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Interventional Cardiology Clinics

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https://www.readbyqxmd.com/read/28886847/transcatheter-closure-of-patent-foramen-ovale
#1
EDITORIAL
Matthew J Price
No abstract text is available yet for this article.
October 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28886846/transcatheter-closure-of-patent-foramen-ovale-devices-and-technique
#2
REVIEW
Matthew J Price
Transcatheter closure of a patent foramen ovale (PFO) reduces the risk of recurrent cryptogenic stroke compared with medical therapy. PFO closure is a prophylactic procedure, and will not provide the patient with symptomatic improvement, except in cases of hypoxemia due to right-to-left shunt or possibly migraine headaches. Therefore, appropriate patient selection is critical, and procedural safety is paramount. Herein, we review key characteristics of the devices currently available for transcatheter PFO closure within the United States, and highlight key technical aspects of the PFO closure procedure that will maximize procedural success...
October 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28886845/patent-foramen-ovale-closure-for-hypoxemia
#3
REVIEW
Jonathan M Tobis, Deepika Narasimha, Islam Abudayyeh
A patent foramen ovale (PFO) is a common anatomic finding in 20% of the normal population. Significant hypoxemia can occur in circumstances in which hemodynamic or anatomic changes predispose to increased right-to-left intra-atrial shunting. The subsequent hypoxemia produces substantial dyspnea that may affect the patient's quality of life, independent of underlying pulmonary disease. Profound hypoxemia caused by right-to-left shunt across the interatrial septum usually responds to percutaneous PFO closure...
October 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28886844/patent-foramen-ovale-and-migraine-headache
#4
REVIEW
David Hildick-Smith, Timothy M Williams
Migraine headache is a common and debilitating disease that has a demonstrable association with the presence of patent foramen ovale (PFO) in multiple case series. Closure of PFO has been performed to try to treat migraine with aura, with variable results. Although early trials suggested benefit to PFO closure, these were of poor quality, and subsequent randomized trials have failed to yield positive results. This article discusses the evidence of an association with PFO and migraine headache, and the trials that have so far been performed to assess the benefits of closure...
October 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28886843/current-dataset-for-patent-foramen-ovale-closure-in-cryptogenic-stroke-randomized-clinical-trials-and-observational-studies
#5
REVIEW
Olufunso W Odunukan, Matthew J Price
Approximately one-third of all strokes have no apparent cause. A patent foramen ovale (PFO) is present in as many as 60% of these patients with cryptogenic strokes, which is significantly more frequent than that of the general population. The presumed biologic mechanisms of ischemic stroke in the setting of a PFO are paradoxic embolism from the peripheral venous system through this interatrial shunt or embolism from in situ thrombosis. In this review, the authors summarize and critically assess the contemporary studies evaluating the efficacy and safety of PFO closure for prevention of recurrent cryptogenic strokes...
October 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28886842/imaging-assessment-of-the-interatrial-septum-for-transcatheter-atrial-septal-defect-and-patent-foramen-ovale-closure
#6
REVIEW
Mary Z Bechis, David S Rubenson, Matthew J Price
Transcatheter closure of atrial septal defects and patent foramen ovale has become increasingly common with advances in device and imaging technology. The percutaneous approach is now the preferred method of closure when anatomically suitable. Two-dimensional and 3-dimensional echocardiography determines anatomic suitability by characterizing the interatrial defect and its surrounding structures, and is critical for intraprocedural guidance and postprocedure follow-up. This article provides an overview of interatrial anatomy as it pertains to interventional considerations and discusses the transthoracic, transesophageal, and intracardiac echocardiographic modalities used for periprocedural and intraprocedural imaging of the interatrial septum...
