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Role of Mechanical Circulatory Support in Acute MI Management 机械循环支持在急性心肌梗死治疗中的作用
US Cardiology Review Pub Date : 2023-04-28 DOI: 10.15420/usc.2022.32
Sundeep Kumar, R. Feroze, Farshad Forouzandeh
{"title":"Role of Mechanical Circulatory Support in Acute MI Management","authors":"Sundeep Kumar, R. Feroze, Farshad Forouzandeh","doi":"10.15420/usc.2022.32","DOIUrl":"https://doi.org/10.15420/usc.2022.32","url":null,"abstract":"Cardiogenic shock complicating acute MI carries high mortality and morbidity in many cases. Mechanical circulatory support devices are often used in these cases, aimed at improving patient-centered outcomes, although there is a lack of large randomized clinical trial-based evidence for many of such devices. Various circulatory support devices are available with their associated risks and benefits. Ideal circulatory support device intends to unload the myocardium, halt the spiral of ischemia, provide support for revascularization, and/or allow time for myocardial recovery. In this review paper, the commonly used mechanical circulatory support devices available for use in acute myocardial infarction settings are discussed, and the pros and cons of these devices are examined, considering the contemporary data for each. While this is an evolving field, the authors believe this paper can be helpful to review the current status of the use of mechanical support devices in the setting of acute MI and highlight some of the unmet needs in this field.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44964803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mechanical Circulatory Support for Complex High-risk Percutaneous Coronary Intervention 复杂高危经皮冠状动脉介入治疗的机械循环支持
US Cardiology Review Pub Date : 2023-04-04 DOI: 10.15420/usc.2022.26
A. Truesdell, R. Davies, Moemen Eltelbany, M. Megaly, Carolyn M. Rosner, Lindsey A. Cilia
{"title":"Mechanical Circulatory Support for Complex High-risk Percutaneous Coronary Intervention","authors":"A. Truesdell, R. Davies, Moemen Eltelbany, M. Megaly, Carolyn M. Rosner, Lindsey A. Cilia","doi":"10.15420/usc.2022.26","DOIUrl":"https://doi.org/10.15420/usc.2022.26","url":null,"abstract":"Technological and procedural innovations presently permit the safe and effective performance of increasingly complex percutaneous coronary interventions, while new mechanical circulatory support devices offer circulatory and ventricular support to patients with severely reduced left ventricular systolic function and deranged cardiovascular hemodynamics. Together, these advances now permit the application of complex percutaneous coronary interventions to higher-risk patients who might otherwise be left untreated. Increasing observational data support the use of mechanical circulatory support in appropriate complex and high-risk patients as part of a larger multidisciplinary heart team treatment plan. In-progress and upcoming randomized clinical trials may provide higher-quality evidence to better guide management decisions in the near future.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67576837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Cerebral Embolic Protection Devices: Current State of the Art 脑栓塞保护装置:目前的技术状况
US Cardiology Review Pub Date : 2023-03-31 DOI: 10.15420/usc.2022.12
Ankita Agrawal, T. Isogai, S. Shekhar, S. Kapadia
{"title":"Cerebral Embolic Protection Devices: Current State of the Art","authors":"Ankita Agrawal, T. Isogai, S. Shekhar, S. Kapadia","doi":"10.15420/usc.2022.12","DOIUrl":"https://doi.org/10.15420/usc.2022.12","url":null,"abstract":"Transcatheter aortic valve replacement (TAVR) has become a first-line treatment for severe aortic stenosis with intermediate to high-risk population with its use increasingly expanding into younger and low-risk cohorts as well. Cerebrovascular events are one of the most serious consequential complications of TAVR, which increase morbidity and mortality. The most probable origin of such neurological events is embolic in nature and the majority occur in the acute phase after TAVR when embolic events are most frequent. Cerebral embolic protection devices have been designed to capture or deflect these emboli, reducing the risk of peri-procedural ischaemic events. They also carry the potential to diminish the burden of new silent ischemic lesions during TAVR. Our review explores different types of these device systems, their rationale, and the established clinical data.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44730991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Clozapine-induced Cardiomyopathy: A Case Report 氯氮平诱发的心肌病1例报告
US Cardiology Review Pub Date : 2023-02-09 DOI: 10.15420/usc.2022.22
E. Hariri, Anna Scandinaro, Mazen M Al Hammoud, Ashley Kasper, Craig Parris, Beka Bakhtadzi, A. Higgins
{"title":"Clozapine-induced Cardiomyopathy: A Case Report","authors":"E. Hariri, Anna Scandinaro, Mazen M Al Hammoud, Ashley Kasper, Craig Parris, Beka Bakhtadzi, A. Higgins","doi":"10.15420/usc.2022.22","DOIUrl":"https://doi.org/10.15420/usc.2022.22","url":null,"abstract":"The diagnosis and treatment of new-onset systolic dysfunction can be challenging, particularly in patients presenting with cardiogenic shock. We present a case of a young African-American male who was admitted for cardiogenic shock following an admission a month earlier for treatmentresistant psychosis. He was diagnosed with medication-induced cardiomyopathy, which resolved with a remarkable recovery of his systolic function after discontinuation of the culprit medication, clozapine.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45670331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Fontan-associated Liver Disease in Adults: What a Cardiologist Needs to Know. A Comprehensive Review for Clinical Practitioners 成人丰坦相关肝病:心脏病专家需要知道的临床从业人员的综合评价
