Publications by authors named "James Yun"

Background: Limited studies are available which aim to identify patient populations that would potentially benefit from the use of cerebral embolic protection devices (CPDs) during transcatheter aortic valve replacement (TAVR). We aimed to analyze the impact of CPD use during TAVR among patients with atrial fibrillation (AF).

Methods: Data on adult TAVR patients with a concomitant diagnosis of AF was obtained from the 2017-2020 National Readmissions Database.

View Article and Find Full Text PDF

Objectives: To evaluate the performance of a commercial line immunoassay (LIA) in cohorts of healthy controls (HC), disease controls (DC), and patients with idiopathic inflammatory myopathies (IIMs), and investigate whether different cut-offs would enhance the accuracy of myositis antibodies (MAs) by LIA.

Methods: Sera from patients with positive MAs (n = 118), DC (n = 124) and HC (n = 60), were analysed for MAs using EUROLINE Myopathies 16 Ag LIA (EUROIMMUN).

Results: The newly established MAs cut-offs resulted in significantly lower both false-positive and multiple positive rates compared with the manufacturer's single cut-off, from 36.

View Article and Find Full Text PDF

This study sought to explore the clinical factors associated with classical low-flow low-gradient (C-LFLG) and normal-flow low-gradient (NFLG) aortic stenosis (AS) compared with high-gradient (HG) AS. We also compared clinical and echocardiographic outcomes after transcatheter aortic valve replacement (TAVR) across flow-gradient patterns. Patients with C-LFLG AS have a higher mortality rate after TAVR than those with HG AS.

View Article and Find Full Text PDF

Background: Data supporting the use of transcatheter aortic valve replacement (TAVR) for bicuspid aortic valve (BAV) is limited compared to tricuspid aortic valve (TAV) anatomy, as the BAV anatomy poses unique challenges to prosthesis expansion and symmetric deployment.

Aims: We aim to compare the acute recoil and asymmetry of the SAPIEN-3 valve between BAV and TAV anatomies and their impact on procedural outcomes.

Methods: We conducted a single-center study of patients who underwent TAVR with the SAPIEN-3 valve.

View Article and Find Full Text PDF
Article Synopsis
  • There is increasing use of veno-arterial extracorporeal membrane oxygenation (VA ECMO) during lung transplants, but protocols and outcomes are not yet standardized.
  • The article discusses the rationale behind using VA ECMO, its protocols, applications, and overall impact on patient outcomes during lung transplantation.
  • Evidence indicates that routine use of VA ECMO can reduce complications and improve early outcomes by enabling controlled reperfusion and preventing hemodynamic crises, but more research is needed for consensus on its best application.
View Article and Find Full Text PDF
Article Synopsis
  • Novel transcatheter therapies for tricuspid regurgitation (TR) show promise, but their suitability for the general TR patient population is still uncertain.
  • In a study involving 178 patients with moderate symptomatic TR, only 10.7% qualified for investigative therapies, while many received off-label clipping, surgery, or medical treatment due to factors like unsuitable anatomy or existing health issues.
  • Although the investigative group experienced significant improvement in TR severity after one year compared to the medical treatment group, their outcomes were similar to off-label clipping but not as favorable as surgery, highlighting the need for broader access to effective therapies for TR patients.
View Article and Find Full Text PDF

Valve-in-mitral annular calcification presents a great challenge with a risk of left ventricular outflow tract obstruction (LVOTO). We demonstrate the first-in-human experience of performing percutaneous electrosurgery-guided perforation and balloon dilation of the anterior mitral valve leaflet followed by transcatheter valve implantation to prevent LVOTO.

View Article and Find Full Text PDF

Background: Subcutaneous immunoglobulin (SCIg) therapy is important in the treatment of primary (PID) and secondary immunodeficiencies (SID) and chronic inflammatory demyelinating polyneuropathy (CIDP). Patient support programmes (PSPs) help patients self-administer medication regimens and play a more active role in the self-management of their medical conditions.

Aim: To describe the effectiveness of the CSL Behring CARES PSP in optimising the quality use of SCIg in a hospital-free environment.

View Article and Find Full Text PDF

Background: Single lung transplantation (SLT) has been shown to be associated with worse long-term outcomes than bilateral lung transplantation (BLT), but often is performed in older adults at risk of not tolerating BLT.

Research Question: How do the outcomes of SLT and BLT compare among older adult recipients?

Study Design And Methods: The Scientific Registry of Transplant Recipients database (2005-2022) was queried for lung transplant recipients aged 65 years older. Patients were stratified by whether they underwent BLT or SLT and were propensity matched.

View Article and Find Full Text PDF

Background: Severe cutaneous adverse reactions (SCAR) are a group of delayed presumed T-cell mediated hypersensitivities associated with significant morbidity and mortality. Despite their shared global healthcare burden and impact, the clinical phenotypes, genomic predisposition, drug causality, and treatment outcomes may vary. We describe the establishment and results from the first Australasian registry for SCAR (AUS-SCAR), that via a collaborative network advances strategies for the prevention, diagnosis and treatment of SCAR.

