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Gupta M, Minhas AMK, Goel SS, Dani SS, Alam M, Nazir S, Khan SU, Aronow W, Jain V. Contemporary trends in utilization and outcomes of percutaneous left atrial appendage occlusion in the United States from 2016 to 2019. Heart Rhythm 2023; 20:313-314. [PMID: 36257480 DOI: 10.1016/j.hrthm.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/21/2022] [Accepted: 10/12/2022] [Indexed: 11/04/2022]
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Hatab T, Wessly P, Syed Z, Telmesani A, Villanueva V, Faza N, Atkins MD, Reardon MJ, Kleiman NS, Little SH, Zoghbi WA, Goel SS. CRT-700.09 Impact of Mitral Annular Calcification on Outcomes After Mitral Transcatheter Edge-to-Edge Repair. JACC Cardiovasc Interv 2023. [DOI: 10.1016/j.jcin.2023.01.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Islam M, Hennawi HA, Bakir M, Khedr A, Goel SS. MINOCA mimic: Type 2 myocardial infarction due to severe aortic stenosis complicated by cardiogenic shock. Glob Cardiol Sci Pract 2023; 2023:e202301. [PMID: 36890844 PMCID: PMC9988295 DOI: 10.21542/gcsp.2023.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/10/2023] [Indexed: 02/08/2023] Open
Abstract
Acute myocardial infarction without significant obstructive coronary disease presents a challenging clinical entity that requires timely intervention. The term myocardial infarction with nonobstructive coronary arteries (MINOCA) describes a working diagnosis attributed to varying etiologies in patients with a presumed ischemic cardiac condition. Several overlapping etiologies can be classified as type 2 myocardial infarction (MI). The 2019 AHA statement established diagnostic criteria and clarified the associated confusion, aiding in appropriate diagnosis. In this report, we present a case of demand-ischemia MINOCA and cardiogenic shock in a patient with severe aortic stenosis (AS).
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Aoun J, Reardon MJ, Goel SS. Transcatheter Mitral Valve Replacement with Dedicated Devices. Methodist Debakey Cardiovasc J 2023; 19:50-56. [PMID: 37213879 PMCID: PMC10198241 DOI: 10.14797/mdcvj.1231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 04/26/2023] [Indexed: 05/23/2023] Open
Abstract
Mitral regurgitation is the most common form of valvular heart disease. The anatomy and pathophysiology of mitral valve regurgitation are very complex, and dedicated devices are required for transcatheter mitral valve replacement in patients with a high or prohibitive surgical risk. In the United States, all transcatheter mitral valve replacement devices are still being studied and are not yet approved for commercial use. Early feasibility studies have demonstrated good technical success and short-term outcomes, but larger samples and longer-term outcomes still need to be assessed. Furthermore, significant advances in device technology, delivery systems, and implantation techniques are essential to avoid left ventricular outflow tract obstruction, and valvular and paravalvular regurgitation as well as ensuring good anchoring of the prosthesis.
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Desai PV, Goel SS, Kleiman NS, Reardon MJ. Transcatheter Aortic Valve Implantation: Long-Term Outcomes and Durability. Methodist Debakey Cardiovasc J 2023; 19:15-25. [PMID: 37213878 PMCID: PMC10198228 DOI: 10.14797/mdcvj.1201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 04/27/2023] [Indexed: 05/23/2023] Open
Abstract
Transcatheter aortic valve implantation (TAVI) has become the standard of care in symptomatic older patients with severe aortic stenosis regardless of surgical risk. With the development of newer generation transcatheter bioprostheses, improved delivery systems, better preprocedure planning with imaging guidance, increased operator experience, shorter hospital length of stay, and low short- and mid-term complication rates, TAVI is gaining popularity among younger patients at low or intermediate surgical risk. Long-term outcomes and durability of transcatheter heart valves have become substantially important for this younger population due to their longer life expectancy. The lack of standardized definitions of bioprosthetic valve dysfunction and disagreement about how to account for the competing risks made comparison of transcatheter heart valves with surgical bioprostheses challenging until recently. In this review, the authors discuss the mid- to long-term (≥ 5 years) clinical outcomes observed in the landmark TAVI trials and analyze the available long-term durability data emphasizing the importance of using standardized definitions of bioprosthetic valve dysfunction.
