216 results match your criteria: "Gagnon Cardiovascular Institute[Affiliation]"
The Impact of Cardiac Damage on In-Hospital Outcomes for Patients With Aortic Stenosis in the United States: An Analysis From The National Inpatient Sample.
Catheter Cardiovasc Interv
January 2025
Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey, USA.
Article Synopsis
- The study investigates the relationship between cardiac damage (classified by hospital discharge codes) and in-hospital outcomes for patients with aortic stenosis (AS) using data from a large national sample.
- It analyzed nearly 3 million hospital admissions from 2016 to 2021, noting significant impacts of cardiac damage on mortality, length of stay, and costs, particularly for those undergoing surgical aortic valve replacement (SAVR).
- Findings indicate that patients with higher stages of cardiac damage experience worse in-hospital outcomes, with those receiving SAVR showing the most dramatic differences compared to other treatment options like transcatheter aortic valve replacement (TAVR) and conservative management.
The relationship between symptoms and regurgitant severity in primary mitral regurgitation: a cardiovascular magnetic resonance study.
Int J Cardiovasc Imaging
December 2024
East Side Radiology, New York, NY, USA.
In the ACC/AHA guidelines, the presence of symptoms plays a central role in determining timing surgery in primary mitral regurgitation (MR). Studies have shown a disconnect between the severity of MR and symptoms. The purpose of this study is to assess risk factors for symptoms in patients with chronic primary MR.
View Article and Find Full Text PDFFive Year Outcomes in Low-Risk Patients Undergoing Surgery in the PARTNER 3 Trial.
Ann Thorac Surg
December 2024
Baylor Scott & White Healthcare, Plano, TX.
Background: Surgery remains an important treatment for low-risk patients with severe symptomatic aortic stenosis (AS). We evaluated 5-year outcomes in low-risk patients undergoing isolated surgical aortic valve replacement (SAVR) or SAVR with concomitant procedures within the randomized PARTNER 3 trial.
Methods: In the PARTNER 3 trial, 454 patients underwent surgery for severe, symptomatic, tri-leaflet AS and were followed for 5 years.
Aortic Valve Replacement vs Clinical Surveillance in Asymptomatic Severe Aortic Stenosis: A Systematic Review and Meta-Analysis.
J Am Coll Cardiol
November 2024
British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
Background: Current guidelines recommend a strategy of clinical surveillance (CS) for patients with asymptomatic severe aortic stenosis (AS) and a normal left ventricular ejection fraction.
Objectives: The aim of this study was to conduct a study-level meta-analysis of randomized controlled trials (RCTs) evaluating the effect of early aortic valve replacement (AVR) compared with CS in patients with asymptomatic severe AS.
Methods: Studies were quantitatively assessed in a meta-analysis using random-effects modeling.
Major Bleeding and Mortality After Revascularization of Left Main Disease.
J Am Coll Cardiol
December 2024
The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address:
Background: The incidence and prognostic impact of major bleeding (MB) after percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) are unknown.
Objectives: The goal of this study was to investigate the rates and outcomes of MB after LMCAD revascularization.
Methods: In the EXCEL (Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial, 1,905 patients with unprotected LMCAD were randomized to undergo PCI (n = 948) or CABG (n = 957) and followed up for 5 years.
Cardiovascular magnetic resonance imaging in mitral valve disease.
Eur Heart J
November 2024
Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, 100 Madison Avenue, Morristown, NJ 07960, USA.
Article Synopsis
- - This paper discusses how cardiovascular magnetic resonance (CMR) imaging is used to evaluate patients with mitral valve disease, specifically focusing on mitral regurgitation (MR), a common heart valve issue that often has no symptoms but can lead to serious complications.
- - CMR is particularly recommended when traditional ultrasound imaging doesn't provide clear information, as it offers detailed insights into the mitral valve structure and function, including aspects like leaflet shape and how MR affects heart remodeling.
- - The review also aims to present both current and innovative CMR techniques for assessing mitral valve disease, including flow and myocardial evaluations, and suggests a simplified flow chart for healthcare providers to follow when performing CMR assessments.
Trends in surgical and transcatheter interventions for tricuspid regurgitation: A national inpatient sample analysis from 2011 to 2020.