View Article and Find Full Text PDF
Article Synopsis
  • Skeletal muscle mass (SMM) is important for assessing risks in candidates for transcatheter aortic valve replacement (TAVR), but it's often overlooked compared to traditional measures like weakness or performance.
  • A study evaluated three risk models that combined SMM data with frailty assessments to predict complications, rehospitalization, or mortality after TAVR in a cohort of 184 patients.
  • Results showed that patients with sarcopenia and those identified as frail had significantly higher rates of adverse outcomes, and incorporating CT-based SMM into frailty assessments improved predictive accuracy for these risks.
View Article and Find Full Text PDF
Article Synopsis
  • * The V-Wave interatrial shunt system is being studied as a potential solution; it aims to improve heart function by shunting blood between the atria, thereby reducing pressure in the left atrium.
  • * The V-Wave Shunt MitraClip Study is assessing the safety and efficacy of implanting this shunt during the MitraClip surgery, with results expected in late 2024 after following participants for up to 5 years.
View Article and Find Full Text PDF

Background: Real-time lung weight (LW) measurement is a simple and noninvasive technique for detecting extravascular lung water during ex vivo lung perfusion (EVLP). We investigated the feasibility of real-time LW measurement in clinical EVLP as a predictor of transplant suitability and post-transplant outcomes.

Methods: In our clinical acellular EVLP protocol, real-time LW was measured in 117 EVLP cases from June 2019 to June 2022.

View Article and Find Full Text PDF

Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome belong to a family of severe cutaneous adverse reactions that can be life-threatening and carry a risk of significant morbidity and potential mortality in the event of re-exposure. Lifelong avoidance of the culprit agent is mandated, which can lead to the exclusion of multiple medications if the trigger is unclear. This can result in adverse health outcomes analogous to that of a penicillin allergy label.

View Article and Find Full Text PDF

Background: The aims of this study were to understand the incidence and outcomes of patients with cardiogenic shock (CS) due to severe aortic stenosis (AS), and the impact of conventional treatment strategies in this population.

Methods And Results: All patients admitted to the Cleveland Clinic cardiac intensive care unit between January 1, 2010 and December 31, 2021 with CS were retrospectively identified and categorized into those with CS in the setting of severe AS versus CS without AS. The impact of various treatment strategies on mortality was further assessed.

View Article and Find Full Text PDF

Background: Candidates for transcatheter aortic valve replacement (TAVR) occasionally have a "borderline-size" aortic annulus between 2 transcatheter heart valve sizes, based on the manufacturer's sizing chart. Data on TAVR outcomes in such patients are limited.

Methods: We retrospectively reviewed 1816 patients who underwent transfemoral-TAVR with balloon-expandable valve (BEV) at our institution between 2016 and 2020.

View Article and Find Full Text PDF
Article Synopsis
  • Low muscle mass (LMM) is linked to poorer outcomes for patients undergoing transcatheter aortic valve replacement (TAVR), particularly when assessed through advanced imaging technology.
  • In a study involving 238 TAVR recipients, 33.6% exhibited LMM, characterized by lower body mass index and grip strength, along with other health markers.
  • Patients with LMM experienced higher rates of complications and 2-year mortality, suggesting the potential of using muscle mass assessment from CT scans for better preoperative risk evaluation.
View Article and Find Full Text PDF
Article Synopsis
  • Transcatheter aortic valve replacement (TAVR) is rarely performed in patients with congenital heart disease.* -
  • Our study shows that TAVR can be safely and effectively used in these patients in the short term.* -
  • TAVR may play an important role in managing congenital aortic valve disease throughout a patient's life, serving as a temporary solution before recovery, future surgeries, or transplants.*
View Article and Find Full Text PDF
Article Synopsis
  • The study investigates how untreated chronic obstructive coronary artery disease (CAD) affects outcomes in patients undergoing transcatheter aortic valve replacement (TAVR).
  • Researchers analyzed a cohort of 1,911 TAVR patients from 2015 to 2021, categorizing them by CAD severity and assessing complications and long-term outcomes.
  • Results show that TAVR can be performed safely even in patients with untreated chronic obstructive CAD, with low procedural mortality and complication rates, and no significant increase in long-term mortality or major cardiovascular events based on CAD severity.
View Article and Find Full Text PDF

Aims: Conduction abnormalities necessitating permanent pacemaker (PPM) implantation remain the most frequent complication post-transcatheter aortic valve implantation (TAVI), yet reliance on PPM function varies. We evaluated the association of right-ventricular (RV)-stimulation rate post-TAVI with 1-year major adverse cardiovascular events (MACE) (all-cause mortality and heart failure hospitalization).

Methods And Results: This retrospective cohort study of patients undergoing TAVI in two high-volume centers included patients with existing PPM pre-TAVI or new PPM post-TAVI.

View Article and Find Full Text PDF

A PHP Error was encountered

Severity: Warning

Message: fopen(/var/lib/php/sessions/ci_session4v1h5g90kdharj9vbs4ch3udold9gdai): Failed to open stream: No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 177

Backtrace:

File: /var/www/html/index.php
Line: 316
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: session_start(): Failed to read session data: user (path: /var/lib/php/sessions)

Filename: Session/Session.php

Line Number: 137

Backtrace:

File: /var/www/html/index.php
Line: 316
Function: require_once