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5. Electrolyte and hemodynamic changes following percutaneous left atrial appendage ligation with the LARIAT device

Author

Maybrook, Ryan, Pillarisetti, Jayasree, Yarlagadda, Vivek, Gunda, Sampath, Sridhar, Arun Raghav Mahankali, Deibert, Brent, Afzal, Muhammad R., Reddy, Madhu, Atkins, Donita, Earnest, Matthew, Ferrell, Ryan, Nath, Jayant, Kanmanthareddy, Arun, Bommana, Sudharani, Johnson, Rajasingh, Koripalli, Sandeep Reddy, Dawn, Buddhadeb, and Lakkireddy, Dhanunjaya

Published
2015
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9. LEFT ATRIAL APPENDAGE MORPHOLOGY AND CHALLENGES WITH PERCUTANEOUS LEFT ATRIAL APPENDAGE OCCLUSION

Author

Naeem, Arslan, primary, Apte, Nachiket, additional, Ranka, Sagar, additional, Pierpoline, Michael, additional, Patel, Aman, additional, Longmore, Lance, additional, Shrestha, Amit, additional, Jackson, Gregory, additional, Chandler, Jonathan, additional, Jipescu, Daniel, additional, Earnest, Matthew, additional, Sheldon, Seth H., additional, Kanagasundram, Arvindh, additional, Ellis, Christopher R., additional, Thambidorai, Senthil, additional, and Reddy, Madhu, additional

Published
2020
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10. IMPACT OF POST PROCEDURAL ANTI-COAGULATION ON POST PROCEDURAL COMPLICATIONS AND DEVICE RELATED THROMBUS IN WATCHMAN PATIENTS: A MULTI-CENTER EXPERIENCE

Author

Apte, Nachiket Madhav, primary, Patel, Aman, additional, Jackson, Gregory, additional, Naeem, Arslan, additional, Longmore, Lance, additional, Pierpoline, Michael, additional, Shrestha, Amit, additional, Earnest, Matthew, additional, Sheldon, Seth H., additional, Thambidorai, Senthil, additional, Kanagasundram, Arvindh, additional, Ellis, Christopher R., additional, and Reddy, Madhu, additional

Published
2020
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11. SAFETY AND EFFICACY OF WATCHMAN DEVICE IMPLANTATION IN PATIENTS WITH VALVULAR HEART DISEASE A MULTICENTER STUDY

Author

Shrestha, Amit, primary, Apte, Nachiket, additional, Naeem, Arslan, additional, Sheldon, Seth H., additional, Earnest, Matthew, additional, Reddy, Madhu, additional, Pierpoline, Michael, additional, Patel, Aman, additional, Thambidorai, Senthil, additional, Kanagasundram, Arvindh, additional, Jackson, Gregory, additional, Chandler, Jonathan, additional, and Ellis, Christopher R., additional

Published
2020
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12. Impact of short term oral steroid use for intravenous contrast media hypersensitivity prophylaxis in diabetic patients undergoing nonemergent coronary angiography or interventions

Author

Amr, Bashar S., primary, Lippmann, Matthew, additional, Tobbia, Patrick, additional, Isom, Nicholas, additional, Dalia, Tarun, additional, Buechler, Tyler, additional, Pierpoline, Michael, additional, Patel, Nilay, additional, Hockstad, Eric, additional, Wiley, Mark, additional, Tadros, Peter, additional, Mehta, Ashwani, additional, Earnest, Matthew, additional, Chen, John G., additional, and Gupta, Kamal, additional

Published
2019
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14. Safety and efficacy study of the wound care 360° SiteSeal® vascular closure device in percutaneous cardiac catheterization procedures.

Author

Sharma, Suresh, Patel, Nilay, Jeevanantham, Vinodh, Gupta, Kamal, and Earnest, Matthew B

