132 results on '"Anwaruddin S"'
Search Results
2. Elevated intrahepatic pressures and decreased hepatic tissue blood flow prevent gas embolus during limited laparoscopic liver resections
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Ricciardi, R., Anwaruddin, S., Schaffer, B.K., Quarfordt, S.H., Donohue, S.E., Wheeler, S.M., Gallagher, K.A., Callery, M.P., Litwin, D.E.M., and Meyers, W.C.
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- 2001
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3. Deep learning based porosity prediction for additively manufactured laser powder-bed fusion parts
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Anwaruddin Siddiqui Mohammed, Mosa Almutahhar, Karim Sattar, Ali Alhajeri, Aamer Nazir, and Usman Ali
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X-ray computed tomography ,Porosity ,Artificial neural network ,Machine learning ,Mining engineering. Metallurgy ,TN1-997 - Abstract
Machine learning techniques are extensively used to understand and predict complex non-linear phenomena across various applications. Moreover, these techniques minimize the time and costs associated with experimental and numerical analysis. In this work, a deep learning technique, specifically artificial neural networks (ANN), was employed to predict the density/porosity of laser powder-bed fusion (LPBF) additively manufactured (AM) parts by training the ANN model with X-ray computed tomography (CT) images. In addition to the experimental data, synthetic CT data was generated and used to improve the performance of the ANN model. The ANN model was then optimized for the number of hidden layers and neurons. Different errors like mean absolute error (MAE), root mean square error (RMSE), and square of co-relation coefficient (R2) were used as performance metrics to determine the accuracy and effectiveness of the network. The proposed ANN model was validated and showed excellent predictions (R2 = 0.9981, MAE = 1.6944 x 10−5). The framework proposed in this work can be used to speed-up the quality assurance of AM parts by reducing the time required for the analysis of CT data.
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- 2023
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4. Diagnostic and prognostic capabilities of a biomarker and EMR‐based machine learning algorithm for sepsis
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Ishan Taneja, Gregory L. Damhorst, Carlos Lopez‐Espina, Sihai Dave Zhao, Ruoqing Zhu, Shah Khan, Karen White, James Kumar, Andrew Vincent, Leon Yeh, Shirin Majdizadeh, William Weir, Scott Isbell, James Skinner, Manubolo Devanand, Syed Azharuddin, Rajamurugan Meenakshisundaram, Riddhi Upadhyay, Anwaruddin Syed, Thomas Bauman, Joseph Devito, Charles Heinzmann, Gregory Podolej, Lanxin Shen, Sanjay Sharma Timilsina, Lucas Quinlan, Setareh Manafirasi, Enrique Valera, Bobby Reddy Jr., and Rashid Bashir
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Therapeutics. Pharmacology ,RM1-950 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Sepsis is a major cause of mortality among hospitalized patients worldwide. Shorter time to administration of broad‐spectrum antibiotics is associated with improved outcomes, but early recognition of sepsis remains a major challenge. In a two‐center cohort study with prospective sample collection from 1400 adult patients in emergency departments suspected of sepsis, we sought to determine the diagnostic and prognostic capabilities of a machine‐learning algorithm based on clinical data and a set of uncommonly measured biomarkers. Specifically, we demonstrate that a machine‐learning model developed using this dataset outputs a score with not only diagnostic capability but also prognostic power with respect to hospital length of stay (LOS), 30‐day mortality, and 3‐day inpatient re‐admission both in our entire testing cohort and various subpopulations. The area under the receiver operating curve (AUROC) for diagnosis of sepsis was 0.83. Predicted risk scores for patients with septic shock were higher compared with patients with sepsis but without shock (p
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- 2021
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5. Paravalvular regurgitation after transcatheter aortic valve replacement with the Edwards sapien valve in the PARTNER trial: characterizing patients and impact on outcomes
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Kodali, S., primary, Pibarot, P., additional, Douglas, P. S., additional, Williams, M., additional, Xu, K., additional, Thourani, V., additional, Rihal, C. S., additional, Zajarias, A., additional, Doshi, D., additional, Davidson, M., additional, Tuzcu, E. M., additional, Stewart, W., additional, Weissman, N. J., additional, Svensson, L., additional, Greason, K., additional, Maniar, H., additional, Mack, M., additional, Anwaruddin, S., additional, Leon, M. B., additional, and Hahn, R. T., additional
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- 2014
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6. Transcatheter aortic valve implantation in patients with ascending aortic dilatation: safety of the procedure and mid-term follow-up
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Rylski, B., primary, Szeto, W. Y., additional, Bavaria, J. E., additional, Walsh, E., additional, Anwaruddin, S., additional, Desai, N. D., additional, Moser, W., additional, Herrmann, H. C., additional, and Milewski, R. K., additional
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- 2014
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7. Gastrointestinal pathophysiology of SARS-CoV2 – a literature review
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Anwaruddin Syed, Arsalan Khan, Falgun Gosai, Abuzar Asif, and Sonu Dhillon
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sars-cov2 ,covid-19 ,pathophysiology ,liver injury ,gastroenterology ,Internal medicine ,RC31-1245 - Abstract
SARS-CoV2 is a novel coronavirus responsible for causing COVID-19, first identified in the city of Wuhan, China and officially declared a pandemic by the World Health Organization. SARS-CoV2 expresses high affinity to human ACE2 receptors, including within the gastrointestinal tract. Patients with COVID-19 exhibit a wide spectrum of GI symptoms including anorexia, nausea, vomiting, abdominal pain, and abnormal liver function tests. Pathogenesis behind gastrointestinal symptoms caused by SARS-CoV2 has been postulated to be multifactorial including disruption of the intestinal mechanical barrier integrity, alteration of the gut microbiome and systemic inflammatory response to the virus. SARS-CoV-2 RNA has also been found in stool samples of infected patients for a significantly longer period than in nasopharyngeal samples, though the implication of this finding is unclear at this time. Liver injury in patients with COVID-19 is usually mild, stemming from immune-mediated damage, drug induced hepatotoxicity, or ischemia from sepsis. Patients with pre-existing liver disease may be at a higher risk for hospitalization and mortality. Given the high degree of infectivity of this disease, healthcare providers will need to remain watchful for resurgence of this virus. Strict protocols should be implemented regarding hand hygiene, isolation, personal protective equipment, and appropriate disposal of waste. It is also imperative to identify patients with gastrointestinal symptoms at an early stage as these patients may have a prolonged course between symptom onset and viral clearance.
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- 2020
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8. 137 * TRANSCATHETER AORTIC VALVE IMPLANTATION IN PATIENTS WITH ASCENDING AORTIC DILATATION: SAFETY OF THE PROCEDURE AND MID-TERM FOLLOW-UP OF 100 PATIENTS
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Rylski, B., primary, Szeto, W., additional, Bavaria, J. E., additional, Walsh, E., additional, Anwaruddin, S., additional, Desai, N., additional, Herrmann, H., additional, and Milewski, R. K., additional
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- 2013
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9. Outcomes after Ventricular Assist Device Support in Patients Bridged with Temporary Circulatory Support: Analysis from INTERMACS
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Shreenivas, S., primary, Acker, A.L., additional, Atluri, P., additional, Anwaruddin, S., additional, Woo, Y.J., additional, Acker, M.A., additional, Myers, S.L., additional, and Rame, J.E., additional
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- 2013
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10. Amino-terminal pro-brain natriuretic peptide for the diagnosis of acute heart failure in patients with previous obstructive airway disease
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Tung, R.H., primary, Camargo, C.A., additional, Krauser, D., additional, Anwaruddin, S., additional, Baggish, A., additional, Chen, A., additional, and Januzzi, J.L., additional
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- 2006
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11. Ischemia-Modified Albumin Improves the Sensitivity and Negative Predictive Value of Standard Cardiac Biomarkers for the Diagnosis of Myocardial Ischemia
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Lewandrowski, KB, primary, Lewandrowksi, E, additional, Anwaruddin, S, additional, and Januzzi, JL, additional
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- 2004
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12. Effect of transendocardial delivery of autologous bone marrow mononuclear cells on functional capacity, left ventricular function, and perfusion in chronic heart failure: the FOCUS-CCTRN trial.
