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von Buchwald CL, Mohammed M, Shpilsky D, Frisoli T, Lee J, Engel Gonzalez PA, Wang DD, O'Neill B, O'Neill WW, Villablanca PA. Contemporary experience of percutaneous management of complex aortic and ventricular pseudoaneurysms associated to perivalvular leak: A case series and review of literature. Cardiovasc Revasc Med 2024; 62:105-118. [PMID: 38212236 DOI: 10.1016/j.carrev.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Percutaneous closure of aortic and ventricular pseudoaneurysms (PSA) has only been reported on a case report and series basis. In previous case reports, percutaneous closure has been performed successfully in patients of prohibitive surgical risk. This case series aims to show feasibility of percutaneous closure of aortic and ventricular pseudoaneurysm secondary to perivalvular leak (PVL) in a small patient population and the utility of multimodality imaging as an integral tool in procedural planning. This is the largest complex case series to date describing the feasibility and success rate of complex PSA closure, with a follow-up period of up to 4 years. MATERIAL AND METHODS We performed institutional review and systemic literature review to identify all paravalvular leak cases with associated pseudoaneurysm formation for which a closure procedure was performed. Ten patients were identified. Pooled analysis for cases from institutional review (n = 10) and systemic literature review (n = 39) was performed. The success rate was 100 %. At 30-days, the mortality was 0 %. CONCLUSION In paravalvular leak patients with subsequent pseudoaneurysm formation, exhaustive imaging evaluation is required for closure. However, it can be achievable with favorable rates of success.
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Affiliation(s)
| | - Mustafa Mohammed
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Daniel Shpilsky
- Center for Structural Heart Disease, Henry Ford Hospital, Cardiology Division, Detroit, MI, USA
| | - Tiberio Frisoli
- Center for Structural Heart Disease, Henry Ford Hospital, Cardiology Division, Detroit, MI, USA
| | - James Lee
- Center for Structural Heart Disease, Henry Ford Hospital, Cardiology Division, Detroit, MI, USA
| | - Pedro A Engel Gonzalez
- Center for Structural Heart Disease, Henry Ford Hospital, Cardiology Division, Detroit, MI, USA
| | - Dee Dee Wang
- Center for Structural Heart Disease, Henry Ford Hospital, Cardiology Division, Detroit, MI, USA
| | - Brian O'Neill
- Center for Structural Heart Disease, Henry Ford Hospital, Cardiology Division, Detroit, MI, USA
| | - William W O'Neill
- Center for Structural Heart Disease, Henry Ford Hospital, Cardiology Division, Detroit, MI, USA
| | - Pedro A Villablanca
- Center for Structural Heart Disease, Henry Ford Hospital, Cardiology Division, Detroit, MI, USA
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Fang JX, O'Neill BP, Wang DD, Giustino G, von Buchwald CL, Lee JC, Engel Gonzalez P, Frisoli TM, O'Neill WW, Villablanca PA. Feasibility and technicality of aortic valve lithotripsy-facilitate balloon valvuloplasty in patients with severe aortic stenosis unsuitable for immediate valvular replacement. Cardiovasc Revasc Med 2024:S1553-8389(24)00171-4. [PMID: 38670866 DOI: 10.1016/j.carrev.2024.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Aortic valve lithotripsy can fragment aortic valve calcium deposits and potentially restore leaflet pliability in animal model and ex-vivo, but clinical data is limited. Transcatheter aortic valve implantation (TAVR) might not be feasible as an urgent procedure in critically ill patients. Balloon valvuloplasty has the major limitation of valve recoil and inducing aortic regurgitation. AIMS To determine the clinical feasibility of aortic valve lithotripsy-facilitated balloon valvuloplasty in patients with severe aortic stenosis unsuitable for valvular replacement. METHODS We performed lithotripsy as adjunctive therapy to balloon aortic valvuloplasty in ten consecutive patients, most of whom were deemed unfit for TAVR. Lithotripsy of the aortic valve was performed with simultaneous inflation of one to three peripheral lithotripsy balloons to deliver ultrasound pulses. Rapid pacing was not used during lithotripsy. Aortic valve velocity, gradient, and valve area were measured before and after the procedure by echocardiogram. Transvalvular pressure gradient was recorded intra-procedurally. Periprocedural and ninety-day clinical outcomes were followed. RESULTS Procedure was technically successful in 9 out of 10 patients and aborted in one patient due to cardiogenic shock. One patient had femoral closure device related complication. There was a statistically significant decrease in valvular gradient and increase in aortic valve area. 9 out of 10 patients recovered from acute episode and were discharged. 6 patients had improvement in NYHA class. 4 patients were subsequently able to receive TAVR. 90-day mortality occurred in 3 patients. There was no stroke or bradyarrhythmia peri-procedurally and no heart failure hospitalization at 90 days. CONCLUSION Aortic valve lithotripsy-facilitated balloon valvuloplasty has reasonable feasibility, safety and technical reproducibility and acute clinical result. Hemodynamic effect is similar to that of balloon valvuloplasty reported in the literature. Subsequent Prognosis is not altered in critically ill patients.
