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Randall MH, Anderson RD. Editorial: The Carillon Mitral Contour System: Another tool in the fight against functional mitral regurgitation. Cardiovasc Revasc Med 2024; 60:41-42. [PMID: 37951760 DOI: 10.1016/j.carrev.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/03/2023] [Indexed: 11/14/2023]
Affiliation(s)
- Morgan H Randall
- University of Tennessee Medical Center, Knoxville, TN, United States of America
| | - R David Anderson
- University of Florida, Gainesville, FL, United States of America.
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Laurent D, Lucke-Wold B, Leary O, Randall MH, Porche K, Koch M, Chalouhi N, Polifka A, Hoh BL. The Evolution of Endovascular Therapy for Intracranial Aneurysms: Historical Perspective and Next Frontiers. Neurosci Insights 2022; 17:26331055221117560. [PMID: 35924091 PMCID: PMC9340900 DOI: 10.1177/26331055221117560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 07/18/2022] [Indexed: 11/20/2022] Open
Abstract
The history of cerebral aneurysm treatment has a rich and storied past with multiple notable luminaries contributing insights. The modern era has transitioned from primarily clip ligation to increasing use of endovascular therapy. Even more recently, the use of intrasaccular flow diverters has been introduced for the treatment of wide necked aneurysms. The field is continuing to transform, and bioactive coils and stents have resurfaced as promising adjuvants to promote aneurysm healing. Advanced imaging modalities are being developed that could further advance the endovascular arsenal and allow for porous memory polymer devices to enter the field. This focused review highlights notable historic contributions and advances to the point of futuristic technology that is actively being developed.
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Affiliation(s)
- Dimitri Laurent
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| | | | - Owen Leary
- Department of Neurosurgery, Brown University, Providence, RI, USA
| | - Morgan H Randall
- Department of Cardiology, University of Florida, Gainesville, FL, USA
| | - Ken Porche
- School of Medicine, University of Arkansas for Medical Sciences, Little Rock AR, USA
| | - Matthew Koch
- School of Medicine, University of Arkansas for Medical Sciences, Little Rock AR, USA
| | - Nohra Chalouhi
- School of Medicine, University of Arkansas for Medical Sciences, Little Rock AR, USA
| | - Adam Polifka
- School of Medicine, University of Arkansas for Medical Sciences, Little Rock AR, USA
| | - Brian L Hoh
- School of Medicine, University of Arkansas for Medical Sciences, Little Rock AR, USA
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Matthia EL, Mohadjer A, Randall MH, Canha C, Warren E, Ashraf HM, Plasschaert JM, Winchester DE, Keeley EC. Promoting Cardiac Rehabilitation in Acute Coronary Syndrome Patients: Quality Initiative Based on Education, Automated Referral, and Multidisciplinary Rounds. Crit Pathw Cardiol 2021; 20:115-118. [PMID: 34238793 DOI: 10.1097/hpc.0000000000000263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cardiac rehabilitation is a class 1 recommendation for acute coronary syndrome (ACS) patients according to the American College of Cardiology/American Heart Association. However, only 1 in 5 ACS patients are referred for cardiac rehabilitation nationally, and even fewer at our institution. We sought to improve the number of referrals to cardiac rehabilitation for post-ACS patients admitted to our inpatient cardiology service, and ultimately their participation in the program. We designed a quality improvement initiative that included education of patients and house staff, automated referral order, and participation of cardiac rehabilitation staff members on multidisciplinary rounds. We compared the number of patients who received a referral to cardiac rehabilitation, had the first appointment scheduled before hospital discharge, and attended the program before and after our intervention. Six months after initiation of the project, the proportion of ACS patients referred to cardiac rehabilitation before hospital discharge increased from 10% to 43% (P < 0.001). The mean number of patients with a cardiac rehabilitation appointment scheduled before discharge was 2 before and 5 after the intervention (P < 0.001), and the mean number of patients who attended their scheduled appointment was 1 before and 3 after the intervention (P = 0.001). Run charts demonstrated that the number of referrals and the number of scheduled appointments remained above the median following the intervention. In conclusion, an initiative that included education, automated referrals, and direct one-on-one contact with cardiac rehabilitation staff before discharge increased the number of cardiac rehabilitation referrals, and appointments scheduled and attended in post-ACS patients.