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Perin EC, Willerson JT, Pepine CJ, Henry TD, Ellis SG, Zhao DX, Silva GV, Lai D, Thomas JD, Kronenberg MW, Martin AD, Anderson RD, Traverse JH, Penn MS, Anwaruddin S, Hatzopoulos AK, Gee AP, Taylor DA, Cogle CR, and Smith D
- Abstract
Context: Previous studies using autologous bone marrow mononuclear cells (BMCs) in patients with ischemic cardiomyopathy have demonstrated safety and suggested efficacy.Objective: To determine if administration of BMCs through transendocardial injections improves myocardial perfusion, reduces left ventricular end-systolic volume (LVESV), or enhances maximal oxygen consumption in patients with coronary artery disease or LV dysfunction, and limiting heart failure or angina.Design, Setting, and Patients: A phase 2 randomized double-blind, placebo-controlled trial of symptomatic patients (New York Heart Association classification II-III or Canadian Cardiovascular Society classification II-IV) with a left ventricular ejection fraction of 45% or less, a perfusion defect by single-photon emission tomography (SPECT), and coronary artery disease not amenable to revascularization who were receiving maximal medical therapy at 5 National Heart, Lung, and Blood Institute-sponsored Cardiovascular Cell Therapy Research Network (CCTRN) sites between April 29, 2009, and April 18, 2011.Intervention: Bone marrow aspiration (isolation of BMCs using a standardized automated system performed locally) and transendocardial injection of 100 million BMCs or placebo (ratio of 2 for BMC group to 1 for placebo group).Main Outcome Measures: Co-primary end points assessed at 6 months: changes in LVESV assessed by echocardiography, maximal oxygen consumption, and reversibility on SPECT. Phenotypic and functional analyses of the cell product were performed by the CCTRN biorepository core laboratory.Results: Of 153 patients who provided consent, a total of 92 (82 men; average age: 63 years) were randomized (n = 61 in BMC group and n = 31 in placebo group). Changes in LVESV index (-0.9 mL/m(2) [95% CI, -6.1 to 4.3]; P = .73), maximal oxygen consumption (1.0 [95% CI, -0.42 to 2.34]; P = .17), and reversible defect (-1.2 [95% CI, -12.50 to 10.12]; P = .84) were not statistically significant. There were no differences found in any of the secondary outcomes, including percent myocardial defect, total defect size, fixed defect size, regional wall motion, and clinical improvement.Conclusion: Among patients with chronic ischemic heart failure, transendocardial injection of autologous BMCs compared with placebo did not improve LVESV, maximal oxygen consumption, or reversibility on SPECT.Trial Registration: clinicaltrials.gov Identifier: NCT00824005. [ABSTRACT FROM AUTHOR]- Published
- 2012
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13. Utility of amino-terminal pro-brain natriuretic peptide testing for prediction of 1-year mortality in patients with dyspnea treated in the emergency department.
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Januzzi JL Jr, Sakhuja R, O'donoghue M, Baggish AL, Anwaruddin S, Chae CU, Cameron R, Krauser DG, Tung R, Camargo CA Jr, and Lloyd-Jones DM
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- 2006
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14. Postoperative troponin-T predicts prolonged intensive care unit length of stay following cardiac surgery.
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Baggish AL, MacGillivray TE, Hoffman W, Newell JB, Lewandrowski KB, Lee-Lewandrowski E, Anwaruddin S, Siebert U, Januzzi JL, Baggish, Aaron L, MacGillivray, Thomas E, Hoffman, William, Newell, John B, Lewandrowski, Kent B, Lee-Lewandrowski, Elizabeth, Anwaruddin, Saif, Siebert, Uwe, and Januzzi, James L
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- 2004
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15. Sliding Water Droplet on Oil Impregnated Surface and Dust Particle Mitigation
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Saeed Bahatab, Bekir Sami Yilbas, Abba Abdulhamid Abubakar, Ghassan Hassan, Anwaruddin Siddiqui Mohammed, Hussain Al-Qahtani, Ahmet Z. Sahin, and Abdullah Al-Sharafi
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water droplet ,silicon oil impregnation ,crystallization ,hydrophobic ,polycarbonate ,Organic chemistry ,QD241-441 - Abstract
Self-cleaning of surfaces becomes challenging for energy harvesting devices because of the requirements of high optical transmittance of device surfaces. Surface texturing towards hydrophobizing can improve the self-cleaning ability of surfaces, yet lowers the optical transmittance. Introducing optical matching fluid, such as silicon oil, over the hydrophobized surface improves the optical transmittance. However, self-cleaning ability, such as dust mitigation, of the oil-impregnated hydrophobic surfaces needs to be investigated. Hence, solution crystallization of the polycarbonate surface towards creating hydrophobic texture is considered and silicon oil impregnation of the crystallized surface is explored for improved optical transmittance and self-cleaning ability. The condition for silicon oil spreading over the solution treated surface is assessed and silicon oil and water infusions on the dust particles are evaluated. The movement of the water droplet over the silicon oil-impregnated sample is examined utilizing the high-speed facility and the tracker program. The effect of oil film thickness and the tilting angle of the surface on the sliding droplet velocity is estimated for two droplet volumes. The mechanism for the dust particle mitigation from the oil film surface by the sliding water droplet is analyzed. The findings reveal that silicon oil impregnation of the crystallized sample surface improves the optical transmittance significantly. The sliding velocity of the water droplet over the thick film (~700 µm) remains higher than that of the small thickness oil film (~50 µm), which is attributed to the large interfacial resistance created between the moving droplet and the oil on the crystallized surface. The environmental dust particles can be mitigated from the oil film surface by the sliding water droplet. The droplet fluid infusion over the dust particle enables to reorient the particle inside the droplet fluid. As the dust particle settles at the trailing edge of the droplet, the sliding velocity decays on the oil-impregnated sample.
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- 2021
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16. From mice to men commonalities in physiology for stem cell-based cardiac repair.
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Penn MS, Anwaruddin S, Nair R, and Ellis S
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- 2009
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17. Recapturing the magic: revisiting the pleiotropic effects of statins in percutaneous coronary revascularization.
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Ellis SG and Anwaruddin S
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- 2009
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18. 137TRANSCATHETER AORTIC VALVE IMPLANTATION IN PATIENTS WITH ASCENDING AORTIC DILATATION: SAFETY OF THE PROCEDURE AND MID-TERM FOLLOW-UP OF 100 PATIENTS.
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Rylski, B., Szeto, W., Bavaria, J.E., Walsh, E., Anwaruddin, S., Desai, N., Herrmann, H., and Milewski, R.K.
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- 2013
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19. Usefulness of Aminoterminal Pro-Brain Natriuretic Peptide Testing for the Diagnostic and Prognostic Evaluation of Dyspneic Patients With Diabetes Mellitus Seen in the Emergency Department (from the PRIDE Study)
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O'Donoghue M, Kenney P, Oestreicher E, Anwaruddin S, Baggish AL, Krauser DG, Chen A, Tung R, Cameron R, and Januzzi JL Jr
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- 2007
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20. Combination of D-Dimer and amino-terminal pro-B-type natriuretic peptide testing for the evaluation of dyspneic patients with and without acute pulmonary embolism.
