Publications by authors named "Sachin Goel"
Background: Cardiovascular disease (CVD) is associated with high mortality in the United States, but the burden of CVD mortality is unevenly distributed between demographic and geographic subgroups, with poor characterization of state-specific trends. In this study, the disparities in CVD-related mortality trends in Texas and the United States from 1999 to 2019 were assessed.
Methods: Trends in CVD-related mortality were evaluated through analysis of the Multiple Causes of Death Files from the National Center for Health Statistics.
Article Synopsis
- * The J-Valve device, developed by JC Medical, shows promising outcomes, particularly in patients with complex anatomical challenges.
- * Two successful cases of transcatheter aortic valve replacement using the J-Valve were reported in patients who had significant aortic angulation.
Background: Limited data exist on the risk profile and prognosis of young patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). This study sheds light on the burden of cardiovascular risk factors and outcomes in this population.
Methods: The Houston Methodist Young ACS-PCI registry is a retrospective analysis of young adults (18 to 50 years) undergoing PCI for ACS between 2010 and 2022.
Article Synopsis
- This study investigated the effect of mitral stenosis (MS) on outcomes in patients undergoing transcatheter aortic valve replacement (TAVR) with modern balloon-expandable valves, using data from over 327,000 patients across multiple centers.
- It was found that while patients with severe MS initially had worse outcomes, when matched for similar characteristics, their 30-day outcomes were similar to those with mild or less MS, except for a higher rate of pacemaker implantation.
- However, by three years post-TAVR, patients with severe MS showed a significantly higher mortality rate compared to those with mild or less MS, suggesting long-term risks associated with severe MS.
Background: Transcatheter aortic valve replacement (TAVR) for high surgical risk patients with severe native aortic regurgitation (AR) presents unique challenges. Dedicated devices such as the JenaValve (JenaValve Technology) and J-Valve (JC Medical Inc) show promising results in addressing these challenges.
Objectives: This study compares the safety and efficacy of dedicated vs off-label devices among high surgical risk patients with pure native AR.
Background: The impact of mitral annular calcification (MAC) on the clinical outcomes of patients undergoing mitral transcatheter edge-to-edge repair (MTEER) remains unclear. This meta-analysis aims to evaluate the clinical outcomes of MTEER among patients with moderate to severe MAC compared to those with mild or no MAC.
Methods: We systematically searched PubMed, EMBASE, and Cochrane CENTRAL databases through March 31st, 2024, comparing clinical outcomes of MTEER among patients with moderate/severe (MAC+) versus no/mild MAC (MAC-).
Background: Anatomical factors may preclude transfemoral (TF) arterial access for transcatheter aortic valve implantation (TAVI). Transcaval (TCav) access has been utilized as an alternative access for these patients. We aimed to investigate the outcomes of TCav access in patients undergoing TAVI.
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- The study explored the impact of residual transmitral mean pressure gradient (TMPG) after mitral transcatheter edge-to-edge repair (M-TEER) on patient outcomes, focusing on all-cause mortality and hospitalizations related to heart failure.
- Higher baseline TMPG was found to predict increased residual TMPG post-procedure, with patients in the highest quartile experiencing significantly worse outcomes, including higher risks of mortality and heart failure hospitalization over three years.
- The findings suggest that efforts should be made to minimize residual TMPG after M-TEER, particularly in patients with primary mitral regurgitation (MR).
Periprosthetic joint infection (PJI) is a severe complication following joint replacement surgeries, particularly in aseptic revision arthroplasty, where infection rates are higher compared to primary procedures. The extended surgical time, increased blood loss, and the presence of scar tissue contribute to the higher susceptibility to PJI in revision surgeries. Tranexamic acid (TXA), a synthetic antifibrinolytic agent, is widely used in orthopaedic surgery to reduce intraoperative and postoperative bleeding.
View Article and Find Full Text PDFWe present one of the inaugural transcatheter aortic valve implantation procedures using the latest Medtronic platform, Evolut FX+. Successful coronary angiography was achieved within 28 seconds and 1 minute 49 seconds for the left and right coronary arteries, respectively. Postoperative cardiac computed tomography scan demonstrated optimal commissural and diamond-coronary alignment.
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- The study investigates the significance of measuring pulmonary venous flow (PVF) patterns during mitral transcatheter edge-to-edge repair (TEER) to predict patient outcomes, focusing on systolic dominant-PVF (SD-PVF) morphology.
- Researchers analyzed data from 187 patients and found that those with SD-PVF had lower rates of severe residual mitral regurgitation (MR) and were less likely to experience all-cause mortality or heart failure hospitalization within one year.
- The findings suggest that post-TEER PVF morphology could serve as an effective and straightforward prognostic tool, but more large-scale studies are needed to validate its impact further.
Article Synopsis
- Patients with mitral regurgitation (MR) and significant mitral annular calcification (MAC) face limited treatment options, making transcatheter mitral valve replacement (TMVR) an interesting area of study.
