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7 results on '"Rahul Sakhuja"'

1. Patient‐ and Process‐Related Contributors to the Underuse of Aortic Valve Replacement and Subsequent Mortality in Ambulatory Patients With Severe Aortic Stenosis

Author

Laura Flannery, Muhammad Etiwy, Alexander Camacho, Ran Liu, Nilay Patel, Arpi Tavil‐Shatelyan, Varsha K. Tanguturi, Jacob P. Dal‐Bianco, Evin Yucel, Rahul Sakhuja, Arminder S. Jassar, Nathaniel B. Langer, Ignacio Inglessis, Jonathan J. Passeri, Judy Hung, and Sammy Elmariah

Subjects
aortic stenosis, aortic valve replacement, treatment predictors, survival, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background Many patients with severe aortic stenosis (AS) and an indication for aortic valve replacement (AVR) do not undergo treatment. The reasons for this have not been well studied in the transcatheter AVR era. We sought to determine how patient‐ and process‐specific factors affected AVR use in patients with severe AS. Methods and Results We identified ambulatory patients from 2016 to 2018 demonstrating severe AS, defined by aortic valve area ≤1.0 cm2. Propensity scoring analysis with inverse probability of treatment weighting was used to evaluate associations between predictors and the odds of undergoing AVR at 365 days and subsequent mortality at 730 days. Of 324 patients with an indication for AVR (79.3±9.7 years, 57.4% men), 140 patients (43.2%) did not undergo AVR. The odds of AVR were reduced in patients aged >90 years (odds ratio [OR], 0.24 [95% CI, 0.08–0.69]; P=0.01), greater comorbid conditions (OR, 0.88 per 1‐point increase in Combined Comorbidity Index [95% CI, 0.79–0.97]; P=0.01), low‐flow, low‐gradient AS with preserved left ventricular ejection fraction (OR, 0.11 [95% CI, 0.06–0.21]), and low‐gradient AS with reduced left ventricular ejection fraction (OR, 0.18 [95% CI, 0.08–0.40]) and were increased if the transthoracic echocardiogram ordering provider was a cardiologist (OR, 2.46 [95% CI, 1.38–4.38]). Patients who underwent AVR gained an average of 85.8 days of life (95% CI, 40.9–130.6) at 730 days. Conclusions The proportion of ambulatory patients with severe AS and an indication for AVR who do not receive AVR remains significant. Efforts are needed to maximize the recognition of severe AS, especially low‐gradient subtypes, and to encourage patient referral to multidisciplinary heart valve teams.

Published
2022
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2. Incidence, Predictors, and Outcomes of Thrombotic Events in Hospitalized Patients With Viral Pneumonia

Author

Mazen Albaghdadi, James L. Januzzi, Michael K. Mansour, Farouc A. Jaffer, Rahul Sakhuja, Dhaval Kolte, Tomas G. Neilan, Ido Weinberg, Sammy Elmariah, and Islam Y. Elgendy

Subjects
Male, Multivariate analysis, Hospitalized patients, Myocardial Infarction, Comorbidity, Sex factors, Ischemia, Risk Factors, Hospital Mortality, Peripheral Vascular Diseases, Incidence (epidemiology), Incidence, Age Factors, Venous Thromboembolism, Shock, Septic, Hospitalization, Viral pneumonia, Hypertension, Cardiology, Female, Cardiology and Cardiovascular Medicine, Respiratory Insufficiency, medicine.medical_specialty, 2019-20 coronavirus outbreak, Pneumonia, Viral, MEDLINE, Hyperlipidemias, Article, Sex Factors, Internal medicine, Sepsis, Influenza, Human, medicine, Diabetes Mellitus, Humans, Renal Insufficiency, Chronic, Aged, Ischemic Stroke, business.industry, SARS-CoV-2, COVID-19, Extremities, Thrombosis, medicine.disease, Respiration, Artificial, United States, Superinfection, Multivariate Analysis, business
Published
2021

3. Hybrid approach to the management of infective endocarditis complicated by coronary artery embolism: a case report

Author

James R. Stone, Robert C. Schutt, David Greenhouse, Thoralf M. Sundt, Amy G. Fiedler, and Rahul Sakhuja

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Combined use, Aspiration Thrombectomy, Case Report, 030204 cardiovascular system & hematology, medicine.disease, Hybrid approach, Coronary artery embolism, Surgery, 03 medical and health sciences, 0302 clinical medicine, Infective endocarditis, medicine, Endocarditis, 030212 general & internal medicine, Embolization, Complication, business
Abstract

Septic coronary embolization in a patient with endocarditis is a rare and can be a devastating complication. The management of this clinical problem in the current era may be best served with a multi-modality approach. We present an interesting case of a patient with septic coronary embolization managed with the combined use of aspiration thrombectomy followed by surgical management of the infected valve.