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Melanson SEF, Laposata M, Camargo CA, Chen AA, Tung R, Krauser D, Anwaruddin S, Baggish A, Cameron R, Sluss P, Lewandrowski KB, Lee-Lewandrowski E, and Januzzi JL
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- 2006
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21. Novel valve-in-surgical bioprosthetic transcatheter aortic valve replacement: Undermining iatrogenic coronary obstruction with radiofrequency needle (UNICORN).
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Buchanan CE, Iskander M, Anwaruddin S, and Mason PJ
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- Humans, Aged, 80 and over, Female, Treatment Outcome, Catheter Ablation adverse effects, Prosthesis Failure, Heart Valve Prosthesis Implantation instrumentation, Heart Valve Prosthesis Implantation adverse effects, Heart Injuries etiology, Heart Injuries diagnostic imaging, Heart Injuries therapy, Needles, Ventricular Function, Left, Coronary Occlusion diagnostic imaging, Coronary Occlusion etiology, Coronary Occlusion therapy, Coronary Occlusion physiopathology, Coronary Angiography, Heart Valve Prosthesis, Bioprosthesis, Iatrogenic Disease, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement instrumentation, Aortic Valve surgery, Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Aortic Valve Stenosis surgery, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis physiopathology, Prosthesis Design
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An 86-year-old female with history of surgical aortic valve replacement presented with clinical signs of heart failure. Echocardiography revealed a reduction in left ventricular systolic function and severe bioprosthetic aortic valve dysfunction. This is the first reported case of valve-in-valve transcatheter aortic valve replacement with concomitant undermining iatrogenic coronary obstruction with radiofrequency needle procedure in a surgical bioprosthetic valve., (© 2024 Wiley Periodicals LLC.)
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- 2024
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22. Reply: Omnipresence of the Multidisciplinary Heart Team: It's Not Just About Valves….
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Batchelor WB, Anwaruddin S, and Wang DD
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- 2023
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23. The Multidisciplinary Heart Team in Cardiovascular Medicine: Current Role and Future Challenges.
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Batchelor WB, Anwaruddin S, Wang DD, Perpetua EM, Krishnaswami A, Velagapudi P, Wyman JF, Fullerton D, Keegan P, Phillips A, Ross L, Maini B, Bernacki G, Panjrath GS, Lee J, Geske JB, Welt F, Thakker PD, Deswal A, Park K, Mack MJ, Leon M, Lewis S, and Holmes D
- Abstract
Cardiovascular multidisciplinary heart teams (MDHTs) have evolved significantly over the past decade. These teams play a central role in the treatment of a wide array of cardiovascular diseases affecting interventional cardiology, cardiac surgery, interventional imaging, advanced heart failure, adult congenital heart disease, cardio-oncology, and cardio-obstetrics. To meet the specific needs of both patients and heart programs, the composition and function of cardiovascular MDHTs have had to adapt and evolve. Although lessons have been learned from multidisciplinary cancer care, best practices for the operation of cardiovascular MDHTs have yet to be defined, and the evidence base supporting their effectiveness is limited. This expert panel review discusses the history and evolution of cardiovascular MDHTs, their composition and role in treating patients across a broad spectrum of disciplines, basic tenets for successful operation, and the future challenges facing them., Competing Interests: Dr Batchelor has received institutional research grant support from Abbott and Boston Scientific; and is a consultant for Abbott, Medtronic, Edwards, V-Wave Medical, and Boston Scientific. Dr Anwaruddin is a consultant/proctor/advisory board member at Medtronic; proctor at Edwards; on the steering committee of Boston Scientific; on the advisory board of OpSens; and has equity in East End Medical. Dr Wang is a consultant at Edwards Lifesciences, Boston Scientific, Abbott, and Neochord; and has received institutional research grant support from Boston scientific. Dr Velugapudi is on the Speakers Bureau of Abiomed and Opsens; and is on the advisory board of Women’s Health Initiative. Ms Wyman is a consultant at Edwards Lifesciences and Boston Scientific. Ms Perpetua is a consultant at Abbott and Edwards; and is on the advisory board of Abbott. Dr Maini has equity in East End Medical; is on the advisory board of Boston Scientific, Abbott, and Medtronic; is on the Speakers Bureau of Boston Scientific, Abbott, and Medtronic; and has received proctorship honoraria from Boston Scientific, Abbott, and Medtronic. Dr Mack is a co-principal investigator/study chair (no renumeration) for Abbott, Edwards Lifesciences, and Medtronic. Dr Leon is on the advisory board (no renumeration) of Abbott, BSC, MDT, Edwards, Gore, and Venus Medtech. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2023 The Authors.)
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- 2023
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24. A Practical Approach to Left Main Coronary Artery Disease: JACC State-of-the-Art Review.
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Davidson LJ, Cleveland JC, Welt FG, Anwaruddin S, Bonow RO, Firstenberg MS, Gaudino MF, Gersh BJ, Grubb KJ, Kirtane AJ, Tamis-Holland JE, Truesdell AG, Windecker S, Taha RA, and Malaisrie SC
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- Humans, Coronary Artery Bypass, Meta-Analysis as Topic, Randomized Controlled Trials as Topic, Practice Guidelines as Topic, Coronary Artery Disease diagnosis, Coronary Artery Disease surgery, Percutaneous Coronary Intervention
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The treatment of left main (LM) coronary artery disease (CAD) requires complex decision-making. Recent clinical practice guidelines provide clinicians with guidance; however, decisions regarding treatment for individual patients can still be difficult. The American College of Cardiology's Cardiac Surgery Team and Interventional Council joined together to develop a practical approach to the treatment of LM CAD, taking into account randomized clinical trial, meta-analyses, and clinical practice guidelines. The various presentations of LM CAD based on anatomy and physiology are presented. Recognizing the complexity of LM CAD, which rarely presents isolated and is often in combination with multivessel disease, a treatment algorithm with medical therapy alone or in conjunction with percutaneous coronary intervention or coronary artery bypass grafting is proposed. A heart team approach is recommended that accounts for clinical, procedural, operator, and institutional factors, and features shared decision-making that meets the needs and preferences of each patient and their specific clinical situation., Competing Interests: Funding Support and Author Disclosures Dr Davidson is a co-investigator for Edwards Lifesciences and Abbott clinical trials. Dr Cleveland has received research grants from Medtronic and Abbott; has served on research committees for Abbott; has been a consultant for and received honoraria from ConneX Biomedical and Medtronic; and has received honoraria from Edwards Lifesciences. Dr Welt has been a consultant for and received honoraria from Medtronic; and holds stock in Xenter, Inc. Dr Anwaruddin has been a consultant and proctor for Edwards Lifesciences and Medtronic; has served on a steering committee for Boston Scientific; and holds equity in East End Medical. Dr Grubb has been a speaker for Edwards Lifesciences, Boston Scientific, and Medtronic; has been a proctor for Edwards Lifesciences and Medtronic; has served on advisory boards for Medtronic and Abbott; has been a principal investigator for trials sponsored by Edwards Lifesciences and Medtronic; and has been a consultant for Gore. Dr Kirtane has been a consultant for IMDS; has received travel expenses/meals from Medtronic, Boston Scientific, Abbott Vascular, CSI, Siemens, Philips, ReCor Medical, Chiesi, OpSens, Zoll, and Regeneron; and has received research grants from, been a consultant for, an/or received speaker fees from Medtronic, Boston Scientific, Abbott Vascular, Amgen, CSI, Philips, ReCor Medical, Neurotronic, Biotronik, Chiesi, Bolt Medical, Magenta Medical, Canon, and SoniVie, paid to his institution. Dr Truesdell has received consultant and speaker fees, paid to his institution, from Abiomed Inc. Dr Windecker has received research and educational grants paid to employer from Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardinal Health, CardioValve, Corflow Therapeutics, CSL Behring, Daiichi-Sankyo, Edwards Lifesciences, Guerbet, InfraRedx, Janssen-Cilag, Johnson & Johnson, Medicure, Medtronic, Merck Sharp & Dohm, Miracor Medical, Novartis, Novo Nordisk, Organon, OrPha Suisse, Pfizer, Polares, Regeneron, Sanofi, Servier, Sinomed, Terumo, Vifor, V-Wave; has served as advisory board member and/or member of the steering/executive group of trials funded by Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Boston Scientific, Biotronik, Bristol Myers Squibb, Edwards Lifesciences, Janssen, MedAlliance, Medtronic, Novartis, Polares, Recardio, Sinomed, Terumo, V-Wave, and Xeltis with payments to employer but no personal payments; and has been a member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration. Dr Malaisrie has been a consultant for and received research funding from Edwards Lifesciences, Medtronic, Terumo Aortic, and Artivion. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2022. Published by Elsevier Inc.)