- The research involved 279 patients, revealing that those with MAC had higher rates of post-procedural bleeding and renal failure but similar overall survival rates and functional improvement compared to those without MAC.
- The findings suggest that while TMVR can be performed in MAC patients, it comes with increased complications, highlighting the need for more research on tailored TMVR devices for this group.
Article Synopsis
- Tricuspid regurgitation (TR) is linked to poorer health outcomes after procedures like TAVR and M-TEER, emphasizing the need to understand its impact on patient health status.
- The study analyzed data from a large registry to explore the relationship between levels of baseline TR and health status, measured through KCCQ-OS scores, as well as clinical outcomes post-procedure.
- Results indicated that patients with moderate to severe TR before intervention had significantly lower health scores and higher risks for mortality and readmission after 1 year compared to those with none to mild TR.
Total knee arthroplasty (TKA) is a widely performed surgical procedure to restore function and relieve pain in patients with advanced knee arthritis. One of the key challenges in TKA is managing perioperative blood loss, which can lead to complications such as postoperative anemia and the need for blood transfusions. Tranexamic acid (TXA), an antifibrinolytic agent, has shown promising results in reducing blood loss and transfusion requirements in various surgical settings, including TKA.
View Article and Find Full Text PDFHip tuberculosis (TB) is not a common disease, and this devastating illness requires complete treatment. This case study describes the treatment of a 25-year-old female who suffered from hip TB. She came with right hip discomfort, limping, and a restricted range of movement.
View Article and Find Full Text PDFBackground: Pulmonary embolism is one of the leading causes of morbidity and mortality in the United States. Catheter-directed therapies have emerged as a promising treatment for managing intermediate- and high-risk patients; however, data comparing standard catheter-directed thrombolysis (SCDT) and ultrasound-assisted thrombolysis (USAT) are limited. This study aimed to investigate trends, outcomes, and predictors of mortality of both modalities from a nationally representative sample.
View Article and Find Full Text PDF"Steering" Toward Complete Left Atrial Appendage Closure.
J Soc Cardiovasc Angiogr Interv
April 2024
Polymer microparticles are often used to encapsulate drugs for sustained drug-release treatments. One of the ways they are manufactured is by using a solvent extraction process, in which the polymer solution is emulsified into an aqueous bulk phase using a surfactant as a stabilizing agent, followed by the removal of the solvent. The radius of a polymer drop decreases as a function of time until the polymer reaches the gelling point, after which it is separated and dried.
View Article and Find Full Text PDFTranscatheter aortic valve replacement (TAVR) has undergone significant advancements in the last two decades, expanding its indications and refining transcatheter heart valve (THV) and delivery system designs to improve procedural success and patient outcomes. This review focuses on the Navitor™ valve, a third-generation intra-annular Portico™ valve (Abbott Structural Heart, St Paul, MN, USA) designed to address TAVR complications, particularly paravalvular leak (PVL). We present an overview of the Navitor™ system, comparing it to the first-generation Portico™ THV in terms of THV design, key iterations and clinical outcomes.
View Article and Find Full Text PDFThis case report describes the presentation, diagnosis, and surgical management of a 61-year-old female admitted to a tertiary care hospital with a two-month history of neck pain and weakness in all four limbs. Despite the absence of a clear history of trauma, a detailed examination revealed restricted neck flexion, paraspinal muscle spasm, and neurological deficits. Contrast-enhanced MRI indicated vertebral osteomyelitis and discitis at the C5-C6 level, with a suspected infective etiology, possibly tuberculosis spondylitis.
View Article and Find Full Text PDFImpact of Left Atrial Pressure on Outcomes After Mitral Transcatheter Edge-to-Edge Repair.
Circ Cardiovasc Interv
September 2024
Background: Increased left atrial pressure (LAP) has been associated with adverse outcomes after mitral transcatheter edge-to-edge repair (M-TEER). We sought to evaluate outcomes based on differences in postprocedural LAP measured after the final clip deployment.
Methods: We included consecutive patients who underwent M-TEER at our institution between 2014 and 2022 with LAP monitoring.
The changing trend of fungal infection in invasive rhinosinusitis in the COVID era.
J Family Med Prim Care
April 2024
Background: SARS-COV virus operates as a significant risk factor for invasive fungal aspergillosis and mucormycosis. Successful management of this fulminant infection requires early recognition of the disease and aggressive medical or surgical interventions to prevent the high morbidity and mortality associated with the disease process.
Aims And Objective Of The Study: 1.
Background And Aims: Surgical explantation of transcatheter heart valves (THVs) is rapidly increasing, but there are limited data on patients with THV-associated infective endocarditis (IE). This study aims to assess the outcomes of patients undergoing THV explant for IE.
Methods: All patients who underwent THV explant between 2011 and 2022 from 44 sites in the EXPLANT-TAVR registry were identified.