Publications by authors named "Dee Dee Wang"
Background: Protruding coronary artery stents can adversely affect transcatheter aortic valve replacement (TAVR) procedure. Current evidence on the topic is limited.
Aims: We aim to study the clinical feasibility and safety of flaring of protruding coronary artery stents before TAVR to reduce interaction with transcatheter heart valves.
Subaortic Membrane and Cardiac Catheterization-Beware of Diagnostic Pitfall.
J Soc Cardiovasc Angiogr Interv
November 2024
Article Synopsis
- Tricuspid regurgitation (TR) is a serious condition linked to long-term health issues, including severe right heart failure, but newer less invasive treatments like transcatheter valve interventions (TTVI) are gaining attention.
- A study analyzing over 98,000 tricuspid valve procedures from 2011 to 2020 revealed trends in intervention types, showing a rise in TTVI and a decline in traditional surgical options.
- Findings indicate demographic factors like age and race affect procedure choice and outcomes, with surgical interventions showing higher mortality rates; further research is needed to understand the causes of these evolving trends in treatment results.
Article Synopsis
- Mechanical circulatory support for patients with cardiogenic shock due to valvular heart disease is complicated, but the emerging LAVA-ECMO technique offers a solution by providing circulatory support and ventricular unloading.
- A case study describes a patient with severe heart issues who successfully underwent dual-aortic and mitral valve replacement using LAVA-ECMO.
- Careful planning and operator awareness of the ECMO circuit's management are crucial for avoiding complications during these high-risk procedures.*
Article Synopsis
- - Transcatheter aortic valve replacement (TAVR) is becoming a popular option for low-risk patients, serving as an alternative to traditional surgical valve replacement.
- - The paper reviews scientific evidence, including observational and clinical trial data, focusing on low-risk patients who often have specific conditions like a bicuspid aortic valve.
- - It emphasizes the importance of a multidisciplinary heart team and introduces the concept of 'minimalist TAVR' as a new approach in treating low-risk patients.
Background: There is no clear consensus regarding the optimal risk stratification of high-degree atrioventricular block (HDAVB) after transcatheter aortic valve replacement (TAVR).
Methods: This prospective study sought to determine the utility of the pre- and post-TAVR His-ventricular (HV) interval in the risk stratification of post-TAVR HDAVB. One hundred twenty-one patients underwent an electrophysiology study before and after TAVR.
ECG-gated CT improves diagnosis in prosthetic valve degeneration.
Eur Heart J Imaging Methods Pract
January 2024
Article Synopsis
- TAVR (transcatheter aortic valve replacement) offers treatment for severely ill patients, but outcomes for those with cardiogenic shock (CS) are not well understood.
- A meta-analysis of five studies showed that 30-day mortality and major vascular complications were significantly higher in patients with CS compared to those without, but there were no significant differences in longer-term outcomes at one year.
- The study suggests that while short-term risks are elevated for TAVR patients with CS, their long-term prognosis may be similar to those without CS; further research is needed to explore the timing and management strategies of TAVR for this group.
3-Year Outcomes of Balloon-Expandable Valves: 20-mm vs Larger Valves (≥23 mm).
JACC Cardiovasc Interv
September 2024
Background: A prior Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry-based analysis reported similar 1-year clinical outcomes with small (20-mm) vs large (≥23-mm) balloon-expandable valves (BEV).
Objectives: The aim of this study was to describe mid-term 3-year clinical outcomes for small vs large BEV and the relationship between discharge echocardiographic mean gradient (MG) and different definitions of prothesis-patient mismatch (PPM) with clinical outcomes.
Methods: Using the TVT Registry with Centers for Medicare and Medicaid Services linkage, a propensity-matched analysis of patients receiving 20- vs ≥23-mm BEVs was performed.
Article Synopsis
- Left atrial appendage occlusion (LAAO) is becoming an important method for preventing strokes in patients with atrial fibrillation, with cardiac imaging being crucial for planning and follow-up.
- Recent advancements in cardiac computed tomography (CCT) have made it a preferred option over transesophageal echocardiography for assessing LAAO procedures, particularly in identifying device-related complications.
- This paper aims to standardize how to acquire and interpret CCT images after LAAO, addressing current inconsistencies and providing guidance based on expert consensus from specialists in Europe and North America.
Background: Post-transcatheter aortic valve replacement (TAVR), paravalvular leak (PVL) is a quality metric associated with worse clinical outcomes. Transcatheter heart valve (THV) sizing is based primarily on the systolic annular size without regard to the left ventricular outflow tract (LVOT), which also lies within the THV landing zone. We hypothesized that LVOT size relative to the annulus is associated with post-TAVR PVL.
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- Women in cardiology face big inequalities in getting published, which makes it harder for them to move up in their careers.
- A study looked at almost 18,000 papers from major heart magazines over 10 years and found only 20.6% of authors were women.
- The number of women authors barely changed during that time, and more action is needed to help women in cardiology have equal chances.
Introduction: Patients with a small aortic annulus (SAA) undergoing aortic valve replacement are at increased risk of patient-prosthesis mismatch (PPM), which adversely affects outcomes. Transcatheter aortic valve replacement (TAVR) has shown promise in mitigating PPM compared to surgical aortic valve replacement (SAVR).
Methods: We conducted a systematic review and meta-analysis following PRISMA guidelines to compare clinical outcomes, mortality, and PPM between SAA patients undergoing TAVR and SAVR.
Up to 20 % of patients presenting with acute heart failure and cardiogenic shock have a structural etiology. Despite efforts in timely management, mortality rates remain alarmingly high, ranging from 50 % to 80 %. Surgical intervention is often the definitive treatment for structural heart disease; however, many patients are considered high risk or unsuitable candidates for such procedures.
View Article and Find Full Text PDFBackground: Aortic valve lithotripsy can fragment aortic valve calcium deposits and potentially restore leaflet pliability in animal model and ex-vivo, but clinical data is limited. Transcatheter aortic valve implantation (TAVR) might not be feasible as an urgent procedure in critically ill patients. Balloon valvuloplasty has the major limitation of valve recoil and inducing aortic regurgitation.
View Article and Find Full Text PDFBackground: The clinical efficacy and safety of alcohol septal ablation (ASA) for obstructive hypertrophic cardiomyopathy (HCM) have been well-established; however, less is known about outcomes in patients undergoing preemptive ASA before transcatheter mitral valve replacement (TMVR).
Aims: The goal of this study is to characterize the procedural characteristics and examine the clinical outcomes of ASA in both HCM and pre-TMVR.
Methods: This retrospective study compared procedural characteristics and outcomes in patient who underwent ASA for HCM and TMVR.
Structural heart disease interventions rely heavily on preprocedural planning and simulation to improve procedural outcomes and predict and prevent potential procedural complications. Modeling technologies, namely 3-dimensional (3D) printing and computational modeling, are nowadays increasingly used to predict the interaction between cardiac anatomy and implantable devices. Such models play a role in patient education, operator training, procedural simulation, and appropriate device selection.
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