Abstract

Objectives: Vascular access site complications after percutaneous transfemoral cardiovascular procedures remain a common cause of morbidity and mortality. We evaluated the SiteSeal® VCD for achieving hemostasis following diagnostic cardiac catheterization. Methods: We conducted a prospective case control single center study to assess the safety and efficacy of SiteSeal® VCD compared to standard manual compression following diagnostic cardiac catheterization. Forty patients were enrolled in study to receive either SiteSeal® device or manual compression (20 in each group). Results: Patients in the SiteSeal® group achieved hemostasis in a significantly shorter time (4 ± 2.4 vs. 19 ± 2.4 min, P < 0.001), had shorter time from hemostasis to ambulation (95 ± 44 vs. 388 ± 63 min, P < 0.001) and significantly earlier device deployment to discharge time compared to the manual compression group (4.7 ± 1.1 vs. 8.9 ± 4.8 h, P = 0.001). There was one non-major bleeding event in the SiteSeal® group which occurred >24 h after discharge from the hospital and was managed conservatively. In the remaining device patients, there was no clinical or Doppler ultrasound evidence of major or minor vascular complication with good overall patient comfort at discharge, 7 days and 30 days follow-up. Conclusions: In this first clinical experience, the SiteSeal® VCD achieved safe and efficient hemostasis, allowed for earlier ambulation and faster discharge compared to manual compression. [ABSTRACT FROM AUTHOR]

Published
2021
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17. Prognostic significance, angiographic characteristics and impact of antithrombotic and anticoagulant therapy on outcomes in high versus low grade coronary artery ectasia: A long-term follow-up study

Author

Gunasekaran, Prasad, primary, Stanojevic, Dusan, additional, Drees, Taylor, additional, Fritzlen, John, additional, Haghnegahdar, Megan, additional, McCullough, Matthew, additional, Barua, Rajat, additional, Mehta, Ashwani, additional, Hockstad, Eric, additional, Wiley, Mark, additional, Earnest, Matthew, additional, Tadros, Peter, additional, Genton, Randall, additional, and Gupta, Kamal, additional

Published
2018
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19. DUAL ANTIPLATELET THERAPY OR ORAL ANTICOAGULATION REDUCES THE INCIDENCE OF ACUTE CORONARY SYNDROMES IN PATIENTS WITH CORONARY ARTERY ECTASIA

Author

Gunasekaran, Prasad C., primary, Drees, Taylor, additional, Fritzlen, John, additional, Haghnegahdar, Megan, additional, Earnest, Matthew, additional, Mehta, Ashwani, additional, Hockstad, Eric, additional, Wiley, Mark, additional, Tadros, Peter, additional, Dawn, Buddhadeb, additional, and Gupta, Kamal, additional

Published
2018
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20. Left Atrial Appendage Tachycardia Termination With A LARIAT Suture Ligation

Author

Atoui, Moustapha, Pillarisetti, Jayasree, Iskandar, Sandia, Earnest, Matthew, and Lakkireddy, Dhanunjaya

Subjects
cardiovascular system, Case Report, cardiovascular diseases
Abstract

Left atrial appendage (LAA) is a known trigger for left atrial tachycardia (AT). The use of LARIAT epicardial suture for termination of AT arising from LAA is not yet reported.

Published
2015

21. Safety profiles of percutaneous left atrial appendage closure devices: An analysis of the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database from 2009 to 2016

Author

Jazayeri, Mohammad-Ali, primary, Vuddanda, Venkat, additional, Turagam, Mohit K., additional, Parikh, Valay, additional, Lavu, Madhav, additional, Atkins, Donita, additional, Earnest, Matthew, additional, Di Biase, Luigi, additional, Natale, Andrea, additional, Wilber, David, additional, Reddy, Yeruva Madhu, additional, and Lakkireddy, Dhanunjaya R., additional

Published
2017
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22. CLINICAL PRESENTATION, NATURAL HISTORY AND MANAGEMENT OF CORONARY ARTERY ECTASIA

Author

Gunasekaran, Prasad C., primary, Masoomi, Reza, additional, Stanojevic, Dusan, additional, Drees, Taylor, additional, Fritzlen, John, additional, Haghnegahdar, Megan, additional, McCullough, Matthew, additional, Mehta, Ashwani, additional, Earnest, Matthew, additional, Wiley, Mark, additional, Hockstad, Eric, additional, Tadros, Peter, additional, and Gupta, Kamal, additional

Published
2017
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23. SAFETY AND FEASIBILITY OF ROTATIONAL ATHERECTOMY IN ELDERLY PATIENTS WITH SEVERE AORTIC STENOSIS AND CALCIFIC CORONARY ARTERY DISEASE UNDERGOING EVALUATION FOR TRANSCATHETER AORTIC VALVE REPLACEMENT

Author

Lippmann, Matthew, primary, Patel, Jigar, additional, Kvapil, Jared, additional, Pierpoline, Michael, additional, Tadros, Peter, additional, Wiley, Mark, additional, Earnest, Matthew, additional, Mehta, Ashwani, additional, Hockstad, Eric, additional, and Gupta, Kamal, additional

