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Ajay Kirtane

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https://www.readbyqxmd.com/read/29789301/orbita-2-bringing-some-oxygen-back-to-pci-in-stable-ischemic-heart-disease
#1
Ajay J Kirtane
With the presentation and publication of the ORBITA trial in late 2017,1 for the first time the cardiology community had the results of a blinded randomized trial examining the efficacy of percutaneous coronary intervention (PCI) for stable ischemic heart disease (SIHD). ORBITA was a mechanistic trial, carefully examining a host of endpoints in order to determine potentially measurable effects of PCI vs. a sham comparator at 6 weeks of follow-up. The trial was performed in 200 highly committed research subjects with single vessel SIHD who were treated within a protocol that put them on an average of ~3 antianginal medications, subjected them to serial assessments of symptom status and tests for ischemia, and led to multiple cardiac catheterization procedures (2 procedures for subjects in the PCI arm and 15% of the sham arm, and 3 procedures for the 85% of subjects in the sham arm who underwent post-study treatment with PCI)...
May 22, 2018: Circulation
https://www.readbyqxmd.com/read/29769168/pressure-wire-compared-to-microcatheter-sensing-for-coronary-fractional-flow-reserve-the-perform-study
#2
Ziad A Ali, Yasir Parviz, Matthew Brinkman, Mitsuaki Matsumura, Björn Redfors, David A Brogno, Maria D Corral, Khady N Fall, Gary S Mintz, Gregg W Stone, Akiko Maehara, Allen Jeremias, Ajay J Kirtane
AIMS: Among technologies used to assess FFR, a monorail, sensor-tipped micro pressure catheter (PC) may be advantageous for delivery and re-assessment. We sought to determine whether the larger cross-sectional area of the PC influences FFR measurements compared to the pressure wire. METHODS AND RESULTS: PERFORM was a single-center, prospective study designed to determine the precision and accuracy of the PC compared with the pressure wire (PW) for measurement of FFR...
May 15, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29751953/temporal-trends-and-factors-associated-with-prolonged-length-of-stay-in-patients-with-st-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#3
Poonam Velagapudi, Dhaval Kolte, Kashif Ather, Sahil Khera, Tanush Gupta, Paul C Gordon, Herbert D Aronow, Ajay J Kirtane, J Dawn Abbott
Improved procedural techniques and process of care initiatives have decreased length of stay (LOS) after primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI). However, there remains a subset of patients who continue to require longer LOS. We used the 2005 to 2014 National Inpatient Sample databases to identify all hospitalizations for PPCI for STEMI in patients ≥18 years of age. Hospitalizations in which patients were discharged home alive were included. Multivariable linear and logistic regression models were used to examine temporal trends in LOS and to identify independent predictors of longer LOS (LOS >3 days)...
April 11, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29741482/mortality-risk-after-transcatheter-aortic-valve-implantation-analysis-of-the-predictive-accuracy-of-the-transcatheter-valve-therapy-registry-risk-assessment-model
#4
Pablo Codner, Waqas Malick, Remi Kouz, Amisha Patel, Cheng-Han Chen, Juan Terre, Uri Landes, Torsten Peter Vahl, Isaac George, Tamim Nazif, Ajay J Kirtane, Omar K Khalique, Rebecca T Hahn, Martin B Leon, Susheel Kodali
AIMS: Risk assessment tools currently used to predict mortality in transcatheter aortic valve implantation (TAVI) were designed for patients undergoing cardiac surgery. We aim to assess the accuracy of the TAVI dedicated American College of Cardiology / Transcatheter Valve Therapies (ACC/TVT) risk score in predicting mortality outcomes. METHODS AND RESULTS: Consecutive patients (n=1038) undergoing TAVI at a single institution from 2014 to 2016 were included. The ACC/TVT registry mortality risk score, the Society of Thoracic Surgeons - Patient Reported Outcomes (STS-PROM) score and the EuroSCORE II were calculated for all patients...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29734259/ec-vad-combined-use-of-extracorporeal-membrane-oxygenation-and-percutaneous-microaxial-pump-left-ventricular-assist-device
#5
Olutosin J Akanni, Koji Takeda, Lauren K Truby, Paul A Kurlansky, Codruta Chiuzan, Jiho Han, Veli K Topkara, Melana Yuzefpolskaya, Paolo C Colombo, Dimitrios Karmpaliotis, Jeffery W Moses, Yoshifumi Naka, A Reshad Garan, Ajay J Kirtane, Hiroo Takayama
Combination of venoarterial extracorporeal membrane oxygenation (VA-ECMO) and a percutaneous microaxial left ventricular assist device (pLVAD), or "EC-VAD," has been reported in cases of left ventricular decompression with mixed results. We conducted a retrospective review of patients who received EC-VAD (n = 29) or isolated VA-ECMO therapy (ECMO-only; n = 196) for refractory cardiogenic shock between February 2011 and October 2014. Fourteen patients received VA-ECMO and then Impella pLVAD (E→EC-VAD), and 15 received the Impella pump then VA-ECMO (I→EC-VAD)...
April 19, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29726596/cost-implications-of-intraprocedural-thrombotic-events-and-bleeding-in-percutaneous-coronary-intervention-results-from-the-champion-phoenix-economics-study
#6
Hector Tamez, Philip Généreux, Robert W Yeh, Amit P Amin, Weihong Fan, Harvey D White, Ajay J Kirtane, Gregg W Stone, C Michael Gibson, Robert A Harrington, Deepak L Bhatt, Duane S Pinto
BACKGROUND: Despite improvements in percutaneous coronary intervention (PCI), intraprocedural thrombotic events (IPTE) and bleeding complications occur and are prognostically important. These have not been included in prior economic studies. METHODS: PHOENIX ECONOMICS was a substudy of the CHAMPION PHOENIX trial, evaluating cangrelor during PCI. Hospital bills were reviewed from 1,171 patients enrolled at 22 of 63 US sites. Costs were estimated using standard methods including resource-based accounting, hospital billing data, and the Medicare fee schedule...
