Publications by authors named "Robert Whitbourn"
Aim: Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are simple biomarkers that reflect systemic inflammation and are associated with adverse cardiovascular disease outcomes. The utility of NLR and PLR for risk prediction following transcatheter aortic valve implantation (TAVI) is not clear.
Method: We retrospectively analysed a prospectively maintained database of patients who underwent TAVI at a tertiary hospital from 2009 to 2022.
Objectives: To assess the impact of balloon use for predilation, valve implantation, or postdilation on in-hospital mortality among patients undergoing transcatheter aortic valve replacement (TAVR).
Background: TAVR utilizes self-expanding, mechanically expanding, or balloon-expandable valves. Balloon inflation is inherent to deployment of balloon-expandable valves.
Article Synopsis
- Inflammation significantly impacts acute coronary syndromes (ACS), and colchicine, traditionally used for gout, shows promise for treating ACS due to its anti-inflammatory effects.
- A double-blind trial with 795 patients compared colchicine treatment (0.5 mg twice daily) with a placebo, alongside standard medication, over 12 months.
- Results indicated fewer adverse events in the colchicine group (24 vs. 38), but a higher total death rate (8 vs. 1) and more non-cardiovascular deaths, while adverse effects were similar between both groups, primarily involving gastrointestinal issues.
Background: To determine the safety and performance of the SAPIEN XT transcatheter heart valve (THV) in Australian patients with severe aortic stenosis (AS) and intermediate surgical risk.
Methods: Eligible patients in this multi-centre, prospective, consecutively enrolled, non-randomised, clinical trial, received transcatheter aortic valve replacement via femoral artery access. Follow-up visits were at discharge, 30 days, and 6, 12, and 24 months.
Background: Renal denervation (RDN) is under investigation for treatment of uncontrolled hypertension and might represent an attractive treatment for patients with high cardiovascular (CV) risk. It is important to determine whether baseline CV risk affects the efficacy of RDN.
Objectives: The purpose of this study was to assess blood pressure (BP) reduction and event rates after RDN in patients with various comorbidities, testing the hypothesis that RDN is effective and durable in these high-risk populations.
Background: Bioresorbable scaffolds (BRS) are a novel technology in coronary intervention. However, recent trials demonstrate higher rates of device failure compared to contemporary drug-eluting stents. This study sought to utilise a clinical quality registry to assess the medium-term safety of the Abbott Absorb BRS (Abbott Vascular, Santa Clara, CA, USA), in an Australian context.
View Article and Find Full Text PDFObjective: To compare clinical and functional outcomes of regional and urban patients after transcatheter aortic valve implantation for severe aortic stenosis.
Methods: Data were collected at patient follow-up post-transcatheter aortic valve implantation at 30 days and 12 months. Patients were stratified by residential postcodes into remoteness areas using the Australian Statistical Geography Standard.
Percutaneous coronary intervention in recurrent spontaneous coronary artery dissection: a case report.
Eur Heart J Case Rep
March 2019
Background: Spontaneous coronary artery dissection (SCAD) is an infrequent but potentially life-threatening condition in patients with acute myocardial infarction. Conservative medical therapy is recommended in patients with SCAD. However, very little evidence exists in the management of recurrent SCAD when conservative medical therapy fails.
View Article and Find Full Text PDFArticle Synopsis
- TAVI is a treatment for severe aortic stenosis (AS), and this study evaluates differences between self-expandable valves (SEV) and balloon-expandable valves (BEV) in terms of procedural success and 30-day outcomes.
- A total of 151 patients were analyzed, finding similar procedural success rates but significantly higher complications like paravalvular aortic regurgitation, pacemaker insertion, and strokes in the SEV group compared to the BEV group.
- The study concludes that while mortality rates at 30 days are similar, SEV patients experience more complications than those with BEV after TAVI.
Introduction: Patients with severe aortic stenosis (AS) require multi-detector computed tomography (MDCT) when considered for transcatheter aortic valve implantation (TAVI). Incidental findings on MDCT are common given the age group and region imaged. Our aim was to evaluate the frequency and outcome of incidental findings (IF) identified on MDCT and the impact on survival.
