Jonathon B Ryan, Peter W Grant
BACKGROUND: Transcatheter aortic valve implantation (TAVI) did not receive regulatory approval in Australia until 2013, several years after Europe (2007) and America (2011). Consequently, the uptake of TAVI in Australia initially lagged behind international best practices. This study was undertaken to provide an update on the status of TAVI activity in Australia. METHOD: A descriptive population-level epidemiological study was performed. Annual activity data for both surgical aortic valve replacement (SAVR) and TAVI were obtained from the Australian Institute of Health and Welfare (AIHW) for the period from 1 July 2012 to 30 June 2022...
April 6, 2024: Heart, Lung & Circulation
Emma K Gard, Samer Noaman, Dion Stub, Pieter Vriesendorp, Nay Htun, Rozanne Johnston, Elisha Gartner, Ronald Dick, Antony Walton, David Kaye, Shane Nanayakkara
BACKGROUND: Patients undergoing transcatheter aortic valve implantation (TAVI) have a high comorbidity burden. We sought to stratify patients into functional outcomes using the Kansas City Cardiomyopathy Questionnaire (KCCQ-12), a patient-reported outcome with benefits over both the New York Heart Association (NYHA) classification and the original 23-item KCCQ, and to evaluate the importance of comorbidities in predicting failure of functional improvement post-TAVI in a contemporary cohort...
April 5, 2024: Heart, Lung & Circulation
Md Shajedur Rahman Shawon, Jonathon B Ryan, Louisa Jorm
BACKGROUND: In Australia, transcatheter aortic valve implantation (TAVI) is only performed in a limited number of specialised metropolitan centres, many of which are private hospitals, making it likely that TAVI patients who require readmission will present to another (non-index) hospital. It is important to understand the impact of non-index readmission on patient outcomes and healthcare resource utilisation. METHOD: We analysed linked hospital and death records for residents of New South Wales, Australia, aged ≥18 years, who had an emergency readmission within 90 days following a TAVI procedure in 2013-2022...
April 4, 2024: Heart, Lung & Circulation
Olivia Nuti, Cristian Merchan, John Papadopoulos, James Horowitz, Sunil V Rao, Tania Ahuja
BACKGROUND: Evidence supporting anticoagulation with unfractionated heparin (UFH) in patients with an intra-aortic balloon pump (IABP) to prevent limb ischaemia remains limited, while bleeding risks remain high. Monitoring heparin in this setting with anti-factor Xa (anti-Xa) is not previously described. OBJECTIVES: The study objective is to describe the incidence of thromboembolic and bleeding events with the use of UFH in patients with an IABP utilising monitoring with both anti-Xa and activated partial thromboplastin time (aPTT)...
April 3, 2024: Heart, Lung & Circulation
Arul Baradi, Diem T Dinh, Angela Brennan, Dion Stub, Jithendra Somaratne, Sonny Palmer, Ziad Nehme, Emily Andrew, Karen Smith, Danny Liew, Christopher M Reid, Jeffrey Lefkovits, Andrew Wilson
AIM: We aim to describe prevalence of Emergency Medical Service (EMS) use, investigate factors predictive of EMS use, and determine if EMS use predicts treatment delay and mortality in our ST-elevation myocardial infarction (STEMI) cohort. METHOD: We prospectively collected data on 5,602 patients presenting with STEMI for primary percutaneous coronary intervention (PCI) transported to PCI-capable hospitals in Victoria, Australia, from 2013-2018 who were entered into the Victorian Cardiac Outcomes Registry (VCOR)...
April 2, 2024: Heart, Lung & Circulation
Mohammad Rocky Khan Chowdhury, Dion Stub, Diem Dinh, Md Nazmul Karim, Bodrun Naher Siddiquea, Baki Billah
BACKGROUND AND AIM: Risk adjustment following percutaneous coronary intervention (PCI) is vital for clinical quality registries, performance monitoring, and clinical decision-making. There remains significant variation in the accuracy and nature of risk adjustment models utilised in international PCI registries/databases. Therefore, the current systematic review aims to summarise preoperative variables associated with 30-day mortality among patients undergoing PCI, and the other methodologies used in risk adjustments...
