Publications by authors named "Marino Labinaz"
Background: There is a large variability regarding the management of conduction disturbances (CDs) after TAVR.
Objectives: To validate a pre-specified algorithm for managing CDs in patients undergoing TAVR.
Methods: Prospective multicenter study including consecutive patients without prior pacemaker undergoing TAVR.
Computational simulation model of transcatheter edge-to-edge mitral valve repair: a proof-of-concept study.
Eur Heart J Cardiovasc Imaging
September 2024
Aims: As transcatheter mitral valve (MV) interventions are expanding and more device types and sizes become available, a tool supporting operators in pre-procedural planning and the clinical decision-making process is highly desirable. We sought to develop a finite element computational simulation model to predict the results of transcatheter edge-to-edge repair (TEER) interventions.
Methods And Results: We prospectively enrolled patients with secondary mitral regurgitation (MR) referred for a clinically indicated TEER.
Cost-effectiveness of population screening for aortic stenosis.
Eur Heart J Qual Care Clin Outcomes
May 2024
Background And Aims: Aortic stenosis (AS) is a progressive disease predominantly affecting elderly patients that carries significant morbidity and mortality without aortic valve replacement, the only proven treatment. Our objective was to determine the cost-effectiveness of AS screening using transthoracic echocardiography (TTE) in a geriatric population from the perspective of the publicly funded healthcare system in Canada.
Methods: Markov models estimating the cost-effectiveness ratio (ICER) for AS screening with a one-time TTE were developed.
Article Synopsis
- - The study focused on evaluating the safety and effectiveness of the APTURE transcatheter shunt system in patients with heart failure and left ventricular ejection fraction (LVEF) greater than 40%.
- - Results showed that the APTURE shunt had a low incidence of serious complications (2.6%) and helped improve heart function, as indicated by reduced pulmonary capillary wedge pressure and improved quality of life scores over a year.
- - Overall, the findings suggest that the APTURE shunt is a promising option for managing heart failure in patients with mildly reduced or preserved ejection fraction.
Article Synopsis
- The PERFORM-TAVR trial aims to explore the combined effects of exercise and protein supplementation on older adults with frailty undergoing transcatheter aortic valve replacement (TAVR), which currently shows high procedural success but still leaves many patients with poor health outcomes.
- This multicentre trial will enroll 200 frail adults aged 70 and older, randomly assigning them to either standard lifestyle education (control) or a regimen involving protein-rich supplements and supervised exercises post-TAVR.
- The main goal is to measure physical performance improvements at 3 months, along with secondary outcomes like health-related quality of life and safety assessments over a year, potentially reshaping approaches to treating frailty alongside heart valve diseases.
Article Synopsis
- - Patients receiving coronary stents face a 2% annual risk of complications mainly due to in-stent restenosis (ISR), linked to smooth muscle cell (SMC) activity, and dipyridamole (DP) has shown promise in enhancing vascular health.
- - In a study with 24 rabbits undergoing stent implantation, those treated with DP showed significant reductions in neointimal volume and improvements in stent strut healing compared to control rabbits, with the most notable effects seen in non-atherosclerotic rabbits.
- - The mechanism of DP's protective effects appears to involve modulation of SMC behaviors and signaling through adenosine receptor-A2B (ADOR-A2B), suggesting its potential as a therapeutic
Objectives: Inotropic support is commonly used in patients with cardiogenic shock (CS). High-quality data guiding the use of dobutamine or milrinone among this patient population is limited. We compared the efficacy and safety of these two inotropes among patients with low cardiac output states (LCOS) or CS.
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- Percutaneous coronary intervention (PCI) is used to treat blocked arteries in patients with coronary artery disease, but issues like in-stent restenosis (ISR) still require repeat procedures.
- This study uses optical coherence tomography (OCT) to examine how well stents heal in a rabbit aorta model, highlighting variations in ISR based on factors like stent location and type.
- The findings suggest that pre-clinical models should closely mimic clinical conditions to enhance the application of research outcomes to actual patient care.
Article Synopsis
- - Transradial access (TRA) is increasingly preferred for coronary procedures, but one concern is radial artery occlusion (RAO), which can complicate future procedures.
- - The Rivaroxaban Post-Transradial Access trial aims to study if taking rivaroxaban after TRA can lessen the chance of RAO by comparing its effects against no postprocedural anticoagulation.
- - This study is ethically approved and aims to share its findings through conferences and publications, ensuring transparency in the research process.
Background: Cardiogenic shock (CS) is a state of end-organ hypoperfusion related to cardiac dysfunction. Current guidelines recommend consideration of inotrope therapy in patients with CS, however no robust data support their use. The purpose of the CAPITAL DOREMI2 trial is to examine the efficacy and safety of inotrope therapy against placebo in the initial resuscitation of patients with CS.