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Gupta T, von Ballmoos MWC, Reardon MJ, Kleiman NS, Goel SS. Ventricular Embolization of Mitral Valve in Valve Rescued With a Second Valve. THE JOURNAL OF INVASIVE CARDIOLOGY 2023; 35:E55-E56. [PMID: 36588095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Valve embolization is a catastrophic complication of mitral valve-in-valve and valve-in-ring procedures and occurs due to inadequate ventricular positioning, undersizing, or insufficient anchoring. Emergent cardiac surgery to retrieve the embolized valve is usually required for overt embolization. In the situation described herein, a decision was made to attempt to deploy a second valve at a proper depth to anchor the embolized valve and prevent further migration. This case highlights the technique of deploying a second valve to anchor the embolized valve if valve migration has occurred with minimal movement.
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Ijaz SH, Minhas AMK, Jain V, Rifai MA, Sharma G, Mehta A, Dani SS, Fudim M, Al-Kindi SG, Sperling L, Shapiro MD, Alam M, Virani SS, Goel SS, Nasir K, Khan SU. Characteristics and outcomes in acute myocardial infarction hospitalizations among the older population (age ≥80 years) in the United States, 2004-2018. Arch Gerontol Geriatr 2023; 111:104930. [DOI: 10.1016/j.archger.2023.104930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 01/23/2023]
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Al-Abcha A, Saleh Y, Khan SU, Salazar AM, Zaid S, Abdelkarim O, Halboni A, Abdelfattah OM, Goel SS, Kleiman NS, Guerrero M. Mitral Valve-in-Valve Versus Repeat Surgical Mitral Valve Replacement in Patients With Failed Mitral Bioprostheses. JOURNAL OF THE SOCIETY FOR CARDIOVASCULAR ANGIOGRAPHY & INTERVENTIONS 2023; 2:100516. [PMID: 39132537 PMCID: PMC11307612 DOI: 10.1016/j.jscai.2022.100516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/23/2022] [Accepted: 10/04/2022] [Indexed: 08/13/2024]
Abstract
Background Transcatheter mitral valve-in-valve (MViV) replacement has emerged as an alternative to redo surgical mitral valve replacement (redo-SMVR) in patients with failed mitral bioprostheses deemed to be at a high surgical risk. The aim of this analysis was to compare the outcomes of MViV replacement with those of redo-SMVR in patients with a failed bioprosthetic mitral valve. Methods We performed a study-level meta-analysis that compared MViV replacement with redo-SMVR in patients with failed mitral bioprostheses. Seven observational studies, with a total of 5083 patients, were included (1138 patients [22.4%] in the MViV replacement arm). The primary focus was all-cause mortality. Additional outcomes included major bleeding, stroke, vascular complications, and mean mitral valve gradient at follow-up. Results The in-hospital mortality was lower in patients who underwent MViV replacement than in those who underwent redo-SMVR (odds ratio [OR], 0.64; 95% CI, 0.53-0.78; P = .0023). The short-term mortality (<1 year) was numerically lower in the MViV replacement group (OR, 0.45; 95% CI, 0.18-1.13; P = .069). At 1 year, the risk of mortality was similar in the 2 groups (OR, 0.99; 95% CI, 0.69-1.40; P = .906), and at midterm follow-up (≥1 year), there was a numerically higher risk of mortality in the MViV replacement group (OR, 1.51; 95% CI, 1.00-2.29; P = .051). The risk of major bleeding was significantly lower in the MViV replacement group (OR, 0.23; 95% CI, 0.10-0.56; P = .01). Additionally, stroke and vascular complications were similar between the 2 groups. Conclusions The in-hospital mortality was lower in the MViV replacement group than in the redo-SMVR group. There were no differences in mortality at short-term (<1 year), 1-year, or midterm (≥1 year) follow-ups.
