Transseptal BATMAN Procedure Utilizing a Simplified Technique: "Single Wire Approach for Traversing Tissue" (SWATT).

One of the major issues encountered in patients undergoing evaluation for Transcatheter mitral valve replacement (TMVR) is the risk of Left ventricular outflow tract (LVOT) obstruction. LVOT obstruction is a catastrophic complication of TMVR, the result of displacement of the anterior mitral valve leaflet (AML) toward the interventricular septum. Several strategies to mitigate the risk of LVOT obstruction have been described and include percutaneous laceration of the anterior mitral leaflet (LAMPOON), alcohol septal ablation, trans-atrial leaflet modification (SITRAL) and Balloon Assisted Translocation of Mitral Anterior leaflet to prevent LVOT obstruction (BATMAN).

Transcatheter Aortic Valve Implantation in Mixed Aortic Valve Disease: A Multicenter Study.

Mixed aortic valve disease (MAVD), defined by the concurrent presence of aortic stenosis (AS) and insufficiency is frequently seen in patients who have undergone transcatheter aortic valve implantation (TAVI). However, studies comparing the outcomes of TAVI in MAVD versus isolated AS have demonstrated conflicting results. Therefore, we aim to assess the outcomes of TAVI in patients with MAVD in comparison with those with isolated severe AS.

Blood Culture-Negative Endocarditis Secondary to Skin Popping.

Infectious endocarditis (IE) is a diagnosis in which thorough evaluation must be performed and certain diagnostic criteria must be met. Thorough history and detailed physical examination can affect and guide the management of a patient from the very beginning. One of the main causes of endocarditis that physicians deal with in the hospital is intravenous drug abuse.

Cardiac Metastasis From Renal Cell Carcinoma.

While metastasis is common, it is unusual for renal cell carcinoma (RCC) to spread to the heart and even more so without involving the inferior vena cava (IVC). In fact, only a few cases have been reported where RCC has metastasized to the heart without IVC invasion. There have been only a few cases published that show RCC metastasis to the heart without invasion through the IVC.

Biventricular Takotsubo Cardiomyopathy Secondary to COVID-19.

Takotsubo cardiomyopathy (TCM) is a heart failure syndrome characterized by acute and transient dysfunction of the apical segment of the left ventricle. Since the emergence of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the diagnosis of TCM has increased in prevalence. Here we present an intriguing case of a patient who initially presented to the hospital with respiratory failure and received a diagnosis of COVID-19.

Atrioventricular Nodal Dysfunction Secondary to Chronic Alcohol Abuse.

Atrioventricular (AV) nodal conduction disorders occur when the AV conduction pathway is refractory due to functional or organic reasons, resulting in a delay or complete blockage of atrial impulses to the ventricles. One of the causes of nodal dysfunction includes chronic alcohol abuse and excessive binge drinking. We are presenting a case where a chronic alcoholic was binge drinking due to a loss of a close friend, which resulted in nodal dysfunction and multiple cardiac rhythms, including supraventricular bigeminy, sinus bradycardia, significant sinus pauses, and complete heart block.

Impact of COVID-19 on Acute Myocardial Infarction Care.

The global health crisis caused by the COVID-19 pandemic has evolved rapidly to overburden health care organizations around the world and has resulted in significant morbidity and mortality. Many countries have reported a substantial and rapid reduction in hospital admissions for acute coronary syndromes and percutaneous coronary intervention. The reasons for such abrupt changes in health care delivery are multifactorial and include lockdowns, reduction in outpatient services, reluctance to seek medical attention for fear of contracting the virus, and restrictive visitation policies adopted during the pandemic.

Mechanical Circulatory Support in COVID-19.

Despite aggressive care, patients with cardiopulmonary failure and COVID-19 experience unacceptably high mortality rates. The use of mechanical circulatory support devices in this population offers potential benefits but confers significant morbidity and novel challenges for the clinician. Thoughtful application of this complex technology is of the utmost importance and should be done in a multidisciplinary fashion by teams familiar with mechanical support devices and aware of the particular challenges provided by this complex patient population.

A Case of Symptomatic Paroxysmal Complete Atrioventricular Block.

Paroxysmal complete atrioventricular block (PCAB) is clinically characterized by a sudden change from 1:1 atrioventricular (AV) conduction leading to complete heart block. Patients may have a vast array of symptoms, but commonly, PCAB will lead to syncope and possible sudden cardiac death. The literature currently consists of three different types of PCAB: intrinsic paroxysmal atrioventricular block, extensive vagal paroxysmal atrioventricular block, and extrinsic idiopathic paroxysmal atrioventricular block.

Mechanical Circulatory Support in Patients With COVID-19 Presenting With Myocardial Infarction.

ST-segment elevation myocardial infarction (STEMI) complicating COVID-19 is associated with an increased risk of cardiogenic shock and mortality. However, little is known about the frequency of use and clinical impact of mechanical circulatory support (MCS) in these patients. We sought to define patterns of MCS utilization, patient characteristics, and outcomes in patients with COVID-19 with STEMI.

Impact of COVID-19 on Acute Myocardial Infarction Care.

The global health crisis caused by the COVID-19 pandemic has evolved rapidly to overburden health care organizations around the world and has resulted in significant morbidity and mortality. Many countries have reported a substantial and rapid reduction in hospital admissions for acute coronary syndromes and percutaneous coronary intervention. The reasons for such abrupt changes in health care delivery are multifactorial and include lockdowns, reduction in outpatient services, reluctance to seek medical attention for fear of contracting the virus, and restrictive visitation policies adopted during the pandemic.

Mechanical Circulatory Support in COVID-19.