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- 2022
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25. Fire or Ice: Cryoablation as a Viable Alternative to Radiofrequency Ablation for Renal Artery Denervation?
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Anwaruddin S and Bhatt DL
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Competing Interests: Dr Anwaruddin is a consultant with Medtronic and Edwards Lifesciences; a proctor for Medtronic and Edwards Lifesciences; a member of the Advisory Board for Medtronic and OpSens; a member of the Steering Committee for Boston Scientific; and holds equity in East End Medical. Dr Bhatt is a member of the Advisory Board for Boehringer Ingelheim, Cardax, CellProthera, Cereno Scientific, Elsevier Practice Update Cardiology, Janssen, Level Ex, Medscape Cardiology, MyoKardia, NirvaMed, Novo Nordisk, PhaseBio, PLx Pharma, Regado Biosciences, Stasys; a member of the Board of Directors for Boston VA Research Institute, Society of Cardiovascular Patient Care, and TobeSoft; the Inaugural Chair of the American Heart Association Quality Oversight Committee; a member of the Data Monitoring Committees for Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott), Boston Scientific (Chair, PEITHO trial), Cleveland Clinic (including for the ExCEED trial, funded by Edwards), Contego Medical (Chair, PERFORMANCE 2), Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine (for the ENVISAGE trial, funded by Daiichi Sankyo), Novartis, Population Health Research Institute; and has received honoraria from the American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org; Chair, ACC Accreditation Oversight Committee), Arnold and Porter law firm (work related to Sanofi/Bristol-Myers Squibb clopidogrel litigation), Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute; is a member of the RE-DUAL PCI clinical trial steering committee funded by Boehringer Ingelheim, the AEGIS-II executive committee funded by CSL Behring), Belvoir Publications (Editor in Chief, Harvard Heart Letter), Canadian Medical and Surgical Knowledge Translation Research Group (clinical trial steering committees), Cowen and Company, Duke Clinical Research Institute (clinical trial steering committees, including for the PRONOUNCE trial, funded by Ferring Pharmaceuticals), HMP Global (Editor in Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (Guest Editor; Associate Editor), K2P (Co-Chair, interdisciplinary curriculum), Level Ex, Medtelligence/ReachMD (CME steering committees), MJH Life Sciences, Piper Sandler, Population Health Research Institute (for the COMPASS operations committee, publications committee, steering committee, and USA national co-leader, funded by Bayer), Slack Publications (Chief Medical Editor, Cardiology Today’s Intervention), Society of Cardiovascular Patient Care (Secretary/Treasurer), WebMD (CME steering committees); Other: Clinical Cardiology (Deputy Editor), NCDR-ACTION Registry Steering Committee (Chair), VA CART Research and Publications Committee (Chair); Research Funding: Abbott, Afimmune, Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Cardax, CellProthera, Cereno Scientific, Chiesi, CSL Behring, Eisai, Ethicon, Faraday Pharmaceuticals, Ferring Pharmaceuticals, Forest Laboratories, Fractyl, Garmin, HLS Therapeutics, Idorsia, Ironwood, Ischemix, Janssen, Lexicon, Lilly, Medtronic, MyoKardia, NirvaMed, Novartis, Novo Nordisk, Owkin, Pfizer, PhaseBio, PLx Pharma, Regeneron, Roche, Sanofi, Stasys, Synaptic, The Medicines Company, 89Bio; Royalties: Elsevier (Editor, Cardiovascular Intervention: A Companion to Braunwald’s Heart Disease); Site Co-Investigator: Abbott, Biotronik, Boston Scientific, CSI, St. Jude Medical (now Abbott), Philips, Svelte; Trustee: American College of Cardiology; and unfunded research from FlowCo, Merck, and Takeda.
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- 2022
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26. Long and Short of It: Understanding Transcatheter Edge-to-Edge Repair Outcomes for Mitral Regurgitation in Women.
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Anwaruddin S and Asgar AW
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- Female, Humans, Mitral Valve diagnostic imaging, Mitral Valve surgery, Heart Valve Prosthesis Implantation adverse effects, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency surgery
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- 2021
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27. Meta-analysis of minimalist versus standard care approach for transcatheter aortic valve replacement.
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Qureshi WT, Kundu A, Mir T, Khan A, Anwaruddin S, Sattar Y, Ogunsua A, Dutta A, Majeed CN, Walker J, and Kakouros N
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- Acute Kidney Injury etiology, Aged, Aged, 80 and over, Aortic Valve surgery, Female, Fluoroscopy, Hemorrhage etiology, Hospital Mortality, Humans, Length of Stay, Male, Patient Readmission, Transcatheter Aortic Valve Replacement mortality, Treatment Outcome, Vascular Diseases etiology, Aortic Valve Stenosis surgery, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
Background: The change in practice of transcatheter aortic valve replacement (TAVR) to a minimalist approach is a debate., Methods: Online database search for studies that compared the minimalist approach with the standard approach for TAVR were searched from inception through September 2020. We calculated pooled odds ratios (ORs) and 95% confidence intervals (CIs) using the fixed or random-effects model., Results: A total of 9 studies with 2,880 TAVR patients (minimalist TAVR;1066 and standard TAVR; 1,814) were included. Compared to standard approach, there were no significant differences in in-hospital mortality, 30-day mortality, or hospital readmissions. However, there was a reduced risk of acute kidney injury (OR0.49;95%CI0.27-0.89), major bleeding (OR0.21;95%CI0.12-0.38) and major vascular complications (OR0.60,95%CI0.39-0.91) associated with the minimalist TAVR group. There was comparatively shorter hospital length of stay (mean difference -2.41;95%CI-2.99,-1.83) days, procedural time (mean difference -43.99;95%CI-67.25,-20.75) minutes, fluoroscopy time (mean difference -2.69;95%CI-3.44,-1.94) minutes and contrast volume (mean difference -26.98;95%CI-42.18,-11.79) ml in the minimalist TAVR group., Conclusions: This meta-analysis demonstrated potential benefits of the minimalist TAVR approach over the standard approach regarding some adverse clinical outcomes as well as procedural outcomes without significant differences in mortality or readmission rates.
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- 2021
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28. Reply: On Evaluating Out-of-Hospital 30-Day Mortality After TAVR.
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Anwaruddin S, Desai N, Vemulapalli S, and Reardon MJ
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- Aortic Valve diagnostic imaging, Aortic Valve surgery, Hospitals, Humans, Treatment Outcome, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Transcatheter Aortic Valve Replacement adverse effects
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- 2021
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29. Incidence, Predictors, and Outcomes of Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Replacement: Insights From the Society of Thoracic Surgeons/American College of Cardiology National Cardiovascular Data Registry-Transcatheter Valve Therapy Registry.
