Publications by authors named "Vivian G Ng"
Article Synopsis
- Augmented reality (AR) can enhance transcatheter aortic valve replacement (TAVR) procedures by providing visualization of 3D patient-specific anatomical models, potentially increasing safety and efficiency during the placement of cerebral embolic protection devices (CEP).
- A study involving 24 patients compared those using AR guidance to a control group, finding that AR guidance significantly reduced the contrast volume needed for the procedure while not affecting the time taken for filter placement or fluoroscopy.
- Postprocedure feedback from physicians indicated that AR guidance boosted their confidence in performing the procedure, suggesting it improved overall intervention performance despite similar procedural times.
Article Synopsis
- The study examines outcomes of percutaneous coronary intervention (PCI) for de novo ostial right coronary artery (RCA) lesions, which have previously shown poor outcomes.
- Researchers utilized intravascular ultrasound (IVUS) to categorize 170 identified RCA stenoses into three morphological types: isolated ostial lesions, ostial lesions with calcified nodules (CN), and ostial lesions with diffuse disease.
- Results indicated that patients with CN had a significantly higher two-year target lesion failure (TLF) rate compared to those with diffuse disease, while isolated lesions resulted in no events, highlighting that lesion morphology is crucial for predicting clinical outcomes.
Article Synopsis
- Intravascular ultrasound studies reveal that about 25% of the left anterior descending (LAD) arteries have a myocardial bridge, which can affect stent performance.
- This study aimed to explore the relationship between myocardial bridges and chronic total occlusions (CTOs) in LAD lesions, as well as their impact on clinical outcomes after treatment.
- Results indicated that myocardial bridges were more frequent in LAD CTOs, and stents that extended into these bridges were linked to higher rates of target lesion failure compared to stents not extending into them.
Article Synopsis
- Valve-in-valve (VIV) transcatheter aortic valve implantation (TAVI) is a less invasive option for high-risk patients compared to traditional surgical valve replacement, but it has a higher complication rate when done within stentless valves.
- A study analyzed 25 patients who underwent VIV-TAVI from 2013 to 2022, showing 100% procedural success with no significant complications and an average hospital stay of 2 days.
- After a median follow-up of 16.5 months, all patients demonstrated acceptable valve function, indicating that VIV-TAVI can be a safe and beneficial procedure for those at high risk for reoperation.
Article Synopsis
- Mitral regurgitation is a common heart valve issue affecting over 5 million Americans, with a focus on real-world data collection for regulatory and clinical purposes.
- The study aimed to create a standard set of essential data elements for mitral interventions, going through 703 options and reaching consensus on 127 core elements for effective data use.
- This core data set will enhance the national registry for transcatheter mitral devices, supporting safety monitoring, regulatory submissions, and improving hospital care quality.
Article Synopsis
- The study investigates the causes of in-stent restenosis (ISR) in the right coronary artery (RCA), particularly focusing on mechanical and biological mechanisms.
- Using intravascular ultrasound (IVUS), researchers classified ISR lesions and found that 50% were due to mechanical issues like stent fractures or deformations, while 53% were related to biological factors like neointimal hyperplasia.
- The one-year target lesion failure rate was 11.5%, with significantly higher event rates (41.4%) for mechanically caused ISRs that were managed without new stents, highlighting the need for better treatment strategies.
Article Synopsis
- TAVR is recognized as the standard treatment for severe aortic stenosis, making real-world data collection critical for assessing its benefits and risks across various health organizations, like the FDA and Medicare.
- A systematic review of existing TAVR research was conducted to identify essential data elements necessary for efficient data collection, resulting in the consensus on 132 core elements from an original pool of 276.
- The established core dataset aims to streamline evidence gathering for TAVR, enhancing regulatory submissions, safety monitoring, and evaluations of best practices in healthcare institutions.
Article Synopsis
- Transcatheter aortic valve replacement (TAVR) is the main treatment option for patients with severe aortic stenosis, and real-world data collection is crucial for evaluating its benefits and risks.
- A systematic review was conducted to identify essential data elements needed for effective data collection related to TAVR, involving key organizations and experts.
- The final consensus identified 132 core data elements, focusing on efficient, reusable data for regulatory, safety, and quality assessments while considering the practical challenges of data collection.
Data on depression and stress among patients with spontaneous coronary artery dissection (SCAD) are limited. Using data from the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) study, which prospectively enrolled 3,572 acute myocardial infarction (AMI) patients between 18 and 55 years of age, we identified 67 SCAD cases. We compared Patient Health Questionnaire-9 (PHQ-9) and 14-item Perceived Stress Scale (PSS-14) scores obtained at baseline, 1 month, and 12 months between SCAD and AMI of all other causes.
