US Cardiology ReviewPub Date : 2022-10-14eCollection Date: 2022-01-01DOI: 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 Catheterization Laboratory: Pre-procedural Planning, Intraprocedural Guidance, and Intraprocedural Navigation.","authors":"David Bloom, Michael K Southworth, Jonathan R Silva, Jennifer N Avari Silva","doi":"10.15420/usc.2021.28","DOIUrl":"10.15420/usc.2021.28","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e22"},"PeriodicalIF":0.0,"publicationDate":"2022-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47174957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
US Cardiology ReviewPub Date : 2022-08-04eCollection Date: 2022-01-01DOI: 10.15420/usc.2021.32
Arthur J Lee, Imran Baig, Katherine B 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, Imran Baig, Katherine B Harrington, Molly Szerlip","doi":"10.15420/usc.2021.32","DOIUrl":"10.15420/usc.2021.32","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e21"},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45548531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
US Cardiology ReviewPub Date : 2022-07-26eCollection Date: 2022-01-01DOI: 10.15420/usc.2021.23
Shahana Uddin, Rathai Anandanadesan, Richard Trimlett, Susanna Price
{"title":"Intensive Care Management of the Cardiogenic Shock Patient.","authors":"Shahana Uddin, Rathai Anandanadesan, Richard Trimlett, Susanna Price","doi":"10.15420/usc.2021.23","DOIUrl":"10.15420/usc.2021.23","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e20"},"PeriodicalIF":0.0,"publicationDate":"2022-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43381463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
US Cardiology ReviewPub Date : 2022-07-25eCollection Date: 2022-01-01DOI: 10.15420/usc.2022.04
Sahoor Khan, William Shi, Tsuyoshi Kaneko, Suzanne J Baron
{"title":"The Evolving Role of the Multidisciplinary Heart Team in Aortic Stenosis.","authors":"Sahoor Khan, William Shi, Tsuyoshi Kaneko, Suzanne J Baron","doi":"10.15420/usc.2022.04","DOIUrl":"10.15420/usc.2022.04","url":null,"abstract":"<p><p>Transcatheter aortic valve replacement has transformed the paradigm of care for patients with severe aortic stenosis (AS). With transcatheter aortic valve replacement now commercially approved for AS patients of all surgical risk, clinical decision-making regarding the initial mode of valve replacement (e.g. surgical versus transcatheter) and prosthesis type has become even more complex. The updated American College of Cardiology/American Heart Association and European Society of Cardiology/European Association for Cardio-Thoracic Surgery guidelines on valvular heart disease offer a strong foundation from which to address the nuances of the treatment of AS; however, there remain several clinical scenarios for which evidence and thus definitive societal recommendations are lacking. As such, the heart team continues to play an invaluable role in the management of the AS patient by combining available scientific evidence, expertise across disciplines, and the patient's preferences to optimize individualized patient care and healthcare resource usage.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e19"},"PeriodicalIF":0.0,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47060149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
US Cardiology ReviewPub Date : 2022-07-21eCollection Date: 2022-01-01DOI: 10.15420/usc.2022.08
Quynh Nguyen, Jessica Gy Luc, Thomas E MacGillivray, Ourania A Preventza
{"title":"Transcatheter Versus Surgical Aortic Valve Replacement in Young, Low-risk Patients with Severe Aortic Stenosis.","authors":"Quynh Nguyen, Jessica Gy Luc, Thomas E MacGillivray, Ourania A Preventza","doi":"10.15420/usc.2022.08","DOIUrl":"10.15420/usc.2022.08","url":null,"abstract":"<p><p>Aortic stenosis is a common form of acquired degenerative valvular disease associated with poor survival after the onset of symptoms. Treatment options for patients with aortic stenosis in addition to medical therapy include surgical aortic valve replacement (SAVR) with either tissue or mechanical valves, or transcatheter aortic valve replacement (TAVR) with either balloon-expandable or self-expanding valves via either transfemoral or alternative access routes. In this review, the authors discuss the current evidence and special considerations regarding the use of TAVR versus SAVR in the management of severe aortic stenosis in young (<65 years of age), low-risk patients, highlighting the history of aortic stenosis treatment, the current guidelines and recommendations, and important issues that remain to be addressed. Ultimately, until ongoing clinical trials with long-term follow-up data shed light on whether interventions for aortic stenosis can be broadened to a low-risk population, TAVR in young, low-risk patients should be undertaken with caution and with guidance from a multidisciplinary heart team.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e18"},"PeriodicalIF":0.0,"publicationDate":"2022-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46054411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
US Cardiology ReviewPub Date : 2022-07-08eCollection Date: 2022-01-01DOI: 10.15420/usc.2021.19
Payam Pournazari, Su Min Chang, Stephen H Little, Sachin Goel, Nadeen N Faza
{"title":"Prosthetic Aortic Valve Thrombosis.","authors":"Payam Pournazari, Su Min Chang, Stephen H Little, Sachin Goel, Nadeen N Faza","doi":"10.15420/usc.2021.19","DOIUrl":"10.15420/usc.2021.19","url":null,"abstract":"<p><p>Prosthetic valve thrombosis is the second leading cause of prosthetic valve deterioration and is being more readily diagnosed with the use of echocardiography and multidetector cardiac CT. Presentation of valve thrombosis can be acute or subacute and any change in clinical status of a patient with a prosthetic valve should raise a suspicion of prosthetic valve thrombosis. Diagnosis entails detailed clinical examination and comprehensive imaging. The choice of therapeutic options includes anticoagulation, fibrinolytic therapy, or valve replacement. Antiplatelet and anticoagulation therapy remain the mainstay of thrombosis prevention in patients with a prosthetic valve and a personalized approach is required to optimize prosthetic valve function and minimize the risk of bleeding.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e17"},"PeriodicalIF":0.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47511777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