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Julien HM, Stebbins A, Vemulapalli S, Nathan AS, Eneanya ND, Groeneveld P, Fiorilli PN, Herrmann HC, Szeto WY, Desai ND, Anwaruddin S, Vora A, Shah B, Ng VG, Kumbhani DJ, and Giri J
- Subjects
- Aortic Valve diagnostic imaging, Aortic Valve surgery, Hospital Mortality, Humans, Incidence, Registries, Treatment Outcome, United States epidemiology, Acute Kidney Injury diagnosis, Acute Kidney Injury epidemiology, Acute Kidney Injury etiology, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis epidemiology, Aortic Valve Stenosis surgery, Cardiology, Surgeons, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
[Figure: see text].
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- 2021
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30. Snare-Assisted Valve Positioning of Self-Expanding Valves for Transcatheter Aortic Valve Replacement.
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Kunkel KJ, Fiorilli P, Kobayashi T, Desai ND, Anwaruddin S, and Herrmann HC
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We describe 4 cases in which technical challenges were anticipated in delivering a self-expanding TAVR valve due to challenging aortic anatomy or a previous placed surgical aortic valve. An upfront snare strategy is described which facilitates valve centralization and atraumatic valve delivery. ( Level of Difficulty: Advanced. )., Competing Interests: Dr. Anwaruddin is on the advisory board of Medtronic; has received speaker fees from Medtronic and Edwards Lifesciences; has received honoraria from Medtronic and Siemens; and has been a consultant for V wave. Dr. Herrmann has received institutional research funding from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic; and has received consulting fees from Abbott, Edwards Lifesciences, and Medtronic. Dr. Desai has received institutional research funding from Core, Medtronic, and Cook; and has received consulting fees from Core, Medtronic, Terumo, and Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2021 The Authors.)
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- 2021
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31. Temporal trends and outcomes in utilisation of transcatheter and surgical aortic valve therapies in aortic valve stenosis patients with heart failure.
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Al-Khadra Y, Sattar Y, Ullah W, Moussa Pacha H, Baibars M, Darmoch F, Abu-Mahfouz M, Afonso L, Devireddy C, Anwaruddin S, Sorajja P, Ajmal R, Kwok CS, Asfour AI, Zehr K, Mamas MA, and Alraies MC
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- Aortic Valve surgery, Humans, Risk Factors, Stroke Volume, Treatment Outcome, Aortic Valve Stenosis surgery, Heart Failure epidemiology, Heart Valve Prosthesis Implantation
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Introductions & Aims: Heart failure (HF) is a common comorbidity in patients undergoing surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). We sought to access the temporal trends and outcomes of TAVR or SAVR in HF patients., Method: The NIS database from 2011-2014 was queried for patients that underwent TAVR or SAVR and were subsequently diagnosed with HF. Temporal trends in the utilisation of TAVR or SAVR in HF patients were analysed., Results: Among 27 982 patients who were diagnosed with HF of whom 17 681 (63.2%) had heart failure with reduced ejection fraction (HFrEF) while 10 301 (36.8%) had heart failure with preserved ejection fraction (HFpEF), 9049 (32.3%) underwent TAVR and 16 933 (76.7%) underwent SAVR. Patients with HFrEF and HFpEF had higher utilisation of TAVR compared with SAVR over the course of the study period (P trend < .001). TAVR was associated with lower mortality [2.8% in 2012 and 1.8% in 2014 (P .013)] compared with SAVR. Similarly, multiple logistic regression showed a statistically significant lower in-hospital mortality in the TAVR group compared with SAVR (aOR 0.634; CI 0.504, 0.798, P < .001)., Conclusion: For patients with severe aortic valve stenosis and heart failure who undergo aortic valve intervention, TAVR is associated with less odds of in-hospital mortality compared with SAVR., (© 2020 John Wiley & Sons Ltd.)
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- 2021
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32. Evaluating Out-of-Hospital 30-Day Mortality After Transfemoral Transcatheter Aortic Valve Replacement: An STS/ACC TVT Analysis.
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Anwaruddin S, Desai ND, Vemulapalli S, Marquis-Gravel G, Li Z, Kosinski A, and Reardon MJ
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- Aortic Valve surgery, Hospitals, Humans, Registries, Risk Factors, Stroke Volume, Treatment Outcome, United States, Ventricular Function, Left, Aortic Valve Stenosis surgery, Transcatheter Aortic Valve Replacement
- Abstract
Objectives: This study sought to better understand out-of-hospital 30-day mortality following transfemoral transcatheter aortic valve replacement (TAVR) and identify factors associated with poor outcomes., Background: Despite improvements in outcomes with TAVR for severe aortic stenosis, out-of-hospital 30-day mortality has not been evaluated., Methods: This study examined patients in the Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry undergoing TAVR for severe aortic stenosis from January 2015 to March 2018. Primary and secondary endpoints were 30-day out-of-hospital all-cause mortality and out-of-hospital cardiovascular mortality, respectively. Logistic regression models were used to assess association between pre-specified factors and endpoints., Results: A total of 106,749 patients underwent TAVR and were eligible for analysis. Transfemoral TAVR was performed in 92.3% of patients. A total of 2,137 (2.2%) transfemoral patients died within 30 days of the procedure, and 623 (29%) patients of these patients experienced out-of-hospital 30-day mortality. Cardiovascular and pulmonary etiologies accounted for the majority of observed mortality. Multivariable regression analysis identified older age, gender, lower body surface area, lower left ventricular ejection fraction, lower hemoglobin, atrial fibrillation or flutter, severe lung disease, home oxygen use, lack of moderate-to-severe aortic insufficiency, urgent TAVR, lower Kansas City Cardiomyopathy Questionnaire score, longer hospital length of stay, and in-hospital complications as being independently associated with the primary endpoint. New onset or pre-existent atrial fibrillation or flutter was also independently associated with 30-day out-of-hospital cardiovascular mortality in the transfemoral population., Conclusions: We identified 30-day all-cause mortality rate for TAVR of 2.2%. Approximately one-third of patients experienced out-of-hospital mortality at 30 days. Several factors were identified as being independently associated with 30-day out-of-hospital all-cause and cardiovascular mortality. Further work is needed to understand how best to improve out-of-hospital mortality following TAVR., Competing Interests: Funding Support and Author Disclosures Dr. Anwaruddin has served on the advisory board for Medtronic and OpSens; has received speaking fees from Medtronic, Edwards Lifesciences, and Siemens; received consulting fees from Edwards Lifesciences; has served as a proctor/consultant for V wave; received institutional research support from the Cardiothoracic Surgery Network; and is on the Steering Committee for Boston Scientific. Dr. Desai has served as a speaker or consultant for Gore and Medtronic. Dr. Vemulapalli has served on the advisory board or as a consultant for Boston Scientific, HeartFlow, Baylabs (Caption Health), Janssen, and American College of Physicians; and has received grants or contracts from Abbott Vascular, Boston Scientific, the National Institutes of Health, Patient-Centered Outcomes Research, Nest (Food and Drug Administration), the American College of Cardiology, and the Society of Thoracic Surgeons. Dr. Marquis-Gravel has received grant support from the Canadian Institute of Health Sciences; and has received honoraria from Servier and Novartis. Dr. Reardon has served on the advisory board for Medtronic and Boston Scientific; and has served as a consultant for Gore. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
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- 2021
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33. Response to: Prevention of thrombus formation following transcatheter aortic valve replacement in patients with durable left ventricular assist device.
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Rao SD, Jagasia D, Anwaruddin S, and Birati EY
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- Humans, Treatment Outcome, Aortic Valve Insufficiency surgery, Heart-Assist Devices adverse effects, Thrombosis etiology, Thrombosis prevention & control, Transcatheter Aortic Valve Replacement adverse effects
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- 2021
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34. Diastolic Function and Clinical Outcomes After Transcatheter Aortic Valve Replacement: PARTNER 2 SAPIEN 3 Registry.