May 4, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29706508/the-hybrid-approach-to-chronic-total-occlusion-percutaneous-coronary-intervention-update-from-the-progress-cto-registry
#7
Peter Tajti, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, James W Choi, M Nicholas Burke, Anthony H Doing, Phil Dattilo, Catalin Toma, A J Conrad Smith, Barry Uretsky, Elizabeth Holper, R Michael Wyman, David E Kandzari, Santiago Garcia, Oleg Krestyaninov, Dmitrii Khelimskii, Michalis Koutouzis, Ioannis Tsiafoutis, Jeffrey W Moses, Nicholas J Lembo, Manish Parikh, Ajay J Kirtane, Ziad A Ali, Darshan Doshi, Bavana V Rangan, Imre Ungi, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: The aim of this study was to determine the techniques and outcomes of hybrid chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in a diverse group of patients and operators on 2 continents. BACKGROUND: CTO PCI has been evolving with constant improvement of equipment and techniques. METHODS: Contemporary outcomes of CTO PCI were examined by analyzing the clinical, angiographic, and procedural characteristics of 3,122 CTO interventions performed in 3,055 patients at 20 centers in the United States, Europe, and Russia...
April 24, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29678608/clinical-and-hemodynamic-effects-of-intra-aortic-balloon-pump-therapy-in-chronic-heart-failure-patients-with-cardiogenic-shock
#8
Justin A Fried, Abhinav Nair, Koji Takeda, Kevin Clerkin, Veli K Topkara, Amirali Masoumi, Melana Yuzefpolskaya, Hiroo Takayama, Yoshifumi Naka, Daniel Burkhoff, Ajay Kirtane, S M Dimitrios Karmpaliotis, Jeffrey Moses, Paolo C Colombo, A Reshad Garan
BACKGROUND: The role of the intra-aortic balloon pump (IABP) in acute decompensated heart failure (HF) with cardiogenic shock (CS) is largely undefined. In this study we sought to assess the hemodynamic and clinical response to IABP in chronic HF patients with CS and identify predictors of response to this device. METHODS: We retrospectively reviewed all patients undergoing IABP implantation from 2011 to 2016 at our institution to identify chronic HF patients with acute decompensation and CS (cardiac index <2...
March 20, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29623168/stenting-in-primary-percutaneous-coronary-intervention-for-acute-st-segment-elevation-myocardial-infarction
#9
REVIEW
Sanjog Kalra, Hemal Bhatt, Ajay J Kirtane
The treatment of ST-segment elevation myocardial infarction (STEMI) has advanced dramatically over the past 30 years since the introduction of reperfusion therapies, such that mechanical reperfusion with primary percutaneous coronary intervention is now the standard of care. With STEMI, as with other forms of acute coronary syndrome, stent deployment in culprit lesions is the dominant form of reperfusion in the developed world and is supported by contemporary guidelines. However, the precise timing of stenting and the extent to which both culprit and non-culprit lesions should be treated continue to be active areas of study...
January 2018: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29502934/association-of-tricuspid-regurgitation-with-transcatheter-aortic-valve-replacement-outcomes-a-report-from-the-society-of-thoracic-surgeons-american-college-of-cardiology-transcatheter-valve-therapy-registry
#10
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...
April 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29493509/mechanical-circulatory-support-in-chronic-total-occlusion-percutaneous-coronary-intervention-insights-from-a-multicenter-u-s-registry
#11
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
https://www.readbyqxmd.com/read/29447774/percutaneous-coronary-intervention-of-lesions-with-in-stent-restenosis-a-report-from-the-adapt-des-study
#12
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
https://www.readbyqxmd.com/read/29401287/opiate-use-in-the-cath-lab
#13
Rohan Shah, Ajay J Kirtane, John W McEvoy
No abstract text is available yet for this article.
February 21, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29365092/the-influence-of-advanced-age-on-venous-arterial-extracorporeal-membrane-oxygenation-outcomes
#14
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
https://www.readbyqxmd.com/read/29301644/sex-specific-outcomes-of-transcatheter-aortic-valve-replacement-with-the-sapien-3-valve-insights-from-the-partner-ii-s3-high-risk-and-intermediate-risk-cohorts
#15
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
https://www.readbyqxmd.com/read/29289358/association-of-stress-test-risk-classification-with-health-status-after-chronic-total-occlusion-angioplasty-from-the-outcomes-patient-health-status-and-efficiency-in-chronic-total-occlusion-hybrid-procedures-open-cto-study
#16
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...
March 1, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29246918/thirty-day-readmission-rate-and-costs-after-percutaneous-coronary-intervention-in-the-united-states-a-national-readmission-database-analysis
#17
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
https://www.readbyqxmd.com/read/29224639/a-multinational-clinical-approach-to-assessing-the-effectiveness-of-catheter-based-ultrasound-renal-denervation-the-radiance-htn-and-require-clinical-study-designs
#18
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/29138364/retrograde-cto-pci-of-native-coronary-arteries-via-left-internal-mammary-artery-grafts-insights-from-a-multicenter-u-s-registry
#19
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...
March 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29117319/role-of-hospital-volumes-in-identifying-low-performing-and-high-performing-aortic-and-mitral-valve-surgical-centers-in-the-united-states
#20
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...
December 1, 2017: JAMA Cardiology
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