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Ajay Kirtane

Fenton H McCarthy, Sreekanth Vemulapalli, Zhuokai Li, Vinod Thourani, Roland A Matsouaka, Nimesh D Desai, Ajay Kirtane, Saif Anwaruddin, Matthew L Williams, Jay Giri, Prashanth Vallabhajosyula, Robert H Li, Howard C Herrmann, Joseph E Bavaria, Wilson Y Szeto
BACKGROUND: The purpose of this study is to evaluate the association of tricuspid regurgitation (TR) severity with outcomes after transcatheter aortic valve replacement (TAVR). METHODS: We analyzed data from 34,576 patients who underwent TAVR at 365 US hospitals from November 2011 through March 2015 submitted to The Society of Thoracic Surgeon/American College of Cardiology Transcatheter Valve Therapy Registry. We examined unadjusted mortality and heart failure readmission stratified by degree of preoperative TR and used multivariable models for 1-year mortality and heart failure readmission...
March 2, 2018: Annals of Thoracic Surgery
Barbara A Danek, Mir B Basir, William W O'Neill, Mohammad Alqarqaz, Aris Karatasakis, Dimitri Karmpaliotis, Farouc A Jaffer, Robert W Yeh, Michael Wyman, William L Lombardi, David Kandzari, Nicholas Lembo, Anthony Doing, Mitul Patel, Ehtisham Mahmud, James W Choi, Catalin Toma, Jeffrey W Moses, Ajay Kirtane, Manish Parikh, Ziad A Ali, Santiago Garcia, Judit Karacsonyi, Bavana V Rangan, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis, Khaldoon Alaswad
OBJECTIVE: To study outcomes with use of percutaneous mechanical circulatory support (MCS) devices in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We examined characteristics and outcomes of 1598 CTO-PCIs performed from 2012-2017 at 12 high-volume centers. RESULTS: Patient age was 66 ± 10 years; 86% were men. An MCS device was used electively in 69 procedures (4%) and urgently in 22 procedures (1%). The most commonly used elective MCS device was Impella 2...
March 2018: Journal of Invasive Cardiology
Björn Redfors, Philippe Généreux, Bernhard Witzenbichler, Akiko Maehara, Giora Weisz, Thomas McAndrew, Roxana Mehran, Ajay J Kirtane, Gregg W Stone
BACKGROUND: There is a paucity of data from large contemporary cohorts of patients with in-stent restenosis (ISR) treated with drug-eluting stents (DESs), and no studies have examined the impact of high platelet reactivity (HPR) on the occurrence of ischemic events after ISR percutaneous coronary intervention (PCI) with DESs. We sought to report outcomes after PCI of ISR lesions and its association with HPR. METHODS: Patients in the prospective, multicenter ADAPT-DES study were stratified according to whether they had ISR versus non-ISR PCI...
March 2018: American Heart Journal
Rohan Shah, Ajay J Kirtane, John W McEvoy
No abstract text is available yet for this article.
February 1, 2018: European Heart Journal
Michael Salna, Koji Takeda, Paul Kurlansky, Hirohisa Ikegami, Liqiong Fan, Jiho Han, Samantha Stein, Veli Topkara, Melana Yuzefpolskaya, Paolo C Colombo, Dimitrios Karmpaliotis, Yoshifumi Naka, Ajay J Kirtane, Arthur R Garan, Hiroo Takayama
OBJECTIVES: Ethical and health care economic concerns surround the use of venous-arterial extracorporeal membrane oxygenation (VA-ECMO) in elderly patients. Patients requiring VA-ECMO are often in critical condition and the decision to cannulate is time-sensitive. We investigated the relationship between age and VA-ECMO outcomes to better inform this decision. METHODS: This is a retrospective study of 355 patients placed on VA-ECMO between March 2007 and August 2016 at our institution...
January 22, 2018: European Journal of Cardio-thoracic Surgery
Molly Szerlip, Sarah Gualano, Elizabeth Holper, John J Squiers, Jonathon M White, Darshan Doshi, Mathew R Williams, Rebecca T Hahn, John G Webb, Lars G Svensson, Ajay J Kirtane, David J Cohen, Pamela S Douglas, Maria C Alu, Aaron Crowley, E Murat Tuzcu, Raj R Makkar, Howard C Herrmann, Vasilis Babaliaros, Vinod H Thourani, Martin B Leon, Susheel K Kodali, Michael J Mack
OBJECTIVES: The purpose of this study was to identify sex-specific outcomes of intermediate risk patients undergoing transcatheter aortic valve replacement with the SAPIEN 3 valve. BACKGROUND: A survival difference has been observed in women as compared with men in inoperable and high-risk patients receiving early-generation balloon-expandable valves for transcatheter aortic valve replacement (TAVR). Whether a sex-specific outcome difference persists with newer-generation valves and in lower-risk patients is unknown...
