An Integrated Pressure-Volume Loop and Pulmonary Artery Catheter.

An admittance technology (AT) pulmonary artery catheter was developed to measure instantaneous right ventricular (RV) pressure-volume loops. Admittance RV volumes were validated in vivo through 10 swine subjected to positive and negative hemodynamic perturbations compared with magnetic resonance imaging and ex vivo RV foam casts. Finite element analysis demonstrated the AT electric field was confined to RV blood volume.

Histology-Grounded Automated Plaque Subtype Segmentation in Intravascular Optical Coherence Tomography.

Background: Intravascular optical coherence tomography (IVOCT) adoption has been limited by the complexity of image interpretation. The interpretation of histologic subtypes beyond lipid, calcium, and fibrous is challenging to human readers. To assist and standardize IVOCT image analysis, we demonstrate an artificial intelligence algorithm based on a histology data set that identifies lipid pools, fibrofatty, calcified lipid, and calcified fibrous in human coronary arteries for the first time.

Measurement of left ventricular volume with admittance incorporated onto percutaneous ventricular assist device.

Percutaneous ventricular assist devices (pVADs) incorporated with admittance electrodes have been validated in animal studies for accurate instantaneous volumetric measurements. Since miniaturization of the pVAD profile is a priority to reduce vascular complications in patients, our study aimed to validate admittance measurements using three electrodes instead of the standard four. Complex admittance was measured between an electrode pair and a pVAD metallic blood-intake tip, both with finite element analysis and on the benchtop.

Review of intravascular lithotripsy for treating coronary, peripheral artery, and valve calcifications.

Management of intracoronary calcium (ICC) continues to be a challenge for interventional cardiologists. There have been significant advances in calcium treatment devices. However, there still exists a knowledge gap regarding which devices to choose for the treatment of ICC.

Intravascular laser lithotripsy for calcium fracture in human coronary arteries.

Background: Electrical intravascular lithotripsy (E-IVL) uses shock waves to fracture calcified plaque.

Aims: We aimed to demonstrate the ability of laser IVL (L-IVL) to fracture calcified plaques in ex vivo human coronary arteries and to identify and evaluate the mechanisms for increased vessel compliance.

Methods: Shock waves were generated by a Ho:YAG (Holmium: yttrium-aluminium-garnet) laser (2 J, 5 Hz) and recorded by a high-speed camera and pressure sensor.

Open Radial Artery Study.

Radial artery occlusion (RAO) has been the most common postprocedural complication of transradial artery access. The optimal method of prevention of RAO is still lacking. In our study, we aimed to evaluate the effect of patent hemostasis on early (24 hours) and late (2 weeks) RAO prevention.

Mechanical circulatory support versus vasopressors alone in patients with acute myocardial infarction and cardiogenic shock undergoing percutaneous coronary intervention.

Background: Previous studies have compared Impella use to intra-aortic balloon pump (IABP) use in patients with acute myocardial infarction and cardiogenic shock (AMI-CS) undergoing percutaneous coronary intervention (PCI). Our objective was to compare clinical outcomes in patients with AMI-CS undergoing PCI who received Impella (percutaneous left ventricular assist device) without vasopressors, IABP without vasopressors, and vasopressors without mechanical circulatory support (MCS).

Methods: We queried the National Inpatient Sample (NIS) using ICD-10 codes (2015-2018) to identify patients with AMI-CS undergoing PCI.

Thrombosis and myocardial infarction: the role of bioresorbable scaffolds.

Coronary stents have dramatically improved the treatment of coronary artery stenosis. In-stent-restenosis (ISR) and stent thrombosis (ST) pose major obstacles to the success of coronary stenting. Drug-eluting stents (DES) emerged as a major breakthrough in stenting and significantly reduced ISR.

Modification of a Transvalvular Microaxial Flow Pump for Instantaneous Determination of Native Cardiac Output and Volume.

Background: The current Impella cardiopulmonary (CP) pump, used for mechanical circulatory support in patients with cardiogenic shock (CS), cannot assess native cardiac output (CO) and left ventricular (LV) volumes. These data are valuable in facilitating device management and weaning. Admittance technology allows for accurate assessment of cardiac chamber volumes.

Smart Drain for Post-Cardiac Surgery Left Ventricular Volumes Evaluated in Large Animal Models.