Cardiovasc Revasc Med
November 2024
Division of Cardiology, Center Structural Heart Disease, Henry Ford Hospital, Detroit, MI, USA.
Article Synopsis
- Tricuspid regurgitation (TR) is a serious condition linked to long-term health issues, including severe right heart failure, but newer less invasive treatments like transcatheter valve interventions (TTVI) are gaining attention.
- A study analyzing over 98,000 tricuspid valve procedures from 2011 to 2020 revealed trends in intervention types, showing a rise in TTVI and a decline in traditional surgical options.
- Findings indicate demographic factors like age and race affect procedure choice and outcomes, with surgical interventions showing higher mortality rates; further research is needed to understand the causes of these evolving trends in treatment results.
Timing of Aortic Valve Intervention in the Management of Aortic Stenosis.
JACC Cardiovasc Interv
November 2024
Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address:
Aortic stenosis (AS) affects about 12% of people aged ≥75 years. Accumulating evidence on the prognostic importance of cardiac damage in patients with asymptomatic and less than severe AS supports the proposition of advancing aortic valve replacement (AVR) to earlier disease stages. Potential benefits of earlier treatment, including prevention of cardiac damage progression and reduced cardiovascular hospitalizations, need to be balanced against the earlier procedural risk and subsequent lifetime management after AVR.
View Article and Find Full Text PDFTAVR in Patients With Moderate Aortic Stenosis and Heart Failure.
J Am Coll Cardiol
October 2024
Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis.
N Engl J Med
October 2024
From Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ (P.G.); Columbia University Medical Center/New York Presbyterian Hospital (A.S., R.T.H., M.B.L.), the Cardiovascular Research Foundation (D.J.C., R.T.H., B.R., M.B.L.), and Weill Cornell Medicine (B.R.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; University of Colorado Health, Medical Center of the Rockies, Loveland (J.B.O.); Laval University, Quebec, QC (P.P.), St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.L.), and McMaster University, Hamilton, ON (T.S.) - all in Canada; Vanderbilt University Medical Center, Nashville (B.R.L., K.G.); Emory University, Atlanta (V.B.); the Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, Stanford (W.F.F.), VA Palo Alto Health Care System, Palo Alto (W.F.F.), California Pacific Medical Center, San Francisco (D.V.D.), Cedars-Sinai Medical Center, Los Angeles (R.R.M.), and Edwards Lifesciences, Irvine (H.P., Y.Z.) - all in California; Saint Luke's Mid America Heart Institute, Kansas City, MO (A.K.C.); Beth Israel Deaconess Medical Center/Harvard Medical School (C.K.) and Brigham and Women's Hospital (P.S.) - both in Boston; Pinnacle Health Harrisburg, Harrisburg, PA (H.G.); Baylor Scott and White The Heart Hospital Plano, Plano, TX (M.S., M.M.); CentraCare Heart and Vascular Center, St. Cloud, MN (T.D.); Henry Ford Hospital, Detroit (W.O.); Northwestern University, Chicago (C.J.D.); Gothenburg University/Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.); and London School of Hygiene and Tropical Medicine, London (S.J.P.).
Background: For patients with asymptomatic severe aortic stenosis and preserved left ventricular ejection fraction, current guidelines recommend routine clinical surveillance every 6 to 12 months. Data from randomized trials examining whether early intervention with transcatheter aortic-valve replacement (TAVR) will improve outcomes in these patients are lacking.
Methods: At 75 centers in the United States and Canada, we randomly assigned, in a 1:1 ratio, patients with asymptomatic severe aortic stenosis to undergo early TAVR with transfemoral placement of a balloon-expandable valve or clinical surveillance.
Early Aortic Valve Replacement in Moderate Aortic Stenosis.
JACC Adv
September 2024
Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
Transcatheter Intervention for Heart Failure: Excitement, Progress, and Trepidation.
J Soc Cardiovasc Angiogr Interv
December 2023
Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut.
Patient Selection and End Point Definitions for Decongestion Studies in Acute Decompensated Heart Failure: Part 2.
J Soc Cardiovasc Angiogr Interv
August 2023
Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey.
