Transcatheter edge-to-edge repair for the management of secondary mitral regurgitation - CRT 2025 Beyond the Guidelines.

Secondary mitral regurgitation (SMR) remains a prevalent and challenging complication in patients with heart failure (HF), associated with poor prognosis despite optimal guideline-directed medical therapy (GDMT) and cardiac resynchronization therapy. Current American and European guidelines recommend GDMT as first-line therapy, with transcatheter edge-to-edge repair (TEER) reserved for severe symptomatic SMR patients who remain refractory. However, both guidelines preceded the reporting of pivotal randomized controlled trials (RESHAPE-HF2, MATTERHORN, and EFFORT) and emerging evidence in new clinical scenarios.

Treatment of Ostial Left Anterior Descending Coronary Artery Lesions: to Cross or not to Cross.

None.

Decision-making in valve reintervention: Redo-Transcatheter aortic valve replacement vs. explant surgery.

Objective: Data remain limited on factors influencing the selection of redo-transcatheter aortic valve replacement (TAVR) versus surgical explant in patients with failing transcatheter heart valves. This study aimed to identify clinical and procedural factors guiding treatment decisions.

Methods: This single-center, retrospective study included all patients who underwent aortic valve reintervention following prior TAVR at a U.

Exploring the impact of age on microvascular function: Insights from the coronary microvascular disease registry.

Background: Coronary microvascular dysfunction (CMD) contributes to angina without obstructive coronary artery disease (ANOCA). Although aging is known to impact cardiovascular health, its effect on coronary microvascular function remains unclear. This study examined the relationship between age and microvascular function in patients with ANOCA.

Novel Use of the RevCore Device in Extensive Subacute Iliocaval Thrombus.

A 49-year-old female presented with subacute onset of severe worsening bilateral lower extremity swelling. Bilateral iliac venous thrombus and extensive thrombus of the inferior vena cava with extension to the right atrium and bilateral segmental pulmonary emboli was identified on imaging. She was initiated on therapeutic anticoagulation prior to undergoing percutaneous mechanical thrombectomy with the RevCore TM device (Inari Medical, Irvine, CA) with retrieval of white, relatively well-formed organized clot vs mass.

Artificial intelligence approach to optimise safety for hospitalised patients with dementia.

Background: The aim of the study is to develop a machine learning (ML) model to identify contributing factors to dementia-related safety events using patient safety event report data.

Method: This study uses dementia-related safety event reports from a patient safety reporting system of a 10-hospital health system in the USA. Contributing factors to safety events were coded using the Yorkshire contributory factors framework based on free-text descriptions in the reports.

Antibiotic therapy for severe bacterial infections.

Background: Early antibiotic therapy for patients with severe infections is essential to improve outcomes. Conversely, use of overly broad antibiotic therapy for susceptible pathogens or unnecessary antibiotics in patients without bacterial infections is associated with adverse life-threatening events and superinfections. Antibiotics-induced changes in the human microbiota alter both immune and metabolic systems.

Racial and Ethnic Disparities in Catheter Ablation Utilization for Atrial Fibrillation: A Systematic Review and Meta-Analysis.

Background: Racial and ethnic disparities in catheter ablation (CA) utilization for atrial fibrillation have been reported, but inconsistent estimates complicate comparisons and understanding of root causes of disparity.

Objectives: The purpose of this study was to quantify CA disparities by race/ethnicity, explore sources of heterogeneity, and offer recommendations for standardized definitions and methods to improve research.

Methods: We systematically searched MEDLINE, Embase, Web of Science, and Cochrane's CENTRAL from inception to January 15, 2024, for U.

Impact of proning with and without inhaled pulmonary vasodilators and neuromuscular blocking agents in COVID acute respiratory distress syndrome.

Background: A major cause of mortality in the coronavirus disease 2019 (COVID-19) pandemic was acute respiratory distress syndrome (ARDS). Currently, moderate to severe ARDS induced by COVID-19 (COVID ARDS) and other viral and non-viral etiologies are treated by traditional ARDS protocols that recommend 12-16 hours of prone position ventilation (PPV) with neuromuscular blocking agents (NMBA) and a trial of inhaled vasodilators (IVd) if oxygenation does not improve. However, debate on the efficacy of adjuncts to PPV and low tidal volume ventilation persists and evidence about the benefits of IVd/NMBA in COVID ARDS is sparse.

Bridging diagnostic safety and mental health: a systematic review highlighting inequities in autism spectrum disorder diagnosis.

Introduction: There is increased recognition that diagnostic errors disproportionately affect marginalised and underserved patient populations in the USA. However, evidence on diagnostic inequities in mental disorders is sparse and not well integrated into the overall diagnostic safety literature.

Objective: We systematically reviewed and narratively synthesised evidence on inequities in diagnosis of mental disorders, guided by the Diagnostic Process Framework developed by The National Academies of Sciences, Engineering, and Medicine.

