Search

Your search keyword '"Attanasio, Steve"' showing total 42 results
Start Over Author "Attanasio, Steve"
42 results on '"Attanasio, Steve"'

14. Network Meta-Analysis Comparing Angiotensin Receptor-Neprilysin Inhibitors, Angiotensin Receptor Blockers, and Angiotensin-Converting Enzyme Inhibitors in Heart Failure With Reduced Ejection Fraction

Author

Park, Dae Yong, primary, An, Seokyung, additional, Attanasio, Steve, additional, Jolly, Neeraj, additional, Malhotra, Saurabh, additional, Doukky, Rami, additional, Samsky, Marc D., additional, Sen, Sounok, additional, Ahmad, Tariq, additional, Nanna, Michael G., additional, and Vij, Aviral, additional

Published
2023
Full Text
View/download PDF

15. Chronological comparison of TAVI and SAVR stratified to surgical risk: a systematic review, meta-analysis, and meta-regression

Author

Park, Dae Yong, An, Seokyung, Kassab, Kameel, Jolly, Neeraj, Attanasio, Steve, Sawaqed, Ray, Malhotra, Saurabh, Doukky, Rami, and Vij, Aviral

Abstract

Transcatheter aortic valve implantation (TAVI) has been established as a reasonable alternative to surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis. However, long-term outcomes including valve durability and the need for reintervention are unanswered, especially in younger patients who tend to be low surgical risk. We performed a meta-analysis comparing clinical outcomes after TAVI and SAVR over 5 years stratified to low, intermediate, and high surgical risks. We identified propensity score-matched observational studies and randomised controlled trials comparing TAVI and SAVR. Primary outcomes, including all-cause mortality, moderate or severe aortic regurgitation, moderate or severe paravalvular regurgitation, pacemaker placement, and stroke, were extracted. Meta-analyses of outcomes after TAVI compared to SAVR were conducted for different periods of follow-up. Meta-regression was also performed to analyse the correlation of outcomes over time. A total of 36 studies consisting of 7 RCTs and 29 propensity score-matched studies were selected. TAVI was associated with higher all-cause mortality at 4–5 years in patients with low or intermediate surgical risk. Meta-regression time demonstrated an increasing trend in the risk of all-cause mortality after TAVI compared with SAVR. TAVI was generally associated with a higher risk of moderate or severe aortic regurgitation, moderate or severe paravalvular regurgitation, and pacemaker placement. TAVI demonstrated an increasing trend of all-cause mortality compared with SAVR when evaluated over a long-term follow-up. More long-term data from recent studies using newer-generation valves and state-of-the-art techniques are needed to accurately assign risks. Transcatheter aortic valve implantation (TAVI) was associated with increased all-cause mortality at longer periods of follow-up irrespective of surgical risk. Aortic regurgitation, paravalvular regurgitation, major vascular complications, and pacemaker placement favoured surgical aortic valve replacement (SAVR) over TAVI. TAVI remained superior to SAVR in major bleeding and renal failure events. Long-term data on newer generation valves and up-to-date implantation techniques may provide better durability and improved outcomes after TAVI. TAVI had higher mortality at longer follow up irrespective of surgical risk.Aortic regurgitation and paravalvular regurgitation favour SAVR over TAVI.Major vascular complications and pacemaker placement also favour SAVR over TAVI.TAVI remains superior to SAVR in major bleeding and renal failure events.Long-term data on newer generation valves and up-to-date techniques are needed. TAVI had higher mortality at longer follow up irrespective of surgical risk. Aortic regurgitation and paravalvular regurgitation favour SAVR over TAVI. Major vascular complications and pacemaker placement also favour SAVR over TAVI. TAVI remains superior to SAVR in major bleeding and renal failure events. Long-term data on newer generation valves and up-to-date techniques are needed.

Published
2023
Full Text
View/download PDF

20. pVAD-assisted left main DK-Crush Bifurcation PCI Post-ViV TAVR

Author

Attanasio Steve, Das Anshuman, and Maria Planek Isabel Camara

Subjects
medicine.medical_specialty, business.industry, Internal medicine, Conventional PCI, Cardiology, medicine, cardiovascular diseases, business, Bifurcation
Abstract

We describe successful percutaneous coronary intervention (PCI) of significantly diseased ostial left main (LM) and distal LM bifurcation (Medina 1,1,1) in a patient with a reduced left ventricular ejection fraction and a recent valve-in-valve balloon-expandable TAVR using the DK-Crush technique with the support of a percutaneous left ventricular assist device.

Published
2021

26. TCT-350 Left vs Right Ventricular Pacing for TAVR

Author

Iskander, Mina, primary, Iskander, Fady, additional, Osman, Mohammed, additional, Abugroun, Ashraf, additional, Attanasio, Steve, additional, Suradi, Hussam, additional, Kaple, Ryan, additional, and Kavinsky, Clifford, additional

Published
2021
Full Text
View/download PDF

40. Comparison of in-hospital outcomes of ST-elevation myocardial infarction patients with cardiogenic shock receiving left ventricular mechanical circulatory support devices based on transfer status.