View Article and Find Full Text PDFBackground: Data on health status outcomes after spontaneous coronary artery dissection (SCAD) are limited.
Methods And Findings: Using the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study we compared patients with SCAD and other acute myocardial infarction (AMI) at presentation (baseline), 1-month, and-12 months using standardized health status instruments. Among 3572 AMI patients ≤ 55 years, 67 had SCAD.
Article Synopsis
- Right ventricular pressure-volume (PV) analysis assesses the heart's pumping abilities regardless of external factors like blood volume and pressure.
- It has historically been a complex technique used mainly in research, but advancements in technology have made it more accessible for clinical use.
- The review highlights foundational techniques for measuring and interpreting PV loops, explores its clinical applications, and emphasizes its significance in understanding right ventricular function in various health contexts.
Background Aortic stenosis is prevalent in end-stage renal disease. Transcatheter aortic valve replacement (TAVR) is a plausible alternative for surgical aortic valve replacement. However, little is known regarding long-term outcomes in patients with end-stage renal disease who undergo TAVR.
View Article and Find Full Text PDFArticle Synopsis
- Suprasternal access for transcatheter aortic valve replacement (TAVR) involves cannulating the innominate artery through an incision above the sternal notch, and it has not been directly compared to the more commonly used transfemoral access until now.
- In this study, 89 patients underwent suprasternal TAVR and 159 patients underwent transfemoral TAVR to evaluate safety and early clinical outcomes, with no significant difference in in-hospital mortality or major complications between the two methods.
- The findings suggest that suprasternal TAVR is safe with promising short-term outcomes, leading to recommendations for further studies to explore its effectiveness compared to other alternative access techniques.
A 66-year-old man with refractory multiple myeloma presented with acute severe aortic insufficiency leading to cardiogenic shock and multiorgan failure. After comprehensive heart team evaluation, he underwent successful JenaValve transcatheter aortic valve (JenaValve Technology, Inc., Irvine, California) implantation resulting in resolution of his aortic insufficiency and improvement in his clinical status.
View Article and Find Full Text PDFIncidence, Predictors, and Outcomes of Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Replacement: Insights From the Society of Thoracic Surgeons/American College of Cardiology National Cardiovascular Data Registry-Transcatheter Valve Therapy Registry.
Circ Cardiovasc Interv
April 2021
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View Article and Find Full Text PDFControversies in the Treatment of Women with ST-Segment Elevation Myocardial Infarction.
Interv Cardiol Clin
October 2016
Coronary artery disease is the leading cause of death in women. Women with ST-segment elevation myocardial infarctions continue to have worse outcomes compared with men despite advancements in therapies. Furthermore, these differences are particularly pronounced among young men and women with myocardial infarctions.
View Article and Find Full Text PDFBiodegradable Polymer Drug-Eluting Stents: Can a Class Effect Be Assumed?
JACC Cardiovasc Interv
March 2017
Surgical and catheter-based cardiovascular procedures and adjunctive pharmacology have an inherent risk of neurological complications. The current diversity of neurological endpoint definitions and ascertainment methods in clinical trials has led to uncertainties in the neurological risk attributable to cardiovascular procedures and inconsistent evaluation of therapies intended to prevent or mitigate neurological injury. Benefit-risk assessment of such procedures should be on the basis of an evaluation of well-defined neurological outcomes that are ascertained with consistent methods and capture the full spectrum of neurovascular injury and its clinical effect.
View Article and Find Full Text PDFSurgical and catheter-based cardiovascular procedures and adjunctive pharmacology have an inherent risk of neurological complications. The current diversity of neurological endpoint definitions and ascertainment methods in clinical trials has led to uncertainties in the neurological risk attributable to cardiovascular procedures and inconsistent evaluation of therapies intended to prevent or mitigate neurological injury. Benefit-risk assessment of such procedures should be on the basis of an evaluation of well-defined neurological outcomes that are ascertained with consistent methods and capture the full spectrum of neurovascular injury and its clinical effect.
View Article and Find Full Text PDFCerebral embolization during transcatheter aortic valve implantation (TAVI) can lead to a spectrum of clinically relevant manifestations, ranging from overt stroke to mild neurologic or cognitive deficits and subclinical cerebral infarcts. This study sought to determine the frequency of neurologic injury, cerebral ischemic lesions, and cognitive dysfunction in subjects undergoing contemporary commercial TAVI in the United States. Neuro-TAVR is the first prospective, multicenter study to use serial systematic neurologic and cognitive assessments and diffusion-weighted magnetic resonance imaging (at 4 ± 2 days after procedure) to investigate the incidence and severity of neurologic injury after contemporary unprotected TAVI in the United States.
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