Article Synopsis
- Congestion is a key symptom of acute decompensated heart failure (ADHF) and often persists despite initial treatment, leading to poorer patient outcomes.* -
- There is currently no standard definition for what constitutes successful decongestion, which complicates assessment and treatment planning.* -
- The review suggests a new 4-class grading system for congestion and decongestion endpoints to improve consistency in ADHF research and patient care.*
Patient Selection and End Point Definitions for Decongestion Studies in Acute Decompensated Heart Failure: Part 1.
J Soc Cardiovasc Angiogr Interv
August 2023
Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey.
Article Synopsis
- * Persistent congestion during increased diuretic treatment is an indicator of poor prognosis, leading to the development of new device-based therapies aimed at improving outcomes.
- * The review identifies patient risk factors for severe congestion related to their past medical history, the extent of their congestion, how well they respond to diuretics, and their kidney function, while also outlining criteria for including high-risk patients in future studies.
Heart Failure and Secondary Mitral Regurgitation: A Contemporary Review.
J Soc Cardiovasc Angiogr Interv
December 2023
Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
Article Synopsis
- Secondary mitral regurgitation (SMR) in heart failure patients is linked to high morbidity and mortality, prompting increased scientific focus and improved diagnostic methods like echocardiography and cardiac imaging.
- Treatment has evolved to include guideline-directed medical therapies, aimed at addressing the underlying heart issues, along with diuretics and cardiac resynchronization therapy, which can help alleviate symptoms and improve survival.
- Innovative procedures like transcatheter edge-to-edge repair (TEER) show promise in enhancing survival and quality of life for symptomatic patients, emphasizing the need for a multidisciplinary approach to optimize treatment strategies for high-risk individuals.
Predictors of outcomes after PCI with incomplete revascularization: Impact of CTO and LAD vessel.
Catheter Cardiovasc Interv
September 2024
The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Article Synopsis
- Incomplete revascularization (ICR) after percutaneous coronary intervention (PCI) can lead to higher risks of mortality and morbidity, and this study aimed to compare the effects of ICR in different arteries (LAD vs. RCA/LCX) and in patients with chronic total occlusion (CTO) versus those without.
- The research included 2,651 patients from the RIVER-PCI trial and found that about 66.5% had ICR involving the left anterior descending artery, and follow-up showed similar rates of hospitalization for ischemia regardless of the artery affected.
- However, patients with a CTO experienced increased hospitalizations for ischemia, heart failure, and myocardial infarction compared to those without CTO
Cardiac Damage Staging Predicts Outcomes in Aortic Valve Stenosis After Aortic Valve Replacement: Meta-Analysis.
JACC Adv
May 2024
Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey, USA.
Background: The prognostic value of cardiac damage staging classification based on the extent of extravalvular damage has been proposed in moderate/severe aortic stenosis (AS).
Objectives: The purpose of this study was to assess the association of cardiac damage staging with mortality across the spectrum of patients with AS following aortic surgical or transcatheter aortic valve replacement (AVR).
Methods: We conducted a pooled meta-analysis of Kaplan-Meier-derived reconstructed time-to-event data from studies published through February 2023.
Article Synopsis
- * The 12 areas include issues like setup for PCI, managing vessel injuries, preventing haemodynamic collapse, and dealing with complications like perforations and radiation injuries.
- * The statement serves to enhance clinical practice, research, and education by providing strategies to prevent complications and improve patient outcomes during CTO PCI procedures.
AltaValve Atrial Fixation System for the Treatment of Severe Mitral Regurgitation and Mitral Annular Calcification.
Struct Heart
May 2024
Minneapolis Heart Institute, Minneapolis, Minnesota, USA.
Background: Treatment options for patients with mitral regurgitation (MR) and mitral annular calcification (MAC) are limited. The limitations of current transcatheter mitral valve replacement (TMVR) technologies include high screen failure rates, increased risk of left ventricular outflow tract obstruction, and high residual regurgitation. The aim of this study was to evaluate outcomes of TMVR with the AltaValve system (4C Medical, Maple Grove, MN), a supra-annular TMVR with atrial fixation, in patients with severe MR and moderate or severe MAC.
View Article and Find Full Text PDFLeaflet modification before transcatheter aortic valve implantation in patients at risk for coronary obstruction: the ShortCut study.
Eur Heart J
September 2024
Columbia University Medical Center, New York Presbyterian, New York, NY, USA.
