Sulodexide versus Control and the Risk of Thrombotic and Hemorrhagic Events: Meta-Analysis of Randomized Trials.

Thrombotic cardiovascular disease (myocardial infarction [MI], stroke, and venous thromboembolism [VTE]) remains a major cause of death and disability. Sulodexide is an oral glycosaminoglycan containing heparan sulfate and dermatan sulfate. We conducted a systematic review and meta-analysis to determine the cardiovascular efficacy, and safety of sulodexide versus control in randomized controlled trials (RCTs).

Cardiac structural changes after transcatheter aortic valve replacement: systematic review and meta-analysis of cardiovascular magnetic resonance studies.

Background: Transcatheter aortic valve replacement (TAVR) is increasingly used to treat patients with severe aortic stenosis (AS). Cardiovascular magnetic resonance imaging (CMR) provides reliable and reproducible estimates for assessment of cardiac structure and function after TAVR. The goal of this study was to conduct a systematic review and meta-analysis of the literature to assess left ventricular (LV) volumes, mass and function by CMR after TAVR.

Multiple unplanned readmissions after discharge for an admission with percutaneous coronary intervention.

Objective: This study aims to describe temporal trends, characteristics, and clinical outcomes of patients with more than one unplanned readmission within 30 and 180 days after admission with percutaneous coronary intervention (PCI).

Background: There is limited understanding of multiple readmissions after PCI.

Methods: Patients undergoing PCI between 2010 and 2014 in the U.

Etiologies, trends, and predictors of readmission in ST-elevation myocardial infarction patients undergoing multivessel percutaneous coronary intervention.

Background: Recent trials have shown benefits with percutaneous coronary intervention (PCI) on nonculprit coronary vessels in select ST-elevation myocardial infarction (STEMI) patients with multivessel coronary artery disease (CAD). However, readmission rates and causes in this high-risk group are unknown. Objective of this study is to explore pattern, causes and factors associated with 30-day readmission after multivessel PCI in STEMI patients.

Radial Artery Versus Saphenous Vein Grafts in Coronary Artery Bypass Surgery: a Literature Review.

Purpose Of Review: Coronary artery bypass grafting is a preferred strategy for complete coronary revascularization in patients who have multi-vessel coronary artery disease, left ventricular dysfunction, and/or diabetes. Both arterial (internal thoracic artery/radial artery) and venous grafts are utilized to bypass the obstruction in native vessels. Despite having radial arterial grafts as a preferred second conduit for bypass, venous grafts are more commonly used.

Systemic Thrombolysis for Pulmonary Embolism: Evidence, Patient Selection, and Protocols for Management.

Acute pulmonary embolism presents a clinical challenge for optimal risk stratification. Although associated with significant morbidity and mortality at the population level, the spectrum of presentation in an individual patient varies from mild symptoms to cardiac arrest. Treatment options include anticoagulation, systemic thrombolysis, catheter-based interventions, and surgical embolectomy.

Clenbuterol toxicity: an emerging epidemic. A case report and review.

A 55-year-old Hispanic male found unresponsive at home was brought to our emergency department. The patient was found to have rapid atrial fibrillation and acute inferior ST-elevation myocardial infarction on electrocardiogram. Cardiac catheterization failed to reveal any significant stenotic lesions in the coronary arteries.

Consultation and management of patients with lipid disorders: importance of life-style changes and intensive follow-up.

The purpose was to compare long-term involvement (LTI) vs short-term involvement (STI) of patients in a Lipid Education Service (LES) and to assess the effects of life-style changes. Patients were referred for LTI and STI by their physicians. Three-hundred eighty-one consecutive patients, 287 LTI and 94 STI, were analyzed.

Single coronary artery with aortic regurgitation.

An isolated single coronary artery can be associated with normal life expectancy; however, patients are at an increased risk of sudden death. A case is reported of a 54-year-old man with several months of chest pressure with activity. On exercise Sestamibi stress testing, the patient developed a hypotensive response with no symptoms and minimal electrocardiographic changes.

