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Your search keyword '"Khan, Jaffar"' showing total 31 results
Start Over Author "Khan, Jaffar" Journal journal of the american college of cardiology (jacc)
31 results on '"Khan, Jaffar"'

1. Transcatheter Electrosurgery: JACC State-of-the-Art Review.

Author

Khan, Jaffar M., Rogers, Toby, Greenbaum, Adam B., Babaliaros, Vasilis C., Yildirim, Dursun Korel, Bruce, Christopher G., Herzka, Daniel A., Schenke, William H., Ratnayaka, Kanishka, and Lederman, Robert J.

Subjects
*ELECTROSURGERY, *ARTERIAL puncture, *ARTERIAL occlusions, *BLOOD flow, *HEART diseases, *DEXTROSE, PULMONARY atresia
Abstract

Transcatheter electrosurgery refers to a family of procedures using radiofrequency energy to vaporize and traverse or lacerate tissue despite flowing blood. The authors review theory, simulations, and benchtop demonstrations of how guidewires, insulation, adjunctive catheters, and dielectric medium interact. For tissue traversal, all but the tip of traversing guidewires is insulated to concentrate current. For leaflet laceration, the "Flying V" configuration concentrates current at the inner lacerating surface of a kinked guidewire. Flooding the field with non-ionic dextrose eliminates alternative current paths. Clinical applications include traversing occlusions (pulmonary atresia, arterial and venous occlusion, and iatrogenic graft occlusion), traversing tissue planes (atrial and ventricular septal puncture, radiofrequency valve repair, transcaval access, Potts and Glenn shunts), and leaflet laceration (BASILICA, LAMPOON, ELASTA-Clip, and others). Tips are provided for optimizing these techniques. Transcatheter electrosurgery already enables a range of novel therapeutic procedures for structural heart disease, and represents a promising advance toward transcatheter surgery. [ABSTRACT FROM AUTHOR]

Published
2020
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2. Anterior Leaflet Laceration to Prevent Ventricular Outflow Tract Obstruction During Transcatheter Mitral Valve Replacement.

Author

Khan, Jaffar M, Babaliaros, Vasilis C, Greenbaum, Adam B, Foerst, Jason R, Yazdani, Shahram, McCabe, James M, Paone, Gaetano, Eng, Marvin H, Leshnower, Bradley G, Gleason, Patrick T, Chen, Marcus Y, Wang, Dee Dee, Tian, Xin, Stine, Annette M, Rogers, Toby, and Lederman, Robert J

Abstract

Background: Left ventricular outflow tract (LVOT) obstruction is a leading cause of mortality and exclusion from transcatheter mitral valve replacement (TMVR). Intentional laceration of the anterior mitral valve leaflet to prevent LVOT obstruction (LAMPOON) is a transcatheter mimic of surgical chord-sparing leaflet resection.Objectives: The purpose of this prospective multicenter trial was to study LAMPOON with transseptal (Edwards Lifesciences, Irvine, California) TMVR in annuloplasty rings or native mitral annular calcification (MAC).Methods: Subjects at high or extreme surgical risk and prohibitive risk of LVOT obstruction from TMVR were included. Eligibility was modified midtrial to exclude subjects with threatened LVOT obstruction from a Sapien 3 valve fabric skirt. The primary endpoint was procedure survival with successful LAMPOON, with successful TMVR, without reintervention, and with LVOT gradient <30 mm Hg ("optimal") or <50 mm Hg ("acceptable"). Secondary endpoints included 30-day mortality and major adverse cardiovascular events. There was universal source-data verification and independent monitoring. All endpoints were independently adjudicated. Central laboratories analyzed echocardiogram and CT images.Results: Between June 2017 and June 2018, 30 subjects were enrolled equally between the MAC and ring arms. LAMPOON traversal and midline laceration was successful in 100%. Procedure survival was 100%, and 30-day survival was 93%. Primary success was achieved in 73%, driven by additional procedures for paravalvular leak (10%) and high-skirt neo-LVOT gradients observed before a protocol amendment. There were no strokes.Conclusions: LAMPOON was feasible in native and annuloplasty ring anatomies in patients who were otherwise ineligible for treatment, with acceptable safety. LAMPOON was effective in preventing LVOT obstruction from TMVR. Despite LAMPOON, TMVR using Sapien 3 in annuloplasty rings and MAC still exhibits important limitations. (NHLBI DIR LAMPOON Study: Intentional Laceration of the Anterior Mitral Leaflet to Prevent Left Ventricular Outflow Tract Obstruction During Transcatheter Mitral Valve Implantation; NCT03015194). [ABSTRACT FROM AUTHOR]

Published
2019
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3. TAVR-in-TAVR?: Don't Bank on It!

Author

Rogers, Toby, Khan, Jaffar M., Satler, Lowell F., Greenbaum, Adam B., and Lederman, Robert J.

