Sex-Specific Disparities in the Female Vs Male Patient Population in Left Ventricular Assist Device Use.

Women remain severely underrepresented in clinical trials, leading to a significant disparity in clinical care and outcome among male vs female patients with advanced heart failure (HF). Sex-specific disparities regarding the etiology of HF, time to diagnosis, severity of disease at time of index hospitalization, response to treatment, and treatment options, including use of temporary or durable mechanical circulatory support devices, may affect women unfavourably. Lack of knowledge regarding sex-specific complications has had an impact on the overall higher mortality level in women vs men.

Peri-operative fever and LVAD: SIRS or impaired right ventricular strain?

Background: An inflammatory milieu after left ventricular assist device (LVAD) implantation is associated with multi-organ dysfunction and pre-operative heightened inflammatory state is associated with right ventricular failure after LVAD implantation.

Methods: We performed a retrospective analysis of 30 LVAD patients in our institution within the last 2 years for the development of fever and compared them to 30 non-LVAD open-heart surgery patients.

Results: Our results suggest that patients undergoing LVAD implantation are more likely to develop fever in the immediate post-operative period compared to other open-heart surgeries.

Optical Coherence Tomography in the Assessment and Management of Cardiac Allograft Vasculopathy.

Purpose Of Review: Cardiac Allograft vasculopathy (CAV) is a major barrier to improving outcomes after heart transplantation. Coronary angiography has very low sensitivity to detect early CAV and intravascular ultrasound (IVUS) only improves it to some extent. In this article, we detail the current evidence surrounding use of Optical Coherence tomography (OCT) in patients with CAV.

The impact of the OPTN policy change on patients with a durable left ventricular assist device and chronic kidney disease: Analysis of the UNOS database.

Background: The Organ Procurement and Transplantation Network (OPTN) implemented modifications in 2018 to the adult heart transplant allocation system to better stratify the most medically urgent transplant candidates. We evaluated the impact of these changes on patients supported by a durable left ventricular assist device (LVAD) with chronic kidney disease (CKD).

Objective: To evaluate the impact of the OPTN policy change on patients supported by durable left ventricular assist devices (LVAD) with chronic kidney disease (CKD).

Outcomes of outflow graft stenting in HeartMate 3 left ventricular assist devices: A systematic review and individual patient data meta-analysis.

Purpose: LVAD outflow graft stenosis continues to remain prevalent with a high complication rate. We sought to pool the existing evidence on indications, utilization patterns, and outcomes of transcatheter interventions for outflow graft stenosis in the HeartMate 3 LVAD.

Methods: An electronic search was performed to identify all studies in the English literature reporting on HeartMate 3 LVAD outflow graft stenting.

Microaxial mechanical circulatory support after orthotopic heart transplantation.

Aim: Use of microaxial mechanical circulatory support (MCS) has been reported for severe graft rejection or dysfunction after heart transplantation (HTx). We aimed to assess utilization patterns of microaxial MCS after HTx in adolescents (ages 18 and younger) and adults (ages 19 and older).

Methods: Electronic search was performed to identify all relevant studies on post-HTx use of microaxial support in adults and adolescents.

Determinants of pulmonary hypertension in patients with end-stage kidney disease and arteriovenous access.

Background: Pulmonary Hypertension (PH) is a sequela of arteriovenous (AV) fistulas (AVF) or AV grafts (AVG) in patients with end-stage kidney disease (ESKD) due to the creation of shunt physiology and increased pulmonary blood flow. PH has been consistently associated with increased mortality but there is a paucity of data regarding management.

Research Question: The objective of this study was to identify risk factors and outcomes in patients who develop PH after AVF or AVG creation for hemodialysis access.

Left Main Coronary Artery Aneurysm Surgical Treatment by "No-Touch" Technique With Concomitant Left Ventricular Assist Device.

A 57-year-old man with a known left main coronary artery aneurysm presented with acutely decompensated heart failure and ventricular tachycardia secondary to ST elevation myocardial infarction. Transthoracic echocardiography identified a left ventricular ejection fraction <20% and anterior/septal wall akinesis. Left-sided cardiac catheterization revealed left anterior descending coronary artery occlusion.

A multicenter evaluation of the HeartMate 3 risk score.

Background: The Heartmate 3 (HM3) risk score (HM3RS) was derived and validated internally from within the Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate 3 (MOMENTUM 3) trial population and provides 1- and 2-year mortality risk prediction for patients in those before HM3 left ventricular assist device (LVAD) implantation. We aimed to evaluate the HM3RS in nontrial unselected patients, including those not meeting inclusion criteria for MOMENTUM 3 trial enrollment.

