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Objectives This study sought to investigate the technical feasibility and safety of the transaortic (TAO) transcatheter aortic valve replacement (TAVR) approach in patients not eligible for transfemoral (TF) access by using a device commercially available in the United States. Background A large proportion of candidates for TAVR have inadequate iliofemoral vessels for TF access. The transapical route (TAP) is the current alternative but is associated with less favorable outcomes. Other access options need to be explored. Methods Forty-four consecutive patients with inoperable, severe aortic stenosis underwent TAO TAVR in our institution. Procedural and 30-day clinical outcomes data were compared with data from 76 consecutive patients who underwent TAP TAVR at our site. Technical learning curves were assessed by comparing outcomes of the first 20 cases with the subsequent patients who underwent each procedure. Results The TAO and TAP TAVR groups were similar in terms of device success according to Valve Academic Research Consortium criteria (89% vs. 84%; p = 0.59) and rates of the 30-day combined safety endpoint of all-cause mortality, myocardial infarction, major stroke, disabling bleeding, severe acute kidney injury, and valve reintervention (20% vs. 33%; p = 0.21). The TAO approach, compared with TAP TAVR, was associated with lower combined bleeding and vascular event rate (27% vs. 46%; p = 0.05), shorter median intensive care unit length of stay (3 vs. 6 days; p = 0.01), and a favorable learning curve. Conclusions TAVR via the TAO approach is technically feasible, seems to be associated with favorable outcomes, and expands the current alternative options for access sites in patients with inoperable aortic stenosis who are ineligible for TF TAVR.

Ventricular septal rupture (VSR) is a sporadic but lethal complication after an acute myocardial infarction (MI). With the advent of reperfusion strategies, VSRs have become all the more infrequent, yet the outcomes continue to negatively impact the clinical prognosis of these patients while

Background: Syncope is one of the most common reasons for emergency department visits and hospitalizations. We investigated the implications of such presentations from a large volume, nation-wide perspective, particularly to determine the trends in admissions, cost, and mortality. Methods: Data

Background: The outcomes related to chest pain associated with cocaine use and its burden on healthcare system are not well studied. Methods: Data were collected from the Nationwide Inpatient Sample (2001 — 2012). Subjects were identified by using the ICD-9-CM codes. Primary outcome was a

Drug Eluting Stents (DES) decrease in stent re-stenosis by about 80% when compared to Bare Metal Stents (BMS). Racial disparities have been reported in the use of cardiovascular procedures. We explore such disparities in Florida. We conducted a cross-sectional analysis of all stent procedures

Transcatheter aortic valve replacement (TAVR) in combination with percutaneous coronary intervention (PCI) has emerged as a less invasive and feasible therapeutic option for this high surgical risk patient population with AS and CAD. The aim of this study is to determine the outcomes of TAVR when