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Ong G, Pibarot P, Redfors B, Weissman NJ, Jaber WA, Makkar RR, Lerakis S, Gopal D, Khalique O, Kodali SK, Thourani VH, Anwaruddin S, McAndrew T, Zhang Y, Alu MC, Douglas PS, and Hahn RT
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- Aged, 80 and over, Canada, Echocardiography methods, Echocardiography statistics & numerical data, Female, Humans, Male, Outcome and Process Assessment, Health Care, Prognosis, Survival Analysis, Transcatheter Aortic Valve Replacement methods, United States, Aortic Valve Stenosis mortality, Aortic Valve Stenosis physiopathology, Aortic Valve Stenosis surgery, Heart Failure, Diastolic diagnosis, Heart Failure, Diastolic etiology, Heart Failure, Diastolic physiopathology, Patient Readmission statistics & numerical data, Postoperative Complications diagnosis, Postoperative Complications physiopathology, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
Background: Few studies have evaluated if diastolic function could predict outcomes in patients with aortic stenosis., Objectives: The authors aimed to assess the association between diastolic dysfunction (DD) and outcomes in patients with aortic stenosis undergoing transcatheter aortic valve replacement (TAVR)., Methods: Baseline, 30-day, and 1- and 2-year transthoracic echocardiograms from the PARTNER (Placement of Aortic Transcatheter Valves) 2 SAPIEN 3 registry were analyzed by a consortium of core laboratories and divided into the American Society of Echocardiography DD groups., Results: Among the 1,750 included, 682 (54.4%) had grade 1 DD, 352 (28.1%) had grade 2 DD, 168 (13.4%) had grade 3 DD, and 51 (4.1%) had indeterminate DD grade. Incremental baseline grades of DD were associated with an increase in combined 1- and 2-year cardiovascular (CV) death/rehospitalization (all p < 0.002) and all-cause death at 2 years (p = 0.01) but not at 1 year. Improvement in DD grade/grade 1 DD at 30 days post-TAVR was seen in 70.8% patients. Patients with improvement in ≥1 grade of DD/grade 1 DD had reduced 1-year CV death/rehospitalization (p < 0.001) and increased 2-year survival (p = 0.01). Baseline grade 3 DD was a predictor of 1-year CV death/rehospitalization (hazard ratio: 2.73; 95% confidence interval: 1.07 to 6.98; p = 0.04). Improvement in DD grade/grade 1 DD at 30 days was protective for 1-year CV death/rehospitalizations (hazard ratio: 0.39; 95% confidence interval: 0.19 to 0.83; p = 0.01)., Conclusions: In the PARTNER 2 SAPIEN 3 registry, baseline DD was a predictor of up to 2 years clinical outcomes in patients who underwent TAVR. Improvement in DD grade at 30 days was associated with improvement in short-term clinical outcomes. (The PARTNER II Trial: Placement of AoRTic TraNscathetER Valves II - PARTNER II - PARTNERII - S3 Intermediate [PARTNERII S3i]; NCT03222128; PARTNER II Trial: Placement of AoRTic TraNscathetER Valves II - High Risk and Nested Registry 7 [PII S3HR/NR7]; NCT03222141)., Competing Interests: Author Disclosures The PARTNER 2 trial was funded by Edwards Lifesciences. Drs. Pibarot, Weissman, Jaber, Douglas, and Hahn have echocardiographic core laboratory contracts with Edwards Lifesciences (no direct financial compensation). Dr. Makkar has received grant funding from Edwards Lifesciences and St. Jude Medical; and has received consulting fees/honoraria from Abbott Vascular, Cordis Corporation, and Medtronic. Dr. Kodali has received consulting fees/honoraria from Abbott Vascular, Merrill Lifesciences, and Claret Medical; and has served on the Scientific Advisory Boards of Thubrikar Aortic Valve Inc., Dura Biotech, and Biotrace Medical. Dr. Thourani serves on Advisory Boards for Edwards Lifesciences, Abbott Vascular, Gore Vascular, Bard Medical, JenaValve, and Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
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- 2020
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35. MitraClip for Secondary Mitral Regurgitation: Approach to the 2020 ACC/AHA Valvular Heart Disease Guidelines.
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McCauley BD, Herrmann HC, Chen T, and Anwaruddin S
- Abstract
We describe the case of an 83-year-old man with a history of ischemic cardiomyopathy and severe secondary mitral regurgitation. This case highlights the role of transcatheter edge-to-edge repair with the MitraClip in the management of symptomatic functional mitral regurgitation in a surgically unfavorable patient. ( Level of Difficulty: Advanced. )., Competing Interests: Dr. Herrmann has received institutional research funding from Abbott, Edwards Lifesciences, and Medtronic; has received consulting fees from Abbott, Edwards Lifesciences, and Medtronic; and equity from Microinterventional Devices. Dr. Anwaruddin is on the advisory board and is a speaker for Medtronic; has received speaking/consulting fees from Edwards Lifesciences; is a steering committee member for Boston Scientific; has received speaking fees from Siemens; is a proctor/consultant for V Wave; and is an advisory board member for OpSens. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2021 The Authors.)
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- 2020
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36. Who should get surgical aortic valve replacement in the era of transcatheter aortic valve replacement?-interventional cardiology perspective.
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Anwaruddin S and Herrmann HC
- Abstract
Competing Interests: Conflicts of Interest: SA: Consultant/Advisory Board/Speaker/Proctor Fees: Medtronic, Edwards Lifesciences, V wave; Grant or Research Support to the Institution: Cardiothoracic Surgical Network/NHLBI. HCH: Grants or Research Support to the Institution: Abbott Vascular, Boston Scientific, Edwards Lifesciences, Medtronic; Consulting Fees: Abbott Vascular, Edwards Lifesciences, Medtronic.
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- 2020
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37. Triage considerations for patients referred for structural heart disease intervention during the COVID-19 pandemic: An ACC/SCAI position statement.
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Shah PB, Welt FGP, Mahmud E, Phillips A, Kleiman NS, Young MN, Sherwood M, Batchelor W, Wang DD, Davidson L, Wyman J, Kadavath S, Szerlip M, Hermiller J, Fullerton D, and Anwaruddin S
- Subjects
- COVID-19, Cardiac Surgical Procedures methods, Cardiology methods, Cardiology standards, Coronavirus Infections prevention & control, Cross Infection prevention & control, Female, Heart Diseases diagnostic imaging, Humans, Male, Occupational Health statistics & numerical data, Pandemics prevention & control, Patient Safety, Pneumonia, Viral prevention & control, Societies, Medical, Triage statistics & numerical data, United States, Cardiac Surgical Procedures statistics & numerical data, Coronavirus Infections epidemiology, Heart Diseases surgery, Pandemics statistics & numerical data, Pneumonia, Viral epidemiology, Practice Guidelines as Topic, Triage standards
- Abstract
The coronavirus disease-2019 (COVID-19) pandemic has strained health care resources around the world, causing many institutions to curtail or stop elective procedures. This has resulted in an inability to care for patients with valvular and structural heart disease in a timely fashion, potentially placing these patients at increased risk for adverse cardiovascular complications, including CHF and death. The effective triage of these patients has become challenging in the current environment, as clinicians have had to weigh the risk of bringing susceptible patients into the hospital environment during the COVID-19 pandemic against the risk of delaying a needed procedure. In this document, the authors suggest guidelines for how to triage patients in need of structural heart disease interventions and provide a framework for how to decide when it may be appropriate to proceed with intervention despite the ongoing pandemic. In particular, the authors address the triage of patients in need of transcatheter aortic valve replacement and percutaneous mitral valve repair. The authors also address procedural issues and considerations for the function of structural heart disease teams during the COVID-19 pandemic., (© 2020 by the American College of Cardiology Foundation and Wiley Periodicals, Inc.)
