Publications by authors named "Velagapudi Poonam"

While there has been a proliferation of training and practice paradigms in the realm of noncoronary interventions, coronary disease remains the predominant pathology necessitating interventional cardiology expertise. The landscape of coronary disease has also experienced a significant transformation due to rapidly evolving technologies, clinical application of mechanical circulatory support and other device innovations, and increasing acuity and complexity of patients. The modern interventional cardiologist is subject to challenges including decreasing coronary procedural volume, need to maintain clinical and financial productivity, and often also requirements of continued scholastic pursuit.

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Women with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) have a higher burden of symptoms, are older at the time of the TAVR procedure, and have unique anatomic features that increase the periprocedural risk. However, long-term outcomes including mortality are favorable for women compared with men. Careful attention is needed in considering the vascular access route and choice of valve platform to mitigate complications.

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Article Synopsis
  • The field of interventional cardiology (IC) has seen significant advancements and improved training programs over the last 40 years, including accredited fellowship programs and subspecialty certification.
  • Despite these improvements, the application process for IC fellowships has been chaotic and inconsistent, causing stress and pressure on applicants due to competitive recruitment practices.
  • A task force from the Society for Cardiovascular Angiography & Interventions has initiated a grassroots movement to create a national Match system for IC fellowships, aiming to establish fairness and equity in the application process.
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Cardiogenic shock (CS) is a clinical condition characterized by inadequate tissue perfusion in the setting of low cardiac output. CS is the leading cause of death following acute myocardial infarction (AMI). Several temporary mechanical support devices are available for hemodynamic support in CS until clinical recovery ensues or until more definitive surgical procedures have been performed.

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Tricuspid regurgitation (TR) is a highly prevalent valve disorder in the US, with prevalence increasing with age. Without treatment, severe TR carries a poor prognosis. Tricuspid valve (TV) surgery is recommended for patients with severe TR undergoing left-sided valve surgery.

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Background: Non-dominant right coronary artery (RCA) occlusion is uncommon and usually affects a small area of the myocardium. Rarely, it can complicate fatal outcomes such as shock, cardiac arrest, bradyarrhythmia, or tachyarrhythmia.

Case Summary: A 50-year-old man with no significant medical history presented with ventricular fibrillation (VF) cardiac arrest.

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: Patients with prediabetes are at increased risk of coronary artery disease (CAD). However, the association between prediabetes and adverse clinical outcomes following percutaneous coronary intervention (PCI) is inconsistent, in contrast to outcomes in patients with diabetes mellitus (DM). Thus, this meta-analysis evaluated the impact of dysglycaemia on PCI outcomes.

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Article Synopsis
  • Intracoronary imaging (ICI) improves stent implantation by assessing lesion characteristics and optimizing results during percutaneous coronary interventions (PCI) compared to traditional coronary angiography (CA).
  • A systematic review of 9 randomized controlled trials involving 5,879 patients revealed that ICI significantly reduced major adverse cardiovascular events and rates of repeat procedures compared to CA.
  • Overall, the findings suggest that using routine ICI during PCI leads to better patient outcomes, particularly in minimizing the need for further revascularization.
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Background: Cardiogenic shock (CS) associated with severe mitral regurgitation (MR) forebodes a high risk of morbidity and mortality. Transcatheter edge-to-edge repair (TEER) is a rapidly evolving technique for severe MR in haemodynamically stable patients. However, the safety and efficacy of TEER for severe MR in CS are not well established.

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Data on the feasibility of same-day discharge (SDD) following percutaneous left atrial appendage closure (LAAC) remain limited. We analyzed the US Nationwide Readmission Database from quarter four of 2015 to 2019 to study the safety and feasibility of SDD after LAAC. After excluding non-elective cases and in-hospital deaths, a total of 54,880 cases of LAAC were performed during the study period.

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  • Cardiovascular multidisciplinary heart teams (MDHTs) have greatly changed over the past decade, becoming essential in treating various heart diseases across multiple specialties.
  • The structure and function of these teams have adapted to better address patient needs, but there is still a lack of established best practices for their effectiveness compared to cancer care teams.
  • This expert panel review examines the history, current roles, and challenges of cardiovascular MDHTs, while highlighting the need for more evidence on their effectiveness and operational strategies.
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  • The study examined sex differences in patients undergoing percutaneous coronary intervention (PCI) for chronic total occlusion (CTO), finding that female patients were older and had higher rates of diabetes and hypertension.
  • Male patients had more complex procedures and used advanced techniques more frequently than female patients.
  • Despite women experiencing a higher risk of procedural complications, their rates of in-patient mortality and major adverse cardiovascular events were similar to those of men.
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Treatment strategies to combat cardiogenic shock (CS) have remained stagnant over the past decade. Mortality rates among patients who suffer CS after acute myocardial infarction (AMI) remain high at 50%. Mechanical circulatory support (MCS) devices have evolved as novel treatment strategies to restore systemic perfusion to allow cardiac recovery in the short term, or as durable support devices in refractory heart failure in the long term.

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Background: Whilst it is known patients without standard modifiable cardiovascular risk factors (SMuRF; hypertension, diabetes, hypercholesterolaemia, smoking) have worse outcomes in Type 1 acute myocardial infarction (AMI), the relationship between type 2 AMI (T2AMI) and outcomes in patients with and without SMuRF is unknown. This study aimed to determine the prevalence, characteristics and clinical outcomes of patients hospitalised with T2AMI based on the presence of SMuRF.

Methods: Using the National Inpatient Sample, all hospitalizations with a primary discharge diagnosis of T2AMI were stratified according to SMuRF status (SMuRF and SMURF-less).

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