Chak-Yu So, Guson Kang, Pedro A Villablanca, Iván J Núñez Gil, Harish Ramakrishna
No abstract text is available yet for this article.
August 27, 2020: Journal of Cardiothoracic and Vascular Anesthesia
Riley J Batchelor, Diem Dinh, Angela Brennan, Nathan Wong, Jeffrey Lefkovits, Christopher Reid, Stephen J Duffy, William Chan, Nicholas Cox, Danny Liew, Dion Stub
International guidelines suggest revascularization within 24 hours in non-ST segment elevation myocardial infarction (NSTEMI). Within a large population cohort study, we aimed to explore clinical practice regarding timing targets for percutaneous coronary intervention (PCI) in NSTEMI. The Victorian Cardiac Outcomes Registry was established in 2013 as a state-wide clinical quality registry, pooling data from public and private PCI capable centres. Data were collected on 11,852 PCIs performed for NSTEMI from 2014 to 2018...
September 15, 2020: American Journal of Cardiology
Isabelle Malhamé, Valery A Danilack, Christina A Raker, Erica J Hardy, Hannah Spalding, Benjamin A Bouvier, Heather Hurlburt, Roxanne Vrees, David A Savitz, Niharika Mehta
OBJECTIVES: To develop and internally validate risk prediction models identifying women at risk for cardiovascular severe maternal morbidity (CSMM). DESIGN: A retrospective cohort study. SETTING: An obstetric teaching hospital between 2007 and 2017. POPULATION: 89,681 delivery hospitalizations. METHODS: We created and evaluated two models, one predicting CSMM at delivery (delivery model) and the other predicting CSMM postpartum following discharge from delivery hospitalization (postpartum CSMM)...
September 18, 2020: BJOG: An International Journal of Obstetrics and Gynaecology
Douglas Farmer, Ernesto Jimenez
PURPOSE OF REVIEW: The use of coronary artery bypass grafting (CABG) in patients with acute coronary syndrome (ACS) has markedly declined during the past decade, with an increase in the use of percutaneous coronary intervention (PCI). However, long-term data continues to show survival advantages for patients undergoing CABG over PCI. We describe the current indications for and outcomes of CABG in patients who present with ACS. RECENT FINDINGS: Real-world studies demonstrate better long-term outcomes with CABG than with PCI after NSTE-ACS...
September 17, 2020: Current Cardiology Reports
Moinuddin Syed, Muhammad Zia Khan, Mohammed Osman, Anas Alharbi, Muhammad Usman Khan, Muhammad Bilal Munir, Sudarshan Balla
There is limited data on the in-hospital outcomes of cardiogenic shock (CS) secondary to takotsubo syndrome (TS). We aimed to assess the incidence, predictors and outcomes of CS in hospitalized patients with TS. All patients with TS were identified from the National Inpatient Sample (NIS) database from September 2006 to December 2017. The cohort was divided into those with versus without CS and logistic regression analysis was used to identify predictors of CS and mortality in patients admitted with TS. A total of 260,144 patients with TS were included in our study, of whom 14703 (6%) were diagnosed with cardiogenic shock (CS)...
September 14, 2020: American Journal of Cardiology
Supriya Jain, Sheila M Nolan, Aalok R Singh, Leif Lovig, Rachel Biller, Aditi Kamat, Mary H Brennan, Markus Erb, Erin Rescoe, Gary Tatz, Michael H Gewitz
Cardiac involvement as a complication of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in children is a relatively new entity. We present our initial experience managing children with COVID-19-related acute myocardial injury. The 3 patients presented here represent a spectrum of the cardiac involvement noted in children with COVID-19-related Multisystem Inflammatory Syndrome in Children (MIS-C), including myocarditis presenting as cardiogenic shock or heart failure with biventricular dysfunction, valvulitis, coronary artery changes and pericardial effusion...
September 15, 2020: Cardiology in Review
Yasumori Sujino, Kensuke Kuroda, Koichi Yoshitake, Nobuichiro Yagi, Eiji Anegawa, Hiroki Mochizuki, Keiichiro Iwasaki, Seiko Nakajima, Takuya Watanabe, Masanobu Yanase, Satsuki Fukushima, Tomoyuki Fujita, Junjiro Kobayashi, Norihide Fukushima
Aortic insufficiency (AI) is an important adverse event in patients with continuous-flow (CF) left ventricular assist device (LVAD) support. AI is often progressive, resulting in elevated 2-year morbidity and mortality. The effectiveness of echocardiographic ramp studies in patients with AI has been unclear. Here, we describe a patient with a CF-LVAD implant who underwent aortic valve replacement (AVR), following assessment of AI using a hemodynamic ramp test with simultaneous echocardiography and right heart catheterization (RHC)...