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Goel SS. The Current and Future Landscape of Structural Heart Interventions. Methodist Debakey Cardiovasc J 2023; 19:1-3. [PMID: 37213872 PMCID: PMC10198246 DOI: 10.14797/mdcvj.1251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 05/23/2023] Open
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Minhas AMK, Gul S, Sheikh AB, Nazir S, Ahuja KR, Anwar MN, Dani SS, Goel SS, Virani SS, Alam M. Association of Body Mass Index With Outcomes in Patients Undergoing Percutaneous Left Atrial Appendage Closure With the Watchman Device. Curr Probl Cardiol 2022; 47:101009. [PMID: 34599987 DOI: 10.1016/j.cpcardiol.2021.101009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/19/2022]
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Al Abri Q, El Nihum LI, Hinohara T, Chang SM, Faza NN, Goel SS, Kleiman NS, Wyler von Ballmoos MC, Atkins MD, Reardon MJ. Late Transcatheter Aortic Valve Thrombosis Leading to Cardiogenic Shock. JACC Case Rep 2022; 4:1459-1463. [PMID: 36444179 PMCID: PMC9700056 DOI: 10.1016/j.jaccas.2022.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/18/2022] [Accepted: 07/27/2022] [Indexed: 06/16/2023]
Abstract
A 67-year-old woman with prior transcatheter aortic valve replacement presented with worsening dyspnea. Imaging revealed transcatheter aortic valve thrombosis and aortic stenosis. Despite oral anticoagulation, she progressively deteriorated and developed cardiogenic shock. We highlight the Heart Team's role in treating this unusual late thrombosis. (Level of Difficulty: Intermediate.).
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Key Words
- CT, computed tomography
- DAPT, dual antiplatelet therapy
- HALT, hypoattenuated leaflet thrombosis
- IABP, intra-aortic balloon pump
- LVEF, left ventricular ejection fraction
- OAC, oral anticoagulation
- SAPT, single antiplatelet therapy
- SAVR, surgical aortic valve replacement
- TAV, transcatheter aortic valve
- TAVR, transcatheter aortic valve replacement
- TEE, transesophageal echocardiography
- TTE, transthoracic echocardiography
- hypoattenuated leaflet thrombosis
- transcatheter heart valve
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Zahid S, Gowda S, Hashem A, Khan MZ, Ullah W, Kaur G, Nasir U, Rai D, Faza NN, Little SH, Valderrabano M, Goel SS. Feasibility and Safety of Intracardiac Echocardiography Use in Transcatheter Left Atrial Appendage Closure Procedures. JOURNAL OF THE SOCIETY FOR CARDIOVASCULAR ANGIOGRAPHY & INTERVENTIONS 2022; 1:100510. [PMID: 39132376 PMCID: PMC11307399 DOI: 10.1016/j.jscai.2022.100510] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/07/2022] [Accepted: 09/20/2022] [Indexed: 08/13/2024]
Abstract
Background Left atrial appendage closure (LAAC) is usually performed under the guidance of transesophageal echocardiography (TEE). Data on the safety of intracardiac echocardiogram (ICE)-guided LAAC from a real-world population in the United States remain limited. In this study, the aim was to evaluate the trends and outcomes of ICE-guided LAAC procedures using the US National Inpatient Sample. Methods This study used the National Inpatient Sample database from quarter 4 of 2015 to 2019. We used a propensity-matched analysis and adjusted odds ratios for in-hospital outcomes/complications. A P value of <.05 was considered significant. Results We identified 61,995 weighted LAAC cases. Of these, 1410 patients had ICE-guided LAAC with a lower median age than the patients who had TEE-guided LAAC (75 vs 77 years; P ≤ .01). The use of ICE-guided LAAC increased from 1.7% in 2015 to 2.2% in 2019 (P trend = .75). Major, cardiovascular, neurologic, and pulmonary complications were similar for ICE-guided and TEE-guided LAAC on adjusted analysis. On propensity-matched analysis, the overall vascular complication rates were similar. However, retroperitoneal bleeding remained significantly higher (0.7% vs 0%) with ICE. Gastrointestinal bleeding complications were more frequent in TEE-guided LAAC (3.5% vs 2.1%). The length of stay was similar for both groups (median = 1 day; P = .23); however, ICE was associated with $1769 excess cost of hospitalization ($25,112 vs $23,343; P = .04). Conclusions ICE-guided LAAC is safer than TEE-guided LAAC, with similar rates of major complications. However, ICE use was associated with lower rates of gastrointestinal bleeding and higher rates of retroperitoneal bleeding. In addition, ICE-guided LAAC is associated with a similar length of stay but higher costs of hospitalization.
