Percutaneous Transhepatic Venous Access for Left Atrial Appendage Closure in a Patient with Left Sided Inferior Vena Cava with Hemiazygos Continuation.

The transfemoral venous approach is the standard for Left Atrial Appendage Closure (LAAC) using the WATCHMAN device. However in patients without a patent inferior vena cava, an alternate access site can be utilized. We present a case of a patient with left sided inferior vena cava with hemiazygos continuation who had clinical indication for LAAC and in whom a transhepatic approach was successfully utilized.

Comparative effectiveness of revascularization strategies for early coronary artery disease: A multicenter analysis.

Objectives: The goal of this analysis was to examine the comparative effectiveness of coronary artery bypass grafting versus percutaneous coronary intervention among patients aged less than 60 years.

Methods: We performed a multicenter, retrospective analysis of all cardiac revascularization procedures from 2005 to 2015 among 7 medical centers. Inclusion criteria were age less than 60 years and 70% stenosis or greater in 1 or more major coronary artery distribution.

A multi-center analysis of readmission after cardiac surgery: Experience of The Northern New England Cardiovascular Disease Study Group.

Background: Readmissions after cardiac surgery are common and associated with increased morbidity, mortality and cost of care. Policymakers have targeted coronary artery bypass grafting to achieve value-oriented health care milestones. We explored the causes of readmission following cardiac surgery among a regional consortium of hospitals.

Optical coherence tomography versus intravascular ultrasound in the evaluation of observer variability and reliability in the assessment of stent deployment: the OCTIVUS study.

Objectives: To compare the variability in the assessment of coronary stents among interventional cardiologists (readers) using optical coherence tomography (OCT) and intravascular ultrasound (IVUS).

Background: IVUS is established and validated in the evaluation of coronary stent. For cardiologists without core lab expertise, the utility of IVUS is limited by image quality.

Quantification of the variability associated with repeat measurements of left ventricular two-dimensional global longitudinal strain in a real-world setting.

Background: Global longitudinal strain (GLS) derived from two-dimensional speckle-tracking is an emerging technology, but lack of industry standards limits its application. Prior studies support using this tool to identify subclinical disease through serial changes, but the variability introduced by a change in vendor or reader is not well defined.

Methods: Fifty study subjects were prospectively identified to include four subgroups to ensure a broad range of GLS: normal (n = 20), left ventricular hypertrophy (n = 10), ST-segment elevation myocardial infarction (n = 10), and systolic heart failure (n = 10).

Impact of perioperative acute kidney injury as a severity index for thirty-day readmission after cardiac surgery.

Background: Of patients undergoing cardiac surgery in the United States, 15% to 20% are re-hospitalized within 30 days. Current models to predict readmission have not evaluated the association between severity of postoperative acute kidney injury (AKI) and 30-day readmissions.

Methods: We collected data from 2,209 consecutive patients who underwent either coronary artery bypass or valve surgery at 7 member hospitals of the Northern New England Cardiovascular Disease Study Group Cardiac Surgery Registry between July 2008 and December 2010.