January 8, 2018: JACC. Cardiovascular Interventions
Adam C Salisbury, James Sapontis, John T Saxon, Kensey L Gosch, William L Lombardi, Dimitri Karmpaliotis, Jeffery W Moses, Mohammed Qintar, Ajay J Kirtane, John A Spertus, David J Cohen, J Aaron Grantham
Stress testing is endorsed by the American College of Cardiology/American Heart Association Appropriate Use Criteria to identify appropriate candidates for Chronic Total Occlusion (CTO) Percutaneous Coronary Intervention (PCI). However, the relation between stress test risk classification and health status after CTO PCI is not known. We studied 449 patients in the 12-center OPEN CTO registry who underwent stress testing before successful CTO PCI, comparing outcomes of patients with low-risk (LR) versus intermediate to high-risk (IHR) findings...
December 11, 2017: American Journal of Cardiology
Avnish Tripathi, J Dawn Abbott, Gregg C Fonarow, Abdur R Khan, Neil G Barry, Sohail Ikram, Rita Coram, Verghese Mathew, Ajay J Kirtane, Brahmajee K Nallamothu, Glenn A Hirsch, Deepak L Bhatt
BACKGROUND: The association of short-term readmissions after percutaneous coronary intervention (PCI) on healthcare costs has not been well studied. METHODS AND RESULTS: The Healthcare Cost and Utilization Project National Readmission Database encompassing 722 US hospitals was used to identify index PCI cases in patients ≥18 years old. Hierarchical regression analyses were used to examine the factors associated with risk of 30-day readmission and higher cumulative costs...
December 2017: Circulation. Cardiovascular Interventions
Laura Mauri, Kazuomi Kario, Jan Basile, Joost Daemen, Justin Davies, Ajay J Kirtane, Felix Mahfoud, Roland E Schmieder, Michael Weber, Shinsuke Nanto, Michel Azizi
Catheter-based renal denervation is a new approach to treat hypertension via modulation of the renal sympathetic nerves. Although nonrandomized and small, open-label randomized studies resulted in significant reductions in office blood pressure 6months after renal denervation with monopolar radiofrequency catheters, the first prospective, randomized, sham-controlled study (Symplicity HTN-3) failed to meet its blood pressure efficacy end point. New clinical trials with new catheters have since been designed to address the limitations of earlier studies...
January 2018: American Heart Journal
Peter Tajti, Aris Karatasakis, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, James W Choi, Anthony H Doing, Catalin Toma, Barry Uretsky, Santiago Garcia, Jeffrey W Moses, Manish Parikh, Ajay Kirtane, Ziad A Ali, Raja Hatem, Judit Karacsonyi, Barbara A Danek, Bavana V Rangan, Subhash Banerjee, Imre Ungi, Emmanouil S Brilakis
BACKGROUND: Retrograde percutaneous coronary intervention (PCI) of native coronary artery chronic total occlusion (CTO) via left internal mammary artery (LIMA) graft has received limited study. METHODS AND RESULTS: We compared the clinical and procedural characteristics and outcomes of retrograde CTO-PCI through LIMA grafts vs other conduits in a contemporary multicenter CTO registry. The LIMA was used as the collateral channel in 20 of 990 retrograde CTO-PCIs (2...
November 15, 2017: Journal of Invasive Cardiology
Rohan Khera, Ambarish Pandey, Thomas Koshy, Colby Ayers, Brahmajee K Nallamothu, Sandeep R Das, Mark H Drazner, Michael E Jessen, Ajay J Kirtane, Timothy J Gardner, James A de Lemos, Deepak L Bhatt, Dharam J Kumbhani
Importance: Identifying high-performing surgical valve centers with the best surgical outcomes is challenging. Hospital surgical volume is a frequently used surrogate for outcomes. However, its ability to distinguish low-performing and high-performing hospitals remains unknown. Objective: To examine the association of hospital procedure volume with hospital performance for aortic and mitral valve (MV) surgical procedures. Design, Setting, and Participants: Within an all-payer nationally representative data set of inpatient hospitalizations, this study identified 682 unique hospitals performing surgical aortic valve replacement (SAVR) and MV replacement and repair with or without coronary artery bypass grafting (CABG) between 2007 and 2011...
November 8, 2017: JAMA Cardiology
Kinjan H Parikh, Ajay J Kirtane
No abstract text is available yet for this article.
November 2, 2017: Revista Española de Cardiología
A Reshad Garan, Christina Eckhardt, Koji Takeda, Veli K Topkara, Kevin Clerkin, Justin Fried, Amirali Masoumi, Ryan T Demmer, Pauline Trinh, Melana Yuzefpolskaya, Yoshifumi Naka, Dan Burkhoff, Ajay Kirtane, Paolo C Colombo, Hiroo Takayama
BACKGROUND: Cardiogenic shock following acute myocardial infarction (AMI-CS) portends a poor prognosis. Short-term mechanical circulatory support devices (MCSDs) provide hemodynamic support for patients with cardiogenic shock but predictors of survival and the ability to wean from short-term MCSDs remain largely unknown. METHODS: All patients > 18 years old treated at our institution with extra-corporeal membrane oxygenation or short-term surgical ventricular assist device for AMI-CS were studied...
