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Shockwave and Non-transfemoral Transcatheter Aortic Valve Replacement. 冲击波与非经股动脉导管主动脉瓣置换术
US Cardiology Review Pub Date : 2021-11-29 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2021.16
Eden C Payabyab, Lindsay S Elbaum, Navneet Sharma, Isaac George, Stephanie L Mick
{"title":"Shockwave and Non-transfemoral Transcatheter Aortic Valve Replacement.","authors":"Eden C Payabyab, Lindsay S Elbaum, Navneet Sharma, Isaac George, Stephanie L Mick","doi":"10.15420/usc.2021.16","DOIUrl":"10.15420/usc.2021.16","url":null,"abstract":"<p><p>Transcatheter aortic valve replacement (TAVR) has become a widely adopted treatment modality for severe aortic stenosis. Transfemoral access is the approach of choice; however, approximately 25% of patients undergoing TAVR also have concomitant peripheral arterial disease. The recent advent of intravascular lithotripsy has enabled preservation of transfemoral access in some patients; although, a proportion still require alternative, non-femoral access. Alternative access sites can be broadly categorized into transthoracic and peripheral, facilitated by surgical or percutaneous techniques. In this review, the technical details and clinical outcomes of various TAVR accesses are discussed. Initially, transthoracic approaches were most common, but recently, the trend has been toward alternative peripheral access due to superior outcomes. Although there are no randomized data to support all the alternative access sites, the experiences reported provide available options for a large portion of patients to be candidates for TAVR. The intervention site should be selected by a multidisciplinary heart team based on patient anatomical factors and institutional expertise.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e25"},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44420017","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}
引用次数: 0
Mixed-Valve Disease: Management of Patients with Aortic Stenosis and Mitral Regurgitation: Thresholds for Surgery Versus Percutaneous Therapies. 混合瓣膜疾病：主动脉瓣狭窄和二尖瓣反流患者的治疗：手术与经皮治疗的阈值。
US Cardiology Review Pub Date : 2021-11-29 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2021.17
Jean-Bernard Masson, Jessica Forcillo
{"title":"Mixed-Valve Disease: Management of Patients with Aortic Stenosis and Mitral Regurgitation: Thresholds for Surgery Versus Percutaneous Therapies.","authors":"Jean-Bernard Masson, Jessica Forcillo","doi":"10.15420/usc.2021.17","DOIUrl":"10.15420/usc.2021.17","url":null,"abstract":"<p><p>Significant mitral regurgitation (MR), frequently seen in the presence of severe aortic stenosis (AS), results in an association that negatively affects prognosis and imposes particular challenges for both the assessment of the severity of valvular lesions and decisions regarding treatment allocation. This article reviews the available literature with regards to the assessment of MR and AS in the presence of both; surgical management and results in patients with concomitant AS and MR; the effect of MR on outcomes in patients undergoing transcatheter aortic valve replacement; the effect of transcatheter aortic valve replacement on MR severity; and percutaneous treatment for MR after transcatheter aortic valve implantation. The authors aim to provide assistance in the decision-making process to treat patients with either a higher-risk double-valve procedure or a simpler, but perhaps incomplete, single-valve option.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":"1 1","pages":"e26"},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67576817","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}
引用次数: 0
The Contemporary Cardiogenic Shock 'Playbook'. 当代心源性休克“行动手册”
US Cardiology Review Pub Date : 2021-11-26 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2020.28
Alexander G Truesdell
{"title":"The Contemporary Cardiogenic Shock 'Playbook'.","authors":"Alexander G Truesdell","doi":"10.15420/usc.2020.28","DOIUrl":"10.15420/usc.2020.28","url":null,"abstract":"","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e24"},"PeriodicalIF":0.0,"publicationDate":"2021-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45297045","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}
引用次数: 0
Extracorporeal Life Support for Cardiac Arrest and Cardiogenic Shock. 心脏骤停和心源性休克的体外生命支持
US Cardiology Review Pub Date : 2021-11-10 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2021.13
Andrea Elliott, Garima Dahyia, Rajat Kalra, Tamas Alexy, Jason Bartos, Marinos Kosmopoulos, Demetri Yannopoulos
{"title":"Extracorporeal Life Support for Cardiac Arrest and Cardiogenic Shock.","authors":"Andrea Elliott, Garima Dahyia, Rajat Kalra, Tamas Alexy, Jason Bartos, Marinos Kosmopoulos, Demetri Yannopoulos","doi":"10.15420/usc.2021.13","DOIUrl":"10.15420/usc.2021.13","url":null,"abstract":"<p><p>The rising incidence and recognition of cardiogenic shock has led to an increase in the use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO). As clinical experience with this therapy has increased, there has also been a rapid growth in the body of observational and randomized data describing the clinical and logistical considerations required to institute a VA-ECMO program with successful clinical outcomes. The aim of this review is to summarize this contemporary data in the context of four key themes that pertain to VA-ECMO programs: the principles of patient selection; basic hemodynamic and technical principles underlying VA-ECMO; contraindications to VA-ECMO therapy; and common complications and intensive care considerations that are encountered in the setting of VA-ECMO therapy.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e23"},"PeriodicalIF":0.0,"publicationDate":"2021-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43324504","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}