Despite aggressive care, patients with cardiopulmonary failure and COVID-19 experience unacceptably high mortality rates. The use of mechanical circulatory support devices in this population offers potential benefits but confers significant morbidity and novel challenges for the clinician. Thoughtful application of this complex technology is of the utmost importance and should be done in a multidisciplinary fashion by teams familiar with mechanical support devices and aware of the particular challenges provided by this complex patient population.

Distal Coronary Perforation Sealing With Combined Coil and Fat Embolization.

Distal coronary perforation is a rare complication of percutaneous coronary intervention. While temporary balloon occlusion of the proximal coronary artery is the first step in perforation management, more definitive treatment options include covered stent implantation for large vessel perforations or fat/coil embolization for distal vessel perforations. We report a case of an 81-year old man who presented with inferior/posterior ST-segment elevation acute myocardial infarction.

Frequency, Etiology, and Impact of Unplanned Repeat Coronary Angiography After ST-Elevation Myocardial Infarction.

Unplanned repeat coronary angiography (CAG) after balloon angioplasty for ST-elevation myocardial infarction (STEMI) was common before the advent of coronary stenting. Limited data are available regarding the role of unplanned repeat CAG in contemporary percutaneous coronary intervention (PCI) for STEMI. Therefore, we analyzed a large, 2-center prospective STEMI registry (January 2011 to June 2020) stratified by the presence or absence of unplanned repeat CAG during index hospitalization.

Transcatheter aortic valve replacement in mixed aortic valve disease: a systematic review and meta-analysis.

Background: Utilization of transcatheter aortic valve replacement (TAVR) has expanded from high-risk patients to intermediate- and select low-risk candidates with severe aortic stenosis (AS). TAVR is currently not indicated for patients with aortic insufficiency, and its outcomes in mixed aortic valve disease (MAVD) are unclear.

Methods: A systematic search of PubMed, Medline, CINHAL, and Cochrane databases was performed to identify studies comparing TAVR outcomes in patients with AS vs.

Paradoxical and Retrograde Air Embolism from Pressurized Peripheral Bolus.

Introduction: Cerebral air embolism is a rare, yet serious neurological occurrence with unclear incidence and prevalence. Here, we present a case of fatal cerebral arterial and venous cerebral gas embolism in a patient with infective endocarditis and known large right-to-left shunt and severe tricuspid regurgitation following pressurized fluid bolus administration. .

Impact of gender on in-hospital mortality and 90-day readmissions in patients undergoing transcatheter edge-to-edge mitral valve repair: Analysis from the National Readmission Database.

Background: Patients undergoing transcatheter edge-to-edge mitral valve repair (TEER) carry a high risk of rehospitalization due to disease, procedure, patient, hospital, and system related factors.

Aims: We aimed to explore the impact of gender on in-hospital mortality and 90-day readmissions in patients undergoing TEER.

Methods: We utilized the National Readmission Database from 2012 to 2018 to identify individuals who underwent TEER for mitral regurgitation.

Sex differences in mortality and 90-day readmission rates after transcatheter aortic valve replacement: a nationwide analysis from the USA.

Aims: To assess gender differences in in-hospital mortality and 90-day readmission rates among patients undergoing transcatheter aortic valve replacement (TAVR) in the USA.

Methods And Results: Hospitalizations for TAVR were retrospectively identified in the National readmissions database (NRD) from 2012 to 2017. Gender based differences in in-hospital mortality and 90-day readmissions were explored using multivariable logistic regression models.

ST-elevation myocardial infarction in nonagenarians: A nationwide analysis of trends and outcomes in the United States.

Objective: To assess ST elevation myocardial infarction (STEMI) trends and outcomes in nonagenarians undergoing primary percutaneous coronary intervention (pPCI) compared to medical management.

Background: Although nonagenarians (age greater than 90 years) represent the fast-growing age decade of the US population, limited evidence is available regarding trends and outcomes of treatment strategies for STEMI in this population cohort.

Methods: We performed a retrospective analysis using the National Inpatient Sample (NIS) database to identify nonagenarians presenting with STEMI and treated with either pPCI or medical management.

Sex Differences in Clinical Outcomes Following Percutaneous Coronary Intervention of Unprotected Left Main Coronary Artery: A Systematic Review and Meta-Analysis.

Introduction: Percutaneous coronary intervention (PCI) has emerged as a reasonable alternative to coronary artery bypass graft (CABG) surgery in well-selected patients with unprotected left main coronary disease (LMCD). We conducted a systematic review and meta-analysis with the aim of assessing the impact of sex on outcomes of PCI in patients with unprotected LMCD.

Methods: A systematic search of PUBMED, EMBASE, Cochrane, and Google Scholar databases was performed to identify studies comparing the outcomes of men vs.

Early vs late cardiac surgery in patients with native valve endocarditis-United States Nationwide Inpatient database.

Objective: Although the standard treatment of infective endocarditis (IE) is antimicrobial therapy, surgical intervention is required in some cases. However, the optimal timing of surgery remains unclear. Hence, we conducted a population-based analysis using the National Inpatient Sample (NIS) database to assess the outcomes of early versus late surgery in patients with native valve IE.

Lipoprotein(a) and calcific aortic valve stenosis: A systematic review.

Calcific aortic valve stenosis (AS) is the most common form of acquired valvular heart disease needing intervention and our understanding of this disease has evolved from one of degenerative calcification to that of an active process driven by the interplay of genetic factors and chronic inflammation modulated by risk factors such as smoking, hypertension and elevated cholesterol. Lipoprotein(a) [Lp (a)] is a cholesterol rich particle secreted by the liver which functions as the major lipoprotein carrier of phosphocholine-containing oxidized phospholipids. Lp(a) levels are largely genetically determined by polymorphisms in the LPA gene.