Published
2017
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24. Use of non-warfarin oral anticoagulants instead of warfarin during left atrial appendage closure with the Watchman device

Author

Enomoto, Yoshinari, primary, Gadiyaram, Varuna K., additional, Gianni, Carola, additional, Horton, Rodney P., additional, Trivedi, Chintan, additional, Mohanty, Sanghamitra, additional, Di Biase, Luigi, additional, Al-Ahmad, Amin, additional, Burkhardt, J. David, additional, Narula, Arvin, additional, Janczyk, Gwen, additional, Price, Matthew J., additional, Afzal, Muhammad R., additional, Atoui, Moustapha, additional, Earnest, Matthew, additional, Swarup, Vijay, additional, Doshi, Shephal K., additional, van der Zee, Sarina, additional, Fisher, Rebecca, additional, Lakkireddy, Dhanunjaya R., additional, Gibson, Douglas N., additional, Natale, Andrea, additional, and Reddy, Vivek Y., additional

Published
2017
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25. Abstract 19610: Safety of Percutaneous Left Atrial Appendage Suture Ligation: Results From the Largest Us Registry

Author

Dhanunjaya Lakkireddy, Sampath Gunda, Muhammad R Afzal, Madhu Reddy, Randall J Lee, Jayant Nath, Hosakote Nagaraj, Christopher Ellis, Eric Altman, Brian Lee, David Wilber, Saibal Kar, Ryan Ferrell, Sudharani Bommana, Donita Atkins, Nitish Bhadwar, Mauricio Sanchez, Varuna Gadiyaram, David Tschopp, Rudolph Evonich, Abdi Rasekh, Jie Cheng, Douglas Gibson, and Earnest Matthew

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Background: Epicardial ligation of left atrial appendage (LAA) is an attractive alternative to oral anticoagulation for patients with atrial fibrillation and high risk of bleeding. Objectives: To delineate the safety of epicardial ligation of the LAA for stroke prevention in atrial fibrillation Methods: This is a retrospective, multicenter registry of consecutive patients undergoing LAA ligation with the LARIAT device at 14 U.S. sites. The primary endpoint was procedural success, defined as device success (suture deployment and Results: A total of 610 patients underwent LARIAT exclusion of LAA. The mean age of the participants was 71 (SD: ± 10) years. The mean CHADs2VASc and HASBLED score was 2.74(±1.33) and 3.87 (±1.8) respectively. Epicardial access was obtained using micro-puncture needle in 60 percent of the cases. The acute closure was achieved in 554 (91 %) patients. Cardiac perforation needing continued drainage and transfusion occurred in 12 patients (1.96 %). Perforation of epigastric artery occurred in 2 patients (0.3 %). Eight patients (1.3 %) required open heart surgery. Five patients required > 2 weeks of treatment for pericarditis. No myocardial infarction or stroke happened in the peri-procedural period. One patient died as complication of the procedure. A follow up transesophageal echocardiogram (TEE) was performed in 76 % of the patients that showed a leak of < 5 mm and thrombus in 49 (8 %) and 12 (1.96 %) patients respectively. Conclusions: In this largest multicenter experience of LAA ligation with the LARIAT device, the rate of acute closure was high with significantly fewer complications compared to limited contemporary data. The use of micro-puncture is probably safer approach to avoid cardiac injury during epicardial access. A prospective randomized trial is required to adequately define clinical efficacy, optimal post-procedure medical therapy, and the effect of operator experience on procedural safety.

Published
2015

26. Short and long-term outcomes of percutaneous left atrial appendage suture ligation: Results from a US multicenter evaluation

Author

Rudolph Evonich, Abdi Rasekh, Randall J. Lee, Eric Altman, Muhammad R. Afzal, David J. Wilber, Saibal Kar, Frank Cuoco, Brett Gidney, Ryan Ferrell, Sampath Gunda, Donita Atkins, Christopher Ellis, Madhu Reddy, Nitish Bhadwar, Varuna Gadiyaram, Mauricio Sanchez, Hosakote Nagaraj, Sheetal Chandhok, Phillip S. Cuculich, Jie Cheng, Jayant Nath, David Tschopp, Douglas N. Gibson, Earnest Matthew, Dhanunjaya Lakkireddy, Sudharani Bommana, and Brian Lee