引用次数: 0
Current Landscape of Temporary Percutaneous Mechanical Circulatory Support Technology. 临时经皮机械循环支持技术的现状
US Cardiology Review Pub Date : 2021-11-02 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2021.15
Rani Upadhyay, Hussayn Alrayes, Scott Arno, Milan Kaushik, Mir B Basir
{"title":"Current Landscape of Temporary Percutaneous Mechanical Circulatory Support Technology.","authors":"Rani Upadhyay, Hussayn Alrayes, Scott Arno, Milan Kaushik, Mir B Basir","doi":"10.15420/usc.2021.15","DOIUrl":"10.15420/usc.2021.15","url":null,"abstract":"<p><p>Mechanical circulatory support devices provide hemodynamic support to patients who present with cardiogenic shock. These devices work using different mechanisms to provide univentricular or biventricular support. There is a growing body of evidence supporting use of these devices as a goal for cardiac recovery or as a bridge to definitive therapy, but definitive, well-powered studies are still needed. Mechanical circulatory support devices are increasingly used using shock team and protocols, which can help clinicians in decision making, balancing operator and institutional experience and expertise. The aim of this article is to review commercially available mechanical circulatory support devices, their profiles and mechanisms of action, and the evidence available regarding their use.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e21"},"PeriodicalIF":0.0,"publicationDate":"2021-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47903724","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}
引用次数: 0
Rediscovered and Unforgotten: Transcatheter Interventions for the Treatment of Severe Tricuspid Valve Regurgitation. 经导管介入治疗严重三尖瓣反流
US Cardiology Review Pub Date : 2021-11-02 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2021.06
Kusha Rahgozar, Sharon Bruoha, Edwin Ho, Ythan Goldberg, Mei Chau, Azeem Latib
{"title":"Rediscovered and Unforgotten: Transcatheter Interventions for the Treatment of Severe Tricuspid Valve Regurgitation.","authors":"Kusha Rahgozar, Sharon Bruoha, Edwin Ho, Ythan Goldberg, Mei Chau, Azeem Latib","doi":"10.15420/usc.2021.06","DOIUrl":"10.15420/usc.2021.06","url":null,"abstract":"<p><p>Tricuspid valve regurgitation is both globally prevalent and undertreated. Historically, surgical intervention for isolated tricuspid regurgitation (TR) was avoided despite the prevalence of TR, largely due to poor surgical outcomes and an incomplete understanding of how it independently affects mortality. Over the past two decades, TR has been shown by several studies to be an independent predictor of worse functional status and poor survival on long-term follow-up. During this same time period, transcatheter interventions for the treatment of valvular heart disease have evolved dramatically. While the transcatheter repair and replacement of the tricuspid valve in patients with severe TR remains in the early stages of investigation relative to the mitral or aortic valve, the field is rapidly expanding. Here, the authors review the field of transcatheter tricuspid valve interventions for severe TR, focusing on the orthotropic devices and valves currently available worldwide.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e22"},"PeriodicalIF":0.0,"publicationDate":"2021-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44076759","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}
引用次数: 0
Cardiogenic Shock: Protocols, Teams, Centers, and Networks. 心源性休克:方案、团队、中心和网络
US Cardiology Review Pub Date : 2021-10-20 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2021.10
Alex F Warren, Carolyn Rosner, Raghav Gattani, Alex G Truesdell, Alastair G Proudfoot
{"title":"Cardiogenic Shock: Protocols, Teams, Centers, and Networks.","authors":"Alex F Warren, Carolyn Rosner, Raghav Gattani, Alex G Truesdell, Alastair G Proudfoot","doi":"10.15420/usc.2021.10","DOIUrl":"10.15420/usc.2021.10","url":null,"abstract":"<p><p>The mortality of cardiogenic shock (CS) remains unacceptably high. Delays in the recognition of CS and access to disease-modifying or hemodynamically stabilizing interventions likely contribute to poor outcomes. In parallel to successful initiatives in other disease states, such as acute ST-elevation MI and major trauma, institutions are increasingly advocating the use of a multidisciplinary 'shock team' approach to CS management. A volume-outcome relationship exists in CS, as with many other acute cardiovascular conditions, and the emergence of 'shock hubs' as experienced facilities with an interest in improving CS outcomes through a hub-and-spoke 'shock network' approach provides another opportunity to deliver improved CS care as widely and equitably as possible. This narrative review outlines improvements from a networked approach to care, discusses a team-based and protocolized approach to CS management, reviews the available evidence and discusses the potential benefits, challenges, and opportunities of such systems of care.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e18"},"PeriodicalIF":0.0,"publicationDate":"2021-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46027111","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}