April 2, 2024: Heart, Lung & Circulation
Stephanie R Sargent, Jordanna R Mladenovic, Jacqueline J T Liaw, Jonathan Siller, Penni L Russell, Matthew K Y Tung, David J Holland
BACKGROUND: Modifiable lifestyle risk factors, in particular obesity and related conditions, are important drivers of atrial fibrillation (AF), impacting the severity of symptoms and influence the efficacy and safety of treatment. OBJECTIVE: The study aimed to assess the impact of modifiable lifestyle factors on the effectiveness and safety of AF ablation, and examine the procedural characteristics, efficacy, safety and cost outcomes of cryoballoon vs radiofrequency ablation, in a real-world clinical setting...
April 2, 2024: Heart, Lung & Circulation
Nicole K Bart, Diane Fatkin, James Gunton, James L Hare, Dariusz Korczyk, Fiona Kwok, Kaitlyn Lam, David Russell, Hasib Sidiqi, Tim Sutton, Simon D J Gibbs, Peter Mollee, Liza Thomas
Over the past 5 years, early diagnosis of and new treatments for cardiac amyloidosis (CA) have emerged that hold promise for early intervention. These include non-invasive diagnostic tests and disease modifying therapies. Recently, CA has been one of the first types of cardiomyopathy to be treated with gene editing techniques. Although these therapies are not yet widely available to patients in Australia and New Zealand, this may change in the near future. Given the rapid pace with which this field is evolving, it is important to view these advances within the Australian and New Zealand context...
April 2, 2024: Heart, Lung & Circulation
Joseph M O'Brien, Rustem Dautov, James Sapontis
The percutaneous management of chronic total occlusions (CTO) is a well-established sub-specialty of Interventional Cardiology, requiring specialist equipment, training, and techniques. The heterogeneity of approaches in CTO has led to the generation of multiple algorithms to guide operators in their management. The evidence base for management of CTOs has suffered from inconsistent descriptive and quantitative terminology in defining the nature of lesions and techniques utilised, as well as seemingly contradictory data about improvement in ventricular function, symptoms of angina, and mortality from large-scale registries and randomised controlled trials...
April 1, 2024: Heart, Lung & Circulation
Wayne C Zheng, Nicole Evans, Diem Dinh, Jason E Bloom, Angela L Brennan, Jocasta Ball, Jeffrey Lefkovits, James A Shaw, Christopher M Reid, William Chan, Dion Stub
BACKGROUND: Clinical outcomes of patients with renal transplant (RT) undergoing percutaneous coronary intervention (PCI) remain poorly elucidated. METHOD: Between 2014 and 2021, data were analysed for the following three groups of patients undergoing PCI enrolled in a multicentre Australian registry: (1) RT recipients (n=226), (2) patients on dialysis (n=992), and (3) chronic kidney disease (CKD) patients (estimated glomerular filtration rate [eGFR], 30‒60 mL/min per 1...
April 1, 2024: Heart, Lung & Circulation
Jen-Li Looi, Aleisha Easton, Mark Webster, Andrew To, Mildred Lee, Andrew J Kerr
BACKGROUND: Recurrent Takotsubo syndrome (TS) is not uncommon but experience with TS recurrence is inherently limited by the infrequency of the condition itself and incomplete long-term follow-up. There is limited published data on the clinical features and outcomes of patients with recurrent TS. We aimed to describe the clinical characteristics and outcomes of patients with recurrent TS in a large Auckland cohort. METHOD: The clinical profile, in-hospital, and long-term outcomes were prospectively assessed in consecutive patients with recurrent TS presenting to Auckland's three major hospitals between January 2006 and January 2023...
March 29, 2024: Heart, Lung & Circulation
Christopher Siderakis, Colin Royse, Justin Ren, David H Tian, Sandy Clarke-Errey, Nilesh Srivastav, Alistair Royse
BACKGROUND AND AIM: The biological behaviour of coronary graft conduits over time may be considered by serial angiography. METHODS: A single institution retrospective cohort received mostly clinically indicated angiography between 1997 and 2020, following coronary bypass surgery. Only perfectly patent grafts (absence of any lumen irregularity) for each conduit type at the first postoperative angiogram were selected for a later comparison. The latest angiograms were at least 5 years postoperatively, and at least 1 year after first postoperative angiogram...
March 19, 2024: Heart, Lung & Circulation
Emma Zhao, Nicole Lowres, Jacqueline Bloomfield, Joseph Weddell, Geoffrey Tofler, Robyn Gallagher
BACKGROUND: Cognitive impairment (CI) is common in patients with acute coronary syndrome (ACS) but is often undetected and may affect recovery and secondary prevention uptake. Nurses play a crucial role providing care for patients with ACS and promoting secondary prevention. AIM: This study aimed to explore current nursing practices and barriers regarding CI screening in patients with ACS. METHODS: Cardiac nurses were recruited from three metropolitan teaching hospitals and two professional associations in Australia and undertook a 38-question purpose-built survey...