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Affiliation(s)
- Jonathan X Fang
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, MI, USA; Cardiology Division, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong.
| | - Brian P O'Neill
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, MI, USA
| | - Dee Dee Wang
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, MI, USA
| | - Gennaro Giustino
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, MI, USA
| | | | - James C Lee
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, MI, USA
| | | | - Tiberio M Frisoli
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, MI, USA
| | - William W O'Neill
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, MI, USA
| | - Pedro A Villablanca
- Center for Structural Heart Disease, Henry Ford Health System, Detroit, MI, USA.
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Shpilsky D, von Buchwald CL, Villablanca PA, O'Neill BP, Engel Gonzalez P, Frisoli T, Lee J, Guruswamy J, Yeldo N, Reeser N, Song T, O'Neill WW, Wang DD. 3D print and multi-modality imaging guided transcatheter closure of multiple left ventricular pseudoaneurysms. Echocardiography 2023; 40:1285-1291. [PMID: 37842844 DOI: 10.1111/echo.15694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/23/2023] [Accepted: 09/07/2023] [Indexed: 10/17/2023] Open
Abstract
Left ventricular pseudoaneurysm (PSA) after surgical aortic valve replacement (AVR) is a known but uncommon complication. It is associated with risks such as thromboembolism and life-threatening rupture. Surgical repair has traditionally been utilized in low-risk patients but transcatheter closure has become a promising therapeutic option. This case report describes the utility of multimodality imaging in pre-, intra-, and post-procedural evaluation of transcatheter PSA closure and is among the first to demonstrate the utility of 3D print model.
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Affiliation(s)
- Daniel Shpilsky
- Center for Structural Heart Disease, Henry Ford Health, Detroit, USA
| | | | | | - Brian P O'Neill
- Center for Structural Heart Disease, Henry Ford Health, Detroit, USA
| | | | - Tiberio Frisoli
- Center for Structural Heart Disease, Henry Ford Health, Detroit, USA
| | - James Lee
- Center for Structural Heart Disease, Henry Ford Health, Detroit, USA
| | - Jayakar Guruswamy
- Center for Structural Heart Disease, Henry Ford Health, Detroit, USA
| | - Nicholas Yeldo
- Center for Structural Heart Disease, Henry Ford Health, Detroit, USA
| | - Nicholas Reeser
- Center for Structural Heart Disease, Henry Ford Health, Detroit, USA
| | - Thomas Song
- Center for Structural Heart Disease, Henry Ford Health, Detroit, USA
| | - William W O'Neill
- Center for Structural Heart Disease, Henry Ford Health, Detroit, USA
| | - Dee Dee Wang
- Center for Structural Heart Disease, Henry Ford Health, Detroit, USA
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Madan N, von Buchwald CL, Golemi L, Iskander M, Attanasio S. Aspiration of Right Sided Intracardiac Masses in High-Risk Surgical Patients Using AngioVac: A Case Series and Review of Literature. Cardiovasc Revasc Med 2023; 53S:S253-S261. [PMID: 36089455 DOI: 10.1016/j.carrev.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/22/2022]
Abstract
Management of large right heart thrombi and vegetations is challenging. Medical management may be insufficient to prevent embolization or treat infection. Surgery carries a high mortality and is often not an option for these patients with multiple comorbidities. We present a case series of four patients describing percutaneous aspiration thrombectomy with AngioVac device as a safe and effective treatment for high-risk patients with right heart thrombi or tricuspid valvular vegetations. Indexing words.
