Publications by authors named "Marc Moon"
Objectives: Although socioeconomic status (SES) is believed to affect patient outcomes after coronary artery bypass grafting (CABG), readmission data are sparse. In a national cohort, we analyzed the influence of SES on readmission, resource utilization, and mortality after CABG.
Methods: We queried the Nationwide Readmissions Database to identify patients who underwent isolated CABG from January 2016 through December 2018.
Background: Rising rates of substance use (SU) have resulted in an increasing need for left-sided valve surgery for SU-associated infective endocarditis (SU-IE). We compared outcomes, readmissions, and costs between IE patients with and without SU-IE in a national cohort.
Methods: Using the Nationwide Readmissions Database (2016-2018), we identified 10,098 patients with infective endocarditis (IE) who underwent isolated aortic or mitral valve replacement.
Background: We have developed a model aimed at identifying preoperative predictors of operative mortality in patients who undergo elective, open thoracoabdominal aortic aneurysm (TAAA) repair. We converted this model into an intuitive nomogram to aid preoperative counseling.
Methods: We retrospectively analyzed data from 2884 elective, open TAAA repairs performed between 1986 and 2023 in a single practice.
Objective: We examined the effect of frailty on in-hospital mortality, readmission rates, and hospitalization costs after transcatheter and surgical aortic valve replacement in a population-level cohort.
Methods: The Nationwide Readmissions Database was queried for patients who underwent transcatheter or surgical aortic valve replacement during 2016-2018. Multivariate logistic regression was used to discern independent effects of frailty on outcomes.
Article Synopsis
- Recent advancements in transcatheter technologies have led to updated guidelines, increasing treatment options for aortic stenosis.
- New "rapid deployment" or "sutureless valves" have been developed to simplify valve implantation and reduce surgery time by eliminating the need for sutures.
- The effectiveness of these sutureless valves compared to traditional surgical methods and TAVR is still under discussion, with the review focusing on existing evidence and outcomes for each method.
Background: We determined the safety of early discharge after coronary artery bypass grafting (CABG) in patients with uncomplicated postoperative courses and compared outcomes with routine discharge in a national cohort. We identified preoperative factors associated with readmission after early discharge after CABG.
Methods: The Nationwide Readmissions Database was queried to identify patients undergoing CABG from January 2016 to December 2018.
Background: Operative blood loss is associated with postoperative morbidity and mortality in surgery. Hemostatic agents are used as adjuncts for hemostasis during surgery and help to prevent postoperative bleeding. We evaluated the safety and efficacy of an investigational polysaccharide hemostatic (PH) topical product compared to a U.
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- Aortic dissection is a common issue during surgeries for thoracoabdominal aortic aneurysms (TAAAs), often chronic and linked to aortic dilation; this study aimed to compare patient outcomes between those with chronic dissection and those with non-dissection aneurysms.
- Researchers analyzed data from 3,470 TAAA surgeries and found that patients with chronic dissection were generally younger, had fewer heart disease risk factors, and experienced lower operative mortality (7.1%) compared to non-dissection patients (9.2%).
- Chronic dissection was not a significant predictor of operative mortality or adverse outcomes; instead, factors like emergency repairs and chronic kidney disease played a more critical role.
Postoperative atrial fibrillation (POAF) after cardiac surgery is associated with elevated morbidity and mortality. Although current prediction models have limited efficacy, several perioperative interventions can reduce patients' risk of POAF. These begin with preoperative medications, including beta-blockers and amiodarone.
View Article and Find Full Text PDFF-FDG PET/CT and radiolabeled leukocyte SPECT/CT imaging for the evaluation of cardiovascular infection in the multimodality context: ASNC Imaging Indications (ASNC I) Series Expert Consensus Recommendations from ASNC, AATS, ACC, AHA, ASE, EANM, HRS, IDSA, SCCT, SNMMI, and STS.
J Nucl Cardiol
April 2024
Article Synopsis
- This document is the first in the ASNC I series focusing on the role of radionuclide imaging for diagnosing cardiovascular infections, notably infective endocarditis, using a detailed consensus-based approach.
- It highlights the rising incidence of cardiovascular infections, which present high risks and complications, and discusses the limitations of current diagnostic methods like echocardiography.
- Advanced imaging techniques such as FDG PET/CT and SPECT/CT can improve diagnostic accuracy by revealing infection in cardiac devices and surrounding areas, emphasizing the need for better imaging strategies in complex cases.
F-FDG PET/CT and Radiolabeled Leukocyte SPECT/CT Imaging for the Evaluation of Cardiovascular Infection in the Multimodality Context: ASNC Imaging Indications (ASNC I) Series Expert Consensus Recommendations From ASNC, AATS, ACC, AHA, ASE, EANM, HRS, IDSA, SCCT, SNMMI, and STS.
JACC Cardiovasc Imaging
June 2024
Article Synopsis
- * A thorough consensus was reached using a modified Delphi method to outline clinical indications, diagnostic criteria, and a structured algorithm for diagnosis due to the rising incidence and high risks associated with these infections.
- * Advanced imaging techniques, such as F-FDG PET/CT, can improve the evaluation and management of cardiovascular infections, particularly in complicated cases involving prosthetic valves and cardiac devices, while also highlighting the need for further research to optimize these applications.
