Publications by authors named "Lucas Burke"

Background: Despite advancements in critical care and coronary revascularization, cardiogenic shock (CS) outcomes remain poor. Implementing a shock team and use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) have been associated with improved CS outcomes, but its feasibility in remote and rural areas remains unknown.

Methods: This retrospective study included patients with CS who required mechanical circulatory support (MCS) at Health Sciences North, Sudbury, Ontario.

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  • Background: Permanent pacemaker (PPM) implantation is a frequent issue after transcatheter aortic valve replacement (TAVR) with self-expanding valves, prompting a comparison of two implantation techniques to assess their impact on PPM rates.
  • Aims: The study aimed to compare the rates of new PPM implantation and complete heart block in patients undergoing TAVR with self-expanding valves using either the conventional three-cusp technique or the cusp-overlap technique.
  • Results: The cusp-overlap technique significantly reduced in-hospital and 30-day rates of new complete heart block (9.4% vs. 23.4%) and PPM implantation (8% vs. 21%) compared to the standard
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  • Optical coherence tomography (OCT) is a technique used to image coronary vessels, which is complicated by challenges in image interpretation for beginners, highlighting a lack of formal training.
  • A study compared two educational approaches: a Standard curriculum (self-directed learning) vs. an Augmented curriculum (which included real-time feedback), aiming to enhance the understanding of OCT for novice readers.
  • Results showed that participants in the Augmented curriculum had significantly improved technical knowledge and were better at identifying key features of coronary vessels compared to those who completed the Standard curriculum.
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Concomitant tricuspid regurgitation (TR) is common in patients with mitral regurgitation (MR). While current guidelines recommend repair of both valves at the time of surgery when feasible, high risk patients are often undertreated, leading to significant morbidity and mortality. With advances in transcatheter edge-to-edge repair (TEER) devices and technique, combined TEER for treating significant MR and TR has emerged as a new tool for heart failure management.

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Purpose Of Review: Coronary artery calcification (CAC) predisposes to suboptimal revascularization outcomes after percutaneous coronary intervention (PCI). Despite the availability of several plaque modification devices, their rates of use remain low despite the prevalence of CAC encountered in clinical practice. It is important to understand how each device can be utilized in clinical practice in order to improve outcomes after PCI.

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Coronary artery bypass grafting improves survival in patients with ischemic cardiomyopathy, however, these patients are at high risk for morbidity and mortality. The role of viability testing to guide revascularization in these patients is unclear. Cardiac magnetic resonance imaging (CMR) has not been studied adequately in this population despite being considered a reference standard for infarct imaging.

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Objective: To compare patient-level risk assessment at Veterans Affairs (VA) hospitals in patients undergoing transcatheter aortic valve replacement (TAVR) with patients included in the Society for Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) registry.

Methods: We retrospectively analyzed the outcomes of veterans with severe aortic stenosis (AS) receiving TAVR from 2012-2016 at eight VA hospitals and compared them with TVT registry outcomes from 2012-2015. Patients were identified via administrative data.

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Objectives: This study sought to describe clinical and procedural characteristics of veterans undergoing transcatheter aortic valve replacement (TAVR) within U.S. Department of Veterans Affairs (VA) centers and to examine their association with short- and long-term mortality, length of stay (LOS), and rehospitalization within 30 days.

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Objectives: We sought to compare outcomes with radial vs femoral approach in female patients undergoing coronary angiography.

Background: Women undergoing cardiac procedures have increased risk of bleeding and vascular complications, but are under-represented in randomized clinical trials (RCTs) involving coronary angiography.

Methods: We performed a meta-analysis of RCTs comparing outcomes in women undergoing angiography with radial vs femoral approaches.

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Background: Cardiac troponin elevation is associated with mortality. We compared the mortality risk related to elevated troponin from acute coronary syndrome (ACS) and non-ACS causes in a hospitalized elderly veteran population.

Methods And Results: As part of a quality initiative at our Veterans Affairs hospital, all patients with elevated troponin were evaluated by a cardiologist to determine if ACS was present and to recommend management.

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Background: Cardiac troponin assays have improved the ability to detect myocardial damage. However, ascertaining whether troponin elevation is due to myocardial infarction (MI) or secondary to another process can be challenging. Our aim is to evaluate provider-level variation in the diagnosis of MI and the use of invasive coronary angiography (ICA) among patients with undifferentiated elevations in cardiac troponin.

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Introduction: The utilization of esophagogastroduodenoscopy (EGD) and related procedures continues to rise. Due to this increase in utilization is an inevitable rise in serious complications such as hemorrhage and perforation. One understudied and dreaded complication of EGD causing significant morbidity and mortality is duodenal perforation.

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