Aspiration of Right Atrial Tumor Metastasis.

A 72-year-old man with cirrhosis had undiagnosed hepatocellular carcinoma with distant metastasis occupying nearly the entire right atrium. He was a poor surgical candidate because of his bleeding risks and advanced liver cirrhosis. He successfully underwent urgent large-bore aspiration thrombectomy under simultaneous echocardiography and fluoroscopy, thus leading to a diagnosis of metastatic malignant disease.

Outcomes of Percutaneous Coronary Intervention Versus Optimal Medical Treatment for Chronic Total Occlusion: A Comprehensive Meta-analysis.

The presence of concurrent chronic total occlusion (CTO) is a strong predictor for both short-term and long-term mortality. Successful percutaneous coronary intervention (PCI) of CTO has been associated with clinical benefit. We sought to perform a meta-analysis comparing CTO-PCI versus optimal medical therapy.

Vascular complications associated with transcatheter aortic valve replacement.

Transcatheter aortic valve replacement (TAVR) is now an accepted pathway for aortic valve replacement for patients who are at prohibitive, severe and intermediate risk for traditional aortic valve surgery. However, with this rising uptrend and adaptation of this new technology, vascular complications and their management remain an Achilles heel for percutaneous aortic valve replacement. The vascular complications are an independent predictor of mortality for patients undergoing TAVR.

Management strategies and possible risk factors for ventricular septal defects after transcatheter aortic valve replacement: Case series from a single center and review of literature.

Development of membranous ventricular septal defects (VSD) is a rare complication of transcatheter aortic valve replacements (TAVR), and is recognized using intraoperative and postoperative imaging. We present two cases of this rare but serious complication; one was successfully managed conservatively and the other with valve-in-valve therapy. Management strategies for post-TAVR VSDs varies, but should be individualized to the clinical scenario.

Thirty-Day Readmissions After Transcatheter Aortic Valve Replacement in the United States: Insights From the Nationwide Readmissions Database.

Background: Readmissions after cardiac procedures are common and contribute to increased healthcare utilization and costs. Data on 30-day readmissions after transcatheter aortic valve replacement (TAVR) are limited.

Methods And Results: Patients undergoing TAVR (International Classification of Diseases-Ninth Revision-CM codes 35.

When we should say no to TAVR-Defining the line between utility and futility.

History of prior coronary artery bypass surgery (CABG) is a frequent scenario encountered in patients with severe symptomatic aortic stenosis deemed inoperable and referred for transcatheter aortic valve replacement (TAVR). Aside from indices of frailty and other comorbidities, these patients remain at higher risk for peri-operative mortality and morbidity compared to their counterparts without prior CABG. Presence of concomitant peripheral arterial disease and patent left internal mammary artery (LIMA) graft pose further access related challenges.

Myocardial salvage and mortality in STEMI: A race against ischemic time.

Total ischemic time (IT) and door-to-balloon time (DBT) are two important measures in patients with ST segment elevation myocardial infarction (STEMI). IT is a better predictor of cardiovascular outcomes than DTB, including infarct size and mortality, in STEMI patients treated with primary percutaneous coronary intervention. IT should be adopted as a standard metric to measure quality of care in STEMI, and will help to promote improvements to our health care delivery system.

First case of a left atrial dissection after transcatheter aortic valve replacement.

The left atrial dissection is a very infrequently encountered complication after valve replacement and never seen after Transcatheter aortic valve replacement (TAVR). We present an 84-year-old female, who underwent successful transapical TAVR and consequently developed contained left atrial dissection seen on transesophageal echocardiogram. The patient remained stable throughout the procedure and was monitored in critical care unit with conservative management.