Subjects
*HEART valve prosthesis implantation, *AORTIC valve transplantation, *PROSTHETIC heart valves
Published
2020
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6. TCT-424 Systematic Review and Pooled Analysis of New- Versus Old-Generation Valves for Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis.

Author

Butt, Nausharwan, Khan, Jaffar, Rogers, Toby, Kolm, Paul, Mussalam, Anees, Edelman, James, Khalid, Nauman, Shlofmitz, Evan, Chen, Yuefeng, Iantorno, Micaela, Gajanana, Deepakraj, Torguson, Rebecca, Weintraub, William, and Waksman, Ron

Subjects
*HEART valve prosthesis implantation, *MITRAL valve, *AORTIC stenosis, *META-analysis
Published
2019
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9. Transcatheter Myotomy to Reduce Left Ventricular Outflow Obstruction.

Author

Greenbaum, Adam B., Ueyama, Hiroki A., Gleason, Patrick T., Khan, Jaffar M., Bruce, Christopher G., Halaby, Rim N., Rogers, Toby, Hanzel, George S., Xie, Joe X., Byku, Isida, Guyton, Robert A., Grubb, Kendra J., Lisko, John C., Shekiladze, Nikoloz, Inci, Errol K., Grier, Elizabeth A., Paone, Gaetano, McCabe, James M., Lederman, Robert J., and Babaliaros, Vasilis C.

Abstract

Left ventricular outflow tract (LVOT) obstruction is a source of morbidity in hypertrophic cardiomyopathy (HCM) and a life-threatening complication of transcatheter mitral valve replacement (TMVR) and transcatheter aortic valve replacement (TAVR). Available surgical and transcatheter approaches are limited by high surgical risk, unsuitable septal perforators, and heart block requiring permanent pacemakers. The authors report the initial experience of a novel transcatheter electrosurgical procedure developed to mimic surgical myotomy. We used septal scoring along midline endocardium (SESAME) to treat patients, on a compassionate basis, with symptomatic LVOT obstruction or to create space to facilitate TMVR or TAVR. In this single-center retrospective study between 2021 and 2023, 76 patients underwent SESAME. In total, 11 (14%) had classic HCM, and the remainder underwent SESAME to facilitate TMVR or TAVR. All had technically successful SESAME myocardial laceration. Measures to predict post-TMVR LVOT significantly improved (neo-LVOT 42 mm2 [Q1-Q3: 7-117 mm2] to 170 mm2 [Q1-Q3: 95-265 mm2]; P < 0.001; skirt-neo-LVOT 169 mm2 [Q1-Q3: 153-193 mm2] to 214 mm2 [Q1-Q3: 180-262 mm2]; P < 0.001). Among patients with HCM, SESAME significantly decreased invasive LVOT gradients (resting: 54 mm Hg [Q1-Q3: 40-70 mm Hg] to 29 mm Hg [Q1-Q3: 12-36 mm Hg]; P = 0.023; provoked 146 mm Hg [Q1-Q3: 100-180 mm Hg] to 85 mm Hg [Q1-Q3: 40-120 mm Hg]; P = 0.076). A total of 74 (97.4%) survived the procedure. Five experienced 3 of 76 (3.9%) iatrogenic ventricular septal defects that did not require repair and 3 of 76 (3.9%) ventricular free wall perforations. Neither occurred in patients treated for HCM. Permanent pacemakers were required in 4 of 76 (5.3%), including 2 after concomitant TAVR. Lacerations were stable and did not propagate after SESAME (remaining septum: 5.9 ± 3.3 mm to 6.1 ± 3.2 mm; P = 0.8). With further experience, SESAME may benefit patients requiring septal reduction therapy for obstructive hypertrophic cardiomyopathy as well as those with LVOT obstruction after heart valve replacement, and/or can help facilitate transcatheter valve implantation. [Display omitted] [ABSTRACT FROM AUTHOR]

Published
2024
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11. TCT-642 Intentional Laceration of the Anterior Mitral valve leaflet to Prevent left ventricular Outflow tract ObstructioN (LAMPOON) during transcatheter mitral valve implantation: preclinical findings.

Author

Khan, Jaffar, Rogers, Toby, Faranesh, Anthony, Greenbaum, Adam, Babaliaros, Vasilis, Chen, Marcus, and Lederman, Robert

Subjects
*MITRAL valve surgery, *VENTRICULAR outflow obstruction, *COMPLICATIONS of cardiac surgery, *CARDIAC catheterization, *FLUOROSCOPY, *ECHOCARDIOGRAPHY
Published
2016
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12. TCT-92 Antegrade LAMPOON (Intentional Percutaneous Laceration of the Anterior Mitral Leaflet to Prevent Outflow Obstruction): A Novel Modification of the Previously Described Retrograde LAMPOON, is a Technically Feasible, Reproducible, Effective, and Safe Modification of This Procedure

Author

Byku, Isida, Lisko, John, Khan, Jaffar, Guyton, Robert, Gleason, Patrick, Maidman, Samuel, Alvarez, Lucia, Grubb, Kendra, Kamioka, Norihiko, Devireddy, Chandan, Rogers, Toby, Lederman, Robert, and Babaliaros, Vasilis

Subjects
*PAMPHLETS, *PERCUTANEOUS balloon valvuloplasty, *MODIFICATIONS
Published
2019
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14. TCT-20 Aortic Root Anatomy in Low-Risk Patients After Transcatheter Aortic Valve Replacement With a Balloon-Expandable Valve: Impact on Coronary Access and Repeat Aortic Valve Interventions.