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Elbadawi A, Dang AT, Sedhom R, Hamed M, Eid M, Golwala H, Goel SS, Mamas MA, Elgendy IY. Direct Oral Anticoagulants Versus Antiplatelet Therapy After Transcatheter Aortic Valve Replacement: A Meta-Analysis of Randomized Trials. Circ Cardiovasc Interv 2022; 15:e012194. [PMID: 36065799 DOI: 10.1161/circinterventions.122.012194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jain V, Minhas AMK, Kleiman NS, Arshad HB, Saleh Y, Pandat SS, Dani SS, Goel SS, Faza N, Butt SA, Blankstein R, Cainzos-Achirica M, Nasir K, Khan SU. Cardiac Arrest in Young Adults with Ischemic Heart Disease in the United States, 2004-2018. Curr Probl Cardiol 2022; 47:101312. [PMID: 35839933 DOI: 10.1016/j.cpcardiol.2022.101312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cardiac arrest (CA) among young adults (<45 y) with ischemic heart disease (IHD) remained understudied. OBJECTIVE To evaluate the trends in clinical profile, in-hospital mortality, and health care resource utilization in CA-related hospitalizations among young adults with IHD. METHODS National Inpatient Sample (2004-2018) was used to identify adults aged 18- 45 years. RESULTS Of 77,359 weighted CA-related hospitalizations (mean age: 39 [0.05] y; 34.3% women), 65% had a myocardial infarction (MI), and 58% had a shockable rhythm. Between 2004 and 2018, CA-related hospitalizations among young adults with IHD increased from 1.8% to 2.4%. Overall, in-hospital mortality was 36.4%, which was higher for women vs. men (40.4% vs. 34.2%; p<0.001) and Black vs. White adults (43.9% vs. 33.3%; p<0.001). In-hospital mortality increased from 33.5% to 38.1%, with a consistent upward trend in men, White adults, and both MI and non-MI cases. However, in STEMI (40%), in-hospital mortality decreased from 34.6% to 20.2% (p-trend <0.001), while it increased in NSTEMI (14.8%) from 34.3% to 47.5% (p-trend <0.001). Overall mean length of stay (LOS) (7 to 9 days) and mean inflation-adjusted care cost ($34,431 to $44,646) increased over the study duration. CONCLUSION CA-related hospitalizations and associated LOS and inflation-adjusted care costs have increased in the last 15 years. In-hospital mortality increased by ∼5% during the study period with a higher mortality in women and among black adults. While increased CA-related hospitalizations may reflect improved pre-hospital care, greater efforts are needed to address improve in-hospital survival in CA among young adults with IHD.
