Publications by authors named "Matthew Whitbeck"

The utilization of mechanical circulatory support (MCS) for complex percutaneous coronary intervention (PCI) in patient with previous bioprosthetic aortic valve replacement continues to increase. This is due to an aging population and increased utilization of transcatheter aortic valve replacement (TAVR) to treat symptomatic severe aortic stenosis (AS). These patients often have concurrent high complexity coronary artery disease (CAD).

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Emerging innovations have led to the development of tools and techniques to perform mechanical aspiration of right-sided endocarditis vegetations. However, blood loss during aspiration, the need for veno-veno bypass, and nonsteerable catheters have limited expansion of these treatment options to more patients. We present a case of pacemaker lead endocarditis treated with the Inari mechanical aspiration system utilizing the new T20 curved catheter (Inari Medical).

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A single-access technique during mechanical circulatory support (MCS) and percutaneous coronary intervention (PCI) has been described for those patients where an additional arterial access site is not available or desired. This technique utilizes the Impella (Abiomed, Danvers, MA) 14 French (F) sheath as a single-access point, with a 7 F sheath through the 14 F sheath hemostatic valve next to the Impella catheter (Abiomed). However, this technique is limited to a 7 F sheath or smaller and can be difficult requiring multiple attempts and limit guide catheter manipulation.

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The incidence of focal infrarenal stenosis of the aorta is rare. Endovascular therapy has evolved as a first-line treatment of aortoiliac occlusive disease and has been shown to substantially improve health-related quality of life. The 8 French sheath compatible, GORE VIABAHN VBX (GORE Flagstaff, AZ) balloon expandable covered stent offers the traditional benefits of a balloon expandable covered stent with a design that improves on flexibility.

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Background: Percutaneous coronary intervention (PCI) of severely calcified lesions is associated with a high risk of angiographic complication, incomplete stent expansion, and restenosis. The prevalence of calcification is increased in diabetics (DM) and the PCI outcome in this population is often suboptimal. Treatment with orbital atherectomy (OA) in severely calcified lesions has been shown to result in favorable procedural outcomes and low reintervention rates; in DM and non-DM.

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Aims: The association of QRS duration (QRSd) with morbidity and mortality is understudied in patients with atrial fibrillation (AF). We sought to assess any association of prolonged QRS with increased risk of death or hospitalization among patients with AF.

Methods And Results: QRS duration was retrieved from the baseline electrocardiograms of patients enroled in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) study and divided into three categories: <90, 90-119, ≥120 ms.

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Everolimus-eluting stents (EES) represent the next generation of drug-eluting stents (DES). Important design modifications include thin strut stent backbones, less inflammatory and more biocompatible polymers, and lower drug dosing. The cobalt chromium EES fluoropolymer XIENCE V stent has been the most extensively studied of such stents.

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Background: Adenosine-induced hyperpolarization may identify pulmonary veins at risk of reconnection following electrical isolation for atrial fibrillation. The potential role of adenosine testing in other arrhythmic substrates, such as cavotricuspid isthmus (CTI)-dependent atrial flutter, remains unclear. We assessed whether dormant conduction across the CTI may be revealed by adenosine after ablation-induced bidirectional block, and its association with recurrent flutter.

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Aims: Digoxin is frequently used for rate control of atrial fibrillation (AF). It has, however, been associated with increased mortality. It remains unclear whether digoxin itself is responsible for the increased mortality (toxic drug effect) or whether it is prescribed to sicker patients with inherently higher mortality due to comorbidities.

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Background: Cardiac electric therapies effectively terminate tachyarrhythmias. Recent data suggest a possible increase in long-term mortality associated with implantable cardioverter-defibrillator shocks. Little is known about the association between external cardioversion episodes (ECVe) and long-term mortality.

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Atrial septal defect (ASD) is a common form of congenital heart disease that often persists well into adulthood before discovery or intervention. The authors report the case of a patient referred for routine percutaneous ASD closure that was found on three-dimensional (3D) transesophageal echocardiography to have two large separate ostium secundum defects which were subsequently closed under 3D echocardiographic guidance.

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While modern implant tools have contributed greatly to the success of cardiac resynchronization therapy, technical challenges remain. A common problem is the inability to advance left ventricular pacing leads into branch veins that are tortuous or arise at steep angles. In these cases, advancement of the lead causes it to buckle and prolapse into the coronary sinus or great cardiac vein.

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