September 17, 2020: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Stacey Chen, Darien Paone, Lilly Spellman, Neel K Ranganath, Julius A Carillo, Claudia G Gidea, Alex Reyentovich, Craig A Thompson, Louai Razzouk, Zachary N Kon, Nader Moazami, Deane E Smith
BACKGROUND: The Impella (Abiomed) ventricular support system is a family of temporary mechanical circulatory support (MCS) devices used to treat patients with cardiogenic shock, acute cardiogenic decompensation, and for high-risk percutaneous or surgical revascularization. These devices include the percutaneously implanted 2.5/cardiac power (CP) and the surgically implanted 5.0/left direct (LD). Despite the beneficial effects and increased usage of these devices, data to assess adverse outcomes and guide clinician decision-making between the Impella CP and 5...
September 16, 2020: Journal of Cardiac Surgery
María Monteagudo-Vela, Vasileios Panoulas, Diana García-Saez, Fabio de Robertis, Ulrich Stock, Andre Simon
INTRODUCTION: The Impella® (Abiomed, Danvers, MA) has become an important adjunct treatment modality in bridging patients with end stage heart failure to recovery or orthotopic heart transplantation (HTx). We compared the outcome of patients directly bridged to HTx with the Impella 5.0 versus patients without mechanical circulatory support (MCS). METHODS: Patients with no previous sternotomy or MCS, who were transplanted between September 2014 and March 2019 were included in this retrospective analysis...
September 16, 2020: Artificial Organs
Ahmed Seliem, Shelley A Hall
PURPOSE OF REVIEW: In recent decades, multiple left and right ventricular assist devices (VAD) have been developed, and the utilization of these devices has grown exponentially. We discuss the most common temporary mechanical circulatory support (tMCS) devices used for patients in cardiogenic shock, including the intra-aortic balloon pump (IABP), transvalvular axial flow support systems (Impella®), the Tandem™ collection, and extracorporeal membrane oxygenation (ECMO). RECENT FINDINGS: In 2018 the United Network for Organ Sharing (UNOS) introduced new listing criteria for candidates awaiting heart transplantation in the USA...
September 16, 2020: Current Heart Failure Reports
Nili Schamroth Pravda, Ran Kornowski
The use of VA-ECMO for patients with cardiac arrest or cardiogenic shock in the cardiac catheterization laboratory may be associated with improved survival. Clinicians should be aware of a high complication rate of this therapy. Further data is needed to best select the appropriate form of mechanical circulatory support in this clinical context.
September 1, 2020: Catheterization and Cardiovascular Interventions
Morton J Kern, Arnold H Seto
Angiographically visible collaterals are seen in a minority of STEMI patients, predominantly to the RCA and in patients with delays to reperfusion. Patients with visible collaterals were less likely to have cardiogenic shock and tended to have a longer survival. Further studies will determine the mechanisms of collateral formation and their protective associations.
September 1, 2020: Catheterization and Cardiovascular Interventions
Anirudh Kumar, Chetan P Huded, Leon Zhou, Chayakrit Krittanawong, Laura D Young, Amar Krishnaswamy, Venu Menon, A Michael Lincoff, Stephen G Ellis, Grant W Reed, Samir R Kapadia, Umesh N Khot
Mortality in patients with STEMI-associated cardiogenic shock (CS) is increasing. Whether a comprehensive ST-elevation myocardial infarction (STEMI) protocol (CSP) can improve their care delivery and mortality is unknown. We evaluated the impact of a CSP on incidence and outcomes in patients with STEMI-associated CS. We implemented a 4-step CSP including: (1) Emergency Department catheterization lab activation; (2) STEMI Safe Handoff Checklist; (3) immediate catheterization lab transfer; (4) and radial-first percutaneous coronary intervention (PCI)...