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Affiliation(s)
- Nidhi Madan
- Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States of America.
| | - Claudia Lama von Buchwald
- Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States of America
| | - Lolita Golemi
- Rush Medical College, Chicago, IL, United States of America
| | - Mina Iskander
- Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States of America
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Lama von Buchwald C, Gonzalez PE, O'Neill B, Wang DD, Frisoli T, O'Neill WW, Villablanca PA. Percutaneous Retrieval of an Aortic Valve Vegetation Causing Severe Regurgitation and Cardiogenic Shock. JACC Cardiovasc Interv 2023; 16:1301-1303. [PMID: 37140503 DOI: 10.1016/j.jcin.2023.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 05/05/2023]
Affiliation(s)
| | - Pedro Engel Gonzalez
- Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA
| | - Brian O'Neill
- Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA
| | - Dee Dee Wang
- Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA
| | - Tiberio Frisoli
- Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA
| | | | - Pedro A Villablanca
- Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA
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Lama von Buchwald C, Sanghani R. PET myocardial perfusion imaging in the diagnosis of apical hypertrophic cardiomyopathy. J Nucl Cardiol 2022; 29:1452-1456. [PMID: 33034834 DOI: 10.1007/s12350-020-02344-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Affiliation(s)
| | - Rupa Sanghani
- Department of Cardiology, Rush University Medical Center, Chicago, USA
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Bortnick AE, Lama von Buchwald C, Hasani A, Liu C, Berkowitz JL, Vega S, Mustehsan MH, Wolfe DS, Taub C. Persistence of abnormal global longitudinal strain in women with peripartum cardiomyopathy. Echocardiography 2021; 38:885-891. [PMID: 33963787 DOI: 10.1111/echo.15071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/15/2021] [Accepted: 04/24/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Data regarding the longitudinal relationship of global longitudinal strain (GLS) and echocardiographic parameters are lacking in peripartum cardiomyopathy (PPCM). We evaluated GLS and its correlation with change (∆) in left ventricular ejection fraction (LVEF). METHODS We retrospectively identified women age ≥16 years hospitalized at Montefiore Medical Center in Bronx, NY from 1999-2015 with International Statistical Classification of Diseases and Related Health Problems, 9th revision codes for PPCM or an occurrence of unexplained heart failure during or up to 5 months postpartum. N = 195 charts were reviewed for inclusion/exclusion criteria, n = 53 patients met criteria for PPCM, and of those, n = 13 had a baseline and follow-up echocardiogram suitable for GLS analysis. RESULTS Of those eligible for strain analysis, the mean age was 30 ± 6 years, 46.2% identified as Black and 38.5% as Hispanic/Latina. Baseline LVEF was 30 (25, 35)%, GLS was -13.2 (-14, -7.6)%. At a mean follow-up time of 1.2 ± 0.7 years, 11/13 had persistently mild -15.6 (-16.3, -12.7)%, and 2/13 severely abnormal GLS -7.05 (-7.1, -7.0)%. There was no correlation between baseline GLS and ∆LVEF (r = .014, P = .965). CONCLUSIONS Global longitudinal strain is a sensitive method to identify subclinical myocardial dysfunction. In this series of women with PPCM, GLS remained persistently abnormal over time, even if LVEF improved. Future studies should examine the implication of persistently abnormal GLS in PPCM.