Published
2017

4. Features of coronary plaque in patients with metabolic syndrome and diabetes mellitus assessed by 3-vessel optical coherence tomography

Author

Yangsoo Jang, Rahul Sakhuja, Soo Joong Kim, Haibo Jia, Shiro Uemura, Iris McNulty, Hang Lee, Robert W. Yeh, Seung-Jung Park, Rocco Vergallo, Koji Kato, Farhad Abtahian, Tsunekazu Kakuta, Bo Yu, Byeong Keuk Kim, Jinwei Tian, Soo Jin Kang, Stephen M. S. Lee, Sining Hu, Ik-Kyung Jang, Taishi Yonetsu, and Shaosong Zhang

Subjects
Male, medicine.medical_specialty, Acute coronary syndrome, Coronary Artery Disease, Coronary Angiography, metabolic syndrome, Coronary artery disease, plaque, Optical coherence tomography, Predictive Value of Tests, Diabetes mellitus, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Registries, Aged, Retrospective Studies, Observer Variation, Chi-Square Distribution, medicine.diagnostic_test, business.industry, diabetes mellitus, Fibrous cap, Reproducibility of Results, Middle Aged, medicine.disease, Coronary Vessels, Fibrosis, Lipids, Plaque, Atherosclerotic, Coronary arteries, medicine.anatomical_structure, Endocrinology, Logistic Models, Predictive value of tests, Multivariate Analysis, Cardiology, Linear Models, Female, Metabolic syndrome, Cardiology and Cardiovascular Medicine, business, Diabetic Angiopathies, Tomography, Optical Coherence
Abstract

Background— The pathophysiological basis for the association between metabolic syndrome (MetS) and coronary artery disease is not well understood. We sought to characterize coronary plaques in patients with MetS by using optical coherence tomography. Methods and Results— We identified 451 coronary plaques from 171 subjects who underwent optical coherence tomographic imaging in 3 coronary arteries. Subjects were divided into 3 groups: diabetes mellitus (DM, n=77), MetS (n=35), and a control group (C group, n=59) without DM or MetS. Optical coherence tomographic analysis included the presence of lipid-rich plaque, maximum lipid arc, lipid-core length, lipid index (LI), fibrous cap thickness, and thin-cap fibroatheroma. We defined LI as mean lipid arc multiplied by lipid-core length. Lipid-core length and LI were significantly greater in DM and MetS than in C group (lipid-core length: 7.7±4.0 and 7.0±3.8 versus 5.5±2.4 mm; P P =0.012, and LI: 1164±716 and 1086±693 versus 796±417 mm; P P =0.008). Maximum lipid arc was significantly greater in DM than in C group, whereas no significant difference was observed between MetS and C group (196±45°, 187±42° versus 176±52°; P =0.002 and P =0.182). Fibrous cap thickness and thin-cap fibroatheroma showed no significant difference among the 3 groups. In multivariate analysis, DM and MetS were independently associated with LI, whereas only acute coronary syndrome was the independent predictor for thin-cap fibroatheroma. Conclusions— Compared with control subjects, coronary plaques in MetS contain larger lipid. However, the MetS criteria used in this study could not distinguish the vulnerable features such as thin-cap fibroatheroma, suggesting the necessity of complementary information to identify patients at high risk for cardiovascular events.

Published
2013

5. A NOVEL ENDOVENOUS APPROACH FOR TREATMENT OF MASSIVE CENTRAL VENOUS OR PULMONARY ARTERIAL THROMBUS, MASS, OR VEGETATION: THE ANGIOVAC SUCTION CANNULA AND CIRCUIT

Author

Michael R. Jaff, Robert Rogers, Sanjay Gandhi, Robert M. Schainfeld, Ronan Margey, and Rahul Sakhuja

Subjects
Suction (medicine), medicine.medical_specialty, business.industry, Cannula, Surgery, Arterial thrombus, Internal medicine, Cardiology, cardiovascular system, Medicine, cardiovascular diseases, medicine.symptom, business, Vegetation (pathology), Cardiology and Cardiovascular Medicine
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6. NON-CULPRIT PLAQUES IN PATIENTS WITH ACUTE CORONARY SYNDROME (ACS) HAVE MORE VULNERABLE FEATURES COMPARED TO THOSE WITH NON-ACS: A 3 VESSEL OCT STUDY

Author

Rahul Sakhuja, Bo Yu, Soo-Joong Kim, Hang Lee, Koji Kato, Shiro Uemura, Ik-Kyung Jang, Iris McNulty, Robert W. Yeh, Taishi Yonetsu, Lei Xing, Kyoichi Mizuno, and Shaosong Zhang

Subjects
Acute coronary syndrome, medicine.medical_specialty, business.industry, Internal medicine, medicine, Cardiology, In patient, Cardiology and Cardiovascular Medicine, medicine.disease, business, Culprit
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