative databases.

Impact of internal mammary artery conduit on long-term outcomes after percutaneous intervention of saphenous vein graft.

Background: The influence of an internal mammary artery (IMA) graft on long-term outcomes after percutaneous saphenous vein graft (SVG) intervention is currently unknown.

Methods And Results: To examine the impact of IMA on outcomes in patients undergoing SVG interventions, we analyzed 2119 patients from the Duke Cardiovascular Disease Database (1986-2003) with prior coronary artery bypass surgery undergoing cardiac catheterization who had at least 1 SVG graft. Patients were categorized into 4 groups: group I, SVG intervention and patent IMA; group II, no SVG intervention and patent IMA; group III, SVG intervention without patent IMA; and group IV, no SVG intervention without patent IMA.

Relation of early saphenous vein graft failure to outcomes following coronary artery bypass surgery.

Up to 20% of saphenous vein grafts (SVGs) fail within 2 years of coronary artery bypass grafting (CABG). The long-term effects of early SVG failure on major clinical events remain undefined in contemporary patient populations. We sought to examine the relation between early SVG failure and long-term outcomes after CABG.

Platelet inhibitor therapy for patients with cardiovascular disease: looking toward the future.

Understanding platelet function and the role of platelets in the response to vascular injury has led to the development of novel platelet-inhibiting therapies that have been proven effective in the treatment of acute and chronic vascular disease. Antiplatelet therapies are cornerstone treatments for patients with acute coronary syndromes and have been essential in reducing the acute and subacute ischemic complications of percutaneous coronary intervention. Furthermore, an increased understanding of the pathobiology behind the platelet's role in atherothrombosis has offered up many new avenues of research and many new targets for therapeutic drug development.