US Cardiology Review Pub Date : 2022-11-29 DOI: 10.15420/usc.2022.02
A. Ciepłucha, W. Budts, M. Gewillig, A. Van De Bruaene
{"title":"Fontan-associated Liver Disease in Adults: What a Cardiologist Needs to Know. A Comprehensive Review for Clinical Practitioners","authors":"A. Ciepłucha, W. Budts, M. Gewillig, A. Van De Bruaene","doi":"10.15420/usc.2022.02","DOIUrl":"https://doi.org/10.15420/usc.2022.02","url":null,"abstract":"Nowadays most patients with a univentricular heart after Fontan repair survive until adulthood. One of the hallmarks of Fontan circulation is \u0000permanently elevated central venous pressure, which leads to congestive hepatopathy. Subsequently, liver fibrosis, cirrhosis, or hepatocellular carcinoma may occur, all of them constituting an entity called Fontan-associated liver disease (FALD). Given that these complications convey poor \u0000prognosis, the need for life-long hepatic surveillance is not in doubt. Many serum biomarkers and sophisticated imaging techniques have been proposed to avoid invasive liver biopsy in this cohort, but none proved to be a relevant surrogate of liver fibrosis seen in histopathological specimens. The surveillance models proposed to date require an extensive diagnostic work-up, which can be problematic, particularly in resource-depleted countries. Moreover, the question of combined heart–liver transplant is gaining more attention in the Fontan cohort. The aim of this study is to provide practical information on the pathophysiology of FALD and to propose a simplified framework for the routine assessment of liver status in Fontan patients that would be helpful in the decision-making process.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48785665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advanced Steering Maneuvers for Special Situations in Mitral Valve Transcatheter Edge-to-edge Repair 二尖瓣导管边缘到边缘修复中特殊情况下的高级转向策略
US Cardiology Review Pub Date : 2022-11-18 DOI: 10.15420/usc.2022.11
Vikram Sharma, Arpit Sothwal, J. Parekh, S. Panaich
{"title":"Advanced Steering Maneuvers for Special Situations in Mitral Valve Transcatheter Edge-to-edge Repair","authors":"Vikram Sharma, Arpit Sothwal, J. Parekh, S. Panaich","doi":"10.15420/usc.2022.11","DOIUrl":"https://doi.org/10.15420/usc.2022.11","url":null,"abstract":"The use of transcatheter percutaneous edge-to-edge mitral valve repair with the MitraClip (Abbott) for the treatment of mitral regurgitation has rapidly expanded since it received Food and Drug Administration approval. Currently, patients with more complex mitral valve anatomies are undergoing this procedure with progressively improving clinical outcomes. This review focuses on the advanced steering maneuvers needed for the technical success of the MitraClip procedure and discusses several scenarios where such advanced steering maneuvers may be needed. These include an anterior transseptal puncture, low or high transseptal puncture with unfavorable transseptal height to mitral valve, large gap height, patients with mitral regurgitation due to dehiscence of a prior mitral valve annuloplasty ring, placing multiple/adjacent MitraClips, or redo edge-to-edge mitral valve repair. Knowledge and mastery of such advanced steering maneuvering techniques can allow operators to complete the procedure successfully with low rate of complications even in difficult scenarios.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45320880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Contemporary Risk Stratification of Acute Coronary Syndrome 急性冠状动脉综合征的当代风险分层
US Cardiology Review Pub Date : 2022-10-14 DOI: 10.15420/usc.2022.10
Gurleen Kaur, Swati Chand, D. Rai, Bipul Baibhav, R. Blankstein, D. Mukherjee, P. Levy, M. Gulati
{"title":"Contemporary Risk Stratification of Acute Coronary Syndrome","authors":"Gurleen Kaur, Swati Chand, D. Rai, Bipul Baibhav, R. Blankstein, D. Mukherjee, P. Levy, M. Gulati","doi":"10.15420/usc.2022.10","DOIUrl":"https://doi.org/10.15420/usc.2022.10","url":null,"abstract":"Chest pain is one of the most common presenting concerns of patients seeking care in the emergency department, and the underlying etiology can range from acute coronary syndrome to various other non-cardiac causes. Initial evaluation should focus on characterizing symptoms and identifying risk factors, but further risk stratification using clinical decision pathways and biomarkers (cardiac troponin) is essential. The 2021 American Heart Association/American College of Cardiology guidelines for the evaluation and diagnosis of chest pain represent the first ever guidelines for the evaluation of patients with acute chest pain. The contemporary risk stratification methods described in these guidelines allow for the identification of patient subgroups: patients who do not require further testing, patients who should proceed directly to the cath lab, and patients who will benefit from further anatomic or functional testing. In this review, we describe contemporary risk stratification methods for acute coronary syndrome and summarize the recommendations put forth by the guidelines.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48057928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Expanding Uses of Medical Extended Reality in the Cardiac Catheterization Laboratory: Pre-procedural Planning, Intraprocedural Guidance, and Intraprocedural Navigation 医学扩展现实在心导管实验室的扩展应用:术前计划、术中指导和术中导航