Article Synopsis
- The trial tested the ShortCut device, aimed at improving safety and effectiveness before TAVI in patients at risk for coronary artery obstruction.
- In a study with 60 patients, 100% successfully underwent leaflet splitting with minimal procedure time and high safety rates; 98.3% were free from major adverse events like stroke or mortality at discharge.
- The results suggest that using ShortCut for modifying failed bioprosthetic aortic valves is safe and leads to positive outcomes for patients facing coronary obstruction during TAVI.
Article Synopsis
- The identification and management of patients at high bleeding risk (HBR) during transcatheter aortic valve implantation (TAVI) is critical, but inconsistent definitions complicate trials and clinical choices.
- The Valve Academic Research Consortium for High Bleeding Risk (VARC-HBR) involves global experts aiming to create a standard definition for HBR patients based on extensive research.
- This initiative, led by the Cardiovascular European Research Center (CERC), seeks to enhance the safety and effectiveness of TAVI interventions and improve future clinical guidelines.
Nitroprusside Combined with Leg Raise at the Time of Right Heart Catheterization to Differentiate Precapillary from Other Hemodynamic Forms of Pulmonary Hypertension: A Single-Center Pilot Study.
J Cardiovasc Dev Dis
April 2024
Heart Success Program (Advanced Heart Failure Program), Department of Cardiology, Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ 07960, USA.
Pulmonary hypertension (PH) can arise from several distinct disease processes, with a percentage presenting with combined pre- and postcapillary pulmonary hypertension (cpcPH). Patients with cpcPH are unsuitable candidates for PH-directed therapies due to elevated pulmonary capillary wedge pressures (PCWPs); however, the PCWP is dynamic and is affected by both preload and afterload. Many patients that are diagnosed with cpcPH are hypertensive at the time of right heart catheterization which has the potential to increase the PCWP and, therefore, mimic a more postcapillary-predominant phenotype.
View Article and Find Full Text PDFLeft atrial to coronary sinus shunting for treatment of heart failure with mildly reduced or preserved ejection fraction: The ALT FLOW Early Feasibility Study 1-year results.
Eur J Heart Fail
April 2024
Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA.
Article Synopsis
- - The study focused on evaluating the safety and effectiveness of the APTURE transcatheter shunt system in patients with heart failure and left ventricular ejection fraction (LVEF) greater than 40%.
- - Results showed that the APTURE shunt had a low incidence of serious complications (2.6%) and helped improve heart function, as indicated by reduced pulmonary capillary wedge pressure and improved quality of life scores over a year.
- - Overall, the findings suggest that the APTURE shunt is a promising option for managing heart failure in patients with mildly reduced or preserved ejection fraction.
Incidence, Predictors, and Impact of Hospital Readmission After Revascularization for Left Main Coronary Disease.
J Am Coll Cardiol
March 2024
The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address:
Article Synopsis
- A study was conducted to examine hospital readmissions and their outcomes after revascularization procedures (PCI and CABG) for left main coronary artery disease (LMCAD) in the EXCEL trial, involving 1,905 patients.
- Results showed that within 5 years, nearly half of hospital survivors experienced readmissions, and the causes were split evenly between cardiovascular and noncardiovascular issues.
- Factors like PCI treatment, female sex, and preexisting health conditions were found to be significant predictors of readmission, which was linked to increased mortality risk, notably higher in patients who underwent PCI compared to CABG.
Real-World Outcomes for the Fifth-Generation Balloon Expandable Transcatheter Heart Valve in the United States.
JACC Cardiovasc Interv
April 2024
Division of Cardiology, University of Washington Medical Center, Seattle, Washington, USA.
Background: The fifth-generation SAPIEN 3 Ultra Resilia valve (S3UR) incorporates several design changes as compared with its predecessors, the SAPIEN 3 (S3) and SAPIEN 3 Ultra (S3U) valves, including bovine leaflets treated with a novel process intended to reduce structural valve deterioration via calcification, as well as a taller external skirt on the 29-mm valve size to reduce paravalvular leak (PVL). The clinical performance of S3UR compared with S3 and S3U in a large patient population has not been previously reported.
Objectives: The aim of this study was to compare S3UR to S3/S3U for procedural, in-hospital, and 30-day clinical and echocardiographic outcomes after transcatheter aortic valve replacement (TAVR).