View Article and Find Full Text PDFLeft Atrial to Coronary Sinus Shunting for Treatment of Symptomatic Heart Failure.
JACC Cardiovasc Interv
June 2023
Background: Heart failure (HF) is associated with both mortality and a significant decline in health status. Interatrial shunting is increasingly being investigated as a novel therapeutic option.
Objectives: The ALT FLOW Early Feasibility Study was designed to evaluate the safety of the Edwards left atrial to coronary sinus APTURE Transcatheter Shunt System in patients with symptomatic HF.
Background: Catheter-induced coronary artery dissection (CICAD) is a rare complication of coronary angiography. The association between access site and CICAD remains unclear; however, transradial access (TRA) may be associated with a higher incidence of CICAD due to access vessel tortuosity and the mechanical disadvantage of catheters designed for the transfemoral access (TFA) approach.
Methods: In this retrospective study, the reports of consecutive left heart catheterizations between April 2007, and December 2021 were reviewed for CICAD.
Objectives: Presentation with ST-segment-elevation myocardial infarction (STEMI) during off-hours may impact timely reperfusion and clinical outcomes. We investigated the association between off-hours presentation, door-to-balloon time, and in-hospital mortality in patients with STEMI referred for primary percutaneous coronary intervention (PCI).
Methods: We included consecutive patients referred for primary PCI at the University of Ottawa Heart Institute between July 2004 and December 2017.
Mechanical complications after acute myocardial infarction are well-described yet catastrophic complications of acute coronary syndromes. Uniquely, we describe a rare case of left ventricular free wall rupture at the site of a septic myocardial abscess after an anterior wall myocardial infarction. ().
View Article and Find Full Text PDFImpact of intracoronary assessments on revascularization decisions: A contemporary evaluation.
Catheter Cardiovasc Interv
November 2022
Article Synopsis
- The study aimed to assess the practical use of intracoronary assessment (ICA) techniques and their effect on the treatment decisions for coronary artery disease (CAD).
- Although traditional coronary angiograms are commonly used for diagnosing vessel narrowing, ICA provides improved three-dimensional imaging and physiological insights, potentially leading to better patient outcomes.
- Results from 1,135 patients indicated that ICA influenced clinical decisions in a significant portion of cases, often resulting in fewer surgical interventions without increasing the risk of major adverse cardiac events in the following year.
Objective: Atrial fibrillation (AF) remains a highly prevalent arrhythmia with significant burden on morbidity and mortality. The impact of AF in the revascularised population remains incompletely described. Given the high prevalence of AF in the revascularised population, we sought to evaluate the incidence and prognosis in patients with pre-existing and new-onset AF following revascularisation.
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- Functional mitral regurgitation (MR) is critical in heart failure patients, and the CAPITAL MINOS trial investigates the impact of transcatheter edge-to-edge repair (TEER) on patients with cardiogenic shock (CS) and MR since this area hasn't been randomized before.!* -
- The study involves 144 patients with advanced CS and significant MR, comparing TEER against standard medical therapy to see which provides better clinical outcomes, including survival and quality of care during hospitalization.!* -
- Findings from the CAPITAL MINOS trial will help clarify the effectiveness of TEER in this high-risk group, potentially leading to improved treatment strategies for patients experiencing both CS and MR.!*
The advances in percutaneous coronary intervention (PCI) have been, above all, dependent on the work of pioneers in surgery, radiology, and interventional cardiology. From Grüntzig's first balloon angioplasty, PCI has expanded through technology development, improved protocols, and dissemination of best-practice techniques. We can nowadays treat more complex lesions in higher-risk patients with favourable results.
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- Patients who experience return of spontaneous circulation (ROSC) after an out-of-hospital cardiac arrest (OHCA) may require sedation for care, prompting a study on the use of volatile anesthetics versus conventional sedatives.
- In a systematic review of 1,973 citations, three studies with 604 patients were included, showing uncertain effects of volatile agents on delirium, survival to discharge, and ICU length of stay, with some indications of shorter mechanical ventilation duration.
- The conclusion suggested that while volatile anesthetics might lead to shorter ventilation times, the evidence is low quality, indicating a need for more research in this area.
Background: Patients with cardiogenic shock (CS) suffer high rates of in-hospital mortality, with little evidence guiding management. The impact of valvular heart disease in patients with CS remains unclear. We therefore conducted a post hoc analysis of the randomized Dobutamine Compared to Milrinone (DOREMI) trial to determine the impact of valvular disease on outcomes in patients with CS.
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- Recent studies highlight the benefit of early mechanical circulatory support in cardiogenic shock but lack clear real-time therapeutic targets based on clinical data.
- A post hoc analysis of the DOREMI trial found that lactate clearance can effectively predict in-hospital survival, with complete lactate clearance showing strong association with patient outcomes.
- These findings support using lactate clearance as a viable treatment target for improving mortality rates in future cardiogenic shock treatments.