Subjects
Male, medicine.medical_specialty, Leak, Percutaneous, Atrial Appendage, Long Term Adverse Effects, Punctures, 030204 cardiovascular system & hematology, 03 medical and health sciences, Pericarditis, 0302 clinical medicine, Postoperative Complications, Physiology (medical), Internal medicine, Atrial Fibrillation, medicine, Humans, 030212 general & internal medicine, Registries, Thrombus, Intraoperative Complications, Ligation, Aged, Suture ligation, business.industry, Cardiovascular Surgical Procedures, Atrial fibrillation, Middle Aged, medicine.disease, United States, Surgery, Outcome and Process Assessment, Health Care, Heart Injuries, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Published studies of epicardial ligation of left atrial appendage (LAA) have reported discordant results.The purpose of this study was to delineate the safety and efficacy of LAA closure with the LARIAT device.This is a multicenter registry of 712 consecutive patients undergoing LAA ligation with LARIAT at 18 US hospitals. The primary end point was successful suture deployment, no leak by intraprocedural transesophageal echocardiography (TEE), and no major complication (death, stroke, cardiac perforation, and bleeding requiring transfusion) at discharge. A leak of 2-5 mm on follow-up TEE was the secondary end point.LARIAT was successfully deployed in 682 patients (95.5%). A complete closure was achieved in 669 patients (98%), while 13 patients (1.8%) had a trace leak (2 mm). There was 1 death related to the procedure. Ten patients (1.44%) had cardiac perforation necessitating open heart surgery, while another 14 (2.01%) did not need surgery. The risk of cardiac perforation decreased significantly after the introduction of a micropuncture (MP) needle for pericardial access. Delayed complications (pericarditis requiring2 weeks of treatment with nonsteroidal anti-inflammatory drugs/colchicine and pericardial and pleural effusion after discharge) occurred in 34 (4.78%) patients, and the risk decreased significantly with the periprocedural use of colchicine. Follow-up TEE (n = 480) showed a leak of 2-5 mm in 6.5% and a thrombus in 2.5%. One patient had a leak of5 mm.LARIAT effectively closes the LAA and has acceptable procedural risks with the evolution of the use of the micropuncture needle for pericardial access and the use of colchicine for mitigating the postinflammatory response associated with LAA ligation and pericardial access.

Published
2015

28. ST-Segment Elevation Myocardial Infarction: What Role for Anticoagulants and Antiplatelet Agents?

Author

Earnest, Matthew B. and Tadros, Peter N.

Subjects
Heart attack -- Drug therapy -- Patient outcomes -- Care and treatment, Anticoagulants (Medicine) -- Dosage and administration, Cardiac patients -- Care and treatment -- Drug therapy -- Patient outcomes, Blood platelets -- Aggregation, Health, Drug therapy, Care and treatment, Patient outcomes, Dosage and administration
Abstract

Byline: MATTHEW B. EARNEST, MD and PETER N. TADROS, MD ABSTRACT: Aspirin is recommended for all patients with ST-segment elevation myocardial infarction (STEMI). Clopidogrel also should be used in all [...]

Published
2007

29. Non-ST-Segment Elevation MI and Unstable Angina: What Role for Anticoagulants and Antiplatelet Agents?

Author

Earnest, Matthew B.

Subjects
Heparin -- Research, Glycoproteins -- Research, Angina pectoris -- Research -- Risk factors -- Care and treatment, Thrombin -- Research, Acute disease -- Research -- Risk factors -- Care and treatment, Health, Care and treatment, Research, Risk factors
Abstract

Byline: MATTHEW B. EARNEST, MD and PETER N. TADROS, MD ABSTRACT: Antiplatelet agents used to treat non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina include aspirin, clopidogrel, and glycoprotein (GP) [...]

Published
2007

30. DOES LEFT ATRIAL APPENDAGE EXCLUSION USING AN EPICARDIAL SYSTEM REDUCE SYSTEMIC BLOOD PRESSURES? THE DAWN OF A NEW FRONTIER

Author

Lakkireddy, Dhanunjaya R., primary, Rajasingh, Johnson, additional, Iskandar, Sandia, additional, Afzal, Muhammad, additional, Earnest, Matthew, additional, Atkins, Donita, additional, Bommana, Sudharani, additional, Di Biase, Luigi, additional, Salzberg, Sacha, additional, Ramlawi, Basel, additional, Gopinathannair, Rakesh, additional, Natale, Andrea, additional, and Cox, James, additional

Published
2016
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31. THE ROLE OF REMOTE ISCHEMIC PRECONDITIONING IN THE PREVENTION OF CONTRAST INDUCED NEPHROPATHY