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Affiliation(s)
- Anna E Bortnick
- Division of Cardiology, At Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.,Division of Geriatrics, At Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.,Maternal Fetal Medicine-Cardiology Joint Program, At Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Aliaskar Hasani
- Department of Medicine, At Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Christina Liu
- Department of Emergency Medicine, Mount Sinai/Morningside West, New York, NY, USA
| | - Julia L Berkowitz
- Department of Medicine, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Shayna Vega
- Department of Obstetrics and Gynecology, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
| | - Mohammad Hashim Mustehsan
- Division of Cardiology, At Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Diana S Wolfe
- Maternal Fetal Medicine-Cardiology Joint Program, At Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Obstetrics and Gynecology, At Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Cynthia Taub
- Department of Cardiovascular Medicine, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine, Lebanon, NH, USA
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von Buchwald CL, Marinescu K, Rao A, Mody NS, Tatooles A, Suboc TM. BEYOND THE USUAL SUSPECTS: LATE COMPLICATION MONTHS POST MYOCARDIAL INFARCTION. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)33837-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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von Buchwald CL, Swearingen S, Marinescu K, Suboc TM, Rao A. TWICE AS ANOMALOUS: CARDIOGENIC SHOCK DUE TO “RIGHT MAIN DISEASE”. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)34021-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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von Buchwald CL, Gomez JMD, Vanloozen D, Collado F, Amin Z, Kavinsky C, Suradi HS. CONTEMPORARY TRENDS AND OUTCOMES OF PATENT FORAMEN OVALE CLOSURE. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31276-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Fonseca Fuentes X, Kashyap R, Hays JT, Chalmers S, Lama von Buchwald C, Gajic O, Gallo de Moraes A. VpALI-Vaping-related Acute Lung Injury: A New Killer Around the Block. Mayo Clin Proc 2019; 94:2534-2545. [PMID: 31767123 DOI: 10.1016/j.mayocp.2019.10.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 10/14/2019] [Indexed: 01/21/2023]
Abstract
The use of electronic cigarettes, known as vaping, has become increasingly popular over the past decade, particularly in the adolescent and young adult population, often exposing users to harmful chemicals. Vaping has been associated with a heterogeneous group of pulmonary disease. Recently, a multistate epidemic has emerged surrounding vaping-related acute lung injury, prompting the Centers for Disease Control and Prevention to list an official health advisory. In this review, we describe the current literature on the epidemiology, clinical significance, as well as recommended evaluation and treatment of vaping-related lung injury.
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Affiliation(s)
| | - Rahul Kashyap
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - J Taylor Hays
- Department of General Internal Medicine, Nicotine Dependence Center, Mayo Clinic, Rochester, MN
| | - Sarah Chalmers
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | | | - Ognjen Gajic
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
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Goldberg AB, Lama von Buchwald C, Kalra DK, Rao AK. An Unusual Cardiac Metastasis: Right Atrial Chondrosarcoma Diagnosed With Multimodality Cardiac Imaging. ACTA ACUST UNITED AC 2019; 3:162-166. [PMID: 31468019 PMCID: PMC6710901 DOI: 10.1016/j.case.2019.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Metastatic cardiac tumors are about 20 times more common than primary cardiac tumors. Metastatic CS to the myocardium has only rarely been described in case reports. Cardiac masses are differentiated by clinical context, location, and imaging appearance. CMR is considered the gold standard in cardiac imaging, but TEE was key in this case.
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Affiliation(s)
- Alan B Goldberg
- Department of Internal Medicine, Division of Cardiology, Rush University Medical Center, Chicago, Illinois
| | - Claudia Lama von Buchwald
- Department of Internal Medicine, Division of Cardiology, Rush University Medical Center, Chicago, Illinois
| | - Dinesh K Kalra
- Department of Internal Medicine, Division of Cardiology, Rush University Medical Center, Chicago, Illinois
| | - Anupama K Rao
- Department of Internal Medicine, Division of Cardiology, Rush University Medical Center, Chicago, Illinois
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Lama von Buchwald C, Faillace RT. Water-bottle heart. Eur Heart J 2018; 39:2431-2432. [DOI: 10.1093/eurheartj/ehy225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Claudia Lama von Buchwald
- Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, 1440 Pelham Parkway South, Bronx, NY, USA
| | - Robert T Faillace
- Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, 1440 Pelham Parkway South, Bronx, NY, USA
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