Publications by authors named "Kimberly Guibone"
Shared decision-making (SDM) and multidisciplinary team-based care delivery are recommended across several cardiology clinical practice guidelines. However, evidence for benefit and guidance on implementation are limited. Informed consent, the use of patient decision aids, or the documentation of these elements for governmental or societal agencies may be conflated as SDM.
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- Mitral regurgitation is a common heart valve issue affecting over 5 million Americans, with a focus on real-world data collection for regulatory and clinical purposes.
- The study aimed to create a standard set of essential data elements for mitral interventions, going through 703 options and reaching consensus on 127 core elements for effective data use.
- This core data set will enhance the national registry for transcatheter mitral devices, supporting safety monitoring, regulatory submissions, and improving hospital care quality.
The COVID19 pandemic brought unprecedented disruption to healthcare. Staggering morbidity, mortality, and economic losses prompted the review and refinement of care for structural heart disease (SHD). To mitigate negative impacts in the face of crisis or capacity constraints, this paper offers best practice recommendations for Planning Efficient and Resource Leveraging Systems (PEARLS) in structural heart programs.
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- TAVR is recognized as the standard treatment for severe aortic stenosis, making real-world data collection critical for assessing its benefits and risks across various health organizations, like the FDA and Medicare.
- A systematic review of existing TAVR research was conducted to identify essential data elements necessary for efficient data collection, resulting in the consensus on 132 core elements from an original pool of 276.
- The established core dataset aims to streamline evidence gathering for TAVR, enhancing regulatory submissions, safety monitoring, and evaluations of best practices in healthcare institutions.
Article Synopsis
- Transcatheter aortic valve replacement (TAVR) is the main treatment option for patients with severe aortic stenosis, and real-world data collection is crucial for evaluating its benefits and risks.
- A systematic review was conducted to identify essential data elements needed for effective data collection related to TAVR, involving key organizations and experts.
- The final consensus identified 132 core data elements, focusing on efficient, reusable data for regulatory, safety, and quality assessments while considering the practical challenges of data collection.
Background: We sought to compare characteristics and outcomes of structural heart disease (SHD) patients treated during the regional peak of the Coronavirus Disease 2019 (COVID-19) pandemic ("COVID era") compared with historical controls. During the COVID era, elective SHD procedures at Beth Israel Deaconess Medical Center were canceled but urgent cases were still performed. We enacted several practice changes in an effort to minimize complications, prevent COVID transmission, and decrease hospital stay during the pandemic.
View Article and Find Full Text PDFBackground: Delirium is a major risk factor for poor recovery after surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). It is unclear whether preoperative physical performance tests improve delirium prediction.
Objective: To examine whether physical performance tests can predict delirium after SAVR and TAVR, and adapt an existing delirium prediction rule for cardiac surgery, which includes Mini-Mental State Examination (MMSE), depression, prior stroke, and albumin level.
Background: Cognitive impairment and frailty are highly prevalent in older adults undergoing transcatheter aortic valve replacement. This study aimed to investigate the relationship of cognitive impairment and frailty with functional recovery after transcatheter aortic valve replacement.
Methods: This was a single-center prospective cohort study of 142 patients who were ≥70 years old and underwent transcatheter aortic valve replacement for aortic stenosis.
Background: Current guidelines recommend considering life expectancy before aortic valve replacement (AVR). We compared the performance of a general mortality index, the Lee index, to a frailty index.
Methods: We conducted a prospective cohort study of 246 older adults undergoing surgical (SAVR) or transcatheter aortic valve replacement (TAVR) at a single academic medical center.
Background: The role of basal septal hypertrophy (BSH) on preprocedural transthoracic echocardiography in transcatheter aortic valve replacement (TAVR) is unknown.
Methods: Medical charts and preprocedural transthoracic echocardiograms of 378 patients who underwent TAVR were examined. The association between BSH and the primary composite outcome of valve pop-out, recapture, embolization, aborted procedure, conversion to open procedure, new conduction disturbance, or need for permanent pacemaker ≤30 days after TAVR was evaluated.
Objectives: Despite evidence, frailty is not routinely assessed before cardiac surgery. We compared five brief frailty tests for predicting poor outcomes after aortic valve replacement and evaluated a strategy of performing comprehensive geriatric assessment (CGA) in screen-positive patients.
Design: Prospective cohort study.
Background: Transcatheter aortic valve replacement (TAVR) may be associated with less delirium and allow faster recovery than surgical aortic valve replacement (SAVR).
Objective: To examine the association of delirium and its severity with clinical and functional outcomes after SAVR and TAVR.
Design: Prospective cohort study.
Importance: Functional status is a patient-centered outcome that is important for a meaningful gain in health-related quality of life after aortic valve replacement.
Objective: To determine functional status trajectories in the year after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR).
Design, Setting, And Participants: A prospective cohort study with a 12-month follow-up was conducted at a single academic center in 246 patients undergoing TAVR or SAVR for severe aortic stenosis.