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- 2020
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38. Systematic Approach Toward Transcatheter Treatment of BAV Disease: One Size Does Not Fit All.
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Anwaruddin S and Desai N
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- Aortic Valve surgery, Humans, Aortic Valve Stenosis surgery, Bicuspid Aortic Valve Disease, Transcatheter Aortic Valve Replacement
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- 2020
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39. Considerations for cardiac catheterization laboratory procedures during the COVID-19 pandemic perspectives from the Society for Cardiovascular Angiography and Interventions Emerging Leader Mentorship (SCAI ELM) Members and Graduates.
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Szerlip M, Anwaruddin S, Aronow HD, Cohen MG, Daniels MJ, Dehghani P, Drachman DE, Elmariah S, Feldman DN, Garcia S, Giri J, Kaul P, Kapur NK, Kumbhani DJ, Meraj PM, Morray B, Nayak KR, Parikh SA, Sakhuja R, Schussler JM, Seto A, Shah B, Swaminathan RV, Zidar DA, and Naidu SS
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- COVID-19, Cardiac Catheterization standards, Cardiology, Coronary Angiography methods, Coronavirus Infections epidemiology, Female, Hospital Mortality, Humans, Laboratories, Hospital, Leadership, Male, Mentors, Pandemics statistics & numerical data, Personal Protective Equipment statistics & numerical data, Pneumonia, Viral epidemiology, Societies, Medical, Survival Analysis, United States, Cardiac Catheterization statistics & numerical data, Coronary Angiography statistics & numerical data, Coronavirus Infections prevention & control, Cross Infection prevention & control, Pandemics prevention & control, Pneumonia, Viral prevention & control, Practice Guidelines as Topic standards
- Abstract
The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is highly infectious, carries significant morbidity and mortality, and has rapidly resulted in strained health care system and hospital resources. In addition to patient-related care concerns in infected individuals, focus must also relate to diminishing community spread, protection of staff, case selection, and concentration of resources. The current document based on available data and consensus opinion addresses appropriate catheterization laboratory preparedness for treating these patients, including procedure-room readiness to minimize external contamination, safe donning and doffing of personal protective equipment (PPE) to eliminate risk to staff, and staffing algorithms to minimize exposure and maximize team availability. Case selection and management of both emergent and urgent procedures are discussed in detail, including procedures that may be safely deferred or performed bedside., (© 2020 Wiley Periodicals LLC.)
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- 2020
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40. Papillary Muscle Rupture Due to Delayed STEMI Presentation in a Patient Self-Isolating for Presumed COVID-19.
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Kunkel KJ and Anwaruddin S
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A 57-year-old man acutely developed chest tightness and dyspnea. Given concern that his symptoms were consistent with COVID-19, the patient self-isolated. After 1 week of worsening symptoms, the patient presented with hypoxia and hypotension. He was found to have an occluded right coronary artery and ruptured posteromedial papillary muscle. ( Level of Difficulty: Beginner. )., (© 2020 The Authors.)
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- 2020
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41. Transcatheter aortic valve replacement thrombosis in patient supported with durable left ventricular assist device.
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Rao SD, Jagasia D, Anwaruddin S, and Birati EY
- Subjects
- Aortic Valve Insufficiency diagnostic imaging, Aortic Valve Insufficiency etiology, Drug Administration Schedule, Female, Heart Failure diagnosis, Heart Failure physiopathology, Heart Valve Prosthesis, Humans, Middle Aged, Perioperative Care, Risk Factors, Shock, Cardiogenic diagnosis, Shock, Cardiogenic physiopathology, Thrombosis diagnostic imaging, Thrombosis drug therapy, Transcatheter Aortic Valve Replacement instrumentation, Treatment Outcome, Anticoagulants administration & dosage, Aortic Valve Insufficiency surgery, Heart Failure therapy, Heart-Assist Devices, Shock, Cardiogenic therapy, Thrombosis etiology, Transcatheter Aortic Valve Replacement adverse effects, Ventricular Function, Left
- Abstract
Aortic insufficiency (AI) is a frequent problem after continuous-flow left ventricular assist device (LVAD) implantation and results in increased morbidity and mortality. Advances in transcatheter aortic valve replacement (TAVR) technology have resulted in this being discussed as a potential option for LVAD patients with AI. While small case series have been published, we report the first case of TAVR thrombosis in an LVAD patient. This case highlights a major diagnostic and management dilemma that should become more present if this strategy becomes more widespread., (© 2020 Wiley Periodicals, Inc.)
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- 2020
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42. Reply: Triage Considerations for Patients Referred for Structural Heart Disease Intervention During the Coronavirus Disease 2019 (COVID-19) Pandemic: An ACC/SCAI Consensus Statement.
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Shah PB, Welt FGP, Mahmud E, Phillips A, and Anwaruddin S
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- Betacoronavirus, COVID-19, Consensus, Humans, SARS-CoV-2, Treatment Outcome, Triage, Coronavirus, Coronavirus Infections, Heart Diseases, Pandemics, Pneumonia, Viral, Transcatheter Aortic Valve Replacement
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- 2020
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43. Prospective CYP2C19 Genotyping to Guide Antiplatelet Therapy Following Percutaneous Coronary Intervention: A Pragmatic Randomized Clinical Trial.
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Tuteja S, Glick H, Matthai W, Nachamkin I, Nathan A, Monono K, Carcuffe C, Maslowski K, Chang G, Kobayashi T, Anwaruddin S, Hirshfeld J, Wilensky RL, Herrmann HC, Kolansky DM, Rader DJ, and Giri J
- Subjects
- Acute Coronary Syndrome genetics, Acute Coronary Syndrome pathology, Acute Coronary Syndrome surgery, Female, Follow-Up Studies, Genotype, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Acute Coronary Syndrome drug therapy, Biomarkers analysis, Cytochrome P-450 CYP2C19 genetics, Percutaneous Coronary Intervention methods, Pharmacogenomic Testing methods, Platelet Aggregation Inhibitors therapeutic use, Polymorphism, Genetic
- Abstract
Background: CYP2C19 loss-of-function alleles impair clopidogrel effectiveness after percutaneous coronary intervention, but the clinical impact of implementing CYP2C19 genotyping in a real-world setting is unknown. The purpose of the study was to determine whether returning CYP2C19 genotype results along with genotype-guided pharmacotherapy recommendations using a rapid turnaround test would change antiplatelet prescribing following percutaneous coronary intervention.The primary outcome was the rate of prasugrel or ticagrelor prescribing in each arm. Secondary outcomes included agreement to the genotype-guided recommendations., Methods: At the time of percutaneous coronary intervention, participants were randomly assigned to prospective rapid point-of-care genotyping of CYP2C19 major alleles (*2, *3, *17) via salivary swab (genotyped group) or no genotyping (usual care) to guide antiplatelet drug selection. Interventional cardiologists at 2 cardiac catheterization laboratories within the same health system were provided genotype information along with genotype-guided pharmacotherapy recommendations., Results: A total of 504 participants were randomized, 249 to the genotyped and 255 to the usual care group. The participants were primarily men (73%); age, 63±10 years; and 50% had acute coronary syndromes. In the genotyped group, 28% were carriers of loss-of-function alleles (*2, *3). The use of prasugrel or ticagrelor was significantly higher in the genotyped group compared with the usual care group (30% versus 21%; odds ratio, 1.60 [95% CI, 1.07-2.42]; P =0.03). Within the genotyped group, 53% of loss-of-function allele carriers were started on prasugrel/ticagrelor, while 47% were started on clopidogrel., Conclusions: In a randomized controlled trial of clinical CYP2C19 genotyping implementation, pharmacogenetic test results significantly influenced antiplatelet drug prescribing; however, almost half of CYP2C19 loss-of-function carriers continued to receive clopidogrel. Interventional cardiologists consider both clinical and genetic factors when selecting antiplatelet therapy following percutaneous coronary intervention., Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique Identifier: NCT02508116.
