Anticoagulation with Nafamostat Mesilate During Impella Support: A Case Report.

Achieving an optimal balance between thrombosis prevention and bleeding risk during temporary mechanical circulatory support remains a significant clinical challenge. Effective anticoagulation management that ensures device functionality while minimizing major bleeding events should have the potential to improve short-term outcomes. Here, we report the successful use of nafamostat mesilate (NM) as an anticoagulant during Impella support in two male patients with advanced heart failure and cardiogenic shock.

Efficacy of Inhaled Treprostinil in a Patient with Systemic Sclerosis-Associated Pulmonary Hypertension and Interstitial Lung Diseases Refractory to Conventional Intravenous Epoprostenol.

Systemic sclerosis-associated pulmonary hypertension (SSc-PH) is widely recognized as the most severe subtype of connective tissue disease-associated pulmonary hypertension (CTD-PH), particularly in patients with complicating factors such as interstitial lung disease (ILD) and biventricular failure. This condition is associated with the poorest clinical outcomes among PH subtypes, presenting significant challenges in both management and prognosis. Despite the use of conventional therapies, including intravenous administration of epoprostenol, a promising prostacyclin analogue, treatment outcomes for SSc-PH remain suboptimal.

Initial Experience of Noninvasive Quantification of Pulmonary Congestion Utilizing the Remote Dielectric Sensing System in Pediatric Patients with Heart Failure.

: Remote dielectric sensing (ReDS) is a recently developed, noninvasive, electromagnetic energy-based technology designed to quantify pulmonary congestion without requiring expert techniques in adult patients with heart failure. However, its applicability in pediatric patients remains unknown. : ReDS values and chest X-rays were simultaneously obtained from pediatric patients with a history of Fontan surgery at an outpatient clinic.

Outcomes of Left Atrial Appendage Closure in Hemodialysis Patients With Atrial Fibrillation: The OCEAN-LAAC Registry.

Background: Left atrial appendage closure (LAAC) has demonstrated favorable outcomes as an alternative to permanent anticoagulation in patients with nonvalvular atrial fibrillation (NVAF). In hemodialysis (HD) patients with NVAF, anticoagulation increases bleeding complications, with inconsistent benefits in stroke prevention.

Objectives: This study aimed to clarify the benefit of LAAC for HD patients.

Re-sheathing failure with Navitor during transcatheter aortic valve implantation: a case report.

Background: Self-expanding valves used in transcatheter aortic valve implantation (TAVI) are designed to allow recapture and repositioning, facilitating optimal placement and mitigating conduction disturbances and paravalvular leakage. Here, we present a rare case in which the Navitor (Abbott Structural Heart, Santa Clara, CA, USA) could not be recaptured.

Case Summary: An 81-year-old Japanese woman with very severe aortic stenosis and a massively calcified nodule at the non-coronary cusp (NCC) underwent TAVI with a 25 mm Navitor valve.

Clinical Implication of HIF-PH Inhibitor in Patients with Heart Failure, Chronic Kidney Disease, and Renal Anemia.

Hypoxia-inducible factor-prolyl hydroxylase (HIF-PH) inhibitors have been developed as a treatment for renal anemia. However, their therapeutic impact on patients with concomitant heart failure remains uncertain. We investigated the impact of HIF-PH inhibitors on improving renal anemia and associated clinical outcomes in patients with heart failure.

Trajectory of Urine Parameters by Adding Herbal Kampo Medicine Goreisan to Tolvaptan in Patients with Congestive Heart Failure.

Even in current guideline-directed medical therapy, including recently introduced vasopressin type 2 receptor antagonist tolvaptan, congestion has not been resolved in patients with heart failure. Kampo medicine goreisan has been receiving considerable attention as an additional therapy for patients who are refractory to conventional diuretics therapy, including tolvaptan. However, the impact of goreisan on urine electrolytes remains uncertain.

Efficacy and Safety of Sodium Zirconium Cyclosilicate in the Management of Hyperkalemia in Patients with Heart Failure with Reduced and Mildly Reduced Ejection Fraction and Chronic Kidney Disease Treated with Spironolactone: Rationale for and Design of the REGISTA-K Trial.

Background: To evaluate whether sodium zirconium cyclosilicate (SZC) enables the up-titration of spironolactone without increasing the risk of hyper- and hypokalemia in patients with heart failure with reduced and mildly reduced ejection fraction (HFrEF and HFmrEF) and moderate/severe chronic kidney disease (CKD) who developed hyperkalemia during treatment with suboptimal spironolactone dose.

Methods: The REGISTA-K is a randomized, double-blind, placebo-controlled, multicenter trial that examined the efficacy and safety of SZC in up-titrating spironolactone without the occurrence of hyperkalemia or hypokalemia. A total of 266 patients with HFrEF and HFmrEF and hyperkalemia will be randomized in a 1:1 ratio to receive either SZC or placebo after treating hyperkalemia with SZC at 25 sites in Japan.