Trend, predictors, and outcomes of combined mitral valve replacement and coronary artery bypass graft in patients with concomitant mitral valve and coronary artery disease: a National Inpatient Sample database analysis.

Aims: Combined mitral valve replacement (MVR) and coronary artery bypass graft (CABG) procedures have been the norm for patients with concomitant mitral valve disease (MVD) and coronary artery disease (CAD) with no large-scale data on their safety and efficacy.

Methods And Results: The National Inpatient Sample database (2002-18) was queried to identify patients undergoing MVR and CABG. The major adverse cardiovascular events (MACE) and its components were compared using a propensity score-matched (PSM) analysis to calculate adjusted odds ratios (OR).

Sex-based differences in clinical outcomes and resource utilization of type 2 myocardial infarction.

Background: Sex-based differences in clinical outcomes have been previously well described in type 1 myocardial infarction (T1MI). However, type 2 myocardial infarction (T2MI) is more common in contemporary practice, with scarce data regarding sex-based differences of outcomes.

Methods: The Nationwide Readmission Database 2018 was queried for hospitalizations with T2MI as a primary or secondary diagnosis.

Utility of Coronary Artery Calcium Scores in Predicting Risk of Subclinical Cardiovascular Atherosclerotic Disease: An Analysis of Limitations to its Adoption With Policy Recommendations.

This survey-based analysis aims to highlight key limitations to a wider adoption of coronary artery calcium (CAC) scoring as a means of screening asymptomatic individuals for atherosclerotic cardiovascular disease. The need for a screening tool that adds objective anatomical information to historically established risk scores in the aforementioned population has been met by this imaging modality. Despite that, there has been a hesitance towards frequent usage of these scans.

Transradial versus transfemoral access for cardiac catheterization: a nationwide pilot study of training preferences and expertise in The United States.

Background: The objective was to assess current training preferences, expertise, and comfort with transfemoral access (TFA) and transradial access (TRA) amongst cardiovascular training fellows and teaching faculty in the United States. As TRA continues to dominate the field of interventional cardiology, there is a concern that trainees may become less proficient with the femoral approach.

Methods: A detailed questionnaire was sent out to academic General Cardiovascular and Interventional Cardiology training programs in the United States.

Interarterial course of anomalous right coronary artery: role of symptoms and surgical outcomes.

Anomalous origin of right coronary artery with interarterial course (ARCA-IA) is a risk factor for sudden death and other cardiac complications. Surgical correction remains its gold standard treatment. We describe clinical characteristics, workup, surgical techniques and outcomes of ARCA-IA at our center.

Appropriateness of Prescription and Safety of Wearable Cardioverter Defibrillators: A Single-center Experience.

Introduction Wearable cardioverter defibrillators (WCD) are recommended for patients with a high risk of sudden cardiac death (SCD) secondary to arrhythmia that have not qualified for placement of an implantable cardiac defibrillator (ICD). This study provides insights into a single-center experience with WCD in terms of its usage and safety. Materials and methods We studied all patients that were prescribed a WCD in the Fairview Hospital in Cleveland Clinic Health System, from January 2014 to June 2016.

Recurrent Bacteremia with Corynebacterium Striatum After Prosthetic Valve Replacement: A Case Report.

Infective endocarditis is typically caused by coagulase-negative staphylococci and streptococci but infection with is also becoming prominent. We present the case of a 65-year-old female with a recent history of the coronary artery bypass graft with bioprosthetic aortic valve replacement. The surgery was complicated by sternal wound dehiscence with methicillin-sensitive  (MSSA) for which she was treated for six weeks with intravenous antibiotics.

Cerebrovascular Events After Cardiovascular Procedures: Risk Factors, Recognition, and Prevention Strategies.

Stroke has long been a devastating complication of any cardiovascular procedure that unfavorably affects survival and quality of life. Over time, strategies have been developed to substantially reduce the incidence of stroke after traditional cardiovascular procedures such as coronary artery bypass grafting, isolated valve surgery, and carotid endarterectomy. Subsequently, with the advent of minimally invasive technologies including percutaneous coronary intervention, carotid artery stenting, and transcatheter valve therapies, operators were faced with a new host of procedural risk factors, and efforts again turned toward identifying novel ways to reduce the risk of stroke.

Long-term mortality in patients with severe secondary mitral regurgitation and normal left ventricular ejection fraction: interventional perspective.

Aims: Patients with severe secondary mitral regurgitation (MR) and normal ejection fraction are being excluded from clinical trials evaluating transcatheter mitral devices. We sought to evaluate the long-term mortality with medical management alone in this patient population.

Methods And Results: We retrospectively evaluated patients diagnosed with ≥3+ MR at our institution over 15 years.

Narrow Complex Ventricular Tachycardia.

Myocardial infarctions are frequently complicated by tachyarrhythmias, which commonly have wide QRS complexes (QRS duration > 120 milliseconds). Many published criteria exist to help differentiate between ventricular and supraventricular mechanisms. We present a case of a 61-year-old male with a history of hypertension, hyperlipidemia and coronary artery disease with prior stenting of the right coronary artery (RCA).

Pacemaker Placement in Persistent Left Superior Vena Cava.

Persistent left superior vena cava (PLSVC) is a rare disorder which is asymptomatic and hence is usually discovered while performing interventions through the left subclavian vein. We present a case of a 78-year-old male who was undergoing elective placement of a permanent pacemaker for tachycardia - bradycardia syndrome with post-conversion pauses of up to nine seconds. After achieving access through the left subclavian vein the wire kept on going on the left side of the chest instead of crossing the midline to the right side.

Clinical Characteristics and Outcomes of Patients with Ischemic and Non-Ischemic Complete Heart Block.

Introduction: Third degree or complete heart block (CHB) is a medical emergency and usually requires permanent pacemaker placement. CHB can be caused by cardiac ischemia or non-ischemic conditions such as infiltrative diseases or fibrosis. The purpose of this study is to identify the baseline clinical characteristics associated with ischemic versus non-ischemic causes of complete heart block and compare their outcomes.

Prognostic significance of mild aortic regurgitation in predicting mortality after transcatheter aortic valve replacement.

Objective: Moderate to severe aortic regurgitation after transcatheter aortic valve replacement is associated with worse outcomes. The impact of mild aortic regurgitation has been less clear, possibly because of the broad categories that have been used in clinical trials, but holds increasing importance in the study of next-generation devices in low- and intermediate-risk cohorts. A more granular scheme, which is common in clinical practice and proposed for future trials, may add prognostic value.