Author

Tobbia, Patrick, primary, Kimber, Cassandra, additional, Jang, Ben, additional, Levine, Micah, additional, Abdoullayev, Alisher, additional, Funk, Robert, additional, Jacobs, David, additional, Wiley, Mark, additional, Mehta, Ashwani, additional, Earnest, Matthew, additional, Tadros, Peter, additional, Dawn, Buddhadeb, additional, and Gupta, Kamal, additional

Published
2016
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32. IMPACT OF LEFT ATRIAL APPENDAGE EXCLUSION ON SYSTEMIC HOMEOSTASIS (THE LAA HOMEOSTASIS STUDY)

Author

Lakkireddy, Dhanunjaya R., primary, Atkins, Donita, additional, Rajasingh, Johnson, additional, Afzal, Muhammad, additional, Reddy, Madhu, additional, Earnest, Matthew, additional, Kanmanthareddy, Arun, additional, Bommana, Sudharani, additional, Nath, Jayant, additional, Ferrell, Ryan, additional, Bormann, Steven, additional, Jaeger, Melissa, additional, Lee, Randall, additional, Bartus, Krysztof, additional, and Ryshon, Kay, additional

Published
2016
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33. EXPERIENCE OF PERCUTANEOUS LEFT ATRIAL APPENDAGE SUTURE LIGATION: RESULTS FROM A UNITED STATES MULTICENTER EVALUATION

Author

Afzal, Muhammad Rizwan, primary, Lee, Randall, additional, Nagaraj, Hosakote, additional, Tschopp, David, additional, Gidney, Brett, additional, Ellis, Christopher, additional, Kar, Saibal, additional, Gadiyaram, Varuna, additional, Evonich, Rudolph, additional, Rasekh, Abdi, additional, Cheng, Jie, additional, Cuoco, Frank, additional, Chandhok, Sheetal, additional, Gunda, Sampath, additional, Iskandar, Sandia, additional, Reddy, Madhu, additional, Atkins, Donita, additional, Bommana, Sudharani, additional, Cuculich, Phillip, additional, Gibson, Douglas, additional, Nath, Jayant, additional, Earnest, Matthew, additional, Wilber, David, additional, and Lakkireddy, Dhanunjaya, additional

Published
2016
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34. Impact of Periprocedural Colchicine on Postprocedural Management in Patients Undergoing a Left Atrial Appendage Ligation Using LARIAT

Author

GUNDA, SAMPATH, primary, REDDY, MADHU, additional, NATH, JAYANT, additional, NAGARAJ, HOSAKOTE, additional, ATOUI, MOUSTAPHA, additional, RASEKH, ABDI, additional, ELLIS, CHRISTOPHER R., additional, BADHWAR, NITISH, additional, LEE, RANDALL J., additional, DI BIASE, LUIGI, additional, MANSOUR, MOUSSA, additional, RUSKIN, JEREMY N., additional, NATALE, ANDREA, additional, EARNEST, MATTHEW, additional, and LAKKIREDDY, DHANUNJAYA R., additional

Published
2015
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35. Endocardial (Watchman) vs epicardial (Lariat) left atrial appendage exclusion devices: Understanding the differences in the location and type of leaks and their clinical implications

Author

Pillarisetti, Jayasree, primary, Reddy, Yeruva Madhu, additional, Gunda, Sampath, additional, Swarup, Vijay, additional, Lee, Randall, additional, Rasekh, Abdi, additional, Horton, Rodney, additional, Massumi, Ali, additional, Cheng, Jie, additional, Bartus, Krzystzof, additional, Badhwar, Nitish, additional, Han, Frederick, additional, Atkins, Donita, additional, Bommana, Sudharani, additional, Earnest, Matthew, additional, Nath, Jayant, additional, Ferrell, Ryan, additional, Bormann, Steven, additional, Dawn, Buddhadeb, additional, Di Biase, Luigi, additional, Mansour, Moussa, additional, Natale, Andrea, additional, and Lakkireddy, Dhanunjaya, additional

Published
2015
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36. INTRAVENOUS ADENOSINE INFUSION IS SAFE AND WELL TOLERATED DURING CORONARY FRACTIONAL FLOW RESERVE ASSESSMENT IN SEVERE AORTIC STENOSIS

