Impact of preexisting coronary arterial disease in patients undergoing percutaneous mitral valve repair (MitraClip).

Introduction: Percutaneous mitral valve repair with Mitraclip device has been approved for the treatment of symptomatic mitral valve regurgitation in patients deemed high surgical risk. It's unclear whether the presence of preexisting coronary arterial disease (CAD) affects the postprocedural outcomes of Mitraclip.

Methods: The study population was extracted from the 2016 Nationwide Readmissions Data (NRD) using the International Classification of Diseases, Tenth Revision, Clinical Modifications/Procedure Coding System (ICD-10-CM/PCS) for Mitraclip, preexisting CAD, and postprocedural complications.

Atherectomy-assisted versus percutaneous angioplasty interventions for treatment of symptomatic infra-inguinal peripheral arterial disease.

Introduction: The role of atherectomy (ATHERO) for the treatment of symptomatic infra-inguinal arterial lesions remains controversial. We evaluated the effectiveness and safety of atherectomy-assisted endovascular interventions in comparison with percutaneous angioplasty (PTA).

Material And Methods: A systematic search utilizing MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials was conducted for studies comparing ATHERO with PTA from February 1995 to May 2018.

Outcomes of fractional flow reserve-guided percutaneous coronary interventions in patients with acute coronary syndrome.

Introduction: Fractional flow reserve (FFR) assessment has been validated as an effective tool to guide revascularization of stable coronary artery disease. The role of utilizing FFR in acute coronary syndrome (ACS) is less established.

Methods: The study population was extracted from the National Readmissions Data (NRD) 2014 using International Classification of Diseases, ninth edition, clinical modification (ICD-9-CM) codes for ACS, percutaneous coronary intervention (PCI), FFR, and periprocedural complications.

Outcomes of transcatheter aortic valve replacement in patients with mitral valve regurgitation.

Introduction: Transcatheter aortic valve replacement (TAVR) is currently considered a class I indication for patients with severe symptomatic aortic stenosis and high/prohibitive surgical risk.

Aim: We describe the effect of concomitant mitral valve regurgitation (MR) on post-procedural TAVR outcomes.

Material And Methods: The study population was extracted from the 2014 National Readmissions Data (NRD) using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for TAVR, MR and post-procedural outcomes.

The safety of morphine use in acute coronary syndrome: a meta-analysis.

Background: Morphine is widely used for pain control in patients with acute coronary syndrome (ACS). Several studies have questioned the safety of morphine in this setting with a concern of interaction with and reduced efficacy of antiplatelet agents.

Objective: This study aims to systematically review the safety of morphine use in ACS.

Accelerated Idioventricular Rhythm at the Termination of an Episode of Vasospastic Angina.

A 57-year-old male with gastroesophageal reflux disease and esophageal stricture with dilation presented as a cardiac catheterization lab activation for anterolateral ST-segment elevation myocardial infarction. He had suffered an unwitnessed syncopal episode after severe substernal chest pain. Electrocardiogram (ECG) showed anterolateral ST-segment elevation.

ST-Elevation Myocardial Infarction in a Patient with Anomalous Left Anterior Descending Artery and Absent Left Circumflex.

The left anterior descending artery originating from the right coronary sinus is very unusual. An absent left circumflex is very rare with a few reported cases in the literature. We report a combination of a non-dominant left anterior descending artery arising from the right coronary cusp and an absent left circumflex artery in a 60-year-old male presenting with ST-segment elevation myocardial infarction.

Giant Negative T Waves and QT Prolongation in Non-cardiogenic Pulmonary Edema: A Case Report and Review of Literature.

Giant negative T-waves have been linked to several cardiac and non-cardiac conditions. However, the presence of giant negative T-waves with QT prolongation in the setting of non-cardiogenic pulmonary edema is a rarely reported, female predominant, and poorly understood electrocardiographic phenomenon. We report a case of a 28-year-old white female who presented with acute diarrhea and was admitted due to acute kidney injury caused by a hemolytic uremic syndrome (HUS).

Obesity and Cardiac Remodeling in Adults: Mechanisms and Clinical Implications.

Obesity, particularly severe obesity is capable of producing hemodynamic alterations that contribute to changes in cardiac morphology which may predispose to impairment of ventricular function and heart failure. These include a high cardiac output state in most, left ventricular (LV) hypertrophy, and LV diastolic dysfunction. Right heart involvement may result from LV failure, the hypercirculatory state, and sleep disordered breathing.

Bivalirudin versus unfractionated heparin in peripheral vascular interventions.