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Zaidi SH, Minhas AMK, Sagheer S, ManeshGangwani K, Dani SS, Goel SS, Alam M, Sheikh AB, Hirji S, Wasty N. Clinical Outcomes of Transcatheter Aortic Valve Replacement (TAVR) vs. Surgical Aortic Valve Replacement (SAVR) in Patients With Durable Left Ventricular Assist Device (LVAD). Curr Probl Cardiol 2022; 47:101313. [PMID: 35817155 DOI: 10.1016/j.cpcardiol.2022.101313] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Patients with left ventricular assist device often develop aortic insufficiency requiring an intervention on the aortic valve. We sought to analyze the outcomes of patients with a history of LVAD who underwent either transcatheter aortic valve replacement or surgical aortic valve replacement. METHODS The Nationwide Readmission Database was used to extract relevant patient information from January 1, 2016, to December 31, 2018. The NRD is a nationally representative sample of all-payer discharges from U.S. non-federal hospitals. The primary outcome of interest was in-hospital mortality. Secondary outcomes included length of stay, clinical outcomes, costs, and 30-day all-cause readmissions. Complex samples multivariable logistic and linear regression models were used to determine the association of procedure type with outcomes. RESULTS Among 148 hospitalizations with a history of LVAD, 87 underwent TAVR, and 61 underwent SAVR. The inpatient mortality in SAVR group was numerically higher compared to the TAVR cohort, however, it did not reach statistical significance. The use of invasive mechanical ventilation, and rates of cardiogenic shock, bleeding, and vascular complications were higher in the SAVR cohort compared to the TAVR cohort. The mean length of stay and costs were higher in the SAVR cohort compared to the TAVR cohort. The 30-day all-cause readmission rate was numerically higher in the SAVR group but not statistically significant. CONCLUSIONS TAVR in patients with LVAD may be a viable treatment option for patients with AI with potential for better inpatient mortality and inpatient outcomes compared to patients who undergo SAVR in appropriately selected patients.
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Kleiman NS, Goel SS. Upping the Transcatheter Edge-to-Edge Repair Game: Patient Selection Based on Newly Described Echocardiographic Measurements. Circ Cardiovasc Interv 2022; 15:e012174. [PMID: 35686546 DOI: 10.1161/circinterventions.122.012174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Goel SS, Zahr F. Center Valve Preference and TAVR Outcomes: Is it Really the Valve? JACC Cardiovasc Interv 2022; 15:1275-1277. [PMID: 35738748 DOI: 10.1016/j.jcin.2022.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 10/18/2022]
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Tanveer Ud Din M, Minhas AMK, Muslim MO, Wazir MHK, Dani SS, Goel SS, Alam M, Sá MP, Seese L, Hirji S. Outcomes of MitraClip and Surgical Mitral Valve Repair in Patients With Left Ventricular Assist Device. Am J Cardiol 2022; 173:143-145. [PMID: 35437161 DOI: 10.1016/j.amjcard.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022]
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Ben Ali W, Ludwig S, Duncan A, Weimann J, Nickenig G, Tanaka T, Coisne A, Vincentelli A, Makkar R, Webb JG, Akodad M, Muller DWM, Praz F, Wild MG, Hausleiter J, Goel SS, von Ballmoos MW, Denti P, Chehab O, Redwood S, Dahle G, Baldus S, Adam M, Ruge H, Lange R, Kaneko T, Leroux L, Dumonteil N, Tchetche D, Treede H, Flagiello M, Obadia JF, Walther T, Taramasso M, Søndergaard L, Bleiziffer S, Rudolph TK, Fam N, Kempfert J, Granada JF, Tang GHL, von Bardeleben RS, Conradi L, Modine T. Characteristics and outcomes of patients screened for transcatheter mitral valve implantation: 1-year results from the CHOICE-MI registry. Eur J Heart Fail 2022; 24:887-898. [PMID: 35338542 DOI: 10.1002/ejhf.2492] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 11/08/2022] Open
Abstract
AIMS Transcatheter mitral valve implantation (TMVI) represents a novel treatment option for patients with mitral regurgitation (MR) unsuitable for established therapies. The CHOICE-MI registry aimed to investigate outcomes of patients undergoing screening for TMVI. METHODS AND RESULTS From May 2014 to March 2021, patients with MR considered suboptimal candidates for transcatheter edge-to-edge repair (TEER) and at high risk for mitral valve surgery underwent TMVI screening at 26 centres. Characteristics and outcomes were investigated for patients undergoing TMVI and for TMVI-ineligible patients referred to bailout-TEER, high-risk surgery or medical therapy (MT). The primary composite endpoint was all-cause mortality or heart failure hospitalization after 1 year. Among 746 patients included (78.5 years, interquartile range [IQR] 72.0-83.0, EuroSCORE II 4.7% [IQR 2.7-9.7]), 229 patients (30.7%) underwent TMVI with 10 different dedicated devices. At 1 year, residual MR ≤1+ was present in 95.2% and the primary endpoint occurred in 39.2% of patients treated with TMVI. In TMVI-ineligible patients (n = 517, 69.3%), rates of residual MR ≤1+ were 37.2%, 100.0% and 2.4% after bailout-TEER, high-risk surgery and MT, respectively. The primary endpoint at 1 year occurred in 28.8% of patients referred to bailout-TEER, in 42.9% of patients undergoing high-risk surgery and in 47.9% of patients remaining on MT. CONCLUSION This registry included the largest number of patients treated with TMVI to date. TMVI with 10 dedicated devices resulted in predictable MR elimination and sustained functional improvement at 1 year. In TMVI-ineligible patients, bailout-TEER and high-risk surgery represented reasonable alternatives, while MT was associated with poor clinical and functional outcomes.