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Affiliation(s)
| | - Ashley Mohadjer
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL
| | - Morgan H Randall
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL
| | - Catarina Canha
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL
| | - Elizabeth Warren
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL
| | | | | | - David E Winchester
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL
| | - Ellen C Keeley
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL
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Randall MH, Lewandowski TJ, Choi C, Beaver TM. Valve-in-valve transcatheter aortic valve replacement to treat multijet paravalvular regurgitation: A case series and review. Clin Cardiol 2020; 44:13-19. [PMID: 33216400 PMCID: PMC7803366 DOI: 10.1002/clc.23504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/22/2020] [Accepted: 10/25/2020] [Indexed: 02/06/2023] Open
Abstract
Treatment advances for severe symptomatic aortic stenosis including transcatheter and open surgical valve replacement have improved patient survival, length of stay, and speed to recovery. However, paravalvular regurgitation (PVR) is occasionally seen and when moderate or greater in severity is associated with an at least 2-fold increase in 1 year mortality. While several treatment approaches focused on single-jet PVR have been described in the literature, few reports describe multijet PVR. Multijet PVR can successfully be treated with a variety of catheter-based options including valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR). We present two patients with at least moderate PVR following aortic valve replacement who were successfully treated with ViV TAVR along with a review of literature highlighting our rationale for utilizing each management approach. Multijet PVR can be treated successfully with ViV TAVR, but additional options such as self-expanding occluder devices and bioprosthetic valve fracture have a role as adjunctive treatments to achieve optimal results. The etiology of multijet PVR can differ between patients, this heterogeneity underscores the paucity of data to guide treatment strategies. Therefore, successful treatment of multijet PVR requires familiarity with available therapeutic options to achieve optimal results and, by extension, decrease patient mortality.
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Affiliation(s)
- Morgan H Randall
- Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
| | - Thomas J Lewandowski
- Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
| | - Calvin Choi
- North Florida/South Georgia Veterans Health System, Medical Service, Cardiology Section Gainesville, Gainesville, Florida, USA
| | - Thomas M Beaver
- Department of Surgery, Division of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida, USA
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Anderson RD, Gargus N, Randall MH. Editorial: The use of Fascia iliaca Block with Minimal Conscious Sedation in Transcatheter Aortic Valve Replacement: Advances in TAVR Anesthesia. Cardiovasc Revasc Med 2020; 21:602-603. [PMID: 32201210 DOI: 10.1016/j.carrev.2020.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 03/10/2020] [Indexed: 11/19/2022]
Affiliation(s)
- R David Anderson
- University of Florida, Division of Cardiovascular Medicine, 1329 SW 16th St., PO Box 100288, Gainesville, FL 32608, United States of America.
| | - Nathan Gargus
- University of Florida, Division of Cardiovascular Medicine, 1329 SW 16th St., PO Box 100288, Gainesville, FL 32608, United States of America
| | - Morgan H Randall
- University of Florida, Division of Cardiovascular Medicine, 1329 SW 16th St., PO Box 100288, Gainesville, FL 32608, United States of America
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Randall MH, Stoermann M, Rockey DC. A "Faux" Case of Acute Liver Failure in a 28-Year-Old Pregnant Woman. Hepatology 2018; 68:1200-1202. [PMID: 29672889 DOI: 10.1002/hep.30044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 09/03/2018] [Indexed: 12/07/2022]
Affiliation(s)
- Morgan H Randall
- Department of Internal Medicine, Medical University of South Carolina, Charleston, SC
| | - Mary Stoermann
- Department of Internal Medicine, Medical University of South Carolina, Charleston, SC
| | - Don C Rockey
- Department of Internal Medicine, Medical University of South Carolina, Charleston, SC
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Randall MH, Moliterno DJ. The impact of left anterior descending coronary artery length on survival following myocardial infarction: to the apex and beyond. Catheter Cardiovasc Interv 2014; 84:321-2. [PMID: 25045098 DOI: 10.1002/ccd.25554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 05/31/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Morgan H Randall
- Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, Kentucky
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Randall MH, Altman LJ, Lefkowitz RJ. Structure and biological activity of (-)-[3H]dihydroalprenolol, a radioligand for studies of beta-adrenergic receptors. J Med Chem 1977; 20:1090-4. [PMID: 197238 DOI: 10.1021/jm00218a020] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
(-)-Alprenolol is a potent competitive beta-adrenergic antagonist. "(-)-[3H]Alprenolol", a radioactive form of this agent produced by catalytic reduction with tritium, has recently been used successfully as a radioligand for direct studies of beta-adrenergic receptors. In this communication it is documented that the compound formed by catalytic reduction of (-)-alprenolol with tritium gas is the saturated product (-)-[3H]dihydroalprenolol in which tritium is added across the double bond and exchanged into the adjacent benzylic position. No exchange into the aromatic ring was observed. These conclusions were substantiated by results obtained on hydrogenation and deuteration of (-)-alprenolol. The biological activity of (-)-[3H]dihydroalprenolol, dihydroalprenolol, and alprenolol was also shown to be identical as assessed by direct ligand binding and inhibition of catecholamine-stimulated adenylate cyclase.
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