Iatrogenic VSDs After TAVRs and Electrophysiologic Implications.

Background: Iatrogenic ventricular septal defects (VSDs) are rare but important complications of transcatheter aortic valve replacement (TAVR). In patients who develop conduction abnormalities post-TAVR, the presence of a VSD can complicate pacing strategies.

Case Summary: We report 2 cases of perimembranous VSDs after TAVR, both complicated by conduction disease and managed with left bundle branch pacing (LBBP).

Pilot Study on Resuscitation Volume's Effect on Perfusion and Inflammatory Cytokine Expression in Peri-Burn Skin: Implications for Burn Conversion.

Fluid resuscitation after thermal injury is paramount to avoid burn shock and restore organ perfusion. Both over- and under-resuscitation can lead to unintended consequences affecting patient outcomes. While many studies have examined systemic effects, limited data exist on how fluid resuscitation impacts burn wound progression in the acute period.

Barriers to Effective Treatment of Genitourinary Syndrome of Menopause: A Qualitative Study on Patient Perspectives on Vaginal Estrogen.

Introduction And Hypothesis: Vaginal estrogen therapy is widely accepted as a safe and effective treatment for symptoms of genitourinary syndrome of menopause (GSM), yet it is likely underutilized owing to various factors relating to patient perceptions, barriers to access, and health care system outreach. The aim of our study is to explore patient beliefs and opinions regarding its use.

Methods: A qualitative study was conducted with patients prescribed vaginal estrogen at an ambulatory urogynecology office between October 2022 and August 2023.

In-Hospital Mortality Risk Among Transfers to Cardiac Intensive Care Units.

Background: Patients treated in tertiary cardiac intensive care units (CICUs) often arrive via transfer from other hospitals. This "transfer population" is poorly described and has been largely excluded from trials in critical care.

Objectives: The aim of this study was to characterize patients who are transferred from other hospitals to advanced CICUs.

Racial Differences in Length of Stay After Atrial Fibrillation Ablation.

Background: Racial and sex disparities in catheter ablation (CA) utilization for atrial fibrillation (AF) have been documented. Less is known about race and sex differences in comorbidity burden and quality of care outcomes after CA.

Objectives: We sought to characterize racial and sex differences in patient and procedural characteristics and their impact on prolonged length of stay (LOS) after CA for AF.

Endothelial dysfunction in areas of unburned skin in a burn injury model.

Introduction: Burn shock is mediated by a complex inflammatory response leading to endothelial cell dysfunction (EnD) and increased vascular permeability in large total body surface area (TBSA) injuries. Smaller TBSA burns do not induce systemic EnD. Previous studies in animal models have examined systemic markers of endothelial cell dysfunction following thermal injury and have aimed to characterize this dysfunction in various end organs.

Treatment Effects of the Integrated Perinatal Diabetes Education and Management Program.

Objective: The Integrated Perinatal Diabetes Education and Management Program (IP-DEMP) was launched to improve outcomes of pregnant and postpartum individuals with diabetes at a large, urban academic hospital system. The purpose of this study was to evaluate treatment outcomes achieved by program participants.

Research Design And Methods: This retrospective cohort study compared diabetes treatment received by participants in the IP-DEMP with diabetes treatment in a historical comparison group at the same health care facility just before implementation of the IP-DEMP.

The Single Coronary Artery: A Rare Anatomic Variant.

We report the case of a 67-year-old female with heart failure and a reduced ejection fraction (25%). Angiography revealed that all of her major coronary vessels stemmed from a single ostium at the right aortic sinus.

Differential expression of NOTCH Signaling genes in tissue collected from hidradenitis suppurativa patients.

Hidradenitis suppurativa (HS) is a morbid chronic inflammatory skin disease that can be treated at burn centers through surgical intervention. Despite multiple pathogenesis theories, the genetic basis of sporadic HS remains largely unknown. This study investigates differences in regulation of multiple genes between normal skin (NS) and HS samples in skin of color patients.

Endovascular Revascularization: A Limb Salvage Strategy After Lower Extremity Burns.

Introduction: Wound complications and amputations are common after lower extremity burn injury in patients with diabetes mellitus (DM). Endovascular revascularization has the potential to promote wound healing and limb salvage in this patient population but has yet to be evaluated. This study describes a burn center's experience incorporating endovascular revascularization into the acute management of lower extremity burns.

"Ignite & engage:" A mixed methods evaluation of a peer-led, school-based substance use prevention program.

Background: Substance use often begins in adolescence, making early identification and prevention essential to avert downstream harms, including substance use disorders. This study evaluated the impact of a peer-led, school-based storytelling program on participating middle- and high school students.

Methods: A cross-sectional, anonymous, online survey was distributed from 2014 to 2020 to Midwestern middle and high-schoolers who had attended a school-based event, "Ignite & Engage," led by a recovery community organization (RCO).