November 1, 2017: European Heart Journal. Acute Cardiovascular Care
Björn Redfors, Philippe Généreux, Bernhard Witzenbichler, Ajay J Kirtane, Akiko Maehara, Giora Weisz, Mahesh V Madhavan, Thomas McAndrew, Roxana Mehran, Gregg W Stone
BACKGROUND: Although bifurcation percutaneous coronary intervention (PCI) is associated with lower procedural success rates and higher risk of complications, there are little data regarding outcomes after successful bifurcation PCI with contemporary stents and techniques. Whether residual platelet reactivity (PR) affects outcomes differently after bifurcation versus non-bifurcation PCI is also unknown. We studied the association between bifurcation PCI, PR, and clinical outcomes among patients undergoing successful PCI with drug-eluting stents...
January 1, 2018: International Journal of Cardiology
Serdar Farhan, Björn Redfors, Akiko Maehara, Thomas McAndrew, Ori Ben-Yehuda, Bernard De Bruyne, Roxana Mehran, Gennaro Giustino, Ajay J Kirtane, Patrick W Serruys, Gary S Mintz, Gregg W Stone
OBJECTIVES: The aim of this study was to investigate the impact of pre-diabetes (pre-DM) on coronary plaque characteristics and ischemic outcomes in patients with acute coronary syndromes (ACS). BACKGROUND: Pre-DM (i.e., the early stages of glucometabolic disturbance) is common among patients with ACS, but the extent to which pre-DM influences coronary plaque characteristics and the risk for adverse ischemic events is unclear. METHODS: In the PROSPECT (Providing Regional Observations to Study Predictors of Events in Coronary Tree) study, patients with ACS underwent quantitative coronary angiography, grayscale intravascular ultrasound, and radiofrequency intravascular ultrasound after successful percutaneous coronary intervention...
October 14, 2017: JACC. Cardiovascular Imaging
Clyde W Yancy, Ajay J Kirtane
No abstract text is available yet for this article.
October 18, 2017: JAMA Cardiology
Gennaro Giustino, Roxana Mehran, George D Dangas, Ajay J Kirtane, Björn Redfors, Philippe Généreux, Sorin J Brener, Jayne Prats, Stuart J Pocock, Efthymios N Deliargyris, Gregg W Stone
BACKGROUND: The risk of recurrent ischemic and bleeding events after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) may not be uniform over time, which may affect the benefit-to-risk ratio of guideline-recommended antithrombotic therapies in different intervals. OBJECTIVES: This study sought to characterize the average daily ischemic rates (ADIRs) and average daily bleeding rates (ADBRs) within the first year after primary PCI for STEMI...
October 10, 2017: Journal of the American College of Cardiology
Evan Shlofmitz, Brad J Martinsen, Michael Lee, Sunil V Rao, Philippe Généreux, Joe Higgins, Jeffrey W Chambers, Ajay J Kirtane, Emmanouil S Brilakis, David E Kandzari, Samin K Sharma, Richard Shlofmitz
The presence of severe coronary artery calcification is associated with higher rates of angiographic complications during percutaneous coronary intervention (PCI), as well as higher major adverse cardiac events compared with non-calcified lesions. Incorporating orbital atherectomy (OAS) for effective preparation of severely calcified lesions can help maximize the benefits of PCI by attaining maximal luminal gain (or stent expansion) and improve long-term outcomes (by reducing need for revascularization). Areas covered: In this manuscript, the prevalence, risk factors, and impact of coronary artery calcification on PCI are reviewed...
October 4, 2017: Expert Review of Medical Devices
Behnood Bikdeli, Saurav Chatterjee, Nihar R Desai, Ajay J Kirtane, Mayur M Desai, Michael B Bracken, Frederick A Spencer, Manuel Monreal, Samuel Z Goldhaber, Harlan M Krumholz
BACKGROUND: Inferior vena cava (IVC) filters are widely used for prevention of pulmonary embolism (PE). However, uncertainty persists about their efficacy and safety. OBJECTIVES: The authors conducted a systematic review and meta-analysis of the published reports on the efficacy and safety of IVC filters. METHODS: The authors searched PubMed, the Cochrane Central Register of Controlled Trials, and through October 3, 2016, for randomized controlled trials (RCTs) or prospective controlled observational studies of IVC filters versus none in patients at risk of PE...
September 26, 2017: Journal of the American College of Cardiology
Mariano Pellicano, Ifat Lavi, Bernard De Bruyne, Hana Vaknin-Assa, Abid Assali, Orna Valtzer, Yonit Lotringer, Giora Weisz, Yaron Almagor, Panagiotis Xaplanteris, Ajay J Kirtane, Pablo Codner, Martin B Leon, Ran Kornowski
BACKGROUND: Fractional flow reserve (FFR), an index of the hemodynamic severity of coronary stenoses, is derived from invasive measurements and requires a pressure-monitoring guidewire and hyperemic stimulus. Angiography-derived FFR measurements (FFRangio) may have several advantages. The aim of this study is to assess the diagnostic performance and interobserver reproducibility of FFRangio in patients with stable coronary artery disease. METHODS AND RESULTS: FFRangio is a computational method based on rapid flow analysis for the assessment of FFR...
September 2017: Circulation. Cardiovascular Interventions
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