Author

Rogers, Toby, Fuery, Michael, Khan, Jaffar, Craig, Paige, Torguson, Rebecca, Zhang, Cheng, Weissman, Gaby, Asch, Federico, Shults, Christian, Satler, Lowell, and Waksman, Ron

Subjects
*HEART valve prosthesis implantation, *AORTIC valve, *ANATOMY, *COMPUTED tomography
Published
2019
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22. ELECTIVE INTRA-AORTIC BALLOON PUMP VERSUS OPTIMAL MEDICAL THERAPY FOR HIGH-RISK PERCUTANEOUS CORONARY INTERVENTION.

Author

Javed, Hasan, Khalid, Nauman, Torguson, Rebecca, Zhang, Cheng, Shlofmitz, Evan, Chen, Yuefeng, Musallam, Anees, Khan, Jaffar, Rogers, Toby, Hashim, Hayder Dhafir, Chezar-Azerrad, Chava, Yerasi, Charan, Ben-Dor, Itsik, Forrestal, Brian, Case, Brian, Bernardo, Nelson L., and Waksman, Ron

Subjects
*INTRA-aortic balloon counterpulsation, *PERCUTANEOUS coronary intervention, *PERCUTANEOUS balloon valvuloplasty, *CORONARY disease, *CORONARY artery bypass, *CHRONIC kidney failure
Published
2020
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25. TCT-660 Repeat Vascular Brachytherapy for Recurrent In-Stent Restenosis in Patients With Failed Intracoronary Radiation Therapy.

Author

Chen, Yuefeng, Khalid, Nauman, Shlofmitz, Evan, Iantorno, Micaela, Gajanana, Deepakraj, Musallam, Anees, Khan, Jaffar, Rogers, Toby, Hashim, Hayder, Bernardo, Nelson, Ben-Dor, Itsik, Zhang, Cheng, Torguson, Rebecca, Satler, Lowell, and Waksman, Ron

Subjects
*RADIOTHERAPY, *DRUG-eluting stents, *RADIOISOTOPE brachytherapy, *CHRONIC kidney failure
Published
2019
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26. TCT-426 TAVR Versus SAVR for Bicuspid Aortic Valve.

Author

Lisko, John, Maidman, Samuel, Kamioka, Norihiko, Guyton, Robert, Gleason, Patrick, Alvarez, Lucia, Byku, Isida, Grubb, Kendra, Shekiladze, Nikoloz, Bakhtadze, Beka, Brown, Matthew, Ho, Annie, Parihar, Siddhant, Khan, Jaffar, Devireddy, Chandan, Rogers, Toby, and Babaliaros, Vasilis

Subjects
*MITRAL valve, *AORTIC valve, *HEART valve prosthesis implantation, *AORTIC stenosis
Published
2019
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27. TCT-452 Septal Correction to Prevent Iatrogenic Left Ventricular Outflow Tract Obstruction (SCORPION) Prior to Transcatheter Mitral Valve Replacement.

Author

Lisko, John, Kamioka, Norihiko, El Chami, Mikhael, Lloyd, Michael, Langberg, Jonathan, Maidman, Samuel, Gleason, Patrick, Grubb, Kendra, Alvarez, Lucia, Byku, Isida, Devireddy, Chandan, Khan, Jaffar, Rogers, Toby, Guyton, Robert, Babaliaros, Vasilis, and Greenbaum, Adam

Subjects
*VENTRICULAR outflow obstruction, *MITRAL valve, *SCORPIONS
Published
2019
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28. TCT-17 Coronary Obstruction Risk Assessment: A Comparison of Snorkel Stenting and BASILICA.

Author

Lisko, John, Kamioka, Norihiko, Babaliaros, Vasilis, Shirai, Shinichi, Kawaguchi, Tomohiro, Yamamoto, Masanori, Miyasaka, Masaki, Khan, Jaffar, Maidman, Samuel, Gleason, Patrick, Alvarez, Lucia, Byku, Isida, Grubb, Kendra, Guyton, Robert, Rogers, Toby, Lederman, Robert, and Greenbaum, Adam

Subjects
*SKIN diving, *RISK assessment, *HEART valve prosthesis implantation
Published
2019
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