Background: A number of studies suggest that bivalirudin (BIV) is associated with similar efficacy but reduced bleeding when compared with unfractionated heparin (UFH) in patients undergoing peripheral vascular interventions (PVI).

Methods: A comprehensive literature search was conducted with the electronic databases MEDLINE, EMBASE and CENTRAL. These were queried to identify studies comparing BIV with UFH in PVI.

Cough as the sole manifestation of pericardial effusion.

A 59-year-old woman with paroxysmal atrial fibrillation (AF) presented with severe non-productive cough, malaise, low-grade fever and AF flare-up 3 weeks following pulmonary vein isolation with radiofrequency catheter ablation. She denied chest pain or dyspnoea. Patient was haemodynamically stable.

Von Willebrand factor revisited.

Degenerative aortic valve stenosis is the most common valvular heart disease seen in developed countries. Since the implementation of transcatheter aortic valve replacement, there has been a surge of efforts to improve procedural technique as well as reduce mortality. Until recently, the mainstay method of assessment of valve implantation as well as paravalvular regurgitation has relied heavily on imaging techniques including transesophageal echocardiography and aortic root angiography.

Percutaneous angioplasty versus atherectomy for treatment of symptomatic infra-popliteal arterial disease.

Background: Outcomes for debulking by atherectomy (ATH) for adjunctive treatment of below the knee (BTK) symptomatic arterial disease compared to percutaneous transluminal angioplasty alone (PTA) are unclear.

Methods: MEDLINE, EMBASE, PubMed and the Cochrane Central Register of Controlled Trials were queried from between 2000 and 2017 including studies comparing PTA alone to PTA-ATH. Random effect meta-analysis model was used to pool the data across the studies.

Proximal balloon occlusion versus distal filter protection in carotid artery stenting: A meta-analysis and review of the literature.

Introduction: Carotid artery stenting (CAS) is typically performed using embolic protection devices (EPDs) as a means to reduce the risk of procedure-related stroke. In this study, we compared procedural morbidity and mortality associated with distal (D-EPD) vs. proximal (P-EPD) protection.

Hemorrhagic and ischemic outcomes of Heparin vs. Bivalirudin in carotid artery stenting: A meta-analysis of studies.

Introduction: Bivalirudin, has been shown to have comparable efficacy and better safety profile when compared to unfractionated heparin (UFH) in percutaneous coronary interventions. Bivalirudin's safety in carotid artery stenting (CAS) was associated with better outcomes than heparin in some studies. In this Meta analysis we examine the hemorrhagic and ischemic outcomes associated with Bivalirudin compared to UFH during CAS.

A Case of Carcinoid Tumor-Associated Hypercalcemia.

Hypercalcemia as a complication of carcinoid tumors is extremely rare. Accordingly, we report the case of a 55-year-old male with metastatic carcinoid tumor and hypercalcemia, which corrected when the patient was treated with octreotide for symptomatic relief of watery diarrhea. The etiology of the hypercalcemia is presumed to be a neoplastic expression of fibroblast growth factor-23, which was found to be inappropriately high-to-normal when other factors such as parathyroid hormone, calcitonin and vitamin D were appropriately low or low-to-normal.

Warfarin Use During Fecal Occult Blood Testing: A Meta-Analysis.

Background: Fecal occult blood testing (FOBT) is a widely used screening test for colorectal cancer (CRC). Given the limited data about the effects of warfarin on FOBT are inconclusive, current screening guidelines for CRC do not address whether warfarin should be discontinued before FOBT. Therefore, we conducted a meta-analysis to evaluate the influence of warfarin on the yield of FOBT.

A Rare Cause of Massive Upper Gastrointestinal Hemorrhage in Immunocompromised Host.

Mucormycosis is an invasive and aggressive opportunistic fungal infection that usually presents with rhinocerebral or pulmonary involvement and rarely involves the gastrointestinal tract. The disease is acute with mortality rate up to 100%. A 68-year-old male was undergoing treatment at a local hospital for COPD exacerbation with IV steroids and antibiotics.

A profile of patients with hyperparathyroidism undergoing lithium therapy for affective psychiatric disorders.

Background: Our objective was to evaluate whether lithium-induced hyperparathyroidism (LIHPT) is caused by single-gland versus multigland disease.

Methods: Medical records of 7 patients who underwent parathyroidectomy for LIHPT were reviewed.

Results: The mean preoperative calcium was 11.

Black thyroid associated with thyroid carcinoma.

Objective. Black thyroid is a rare pigmented change seen almost exclusively in patients upon minocycline ingestion, and the process has previously been thought to be generally benign. There have been 61 reported cases of black thyroid.