View Article and Find Full Text PDFBackground: There is still limited data on the very long term clinical outcomes after ABSORB BRS in daily practice. We sought to evaluate the 3 year-performance of the Absorb bioresorbable vascular scaffolds for the treatment of low/moderate complexity patients enrolled in the ABSORB EXTEND trial.
Methods: ABSORB EXTEND is a prospective, single-arm, open-label clinical study in which 812 patients were enrolled at 56 sites.
Article Synopsis
- * The Heart Team approach involves both doctors and surgeons in making treatment decisions, considering factors like frailty from geriatric assessments to determine the best course of action, whether it be TAVI, surgical options, or conservative management.
- * TAVI has become a standard procedure in Australia since 2018, with advancements leading to fewer complications and shorter recovery times, and it's anticipated that more elderly patients will require this life-saving treatment in the future
Article Synopsis
- - The study focuses on pregnancy-associated spontaneous coronary artery dissection (P-SCAD), reviewing demographics, management, and outcomes over time.
- - A total of 138 P-SCAD cases from 273 screened publications were analyzed, revealing significant improvements in management and outcomes, particularly from 2006-2016.
- - Maternal mortality dropped from 85% to 4%, and foetal mortality from 50% to 0% over the decades, linked to advancements like earlier angiography and conservative treatment strategies.
Article Synopsis
- The study compared microvascular function in patients with STEMI receiving thrombolysis and those with NSTEMI undergoing PCI, involving 17 STEMI and 20 NSTEMI patients.
- Results showed that the baseline microcirculatory function was significantly worse in the STEMI group, but both groups improved post-PCI.
- Notably, post-PCI IMR was linked to left ventricular function, indicating its potential as a predictor of recovery in STEMI patients.
Article Synopsis
- Inflammation and microvascular dysfunction (MVD) are linked to adverse heart issues in ischemic heart disease patients, prompting a study to explore their association with myocardial injury.
- The study evaluated 74 patients undergoing coronary interventions, measuring microvascular function (IMR) and inflammation (hsCRP), with severe MVD identified at IMR ≥ 30.
- Results showed that higher levels of hsCRP corresponded to worse microvascular function and increased heart injury markers, with significant differences in lifestyle factors like smoking and diabetes between high and low CRP groups.
Background: Preclinical data showed that overlapping (OVP) scaffolds might result in delayed healing and strut coverage compared to nonOVP scaffold segments. Furthermore, OVP in patients could result in increased periprocedure myocardial infarction (MI) rate secondary to side branch occlusion; however, little is known whether this may have an impact on long-term clinical outcomes.
Methods: ABSORB EXTEND is a prospective, single-arm, open-label clinical study in which 812 patients were enrolled at 56 sites.
Introduction: There is progressive interest worldwide in spontaneous coronary artery dissection (SCAD). To identify a SCAD cohort and compare risk factors, presentation, and management outcomes compared to acute coronary syndrome (ACS) matched controls.
Methods: Retrospective analysis was performed from 2000 to 2015.
Serial 5-Year Evaluation of Side Branches Jailed by Bioresorbable Vascular Scaffolds Using 3-Dimensional Optical Coherence Tomography: Insights From the ABSORB Cohort B Trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions).
Circ Cardiovasc Interv
September 2017
Background: The long-term fate of Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, CA) struts jailing side branch ostia has not been clarified. We therefore evaluate serially (post-procedure and at 6 months, 1, 2, 3, and 5 years) the appearance and fate of jailed Absorb bioresorbable vascular scaffold struts.
Methods And Results: We performed 3-dimensional optical coherence tomographic analysis of the ABSORB Cohort B trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions) up to 5 years using a novel, validated cut-plane analysis method.
Objectives: This study sought to determine the mechanistic effects of a novel balloon-based lithoplasty system on heavily calcified coronary lesions and subsequent stent placement using optical coherence tomography (OCT).
Background: The Shockwave Coronary Rx Lithoplasty System (Shockwave Medical, Fremont, California) delivers localized, lithotripsy-enhanced disruption of calcium within the target lesion (i.e.