October 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28886841/identification-and-quantification-of-patent-foramen-ovale-mediated-shunts-echocardiography-and-transcranial-doppler
#7
REVIEW
Ahmed N Mahmoud, Islam Y Elgendy, Nayan Agarwal, Jonathan M Tobis, Mohammad Khalid Mojadidi
Once deemed benign, patent foramen ovale (PFO)-mediated right-to-left shunting has now been linked to stroke, migraine, and hypoxemia. Contrast transesophageal echocardiography is considered the standard technique for identifying a PFO, allowing visualization of the atrial septal anatomy and differentiation from non-PFO right-to-left shunts. Transthoracic echocardiography is the most common method for PFO imaging, being cost-effective, but has the lowest sensitivity. Transcranial Doppler is highly sensitive but is unable to differentiate cardiac from pulmonary shunts; it is the best method to quantitate shunt severity, being more sensitive than transthoracic or transesophageal echocardiography so is our preferred screening method for PFO...
October 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28886840/cryptogenic-stroke-and-patent-foramen-ovale-risk-assessment
#8
REVIEW
Emiliya Melkumova, David E Thaler
Stroke is a devastating condition. It is the fifth leading cause of death in the United States, and a leading cause of serious long-term disability. Stroke occurs at any age. Younger patients tend to have strokes of undetermined cause, termed cryptogenic. Herein, the authors describe the classification of stroke cause; the risk of recurrent cryptogenic stroke with patent foramen ovale (PFO); a risk assessment model to stratify incidental versus a pathogenic PFO in patients presenting with stroke; and patient selection for device occluder therapy in the context of the long-term follow-up of the RESPECT randomized clinical trial...
October 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28600100/operationalizing-interventional-heart-failure-adding-substance-to-the-concept
#9
EDITORIAL
Srihari S Naidu
No abstract text is available yet for this article.
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28600099/integrating-interventional-cardiology-and-heart-failure-management-for-cardiogenic-shock
#10
REVIEW
Navin K Kapur, Carlos D Davila, Marwan F Jumean
Cardiogenic shock remains one of the most common causes of in-hospital death. Recent data have identified an overall increase in patient complexity, with cardiogenic shock in the setting of acute myocardial infarction. The use of percutaneous acute mechanical circulatory support (AMCS) has steadily grown in the past decade. Guidelines and consensus statements addressing proper patient selection, timing of AMCS implantation, device choice, and postimplantation protocol are appearing. The emerging role of interventional heart failure specialists within the heart team includes integration and understanding of advanced hemodynamic and cathether-based therapies, with the goal of improving outcomes...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28600098/prioritizing-and-combining-therapies-for-heart-failure-in-the-era-of-mechanical-support-devices
#11
REVIEW
George S Hanzel, Simon Dixon, James A Goldstein
Technological advances have promoted challenges to prioritizing and combining therapies for heart failure. The concept of prioritization implies distinct but inextricably linked considerations. They may be viewed from pathophysiologic, clinical, and procedural perspectives, encompassing analysis of hemodynamic status, anatomic considerations, and technical challenges. It is essential to consider factors, including conduction disease, renal and pulmonary function, hematological derangements, and so forth. These considerations allow determination of clinical goals, which determine prioritization and interventional strategies...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28600097/renal-denervation-to-modify-hypertension-and-the-heart-failure-state
#12
REVIEW
Ming Zhong, Luke K Kim, Rajesh V Swaminathan, Dmitriy N Feldman
Sympathetic overactivation of renal afferent and efferent nerves have been implicated in the development and maintenance of several cardiovascular disease states, including resistant hypertension and heart failure with both reduced and preserved systolic function. With the development of minimally invasive catheter-based techniques, percutaneous renal denervation has become a safe and effective method of attenuating sympathetic overactivation. Percutaneous renal denervation, therefore, has the potential to modify and treat hypertension and congestive heart failure...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28600096/alcohol-septal-ablation-to-reduce-heart-failure
#13
REVIEW
Joshua McKay, Sherif F Nagueh
Hypertrophic cardiomyopathy is a commonly encountered inheritable cardiac disorder with variable phenotypic expression. Although most patients will have no or mild symptoms, 10% will develop heart failure symptoms refractory to medical management. This article discusses the mechanisms through which hypertrophic cardiomyopathy induces heart failure and how alcohol septal ablation can reverse each of these mechanisms to lead to clinical improvement.
