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Valvular Heart Disease Care in Pakistan: Impact of the Multidisciplinary Valve Heart Team.

JACC Adv

December 2024

Department of Interventional Cardiology& structural heart interventions, NICVD, Karachi, Pakistan.

Background: Patients with complex valvular heart disease (VHD) should be evaluated by a multidisciplinary heart team (HT). In low- and middle-income countries, referral practices are more variable, permitting any physician to refer patients directly to a cardiac surgeon without prior formal evaluation by a cardiologist with expertise in VHD.

Objectives: The goal of the study was to examine the demographics of VHD patients seen in a large heart valve center in a low- and middle-income country and to assess the impact of the multidisciplinary HT in patients referred for valve surgery.

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Background: Transcatheter aortic valve replacement (TAVR) has significantly advanced the treatment of severe aortic stenosis (AS), particularly in elderly patients who often have coexisting coronary artery disease (CAD). Chronic total occlusion (CTO), a severe form of CAD, may negatively impact outcomes in TAVR patients, though data are limited. This meta-analysis aims to evaluate the impact of CTO on TAVR outcomes.

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With the cases of mechanical valves, especially double mitral and aortic valves, ablation at the left ventricle is very challenging. This case report used equipments that are readily available in the Electrophysiology laboratory, which can make the access feasible.

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Introduction: is a formidable pathogen that poses a significant threat to immunocompromised and might cause rare atypical forms of the disease especially complicated with coinfection.

Case: We present a case of a patient with meningoencephalitis, endocarditis, sepsis, and osteomyelitis, highlighting the complexities of managing disseminated polymicrobial infection. A 64-year-old female with multiple myeloma treated with chemotherapy presented with fever, altered mental status, nausea, and diarrhea to the emergency department.

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