August 15, 2020: American Journal of Cardiology
Larisa Renata Pantea-Roșan, Vlad Alin Pantea, Simona Bungau, Delia Mirela Tit, Tapan Behl, Cosmin Mihai Vesa, Cristiana Bustea, Radu Dumitru Moleriu, Marius Rus, Mircea Ioachim Popescu, Vladiana Turi, Camelia Cristina Diaconu
The no-reflow phenomenon following primary percutaneous coronary intervention (PPCI) in acute ST-elevation myocardial infarction (STEMI) patients is a predictor of unfavorable prognosis. Patients with no-reflow have many complications during admission, and it is considered a marker of short-term mortality. The current research emphasizes the circumstances of the incidence and complications of the no-reflow phenomenon in STEMI patients, including in-hospital mortality. In this case-control study, conducted over two and a half years, there were enrolled 656 patients diagnosed with STEMI and reperfused through PPCI...
September 12, 2020: Journal of Clinical Medicine
Hyunjin Jo, Hwa Reung Lee, Dongyeop Kim, Yoonha Hwang, Young-Min Shon, Kyoung Soo Lee, DaeWon Seo
No abstract text is available yet for this article.
September 8, 2020: Seizure: the Journal of the British Epilepsy Association
Almendro-Delia Manuel, Seoane García Tania, Villar Calle Pablo, García González Néstor, Lorenzo López Beatriz, Cortés Francisco Javier, García Del Río Manuel, Ruiz García María Del Pilar, J Hidalgo Urbano Rafael, C García-Rubira Juan
Background Seemingly conflicting findings exist regarding the prognostic impact of totally occluded infarct-related arteries (oIRA) in non-ST elevation acute coronary syndromes (NSTE-ACS). Methods Retrospective analysis of prospective multicenter registry data comprising a single-center NSTE-ACS cohort, aimed at assessing the impact of occluded (TIMI flow 0/1) versus patent culprit vessels (pIRA, TIMI flow 2/3) on the composite endpoint of all-cause death and cardiogenic shock events at 30 days. Results Of 568 patients, 183 (32...
September 12, 2020: International Journal of Cardiology
Peng-Yuan Chen, Yuan-Hui Liu, Chong-Yang Duan, Lei Jiang, Xue-Biao Wei, Wei Guo, Ji-Yan Chen, Ning Tan, Peng-Cheng He
OBJECTIVE: We aimed to describe the association between in-hospital infection and prognosis among patients with non-ST elevation acute coronary syndrome (NSTE-ACS) who received percutaneous coronary intervention (PCI). DESIGN: This observational cohort originated from a database of patients with NSTE-ACS who underwent PCI from 1 January 2010 to 31 December 2014. SETTING: Five centres in South China. PARTICIPANTS: This multicentre observational cohort study consecutively included 8197 patients with NSTE-ACS who received PCI...
September 14, 2020: BMJ Open
Kristen T Carter, Robert O'Brien, Sharon B Larson, Lawrence L Creswell, Matthew Kutcher, David A Baran, Jack G Copeland, Hannah Copeland
OBJECTIVE: Venoarterial extracorporeal membrane oxygenation is a rescue therapy for patients in cardiogenic shock. We hypothesize that patients bridged to heart transplant with extracorporeal membrane oxygenation have decreased survival. METHODS: The United Network of Organ Sharing database was retrospectively reviewed from January 1, 1999, to March 31, 2018, for heart transplant recipients. Recipients bridged with any form of mechanical support and those without support were compared with recipients bridged with extracorporeal membrane oxygenation...
August 16, 2020: Journal of Thoracic and Cardiovascular Surgery
Tomoki Ushijima, Hiromichi Sonoda, Yoshihisa Tanoue, Akira Shiose
INTRODUCTION: Ecpella, a combination of veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) and Impella, may result in the differential hypoxia in patients with cardiogenic shock and severe lung dysfunction. Here, we report a solution of this Ecpella-induced unfavorable phenomenon. CASE REPORT: A 70-year-old man developed cardiogenic shock from fulminant myocarditis. As we established Ecpella but immediately significant differential hypoxia became apparent, the ECMO configuration was switched from V-A to veno-arteriovenous (V-AV): a combination of V-AV ECMO and Impella, newly termed VAVEcpella, was instituted...
September 15, 2020: Perfusion
Samantha A King, Ryan Spangler, Zachary D W Dezman, Laura J Bontempo
CASE PRESENTATION: A 36-year-old incarcerated male presented to the emergency department (ED) after an episode concerning for syncope. The patient had nystagmus and ataxia on initial examination. DISCUSSION: There is a broad differential diagnosis for syncope, and for patients presenting to the ED we tend to focus on cardiogenic and neurologic causes. This case takes the reader through the differential diagnosis and systemic work-up of a patient presenting to the ED with syncope...
August 2020: Clinical Practice and Cases in Emergency Medicine
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