March 9, 2024: Heart, Lung & Circulation
Angiza Shahim, Torbjörn Ivert, Magnus Dalén
No abstract text is available yet for this article.
March 9, 2024: Heart, Lung & Circulation
Sylvia Ye, Cathy Corbett, Adelaide S M Dennis, Dylan Jape, Hitesh Patel, Dominica Zentner, Ingrid Hopper
BACKGROUND: Heart failure (HF) has high mortality and healthcare utilisation. It has a complex and unpredictable trajectory, which is often interpreted as a barrier to guideline recommended early integration of palliative care (PC). In particular, lack of referral criteria and misconceptions around PC affect inpatient specialist PC referrals. AIMS: The main objective was to characterise the pattern and predictors of referral of HF patients to the specialist inpatient PC consultative service at our healthcare service...
March 8, 2024: Heart, Lung & Circulation
John D L Brookes, Andrew D Cochrane, Julian A Smith
INTRODUCTION: The use of non-steroidal anti-inflammatory drugs (NSAID) in patients undergoing pleurodesis remains controversial. Although many surgeons are comfortable prescribing NSAIDs post-operatively, some oppose this practice due to concerns of suppressing the inflammatory response and quality of pleurodesis. Only a small body of inconsistent publications exists with respect to guiding therapy in this common clinical scenario. METHODS: A retrospective cohort study was undertaken assessing effect of NSAID exposure on pleurodesis outcomes...
March 7, 2024: Heart, Lung & Circulation
Anna H Balabanski, Lee Nedkoff, Amanda G Thrift, Timothy J Kleinig, Alex Brown, Odette Pearson, Steven Guthridge, Angela Dos Santos, Judith M Katzenellenbogen
BACKGROUND AND AIM: Quantifying stroke incidence and mortality is crucial for disease surveillance and health system planning. Administrative data offer a cost-effective alternative to "gold standard" population-based studies. However, the optimal methodology for establishing stroke deaths from administrative data remains unclear. We aimed to determine the optimal method for identifying stroke-related deaths in administrative datasets as the fatal component of stroke incidence, comparing counts derived using underlying and all causes of death (CoD)...
March 7, 2024: Heart, Lung & Circulation
Elizabeth Suo, Andrea Driscoll, Diem Dinh, Angela Brennan, David M Kaye, Dion Stub, Jeffrey Lefkovits, Christopher M Reid, Ingrid Hopper
BACKGROUND: Acute decompensated heart failure (ADHF) is a leading cause of cardiovascular disease hospitalisations associated with significant morbidity and mortality. In hospitals, HF patients are typically managed by cardiology or physician teams, with differences in patient demographics and clinical outcomes. This study utilises contemporary HF registry data to compare patient characteristics and outcomes in those with ADHF admitted into General Medicine and Cardiology units. METHODS: The Victorian Cardiac Outcomes Registry was utilised to identify patients hospitalised with ADHF 30-day period in each of four consecutive years...
March 7, 2024: Heart, Lung & Circulation
Rebecca Perry, Anthony Forshaw, Jessie Childs, Deanne Chester, Christopher Edwards
BACKGROUND & AIM: Echocardiography education involves the teaching and assessment of multiple competencies to ensure work-ready graduates. To connect these competency standards to professional practice, it is important that the industry expectation around specific entrustable professional activities (EPAs) is determined. In Australia, echocardiography examinations are eligible for Medicare reimbursement when performed by sonographers listed on the Australian Sonographers Accreditation Registry (ASAR), either as an Accredited Medical Sonographer or as an Accredited Student Sonographer...
March 7, 2024: Heart, Lung & Circulation
Malgorzata Maggie Szpytma, Robert A Baker, Damian Gimpel, Richard F Newland, David G Lance, Gregory D Rice, Gareth Crouch, Jayme S Bennetts
BACKGROUND: Predictors of long-term saphenous vein graft (SVG) patency following coronary artery bypass grafting (CABG) include harvesting technique, degree of proximal coronary stenosis, and target vessel diameter and runoff. The objective of this study was to evaluate the association between vein graft diameter and long-term survival. METHODS: Patients undergoing primary CABG (2000-2017) at Flinders Medical Centre, Adelaide, Australia, were categorised into three groups according to average SVG diameter (<3...
March 7, 2024: Heart, Lung & Circulation
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