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28600095/adult-congenital-interventions-in-heart-failure
#14
REVIEW
Hussam S Suradi, Ziyad M Hijazi
Congenital heart disease (CHD) is the most common birth defect, occurring in approximately 0.8% to 1.0% of neonates. Advances in medical and surgical therapies for children with CHD have resulted in a growing population of patients reaching adulthood, with survival rates exceeding 85%. Many of these patients, especially if managed inappropriately, face the prospect of future complications including heart failure and premature death. For adults with uncorrected or previously palliated CHD, percutaneous therapies have become the primary treatment for many forms of CHD...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28600094/cardiac-resynchronization-therapy-for-heart-failure
#15
REVIEW
Amole Ojo, Sohaib Tariq, Prakash Harikrishnan, Sei Iwai, Jason T Jacobson
Cardiac resynchronization therapy (CRT) has emerged as a valued nonpharmacologic therapy in patients with heart failure, reduced ejection fraction (EF), and ventricular dyssynchrony manifest as left bundle branch block. The mechanisms of benefit include remodeling of the left ventricle leading to decreased dimensions and increased EF, as well as a decrease in the severity of mitral regurgitation. This article reviews the rationale, effects, and indications for CRT, and discusses the patient characteristics that predict response and considerations for nonresponders...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28600093/multivessel-revascularization-in-shock-and-high-risk-percutaneous-coronary-intervention
#16
REVIEW
Sandeep K Krishnan, Robert F Riley, Ravi S Hira, William L Lombardi
This review explores the usefulness of multivessel revascularization with percutaneous coronary intervention in patients with multivessel obstructive coronary artery disease (CAD) presenting with and without cardiogenic shock. We also evaluate the literature regarding complete versus incomplete revascularization for patients with cardiogenic shock, acute coronary syndromes, and stable coronary artery disease.
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28600092/mechanical-circulatory-support-in-acute-decompensated-heart-failure-and-shock
#17
REVIEW
Nishtha Sodhi, John M Lasala
An array of interventional therapeutics is available in the modern era, with uses depending on acute or chronic situations. This article focuses on support in acute decompensated heart failure and cardiogenic shock, including intra-aortic balloon pumps, continuous aortic flow augmentation, and extra-corporeal membrane oxygenation.
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28600091/transcatheter-aortic-valve-replacement-and-mitraclip-to-reverse-heart-failure
#18
REVIEW
Sukhdeep Basra, Molly Szerlip
Valvular heart diseases such as aortic stenosis and mitral regurgitation are often associated with heart failure, which in turn increases patients' Surgical Thoracic Society (STS) score. A high STS score means the patient is high risk for surgical aortic valve replacement and mitral valve repair/replacement. Transcatheter aortic valve replacement and percutaneous mitral valve repair offer a minimally invasive alternative for the treatment of valvular heart disease in patients with severe heart failure. We aim to review the current evidence on the safety, efficacy, and outcomes of these devices in patients with severe heart failure...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28600090/hemodynamics-of-cardiogenic-shock
#19
REVIEW
Ariel Furer, Jeffrey Wessler, Daniel Burkhoff
Cardiogenic shock (CS) represents an advanced state of morbidity along the pathophysiologic pathway of end-organ hypoperfusion caused by reduced cardiac output and blood pressure. Acute coronary syndromes remain the most common cause of CS. The spectrum of hypoperfusion states caused by low cardiac output ranges from pre-CS to refractory CS and can be characterized by an array of hemodynamic parameters. This review provides the foundation for a hemodynamic understanding of CS including the use of hemodynamic monitoring for diagnosis and treatment, the cardiac and vascular determinants of CS, and a hemodynamic approach to risk stratification and management of CS...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28600089/invasive-hemodynamics-of-adult-congenital-heart-disease-from-shunts-to-coarctation
#20
REVIEW
Surendranath R Veeram Reddy, Alan W Nugent, Thomas M Zellers, V Vivian Dimas
Adults with congenital heart disease are a growing population with increasingly more complex disease, in large part due to improvements in delivery of care to the pediatric population. Cardiac catheterization is an integral component of diagnosis and management in these patients. Careful attention to detail and a thorough understanding of intracardiac hemodynamics are critical to performing complete diagnostic evaluations. This article outlines the most commonly encountered lesions with guidelines for invasive assessment to help guide further therapy...
July 2017: Interventional cardiology clinics
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