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- 2020
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44. Moving Toward Patient-Centered Endpoints in Future Clinical Trial Design: The Customer Is Always Right.
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Anwaruddin S and Desai ND
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- Aortic Valve, Health Status, Humans, Patient-Centered Care, Aortic Valve Stenosis, Heart Valve Prosthesis
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- 2019
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45. The Lotus Valve System: an In-depth Review of the Technology.
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Seigerman ME, Nathan A, and Anwaruddin S
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- Forecasting, Humans, Prosthesis Design trends, Risk Factors, United States, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement
- Abstract
Purpose of Review: Innovation for transcatheter aortic valve replacement (TAVR) has transformed a medically complex treatment into a standardized procedure. While Edwards SAPIEN and Medtronic CoreValve occupy the market for TAVR in the United States (US), additional valve systems are being developed. The Boston Scientific Lotus Valve system was recently FDA-approved and will represent the third valve in the US market. This evidence-based review will summarize advantages, disadvantages, and projected impact of this new TAVR system., Recent Findings: The Lotus Valve system demonstrates superiority in terms of rates of paravalvular leak, with similar rates of mortality and disabling stroke. This benefit is at the expense of increased pacemaker implantation rates, though preliminary data from subsequent iterations of the Lotus Valve suggest decreasing rates over time. There is much anticipation from ongoing trials utilizing the Lotus Edge system, which may perform best for those with pre-existing pacemakers or anatomy that increases likelihood of paravalvular leak.
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- 2019
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46. Publisher Correction: Combining Biomarkers with EMR Data to Identify Patients in Different Phases of Sepsis.
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Taneja I, Reddy B, Damhorst G, Zhao SD, Hassan U, Price Z, Jensen T, Ghonge T, Patel M, Wachspress S, Winter J, Rappleye M, Smith G, Healey R, Ajmal M, Khan M, Patel J, Rawal H, Sarwar R, Soni S, Anwaruddin S, Davis B, Kumar J, White K, Bashir R, and Zhu R
- Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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- 2019
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47. Aortic Valve Stenosis Treatment Disparities in the Underserved: JACC Council Perspectives.
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Batchelor W, Anwaruddin S, Ross L, Alli O, Young MN, Horne A, Cestoni A, Welt F, and Mehran R
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- Aortic Valve Stenosis diagnosis, Humans, Aortic Valve Stenosis epidemiology, Aortic Valve Stenosis therapy, Health Status Disparities, Healthcare Disparities, Vulnerable Populations
- Abstract
Underserved minorities make up a disproportionately small subset of patients in the United States undergoing transcatheter and surgical aortic valve replacement for aortic stenosis. The reasons for these treatment gaps include differences in disease prevalence and patient, health care system, and disease-related factors. This has major implications not only for minority patients, but also for other groups who face similar challenges in accessing state-of-the-art care for structural heart disease. The authors propose the following key strategies to address these treatment disparities: 1) implementation of measure-based quality improvement programs; 2) effective culturally competent communication and team-based care; 3) improving patient health care access, education, and effective diagnosis; and 4) changing the research paradigm that creates an innovation pipeline for patients. Only a concerted effort from all stakeholders will achieve equitable and broad application of this and other novel structural heart disease treatment modalities in the future., (Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
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- 2019
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48. Self-Expanding Valve System for Treatment of Native Aortic Regurgitation by Transcatheter Aortic Valve Implantation (from the STS/ACC TVT Registry).
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Anwaruddin S, Desai ND, Szeto WY, Hermiller JB Jr, Sorajja P, Kodali S, Popma JJ, Giri J, Herrmann HC, Tang GHL, Rame JE, McCarthy FH, Zhang AQ, and Reardon MJ
- Subjects
- Aged, Aged, 80 and over, Aortic Valve Insufficiency diagnostic imaging, Cause of Death, Female, Hospital Mortality trends, Humans, Male, Multivariate Analysis, Prognosis, Proportional Hazards Models, Prosthesis Design, Retrospective Studies, Risk Assessment, Survival Rate, Treatment Outcome, Aortic Valve Insufficiency mortality, Aortic Valve Insufficiency surgery, Heart Valve Prosthesis, Registries, Transcatheter Aortic Valve Replacement methods, Transcatheter Aortic Valve Replacement mortality
- Abstract
Transcatheter aortic valve implantation (TAVI) is approved for treatment of symptomatic aortic stenosis in patients at increased risk for surgical valve replacement, but outcomes data in patients with severe native aortic regurgitation (AR) treated with TAVI remain limited. The objective of this analysis was to evaluate outcomes among patients identified in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapies Registry who underwent TAVI for native AR with a commercially available self-expanding valve system. From January 2014 to December 2017, 230 patients in the TVT Registry underwent TAVI for primary severe native AR using a commercially available self-expanding valve (n = 81, CoreValve; n = 149, Evolut R). For inclusion, AR was either pure or mixed with predominantly moderate/severe AR and mean aortic valve gradient ≤20 mm Hg. Thirty-day outcomes were evaluated using time-to-event methods. Device success was reported in 81.7% of patients (CoreValve, 72.2%; Evolut R, 86.9%; p = 0.0.01). Thirty-day all-cause mortality was 13.3%. All patients presented with moderate/severe AR at baseline; at 30 days, 9.1% of implanted patients with data continued to have moderate and 1.4% severe AR. There was a significant reduction in residual moderate/severe AR from the CoreValve to Evolut R device (19.1% vs 6.3%, p = 0.02). Multivariable analysis revealed factors associated with 30-day all-cause mortality include number of valves used (hazard ratio [HR] 2.361, 1.643 to 3.391, p <0.001), albumin < 3.3 mg/dL (HR 3.358, 1.551 to 7.273, p=0.002), and left ventricular ejection fraction (HR 0.978, 0.957 to 1.000, p = 0.047). Despite higher 30-day all-cause mortality, self-expanding TAVI may be an option in selected patients with AR who have no surgical options., (Copyright © 2019. Published by Elsevier Inc.)
- Published
- 2019
- Full Text
- View/download PDF
49. Soluble FMS-Like Tyrosine Kinase-1 Is a Circulating Biomarker Associated With Calcific Aortic Stenosis.
- Author
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Small AM, Kiss DH, Anwaruddin S, Giri J, Han Y, Zhao L, Salvador L, Cvijic ME, Li Z, Chirinos JA, Damrauer SM, and Rader DJ
- Subjects
- Aged, Aortic Valve physiopathology, Biomarkers blood, Disease Progression, Female, Hemodynamics, Humans, Male, Reproducibility of Results, Sensitivity and Specificity, Severity of Illness Index, Stroke Volume, Ventricular Function, Left, Aortic Valve pathology, Aortic Valve Stenosis blood, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis physiopathology, Calcinosis blood, Calcinosis diagnosis, Calcinosis physiopathology, Vascular Endothelial Growth Factor Receptor-1 blood
- Published
- 2019
- Full Text
- View/download PDF
50. Improving Quality and Outcomes in TAVR: Turning Up the Volume?
- Author
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Anwaruddin S and Saybolt MD
- Subjects
- Aortic Valve surgery, Humans, Prostheses and Implants, Registries, Aortic Valve Stenosis surgery, Transcatheter Aortic Valve Replacement
- Published
- 2019
- Full Text
- View/download PDF
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