US Cardiology ReviewPub Date : 2022-07-01eCollection Date: 2022-01-01DOI: 10.15420/usc.2022.05
Robert Barcelona
{"title":"Best Practices in Pharmacotherapy for Acute Coronary Syndromes.","authors":"Robert Barcelona","doi":"10.15420/usc.2022.05","DOIUrl":"10.15420/usc.2022.05","url":null,"abstract":"<p><p>Numerous advances have been made in the therapy of acute coronary syndromes. Despite these advances, acute coronary syndromes still cause significant morbidity and mortality. Decisions as to the best therapy vary depending on other patient factors, such as age, need for chronic anticoagulation, tolerability of medications, and the degree of myocardial damage. Recent evidence suggests that a shorter duration of therapy may be beneficial in decreasing bleeding events without compromising benefits of preventing ischemic complications. For those who have an indication for chronic anticoagulation, less intensive therapy may also be beneficial, again without increasing ischemic complications. Data regarding agents that inhibit the renin-angiotensin-aldosterone system are available and these data are reviewed. Knowledge of the pharmacology, potency, and pharmacokinetics of drugs, as well as adverse drug events, may direct clinicians in choosing the optimal pharmacotherapy strategy for their patients.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e16"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46985851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
US Cardiology ReviewPub Date : 2022-06-23eCollection Date: 2022-01-01DOI: 10.15420/usc.2022.03
Gregory Petrossian, Denizhan Ozdemir, Keyvan Karimi Galougahi, Jonathan Scheiner, Susan V Thomas, Richard Shlofmitz, Evan Shlofmitz, Allen Jeremias, Ziad A Ali
{"title":"Role of Intracoronary Imaging in Acute Coronary Syndromes.","authors":"Gregory Petrossian, Denizhan Ozdemir, Keyvan Karimi Galougahi, Jonathan Scheiner, Susan V Thomas, Richard Shlofmitz, Evan Shlofmitz, Allen Jeremias, Ziad A Ali","doi":"10.15420/usc.2022.03","DOIUrl":"10.15420/usc.2022.03","url":null,"abstract":"<p><p>Intravascular imaging with optical coherence tomography (OCT) and intravascular ultrasound provides superior visualization of the culprit plaques for acute coronary syndromes (ACS) compared with coronary angiography. Combined with angiography, intravascular imaging can be used to instigate 'precision therapy' for ACS. Post-mortem histopathology identified atherothrombosis at the exposed surface of a ruptured fibrous cap as the main cause of ACS. Further histopathological studies identified intact fibrous caps and calcified nodules as other culprit lesions for ACS. These plaque types were subsequently also identified on intravascular imaging, particularly with the high-resolution OCT. The less-common non-atherothrombotic causes of ACS are coronary artery spasm, coronary artery dissection, and coronary embolism. In this review, the authors provide an overview of clinical studies using intravascular imaging with OCT in the diagnosis and management of ACS.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e15"},"PeriodicalIF":0.0,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48751102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
US Cardiology ReviewPub Date : 2022-05-09eCollection Date: 2022-01-01DOI: 10.15420/usc.2022.07
Anne H Tavenier, Johny Nicolas, Roxana Mehran
{"title":"The Final Word: Current Strategies for the Lifetime Management of Patients with Aortic Valve Stenosis.","authors":"Anne H Tavenier, Johny Nicolas, Roxana Mehran","doi":"10.15420/usc.2022.07","DOIUrl":"10.15420/usc.2022.07","url":null,"abstract":"","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e13"},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46005115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
US Cardiology ReviewPub Date : 2022-04-28eCollection Date: 2022-01-01DOI: 10.15420/usc.2021.34
Aniket S Rali, Amy Butcher, Ryan J Tedford, Shashank S Sinha, Pakinam Mekki, Harriette Gc Van Spall, Andrew J Sauer
{"title":"Contemporary Review of Hemodynamic Monitoring in the Critical Care Setting.","authors":"Aniket S Rali, Amy Butcher, Ryan J Tedford, Shashank S Sinha, Pakinam Mekki, Harriette Gc Van Spall, Andrew J Sauer","doi":"10.15420/usc.2021.34","DOIUrl":"10.15420/usc.2021.34","url":null,"abstract":"<p><p>Hemodynamic assessment remains the most valuable adjunct to physical examination and laboratory assessment in the diagnosis and management of shock. Through the years, multiple modalities to measure and trend hemodynamic indices have evolved with varying degrees of invasiveness. Pulmonary artery catheter (PAC) has long been considered the gold standard of hemodynamic assessment in critically ill patients and in recent years has been shown to improve clinical outcomes among patients in cardiogenic shock. The invasive nature of PAC is often cited as its major limitation and has encouraged development of less invasive technologies. In this review, the authors summarize the literature on the mechanism and validation of several minimally invasive and noninvasive modalities available in the contemporary intensive care unit. They also provide an update on the use of focused bedside echocardiography.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e12"},"PeriodicalIF":0.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48022269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}