Propafenone versus ibutilide for post operative atrial fibrillation following cardiac surgery: neither strategy improves outcomes compared to rate control alone (the PIPAF study).

Background: It is unclear whether acute conversion of atrial fibrillation (AF) with anti-arrhythmic drugs following cardiac surgery restores and/or maintains sinus rhythm or reduces hospital length of stay (LOS).

Material/methods: A randomized prospective pilot study was conducted in 2 teaching hospitals from 3/28/98 to 8/2/99 to study the effect of the early use of ibutilide or propafenone on the duration of AF, rhythm at discharge, and LOS. A total of 42 stable patients with new AF after surgery were randomized to oral propafenone (600mg, single dose; n=20), ibutilide (1 mg up to 2 doses if necessary; n=10), or rate control only (n=12).

Predictors of conversion of atrial fibrillation after cardiac operation in the absence of class I or III antiarrhythmic medications.

Background: Although risk factors for the development of atrial fibrillation (AF) after cardiac operations have been studied extensively, predictors of conversion to sinus rhythm within 24 hours of onset have not been examined.

Methods: Eleven hundred consecutive adults undergoing cardiovascular operations from July 1997 to June 1998 were screened for new onset AF after operation. Patients with chronic persistent preoperative AF or those who died within 48 hours of the operation were excluded.

Routine transesophageal echocardiography for cerebral ischemia. Is it really necessary?

Background: Patients presenting with stroke or transient cerebral ischemic episodes often undergo transesophageal echocardiography (TEE) as part of their initial evaluation. Previous studies have demonstrated that TEE is superior to transthoracic echocardiography for the detection of potential cardiac sources of embolism. In our institution, this scenario now represents the most frequent reason for requesting TEE.

Coronary stenting for aortocoronary dissection following balloon angioplasty.

We report a case of coronary dissection following percutaneous transluminal coronary angioplasty (PTCA) in which the dissection extended antegrade as well as retrograde into the aortic root. Emergent stenting was able to seal the dissection entry point, resulting in restoration of normal coronary flow and diminution in the degree of aortic dissection.

Pseudoaneurysm causing partial obliteration of the left atrium: case report and review.

We describe a case of left ventricular pseudoaneurysm with subepicardial dissection onto the left atrial wall, mimicking a smooth left atrial mass, causing partial obliteration of the left atrial cavity. This patient presented with a transient ischemic attack, most likely resulting from a thromboembolic episode to the brain. Emergent surgery was successfully performed and the patient is doing well at 1-year follow-up, with no signs of left atrial compression by transthoracic echocardiography.

Coronary artery bypass graft pseudoaneurysm communicating with the right atrium: a case report and review.

We report a pseudoaneurysm of the right coronary artery bypass graft with fistulous drainage into the right atrium. This patient presented with an acute myocardial infarction in a different vascular territory. Cardiac catheterization led to the diagnosis of the pseudoaneurysm.

Is cardiac catheterization necessary in the era of echocardiography? Cost-effective approach combining echocardiography and cardiac catheterization.

Definitive evaluation of cardiovascular disease is traditionally accomplished by cardiac catheterization. Advances in transthoracic and transesophageal Doppler echocardiography provides an accurate and cost-effective approach when compared to cardiac catheterization. Recent data suggests that for most adult patients with aortic or mitral valve disease, Doppler echocardiographic data enables the clinician to make the same decision reached with catheterization data.

Association of fibroblast growth factor receptor-1 with c-Src correlates with association between c-Src and cortactin.

The initiation of maximal DNA synthesis by fibroblast growth factor (FGF)-1 requires the presence of the growth factor during the entire G0 to G1 transition period of the cell cycle (Zhan, X., Hu, X., Friesel, R.

Intraoperative transesophageal echocardiography--an indispensable tool in valve reconstruction and congenital anomalies.

Transesophageal echocardiography (TEE) with color flow mapping has become an excellent tool for evaluating valve reconstruction and correction of congenital anomalies intraoperatively. From February 1990 to September 1990 we have utilized TEE intraoperatively in 14 consecutive patients. Their ages ranged from 25 to 77 years, with a mean age of 58.