Author

Stanojevic, Dusan A., primary, Gunasekaran, Prasad, additional, Levine, Micah, additional, Reichuber, Mark, additional, Genton, Randall, additional, Mehta, Ashwani, additional, Earnest, Matthew, additional, Wiley, Mark, additional, Tadros, Peter, additional, Dawn, Buddhadeb, additional, and Gupta, Kamal, additional

Published
2015
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37. Impact of left atrial appendage exclusion using an epicardial ligation system (LARIAT) on atrial fibrillation burden in patients with cardiac implantable electronic devices

Author

Afzal, Muhammad R., primary, Kanmanthareddy, Arun, additional, Earnest, Matthew, additional, Reddy, Madhu, additional, Atkins, Donita, additional, Bommana, Sudharani, additional, Bartus, Krystof, additional, Rasekh, Abdi, additional, Han, Fred, additional, Badhwar, Nitish, additional, Cheng, Jie, additional, Dibiase, Luigi, additional, Ellis, Christopher R., additional, Dawn, Buddhadeb, additional, Natale, Andrea, additional, Lee, Randall J., additional, and Lakkireddy, Dhanunjaya, additional

Published
2015
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39. HYPONATREMIA AND HEMODYNAMIC CHANGES FOLLOWING PERCUTANEOUS LEFT ATRIAL APPENDAGE LIGATION WITH THE LARIAT DEVICE

Author

Maybrook, Ryan, primary, Pillarisetti, Jayasree, additional, Yarlagadda, Vivek, additional, Sridhar, Arun Raghav Mahankali, additional, Reddy, Madhu, additional, Dawn, Buddhadeb, additional, Earnest, Matthew, additional, Ferrell, Ryan, additional, Nath, Jayant, additional, Kanmanthareddy, Arun, additional, Atkins, Donita, additional, Bommana, Sudharani, additional, Johnson, Rajasingh, additional, and Lakkireddy, Dhanunjaya, additional

Published
2014
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40. LEFT ATRIAL APPENDAGE LIGATION AND ABLATION FOR PERSISTENT ATRIAL FIBRILLATION (LAALA-AF REGISTRY)

Author

Lakkireddy, Dhanunjaya R., primary, Reddy, Madhu, additional, Sridhar, Arun Raghav Mahankali, additional, Pillarisetti, Jayasree, additional, Maybrook, Ryan, additional, Kanmanthareddy, Arun, additional, Earnest, Matthew, additional, Swarup, Vijay, additional, Atkins, Donita, additional, Bommana, Sudharani, additional, Nath, Jayant, additional, Ferrell, Ryan, additional, and Dawn, Buddhadeb, additional

Published
2014
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41. Abstract 18610: Left Atrial Thrombus Formation After the Left Atrial Appendage Exclusion With a Novel Endoepicardial Suture Device (LARIAT®)

Author

Vallakati, Ajay, primary, Reddy, Madhu Y, additional, Gibson, Doug, additional, Price, Matthew, additional, Feldman, Ted, additional, Knight, Bradley, additional, Cheng, Jie, additional, Lee, Randall, additional, Earnest, Matthew, additional, Nath, Jayant, additional, Ferrell, Ryan, additional, Atkins, Donita, additional, Bommana, Sudharani, additional, Loyolka, Pranav, additional, and Lakkireddy, Dhanunjaya, additional

Published
2013
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42. EFFECT OF ENDOEPICARDIAL PERCUTANEOUS LEFT ATRIAL APPENDAGE LIGATION (LARIAT) ON ARRHYTHMIA BURDEN IN PATIENTS WITH ATRIAL FIBRILLATION

Author

Lakkireddy, Dhanunjaya R., primary, Earnest, Matthew, additional, Janga, Pramod, additional, Reddy, Madhu, additional, Vallakati, Ajay, additional, Nath, Jayant, additional, Ferrell, Ryan, additional, Freeman, Steven, additional, Badhwar, Nitish, additional, Lee, Randall, additional, Biase, Luigi Di, additional, Natale, Andrea, additional, and Swarup, Vijay, additional

Published
2013
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43. Performance Characteristics of Polyethylene Terephthalate (PET) Modified Asphalt

Author

Earnest, Matthew D

Subjects
ETD, Civil Engineering, Transportation Engineering, Jack N. Averitt College of Graduate Studies, Electronic Theses & Dissertations, ETDs, Student Research
Abstract

