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Paul Sorajja

Aya J Alame, Aris Karatasakis, Judit Karacsonyi, Barbara A Danek, Erica Resendes, Jose R Martinez Parachini, Pratik Kalsaria, Michele Roesle, Bavana V Rangan, Paul Sorajja, Hani Jneid, Subhash Banerjee, Emmanouil S Brilakis
INTRODUCTION: The American College of Cardiology (ACC), the American Heart Association (AHA), and the European Society of Cardiology (ESC) have been developing guidelines to assist clinicians in making evidence-based decisions. MATERIALS AND METHODS: The current ACC/AHA and ESC guidelines for non-ST-segment elevation acute coronary syndromes (NSTE-ACS) that were updated in 2014 and 2015, respectively, were compared to assess the number of recommendations on the basis of class of recommendation and level of evidence (LOE), the sources cited, and the content...
March 16, 2017: Coronary Artery Disease
Paul Sorajja, Brinder Kanda, Richard Bae, Wesley A Pedersen, Mario Gössl
Mitral valve regurgitation (MR) is common, with a prevalence that exceeds 9% for those patients >75 years of age. For symptomatic patients with prohibitive surgical risk, transcatheter mitral valve repair with the MitraClip(®) system (Abbott Vascular, Menlo Park, CA) is available for clinical use and is effective in reducing MR in select patients. For optimal clinical success, the procedure requires mastery of complex catheterization skills with application of an in-depth understanding of the mitral valve anatomy...
February 1, 2017: Catheterization and Cardiovascular Interventions
David W M Muller, Robert Saeid Farivar, Paul Jansz, Richard Bae, Darren Walters, Andrew Clarke, Paul A Grayburn, Robert C Stoler, Gry Dahle, Kjell A Rein, Marty Shaw, Gregory M Scalia, Mayra Guerrero, Paul Pearson, Samir Kapadia, Marc Gillinov, Augusto Pichard, Paul Corso, Jeffrey Popma, Michael Chuang, Philipp Blanke, Jonathon Leipsic, Paul Sorajja
BACKGROUND: Symptomatic mitral regurgitation (MR) is associated with high morbidity and mortality that can be ameliorated by surgical valve repair or replacement. Despite this, many patients with MR do not undergo surgery. Transcatheter mitral valve replacement (TMVR) may be an option for selected patients with severe MR. OBJECTIVES: This study aimed to examine the effectiveness and safety of TMVR in a cohort of patients with native valve MR who were at high risk for cardiac surgery...
January 31, 2017: Journal of the American College of Cardiology
Naohiko Nemoto, Jonathan G Schwartz, John R Lesser, Wesley D Pedersen, Paul Sorajja, Ross Garberich, Erin M Spinner, Robert S Schwartz
BACKGROUND: Right heart structural abnormalities occur in both tricuspid regurgitation (TR) and pulmonary hypertension (PH). They may occur independently or together, but their joint effects on cardiac structure are incompletely described. This study examined the interactions of TR severity and PH on right heart structural changes. METHODS: The study evaluated 455 patients undergoing both echocardiography and CT angiography (CTA). Cases were divided into 3 groups by TR severity: trace (n=217), mild (n=174), and significant (moderate or severe, n=64)...
March 1, 2017: International Journal of Cardiology
Marcus Burns, Mario Goessl, Lynelle Schneider, Tjorvi Perry, Andrea Sweeney, Craig Strauss, Pam Rush, Kenneth Lamb, Saeid Farivar, Paul Sorajja
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
Paul Sorajja, Susheel Kodali, Michael Reardon, Wilson Szeto, Stanley Chetcuti, James Hermiller, David Adams, Jeffrey Popma
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
Paul Sorajja
For patients with paravalvular mitral prosthetic regurgitation, percutaneous repair is an established therapy for the treatment of symptoms of heart failure or hemolytic anemia. Percutaneous repair of paravalvular mitral regurgitation is a complex procedure with unique technical challenges, even when performed in experienced centers. Herein, the author discusses patient selection, catheter-based techniques for repair, and clinical outcomes of percutaneous repair for paravalvular mitral regurgitation.
January 2016: Interventional cardiology clinics
Paul Sorajja, Mario Gossl
No abstract text is available yet for this article.
July 11, 2016: JACC. Cardiovascular Interventions
Paul Sorajja, Wesley A Pedersen, Richard Bae, John R Lesser, Desmond Jay, David Lin, Kevin Harris, Barry J Maron
BACKGROUND: Few therapeutic options exist for patients with severe heart failure due to obstructive hypertrophic cardiomyopathy (HCM) who are at unacceptable surgical risk. We hypothesized that percutaneous plication of the mitral valve could reduce left ventricular outflow tract (LVOT) obstruction and associated mitral regurgitation, thereby leading to amelioration of heart failure symptoms. OBJECTIVES: This study sought to evaluate the potential effectiveness of percutaneous mitral valve plication as a therapy for patients with symptomatic, obstructive HCM...
June 21, 2016: Journal of the American College of Cardiology
Fabian Nietlispach, Francesco Maisano, Paul Sorajja, Martin B Leon, Charanjit Rihal, Ted Feldman
Paravalvular leak (PVL) occurs after both surgical and transcatheter valve replacement/implantation. It can lead to haemolysis, heart failure and may increase the risk of endocarditis. Percutaneous closure has significantly less morbidity than re-operation and is therefore often the therapy of choice. Percutaneous PVL closure can make an important difference for patients and can improve patient prognosis. These procedures can be intricate and larger case series and research is needed to further develop and improve these procedures...