Author

Murthi M, Prasath N, Memdani A, Bobba A, Ali L, and Attanasio S

Abstract

Background: We aimed to compare outcomes in patients who receive on-site left ventricular mechanical support versus those transferred to other facilities for mechanical support in ST-elevation myocardial infarction (STEMI) patients with cardiogenic shock., Methods: This retrospective study analyzed data from the 2016 to 2020 Nationwide Inpatient Sample (NIS) database. We identified patients with STEMI and cardiogenic shock who received Impella and LVAD placement during their hospital stay. They were divided into two groups: those with in-house (direct) placement and those transferred to higher-level medical centers. The primary goal was to compare mortality rates between these groups., Results: During the study, 15,934 (75.2%) received in-house left ventricular support, while 5255 (24.8%) were transferred. Mean age (63 vs. 64 years) and female percentage (25 vs. 26%) were similar. The average time from admission to receiving LV support was 0.8 days for direct group versus 2.8 days for transfer group (p < 0.001). Transferred patients had a higher rate of prior heart failure (68 vs. 79%, p < 0.001) and peripheral vascular disease (10 vs. 14%, p < 0.001) but a lower rate of hypertension (23 vs. 17%, p = 0.003). There were no significant differences in other comorbidities. Primary outcome mortality did not significantly differ (44.9 vs. 44.2, p = 0.66). After multivariate analysis, transferred patients had higher rates of ECMO usage, acute kidney injury, renal replacement therapy, major bleeding, and ischemic stroke. Length of stay (8 vs. 15 days, p < 0.001) and total charges ($391,472 vs. $581,183, p < 0.001) were significantly higher in the transferred group., Conclusion: Among STEMI patients with cardiogenic shock, our study found no significant difference in mortality between patients transferred for and those with on-site LV support. Those transferred patients experienced more complications, longer length of stay, and increased hospital costs., (© 2024 Wiley Periodicals LLC.)

Published
2024
Full Text
View/download PDF

41. AngioVac debulking of a tricuspid valve mass following complex lead extraction in a rare case of Austrian syndrome: a case report.

Author

Middleton M, McDaniel G, and Attanasio S

Abstract

Background: The European Society of Cardiology recommends surgical valvular intervention in right-sided infective endocarditis for persistent vegetations >20 mm after recurrent pulmonary emboli, infection with a difficult-to-eradicate organism with >7 days of persistent bacteraemia, or tricuspid regurgitation causing right-sided heart failure. In this case report, we discuss the role of percutaneous aspiration thrombectomy for a large tricuspid valve (TV) mass as an alternative to surgery due to poor surgical candidacy in a patient with Austrian syndrome, following a complex implantable cardioverter defibrillator (ICD) device extraction., Case Summary: A 70-year-old female presented to the emergency department after being found acutely delirious at home by family. Infectious workup was notable for growth of Streptococcus pneumoniae in the blood, cerebrospinal, and pleural fluid. Transoesophageal echocardiogram was pursued in the setting of bacteraemia and revealed a mobile mass on the TV consistent with endocarditis. Given the size and embolic potential of the mass and eventual need for ICD replacement, the decision was made to pursue extraction of the valvular mass. The patient was a poor candidate for invasive surgery, so we opted to perform percutaneous aspiration thrombectomy. After the ICD device was extracted, the TV mass was successfully debulked using the AngioVac system without complication., Discussion: Percutaneous aspiration thrombectomy of right-sided valvular lesions has been introduced as a minimally invasive approach to avoid or delay valvular surgery. When intervention is indicated for TV endocarditis, AngioVac percutaneous thrombectomy may be a reasonable operative approach, particularly in patients who are at high risk for invasive surgery. We report a case of successful AngioVac debulking of a TV thrombus in a patient with Austrian syndrome., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2023
Full Text
View/download PDF

42. The clot thickens: role of mechanical thrombectomy in intermediate to high-risk pulmonary embolism in the peri-operative setting-a case report.

Author

Planek MIC, Hoster CH, Vij A, and Attanasio S

Abstract

Background: European Society of Cardiology (ESC) recommends catheter-directed thrombectomy for management of high-risk pulmonary embolism (PE) with contraindications to thrombolytics or in patients that have failed thrombolytic therapy, as well as intermediate-risk PE with haemodynamic deterioration. In this case report, the role of catheter-directed mechanical thrombectomy is highlighted in the urgent peri-operative setting., Case Summary: A 71-year-old female presented with 10 days of progressive lower extremity weakness and was found to have malignant cord compression along with incidental saddle, intermediate-high-risk PE that extended to all lobes on chest computed tomography. Given the intermediate to high-risk PE with acute cor pulmonale, urgent need for surgery, and risk of haemodynamic collapse upon induction of general anaesthesia, the decision was made to proceed with urgent percutaneous treatment of the PE. Percutaneous catheter-directed thrombectomy was successfully performed. The patient returned to the intensive care unit in stable condition and was able to then receive urgent cord decompression and further treatment for malignancy with no complication., Discussion: In this case, single-session thrombectomy resulted in rapid reduction of pre-operative cardiopulmonary risk by alleviating the right ventricular strain, allowing urgent cord decompression surgery to proceed with optimized haemodynamics, no bleeding events, and no further oxygen requirements. While peri-operative risk stratification for cardiovascular outcomes is well established in current guidelines, there are no clear guidelines for peri-operative risk stratification in the setting of pulmonary embolism. The importance of the multidisciplinary PE Response Team is thus emphasized, as well as the importance of continuous evaluation of clinical decompensation in PE., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2021
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results