Polyethylene terephthalate (PET) plastic is utilized primarily in food and beverage packaging. Although a portion of waste PET is recycled, the majority of the waste is buried in landfills. Therefore, the use of ground PET particles in asphalt may provide an environmentally friendly solution for the disposal of large quantities of PET waste. This study evaluated the performance of PET as an asphalt modifier with both asphalt binder and asphalt mixture testing. The binder testing was conducted on wet process blends produced with a high shear mixer at PET contents of 5, 10, and 15 percent by weight of the binder. Dynamic Shear Rheometer (DSR) and Rotational Viscosity (RV) tests were performed on the unaged and Rolling Thin Film Oven (RTFO) aged mixtures. The mixture tests were conducted on the PET modified mixtures in both wet and dry process, and an unmodified control mixture. The wet and dry process mixtures contained 10% PET by weight of the binder. The mixture performance tests included Asphalt Pavement Analyzer (APA) rutting test, retrofitted APA Hamburg test, Indirect Tensile Strength (ITS), and Asphalt mixture Performance Tester (AMPT) dynamic modulus. The results showed: 1) the addition of PET increased the high temperature performance resulting in a bump in PG grade. Additionally, the viscosity and resulting workability of the modified binders were not adversely affected. 2) PET modified mixtures have higher maximum specific gravity and lower bulk specific gravity than the control mixture. 3) The wet process mixture exhibited better rutting resistance and a higher TSR than the control in ITS testing. 4) The dry process mixture exhibited better resistance to permanent moisture damage in APA Hamburg testing and also exhibited a higher TSR than the control in ITS testing. 5) The modified mixtures exhibited lower E* and higher phase angles than the control in AMPT modulus testing.

Published
2015

44. Left Atrial Appendage Tachycardia Termination With A LARIAT Suture Ligation.

Author

Atoui, Moustapha, Pillarisetti, Jayasree, Iskandar, Sandia, Earnest, Matthew, and Lakkireddy, Dhanunjaya

Subjects
*TACHYCARDIA treatment, *HYPERTENSION
Abstract

Left atrial appendage (LAA) is a known trigger for left atrial tachycardia (AT). The use of LARIAT epicardial suture for termination of AT arising from LAA is not yet reported. A 66-year-old female had a history of hypertension, diabetes, sick sinus syndrome, labile INR, and symptomatic persistent AF. She underwent radiofrequency ablation after failed cardioversion and multiple antiarrhythmics. She was in AT originating from LAA on activation map. Radiofrequency endocardial LAA isolation was performed. However, the AT recurred with increased burden and symptoms. Due to her multiple hospitalization for spontaneous bleeds and labile INR, a Lariat epicardial suture ligation of her LAA was performed. With application of the Lariat suture, electrical isolation was achieved and the AT terminated. She remained AT free at 18 months. Our case is the first to illustrate the utility of LARIAT suture in electrical isolation of the LAA in addition to its mechanical exclusion. [ABSTRACT FROM AUTHOR]

Published
2016

45. Safety and Feasibility of Rotational Atherectomy in Elderly Patients With Severe Aortic Stenosis.

Author

Lippmann M, Patel J, Kvapil J, Westover D, Pierpoline M, Tadros P, Wiley M, Zorn G 3rd, Muehlebach G, Mehta A, Hockstad E, Earnest M, and Gupta K

Subjects
Aged, Aged, 80 and over, Elective Surgical Procedures methods, Female, Humans, Male, Monitoring, Intraoperative methods, Outcome and Process Assessment, Health Care, Risk Adjustment methods, Severity of Illness Index, United States, Vascular Calcification diagnosis, Vascular Calcification surgery, Aortic Valve diagnostic imaging, Aortic Valve surgery, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis surgery, Atherectomy, Coronary adverse effects, Atherectomy, Coronary methods, Coronary Artery Disease diagnosis, Coronary Artery Disease surgery, Coronary Vessels diagnostic imaging, Coronary Vessels surgery, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention methods
Abstract