December 14, 2016: European Heart Journal
Megha Prasad, Jeffrey B Geske, Paul Sorajja, Steve R Ommen, Hartzell V Schaff, Bernard J Gersh, Rick A Nishimura
OBJECTIVES: We aimed to assess the utility of changes in systolic and diastolic function by isoproterenol challenge in predicting symptom resolution post-myectomy in selected patients with hypertrophic cardiomyopathy (HCM) and labile obstruction. BACKGROUND: In a subset of symptomatic HCM patients without resting/provocable obstruction on noninvasive assessment, isoproterenol challenge during hemodynamic catheterization may elicit labile left ventricular outflow tract (LVOT) obstruction, and demonstrate the effect of obstruction on diastolic function...
November 15, 2016: Catheterization and Cardiovascular Interventions
Paul Sorajja, Michael Mack, Sreekanth Vemulapalli, David R Holmes, Amanda Stebbins, Saibal Kar, D Scott Lim, Vinod Thourani, Patrick McCarthy, Samir Kapadia, Paul Grayburn, Wesley A Pedersen, Gorav Ailawadi
BACKGROUND: Transcatheter mitral valve (MV) repair with the MitraClip received approval in 2013 for the treatment of prohibitive-risk patients with primary mitral regurgitation (MR). OBJECTIVES: The aim of this study was to report the initial U.S. commercial experience with transcatheter MV repair. METHODS: Data from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry on patients commercially treated with this percutaneous mitral valve repair device were analyzed...
March 15, 2016: Journal of the American College of Cardiology
Brinder S Kanda, Desmond Jay, R Saeid Farivar, Paul Sorajja
No abstract text is available yet for this article.
April 11, 2016: JACC. Cardiovascular Interventions
Azeem Latib, Wesley Pedersen, Francesco Maisano, John Lesser, Neil Ruparelia, Filippo Figini, Antonio Colombo, Anil Poulose, James Kolbeck, Michael Mooney, Robert Schwartz, Alicia Youssef, David Ungs, Irv Goldenberg, Paul Sorajja
OBJECTIVES: The aim of this study was to assess the effect of a novel hourglass-shaped balloon on reduction of paravalvular leak (PVL) in patients undergoing transcatheter aortic valve replacement (TAVR) with self-expanding prostheses. BACKGROUND: An important limitation of TAVR compared with surgical aortic valve replacement remains the higher incidence of PVL. A commonly used strategy to treat PVL is balloon postdilatation (BPD); however, the optimal technique for treating PVL after TAVR is unknown...
June 2016: Catheterization and Cardiovascular Interventions
Thomas M Waterbury, Paul Sorajja, Malcolm R Bell, Ryan J Lennon, Verghese Mathew, Mandeep Singh, Gurpreet S Sandhu, Rajiv Gulati
OBJECTIVES: To investigate the utility and safety of the GuideLiner "mother-and-child" catheter system during transradial and transfemoral percutaneous coronary intervention (PCI). BACKGROUND: In patients with complex coronary anatomy, stent delivery can be challenging and result in procedural failure and complications. The GuideLiner is a coaxial guide extension system designed to enable deep vessel engagement and facilitate device delivery. The purpose of this study was to evaluate procedural success and safety in a series of GuideLiner-facilitated PCI...
December 2016: Catheterization and Cardiovascular Interventions
Nicolo Piazza, Hendrik Treede, Neil Moat, Paul Sorajja, Jeff Popma, Eberhard Grube, Steve Bolling, David Adams
No abstract text is available yet for this article.
September 2015: EuroIntervention
Naohiko Nemoto, John R Lesser, Wesley R Pedersen, Paul Sorajja, Erin Spinner, Ross F Garberich, David M Vock, Robert S Schwartz
OBJECTIVE: Severe, late functional tricuspid regurgitation is characterized by annulus dilation, right ventricular enlargement, and papillary muscle displacement with leaflet tethering. However, the early stages of mild tricuspid regurgitation and its progression are poorly understood. This study examined structural heart changes in mild, early tricuspid regurgitation. METHODS: Sequential patients undergoing cardiac computed tomography and transthoracic echocardiography with tricuspid regurgitation were identified and evaluated...
August 2015: Journal of Thoracic and Cardiovascular Surgery
Navin K Kapur, Vivian Dimas, Paul Sorajja, Barry A Borlaug, James Fang, Morton Kern, Srihari S Naidu
No abstract text is available yet for this article.
August 2015: Catheterization and Cardiovascular Interventions
Paul Sorajja, Richard Bae, John A Lesser, Wesley A Pedersen
Paravalvular prosthetic regurgitation is common, affecting 5-10% of surgical prostheses and 40-70% of transcatheter valves. While many patients may suffer no significant morbidity, paravalvular prosthetic regurgitation can lead to heart failure and haemolytic anaemia, and, in some studies, has been associated with impaired survival. Over the past several years, percutaneous repair of paravalvular prosthetic regurgitation has been demonstrated to be a highly efficacious therapy. When performed in experienced centres, procedural success with percutaneous repair occurs in 90% of patients...
May 2015: Heart: Official Journal of the British Cardiac Society
John R Lesser, B Kelly Han, Marc Newell, Robert S Schwartz, Wesley Pedersen, Paul Sorajja
Percutaneous repair of aortic paravalvular regurgitation can help avoid the need for repeat valve surgery. Although the initial diagnosis of paravalvular regurgitation is usually made with echocardiography, cardiac CT angiography helps to determine the site and morphology of these leaks. The utility of CT is highly dependent on the quality of the data. Herein, we describe a systematic approach to image acquisition and interpretation of cardiac CT angiography in patients with aortic paravalvular regurgitation, which integrates findings from echocardiography...
May 2015: Journal of Cardiovascular Computed Tomography
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