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Abdelfattah OM, Sayed A, Ghonim M, Saleh Y, Généreux P, Goel SS, Krishnaswamy A, Yun J, Kapadia SR. Meta-Analysis of Transcatheter Aortic Valve Implantation Using the Sapien 3 Versus Sapien 3 Ultra Valves. Am J Cardiol 2022; 168:170-172. [PMID: 35067349 DOI: 10.1016/j.amjcard.2021.12.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/24/2021] [Accepted: 12/28/2021] [Indexed: 11/01/2022]
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Thakker RA, Salazar L, Jazar DA, Bhakta P, Baker B, Patel C, Elbadawi A, Agarwal M, Albaeni A, Saleh M, Esclovan J, El Haddad D, Alwash H, Kalra A, Goel SS, Widmer RJ, Chatila K, Khalife W, Motiwala A, McCracken J, Jneid H, Gilani S. Coronary Artery Disease and Aspirin Intolerance: Background and Insights on Current Management. Cardiol Ther 2022; 11:175-183. [PMID: 35344187 PMCID: PMC9135937 DOI: 10.1007/s40119-022-00255-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Indexed: 11/28/2022] Open
Abstract
Aspirin is one of the most widely used medications across the global healthcare system and is the foundation in treating ischemic heart disease, as well as secondary prevention for ischemic and valvular heart disease. Challenges arise in treating patients with cardiovascular disease who have concomitant aspirin intolerance. Through an extensive review of the literature, we provide a comprehensive background on the pharmacology of aspirin, the mechanisms behind aspirin intolerance, the importance of aspirin in cardiovascular disease, and the management of aspirin intolerance in both acute coronary syndrome and stable coronary artery disease. Our review includes a multidisciplinary approach from the internist, allergist/immunologist, and cardiologist when evaluating this important patient population.
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Aoun J, Zaid S, Narasimhan B, Arshad H, Abri QA, Reardon MJ, Goel SS. ACUTE RIGHT VENTRICULAR FAILURE AND CARDIOGENIC SHOCK SECONDARY TO RIGHT CORONARY OCCLUSION AFTER SURGICAL AORTIC VALVE REPLACEMENT. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)04253-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Goel SS, Kleiman NS, Chetcuti SJ, Deeb GM, Yakubov SJ, Boatman SV, Van Mieghem NM, Reardon MJ. IMPACT OF RENIN-ANGIOTENSIN SYSTEM INHIBITORS ON CLINICAL OUTCOMES IN PATIENTS WITH SEVERE SYMPTOMATIC AORTIC STENOSIS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT WITH A SELF-EXPANDING BIOPROSTHESIS. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01767-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pournazari P, Faza NN, Goel SS, Islam MU, Little SH, Nagueh SF. Hemodynamic Determinants of Left Atrial Strain in Symptomatic Patients With Significant Primary Mitral Regurgitation. Circ Cardiovasc Imaging 2022; 15:e013836. [PMID: 35184571 DOI: 10.1161/circimaging.121.013836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abri QA, Hinohara T, Chang SM, Faza NN, Ballmoos MCWV, Goel SS, Kleiman NS, Reardon MJ. LATE TRANSCATHETER HEART VALVE THROMBOSIS WITH SEVERE AORTIC STENOSIS LEADING TO CARDIOGENIC SHOCK: A HEART TEAM APPROACH. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)04259-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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