Background: Percutaneous coronary intervention (PCI) followed by transcatheter aortic valve replacement (TAVR) is an alternative to surgery in patients with severe aortic stenosis (AS) and coronary artery disease (CAD). In many, the coronary arteries are severely calcified and best treated with rotational atherectomy (RA). However, RA is not routinely performed in severe AS patients due to safety concerns. There is a paucity of data on the safety of RA in severe AS patients with calcific CAD., Methods: We retrospectively analyzed the medical records of 29 patients with severe AS who underwent elective RA-facilitated PCI at our center between January 1, 2011 and December 31, 2015., Results: Twenty-nine patients (mean age, 79.8 ± 8.8 years) were enrolled. Mean aortic valve area was 0.71 ± 0.20 cm², mean aortic valve gradient was 40.32 ± 9.88 mm Hg. All PCIs were successful (mean diameter stenosis, 86.3 ± 7.6%; mean burr size, 1.62 ± 0.19 mm). Nineteen patients (65.5%) required temporary pacemaker. Eight patients (27.6%) required vasopressors during PCI. There was a significant reduction in systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) during RA, but without clinical events. No procedure was aborted and there were no deaths or clinical myocardial infarctions., Conclusion: RA-facilitated PCI can be safely performed in elderly patients with severe AS and severely calcified CAD with low risk of complications. There was a significant but transient drop in SBP, DBP, MAP, and HR during RA. However, this was not associated with clinically significant adverse events.

Published
2017

46. Intravenous Adenosine Infusion is Safe and Well Tolerated During Coronary Fractional Flow Reserve Assessment in Elderly Patients With Severe Aortic Stenosis.

Author

Stanojevic D, Gunasekaran P, Tadros P, Wiley M, Earnest M, Mehta A, Lippmann M, Levine M, Dawn B, and Gupta K

Subjects
Academic Medical Centers, Aged, Aged, 80 and over, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis epidemiology, Cardiac Catheterization methods, Cohort Studies, Comorbidity, Coronary Stenosis diagnostic imaging, Coronary Stenosis epidemiology, Female, Follow-Up Studies, Fractional Flow Reserve, Myocardial physiology, Geriatric Assessment, Humans, Infusions, Intravenous, Male, Patient Safety, Preoperative Care methods, Retrospective Studies, Risk Assessment, Severity of Illness Index, Texas, Treatment Outcome, Adenosine administration & dosage, Aortic Valve Stenosis therapy, Coronary Stenosis therapy, Fractional Flow Reserve, Myocardial drug effects, Transcatheter Aortic Valve Replacement methods
Abstract

Background: This study assessed the safety of intravenous adenosine infusion during fractional flow reserve (FFR) evaluation of intermediate coronary lesions in severe aortic stenosis (AS). In severe AS, the extent of underlying coronary artery disease (CAD) can be an important determinant for deciding between surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). Hemodynamic assessment of coronary lesion severity using FFR may reduce the extent of revascularization needed and make TAVR more feasible in higher-risk patients (compared with coronary artery bypass surgery with SAVR)., Methods and Results: We retrospectively analyzed the demographic, clinical, and hemodynamic parameters of 72 patients with severe AS who underwent FFR procedure with intravenous adenosine infusion for hemodynamic assessment of intermediate coronary artery lesions. Severe AS patients were elderly, predominantly male, and had a high prevalence of peripheral arterial disease, prior myocardial infarction, left ventricular hypertrophy, and chronic kidney disease. Mean aortic valve area in these patients was 0.71 ± 0.24 cm². No patient with severe AS required discontinuation of the adenosine and all patients tolerated the infusion well. We observed a statistically significant reduction in systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) during adenosine infusion compared with the baseline values. However, no clinically significant adverse events occurred., Conclusion: In elderly patients with severe AS, adenosine infusion is safe and well tolerated during FFR evaluation of intermediate coronary lesions. There was a significantly greater drop in SBP, DBP, MAP, and HR with adenosine infusion as compared with baseline values. This, however, was not associated with clinically significant adverse events.

Published
2016

47. Left Atrial Appendage Tachycardia Termination With A LARIAT Suture Ligation.

Author

Atoui M, Pillarisetti J, Iskandar S, Earnest M, and Lakkireddy D

Abstract

Left atrial appendage (LAA) is a known trigger for left atrial tachycardia (AT). The use of LARIAT epicardial suture for termination of AT arising from LAA is not yet reported. A 66-year-old female had a history of hypertension, diabetes, sick sinus syndrome, labile INR, and symptomatic persistent AF. She underwent radiofrequency ablation after failed cardioversion and multiple antiarrhythmics. She was in AT originating from LAA on activation map. Radiofrequency endocardial LAA isolation was performed. However, the AT recurred with increased burden and symptoms. Due to her multiple hospitalization for spontaneous bleeds and labile INR, a Lariat epicardial suture ligation of her LAA was performed. With application of the Lariat suture, electrical isolation was achieved and the AT terminated. She remained AT free at 18 months. Our case is the first to illustrate the utility of LARIAT suture in electrical isolation of the LAA in addition to its mechanical exclusion.

Published
2015
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