US Cardiology Review Pub Date : 2022-10-14 DOI: 10.15420/usc.2021.28
David Bloom, Michael K Southworth, Jonathan R Silva, Jennifer N Avari Silva
{"title":"The Expanding Uses of Medical Extended Reality in the Cardiac \u0000Catheterization Laboratory: Pre-procedural Planning, \u0000Intraprocedural Guidance, and Intraprocedural Navigation","authors":"David Bloom, Michael K Southworth, Jonathan R Silva, Jennifer N Avari Silva","doi":"10.15420/usc.2021.28","DOIUrl":"https://doi.org/10.15420/usc.2021.28","url":null,"abstract":"The use of innovative imaging practices in the field of interventional cardiology and electrophysiology has led to significant progress in both diagnostic and therapeutic capabilities. 3D reconstructions of 2D images allows a proceduralist to develop a superior understanding of patient anatomy. Medical extended reality (MXR) technologies employ 3D interactive images for the user to improve depth perception and spatial awareness. Although MXR procedural navigation is a relatively new concept, the potential for use within interventional cardiology and EP is significant with the eventual goal of improving patient outcomes and reducing patient harm. This review article will discuss the current landscape of MXR use in the catheterization lab including pre-procedural planning, intraprocedural planning and intraprocedural guidance in diagnostic cardiac catheterization, valvar and coronary interventions, electrophysiology studies, and device implants.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47174957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bicuspid Aortic Stenosis with and without Aortopathy: Considerations for Surgical Aortic Valve Replacement versus Transcatheter Aortic Valve Replacement 伴或不伴主动脉病变的二尖主动脉狭窄：外科主动脉瓣置换术与经导管主动脉瓣置换手术的考虑因素
US Cardiology Review Pub Date : 2022-08-04 DOI: 10.15420/usc.2021.32
Arthur J Lee, I. Baig, K. Harrington, Molly Szerlip
{"title":"Bicuspid Aortic Stenosis with and without Aortopathy: Considerations for Surgical Aortic Valve Replacement versus Transcatheter Aortic Valve Replacement","authors":"Arthur J Lee, I. Baig, K. Harrington, Molly Szerlip","doi":"10.15420/usc.2021.32","DOIUrl":"https://doi.org/10.15420/usc.2021.32","url":null,"abstract":"The treatment of aortic stenosis has evolved in recent years with the introduction of transcatheter aortic valve replacement (TAVR) as a complementary strategy to surgical aortic valve replacement (SAVR). The majority of clinical trials to date have included only tricuspid aortic stenosis and excluded bicuspid aortic valves (BAVs). BAVs are associated with unique challenges related to their anatomy, clinical presentation, and association with aortopathy. BAV has a spectrum of phenotypes and the classification is still evolving. There have been no definitive clinical guidelines on triaging BAV patients towards TAVR or SAVR. Given that TAVR is moving from high-risk to low-risk patients and becoming more widely used in the treatment of BAV, there are many factors that must be considered. The aim of this article is to review the literature and present considerations for heart teams to discuss in order to offer patients the best lifetime management strategy for BAV stenosis.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45548531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intensive Care Management of the Cardiogenic Shock Patient 心源性休克患者的重症监护管理
US Cardiology Review Pub Date : 2022-07-26 DOI: 10.15420/usc.2021.23
S. Uddin, R. Anandanadesan, R. Trimlett, S. Price
{"title":"Intensive Care Management of the Cardiogenic Shock Patient","authors":"S. Uddin, R. Anandanadesan, R. Trimlett, S. Price","doi":"10.15420/usc.2021.23","DOIUrl":"https://doi.org/10.15420/usc.2021.23","url":null,"abstract":"Optimal management of patients with cardiogenic shock requires a detailed and systematic assessment of all organ systems, balancing the risks and benefits of any investigation and intervention, while avoiding the complications of critical illness. Overall prognosis depends upon a number of factors, including that of the underlying cardiac disease and its potential reversibility, the severity of shock, the involvement of other organ systems, the age of the patient and comorbidities. As with all intensive care patients, the mainstay of management is supportive, up to and including implementation and management of a number of devices, including acute mechanical circulatory support. The assessment and management of these most critically ill patients therefore demands in-depth knowledge and skill relating to cardiac intensive care, extending well beyond standard intensive care or cardiology practice.","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43381463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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