Background: Open heart surgeries for coronary arterial bypass graft and valve replacements are performed on 400,000 Americans each year. Unexplained hypotension during recovery causes morbidity and mortality through cerebral, kidney, and coronary hypoperfusion. An early detection method that distinguishes between hypovolemia and decreased myocardial function before onset of hypotension is desirable.

Data automated bag breathing unit for COVID-19 ventilator shortages.

Background: The COVID-19 pandemic has caused a global mechanical ventilator shortage for treatment of severe acute respiratory failure. Development of novel breathing devices has been proposed as a low cost, rapid solution when full-featured ventilators are unavailable. Here we report the design, bench testing and preclinical results for an 'Automated Bag Breathing Unit' (ABBU).

Coronary Stent Healing in Cancer Patients-An Optical Coherence Tomography Perspective.

This study assessed stent healing patterns and cardiovascular outcomes by optical coherence tomography (OCT) in cancer patients after drug-eluting stent (DES) placement. Cancer treatment, owing to its cytotoxic and antiproliferative effects, could delay stent healing and increase stent thrombosis risk, especially when dual antiplatelet therapy (DAPT) is discontinued early for oncological treatment. OCT can assess stent endothelialization and other healing parameters, which may provide clinical guidance in these challenging scenarios.

Physiologic Assessment of Coronary Stenosis: Current Status and Future Directions.

Purpose Of Review: Percutaneous coronary intervention (PCI) is a commonly used treatment option in coronary artery disease (CAD). Reduced major adverse cardiovascular events (MACE) in those randomized to PCI compared to optimal medical therapy have been demonstrated only if it is performed for physiologically significant coronary lesions. Despite data demonstrating improved outcomes primarily in stable CAD and then acute settings, physiology-guided PCI remains underutilized.

Munchausen by internet and false perinatal crises.

Background: In representative cases of Munchausen by internet (MBI), an individual (or "poser") goes online to falsely report or exaggerate illnesses or life crises. The principal goal, as in factitious disorder imposed on self or another, is to garner emotional satisfaction. We provide the first evidence that MBI can target a specific type of health care provider-in this case, birthing doulas.

Implantable Cardiac Kirigami-Inspired Lead-Based Energy Harvester Fabricated by Enhanced Piezoelectric Composite Film.

Harvesting biomechanical energy to power implantable electronics such as pacemakers has been attracting great attention in recent years because it replaces conventional batteries and provides a sustainable energy solution. However, current energy harvesting technologies that directly interact with internal organs often lack flexibility and conformability, and they usually require additional implantation surgeries that impose extra burden to patients. To address this issue, here a Kirigami inspired energy harvester, seamlessly incorporated into the pacemaker lead using piezoelectric composite films is reported, which not only possesses great flexibility but also requires no additional implantation surgeries.

Flexible Energy Harvester on a Pacemaker Lead Using Multibeam Piezoelectric Composite Thin Films.

Implantable medical devices, such as cardiac pacemakers and defibrillators, rely on batteries for operation. However, conventional batteries only last for a few years, and additional surgeries are needed for replacement. Harvesting energy directly from the human body enables a new paradigm of self-sustainable power sources for implantable medical devices without being constrained by the battery's limited lifetime.

Multifunctional Pacemaker Lead for Cardiac Energy Harvesting and Pressure Sensing.

Biomedical self-sustainable energy generation represents a new frontier of power solution for implantable biomedical devices (IMDs), such as cardiac pacemakers. However, almost all reported cardiac energy harvesting designs have not yet reached the stage of clinical translation. A major bottleneck has been the need of additional surgeries for the placements of these devices.

Assessment of Vascular Patency and Inflammation with Intravascular Optical Coherence Tomography in Patients with Superficial Femoral Artery Disease Treated with Zilver PTX Stents.

Purpose: Zilver PTX nitinol self-expanding drug-eluting stent with paclitaxel coating is effective for treatment of superficial femoral artery (SFA) disease. However, as with any stent, it induces a measure of vascular inflammatory response. The current clinical trial (NCT02734836) aimed to assess vascular patency, remodeling, and inflammatory markers with intravascular optical coherence tomography (OCT) in patients with SFA disease treated with Zilver PTX stents.

Laser brain cancer surgery in a xenograft model guided by optical coherence tomography.

Higher precision surgical devices are needed for tumor resections near critical brain structures. The goal of this study is to demonstrate feasibility of a system capable of precise and bloodless tumor ablation. An image-guided laser surgical system is presented for excision of brain tumors in a murine xenograft model.