引用次数: 0
Antithrombotics in Complex Percutaneous Coronary Interventions: Type and Duration of Treatment. 复杂经皮冠状动脉介入治疗中的抗血栓药物:治疗类型和持续时间
US Cardiology Review Pub Date : 2021-10-13 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2020.30
Despoina-Rafailia Benetou, Charalampos Varlamos, Christos Pappas, Fotios Kolokathis, Dimitrios Alexopoulos
{"title":"Antithrombotics in Complex Percutaneous Coronary Interventions: Type and Duration of Treatment.","authors":"Despoina-Rafailia Benetou, Charalampos Varlamos, Christos Pappas, Fotios Kolokathis, Dimitrios Alexopoulos","doi":"10.15420/usc.2020.30","DOIUrl":"10.15420/usc.2020.30","url":null,"abstract":"<p><p>Patients undergoing complex percutaneous coronary intervention (PCI) are at an increased risk of atherothrombotic complications. Although dual antiplatelet therapy is the mainstay of treatment for patients undergoing PCI with stent implantation, deciding its type and duration in complex PCI patients has long been considered a challenge for clinicians. This is because the beneficial effects of prolonged treatment and/or more potent antiplatelet agents' use in preventing ischemic events are hindered by a concomitant increase in bleeding complications. The aim of this review is to highlight current evidence regarding the optimal antithrombotic therapy regimens used in complex PCI patients, focusing on the evaluation of both safety and efficacy outcomes as well as addressing future perspectives.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e17"},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43670731","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}
引用次数: 0
Heart Transplant and Ventricular Assist: Cardiac Surgery and Heart Failure Perspective. 心脏移植与心室辅助：心脏外科与心力衰竭
US Cardiology Review Pub Date : 2021-09-24 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2021.11
Michael T Cain, Michael S Firstenberg, Joseph C Cleveland
{"title":"Heart Transplant and Ventricular Assist: Cardiac Surgery and Heart Failure Perspective.","authors":"Michael T Cain, Michael S Firstenberg, Joseph C Cleveland","doi":"10.15420/usc.2021.11","DOIUrl":"10.15420/usc.2021.11","url":null,"abstract":"<p><p>For nearly 60 years, there have been two surgical treatment options for individuals with severe advanced heart failure: heart transplantation or implantation of a left ventricular assist device. As these fields have advanced in parallel, improvements in surgical technique, device development, and patient selection have improved outcomes for both therapies. Development of a comprehensive approach to the management of the most severe forms of advanced heart failure requires a deep understanding of both heart transplantation and durable ventricular assistance, including recent advancements in both fields. This article will review the substantial progress in the fields of heart transplantation and mechanical left ventricular assistance, including recent changes to organ allocation prioritization and left ventricular assist device evaluation, both of which have dramatically influenced practice in these fields.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e16"},"PeriodicalIF":0.0,"publicationDate":"2021-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49503696","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}
引用次数: 0
Describing and Classifying Shock: Recent Insights. 冲击的描述和分类：最近的见解
US Cardiology Review Pub Date : 2021-09-15 eCollection Date: 2021-01-01 DOI: 10.15420/usc.2021.09
Ashleigh Long, Amin Yehya, Kelly Stelling, David A Baran
{"title":"Describing and Classifying Shock: Recent Insights.","authors":"Ashleigh Long, Amin Yehya, Kelly Stelling, David A Baran","doi":"10.15420/usc.2021.09","DOIUrl":"10.15420/usc.2021.09","url":null,"abstract":"<p><p>Cardiogenic shock continues to present a daunting challenge to clinicians, despite an increasing array of percutaneous mechanical circulatory support devices. Mortality for cardiogenic shock has not changed meaningfully in more than 20 years. There have been many attempts to generate risk scores or frameworks to evaluate cardiogenic shock and optimize the use of resources and assist with prognostication. These include the Intra-Aortic Balloon Pump in Cardiogenic Shock (IABP-SHOCK) II risk score, the CardShock score and the new CLIP biomarker score. This article reviews the Society for Cardiac Angiography and Interventions (SCAI) classification of cardiogenic shock and subsequent validation studies. The SCAI classification is simple for clinicians to use as it is based on readily available information and can be adapted depending on the data set that can be accessed. The authors consider the future of the field. Underlying all these efforts is the hope that a better understanding and classification of shock will lead to meaningful improvements in mortality rates.</p>","PeriodicalId":37809,"journal":{"name":"US Cardiology Review","volume":" ","pages":"e15"},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47941823","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}
引用次数: 0
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