F-FDG PET/CT and radiolabeled leukocyte SPECT/CT imaging for the evaluation of cardiovascular infection in the multimodality context: ASNC Imaging Indications (ASNC I) Series Expert Consensus Recommendations from ASNC, AATS, ACC, AHA, ASE, EANM, HRS, IDSA, SCCT, SNMMI, and STS.
Heart Rhythm
May 2024
This document on cardiovascular infection, including infective endocarditis, is the first in the American Society of Nuclear Cardiology Imaging Indications (ASNC I) series to assess the role of radionuclide imaging in the multimodality context for the evaluation of complex systemic diseases with multi-societal involvement including pertinent disciplines. A rigorous modified Delphi approach was used to determine consensus clinical indications, diagnostic criteria, and an algorithmic approach to diagnosis of cardiovascular infection including infective endocarditis. Cardiovascular infection incidence is increasing and is associated with high morbidity and mortality.
View Article and Find Full Text PDF18F-FDG PET/CT and radiolabeled leukocyte SPECT/CT imaging for the evaluation of cardiovascular infection in the multimodality context: ASNC Imaging Indications (ASNC I2) Series Expert Consensus Recommendations from ASNC, AATS, ACC, AHA, ASE, EANM, HRS, IDSA, SCCT, SNMMI, and STS.
Clin Infect Dis
March 2024
Article Synopsis
- This document is the first in a series by the American Society of Nuclear Cardiology focusing on the use of radionuclide imaging for diagnosing cardiovascular infections, particularly infective endocarditis, in a comprehensive healthcare context.
- A modified Delphi method was used to establish clinical indications, diagnostic criteria, and a structured approach for diagnosing these infections, which are increasingly common and associated with significant health risks.
- Advanced imaging techniques, such as 18F-FDG PET/CT and SPECT/CT leukocyte scintigraphy, can significantly boost diagnostic accuracy and guide treatment decisions, especially for patients with complex cardiovascular issues or unclear initial imaging results.
Objective: In patients who underwent mitral valve replacement for infectious endocarditis, we evaluated the association of prosthesis choice with readmission rates and causes (the primary outcomes), as well as with in-hospital mortality, cost, and length of stay (the secondary outcomes).
Methods: Patients with infectious endocarditis who underwent isolated mitral valve replacement from January 2016 to December 2018 were identified in the United States Nationwide Readmissions Database and stratified by valve type. Propensity score matching was used to compare adjusted outcomes.
Objective: We evaluated community socioeconomic factors in patients who had unplanned readmission after undergoing proximal aortic surgery (ascending aorta, aortic root, or arch).
Methods: Unplanned readmissions for any reason within 60 days of the index procedure were reviewed by race, acuity at presentation, and gender. We also evaluated 3 community socioeconomic factors: poverty, household income, and education.
Objective: We determined the utilization rate of surgical ablation (SA) during coronary artery bypass grafting (CABG) and compared outcomes between CABG with or without SA in a national cohort.
Methods: The January 2016 to December 2018 Nationwide Readmissions Database was searched for all patients undergoing isolated CABG with preoperative persistent or chronic atrial fibrillation by using the International Classification of Diseases, 10th Revision classification. Propensity score matching and multivariate logistic regressions were performed to compare outcomes, and Cox proportional hazards model was used to assess risk factors for 1-year readmission.
Objective: To identify potential socioeconomic disparities in the procedural choice of patients undergoing surgical aortic valve replacement (SAVR) versus transcatheter aortic valve replacement (TAVR) and in readmission outcomes after SAVR or TAVR.
Methods: The Nationwide Readmissions Database was queried to identify a total of 243,691 patients who underwent isolated SAVR and TAVR between January 2016 and December 2018. Patients were stratified according to a tiered socioeconomic status (SES) metric comprising patient factors including education, literacy, housing, employment, insurance status, and neighborhood median income.
Background: Postoperative atrial fibrillation (POAF) frequently complicates cardiac surgery. Predicting POAF can guide interventions to prevent its onset. This study assessed the incidence, risk factors, and related adverse outcomes of POAF after cardiac surgery.
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- A study evaluated outcomes of open extent I thoracoabdominal aortic aneurysm (TAAA) repairs in 992 patients, comparing those with heritable thoracic aortic disease (HTAD) to those without.
- Patients with HTAD had significantly lower rates of operative mortality (1.7% vs 7.0%) and adverse events (2.8% vs 12.3%), indicating better short-term outcomes.
- The findings suggest that open TAAA repair is effective for HTAD patients, with low risks and better long-term survival, advocating for this approach in their treatment.
Article Synopsis
- - Spinal cord deficit (SCD) is a serious complication that can occur after thoracoabdominal aortic aneurysm repair, so careful management during the entire surgical process is crucial to minimize this risk.
- - Preventive strategies during surgery include optimizing patient conditions beforehand and identifying those who are at greater risk for SCD, as well as using techniques like cerebrospinal fluid drainage and selective reimplantation of specific arteries.
- - It's essential to monitor blood pressure and anemia both during and after the procedure, and if SCD is detected early, timely treatment can help reduce potential damage.