Methods: Patients who underwent HM3 LVAD implant at 1 of 7 US centers between 2017 and 2021, with at least 1-year follow-up, were included in this analysis.

Trends in cardiovascular complications of pregnancy: A nationwide inpatient sample analysis.

Background: Cardiovascular disease (CVD) is the leading cause of pregnancy-related mortality in the United States. Physiologic stress of pregnancy can induce several hemodynamic changes that contribute to an increased risk of cardiac complications in the peripartum period. There are ongoing efforts to improve cardiovascular mortality in pregnant patients.

Transcatheter Edge-to-Edge Repair for Tricuspid Regurgitation-A Systematic Review and Meta-Analysis.

Transcatheter edge-to-edge repair (TEER) has emerged as a widely accepted procedure for tricuspid regurgitation (TR) as gauged by echocardiographic parameters and clinical outcomes. Our study aims to assess TR severity and other echocardiographic outcomes in patients undergoing TEER with TriClip, MitraClip, and PASCAL devices. A literature search of 5 databases was performed until 1st June 2023.

Aortic Valve Replacement in Patients With ESRD and Heart Failure With Reduced Ejection Fraction.

Transcatheter aortic valve replacement (TAVR) has become the standard of care for the treatment of all patients with calcific aortic stenosis. Patients with end-stage renal disease (ESRD) on hemodialysis were excluded from participation in many of the seminal trials proving the safety and efficacy of TAVR. The outcomes of TAVR in the ESRD population from a national registry showed significantly higher in-hospital and 1-year mortality compared with patients not on hemodialysis.

Natriuretic peptide biomarkers in the imminent development of preeclampsia.

Preeclampsia is the most common cause of morbidity and mortality in pregnancy, the incidence being significantly higher in low-income countries with reduced access to health care. Women with preeclampsia are at a higher risk of developing cardiovascular disease with a poorer long-term outcome. Early recognition and treatment are key to improving short- and long-term outcomes.

Transcatheter Aortic Valve Implantation in Cardiac Amyloidosis and Aortic Stenosis.

Aortic stenosis (AS) and cardiac amyloidosis (CA) occur concomitantly in a significant number of patients and portend a higher risk of all-cause mortality. Previous studies have investigated outcomes in patients with concomitant CA/AS who underwent transcatheter aortic valve implantation (TAVI) versus medical therapy alone, but no evidence-based consensus regarding the ideal management of these patients has been established. Medline, Scopus, and Cochrane Central Register of Controlled Trials were systematically searched to identify relevant studies.

Adverse outcomes of atrial fibrillation ablation in heart failure patients with and without cardiac amyloidosis: a Nationwide Readmissions Database analysis (2015-2019).

Aims: Atrial fibrillation (AF) in patients with cardiac amyloidosis (CA) has been linked with a worse prognosis. The current study aimed to determine the outcomes of AF catheter ablation in patients with CA.

Methods And Results: The Nationwide Readmissions Database (2015-2019) was used to identify patients with AF and concomitant heart failure.

Microaxial circulatory support for percutaneous coronary intervention: A systematic review and meta-analysis.

Background: Microaxial circulatory support devices have been used to support patients treated with percutaneous coronary intervention (PCI) for acute myocardial infarction complicated by cardiogenic shock (AMICS). The purpose of this systematic review and meta-analysis was to pool and analyze the existing evidence on the baseline characteristics, periprocedural data, and outcomes of microaxial support before and after PCI in AMICS.

Methods: An electronic database search was performed to identify all cohort studies on Impella and PCI for cardiogenic shock in the English language.

COVID-19 associated development of antibody mediated rejection in orthotopic heart transplantation patients.

Solid organ transplant candidates encountered increased wait times and mortality rates during the coronavirus 2019 (COVID-19) pandemic. Despite improvement in medical management and vaccination efficacy, this patient population remains at increased risk for complications post COVID-19 including organ rejection. We describe the development of antibody mediated rejection with or without cellular rejection in heart transplant (HT) recipients and previous COVID-19 infection or vaccination.

Trends and outcomes of cardiogenic shock in Asian populations compared with non-Asian populations in the US: NIS Analysis (2002-2019).

Background: Current understanding of outcomes of cardiogenic shock (CS) in Asian populations is limited. We aim to study the clinical outcomes of CS in Asian population compared with non-Asians in the US.

Methods: The National Inpatient Sample (NIS) database was queried between 2002-2019 to identify hospitalizations with CS.