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Alexandrou M, Rempakos A, Mutlu D, Al Ogaili A, Choi JW, Poommipanit P, Alaswad K, Basir MB, Davies R, Jaffer FA, Chandwaney RH, Azzalini L, Aygul N, Dattilo P, Jefferson BK, Gorgulu S, Khatri JJ, Krestyaninov O, Frizzell J, Elbarouni B, Rangan BV, Mastrodemos O, Burke MN, Sandoval Y, Brilakis ES. Equipment entrapment/loss during chronic total occlusion percutaneous coronary intervention. J Invasive Cardiol 2024; 36. [PMID: 38412445 DOI: 10.25270/jic/23.00266] [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] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND There is limited data on equipment loss or entrapment during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS We analyzed the baseline clinical and angiographic characteristics and outcomes of equipment loss/entrapment at 43 US and non-US centers between 2017 and 2023. RESULTS Equipment loss/entrapment was reported in 40 (0.4%) of 10 719 cases during the study period. These included guidewire entrapment/fracture (n = 21), microcatheter entrapment/fracture (n = 11), stent loss (n = 8) and balloon entrapment/fracture/rupture (n = 5). The equipment loss/entrapment cases were more likely to have moderate to severe calcification, longer lesion length, higher J-CTO and PROGRESS-CTO complications scores, and use of the retrograde approach compared with the remaining cases. Retrieval was attempted in 71.4% of the guidewire, 90.9% of the microcatheter, 100% of the stent loss, and 100% of the balloon cases, and was successful in 26.7%, 30.0%, 50%, and 40% of the cases, respectively. Procedures complicated by equipment loss/entrapment had higher procedure and fluoroscopy time, contrast volume and patient air kerma radiation dose, lower procedural (60.0% vs 85.6%, P less than .001) and technical (75.0% vs 86.8%, P = .05) success, and higher incidence of major adverse cardiac events (MACE) (17.5% vs 1.8%, P less than .001), acute MI (7.5% vs 0.4%, P less than .001), emergency coronary artery bypass graft (CABG) (2.5% vs 0.1%, P = .03), perforation (20.0% vs 4.9%, P less than .001), and death (7.5% vs 0.4%, P less than .001). CONCLUSIONS Equipment loss is a rare complication of CTO PCI; it is more common in complex CTOs and is associated with lower technical success and higher MACE.
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Affiliation(s)
- Michaella Alexandrou
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Athanasios Rempakos
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Deniz Mutlu
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Ahmed Al Ogaili
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - James W Choi
- Texas Health Presbyterian Hospital, Dallas, Texas, USA
| | - Paul Poommipanit
- University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | | | | | | | | | | | - Lorenzo Azzalini
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Phil Dattilo
- Medical Center of the Rockies, Loveland, CO, USA
| | | | | | | | | | | | | | - Bavana V Rangan
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital,Minneapolis, MN, USA
| | - Olga Mastrodemos
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital,Minneapolis, MN, USA
| | - M Nicholas Burke
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital,Minneapolis, MN, USA
| | - Yader Sandoval
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital,Minneapolis, MN, USA
| | - Emmanouil S Brilakis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital,Minneapolis, MN, USA.
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Basir MB, Gorgis S, Aurora L. Defining the problem, the first step to making progress in acute myocardial infarction and cardiogenic shock care. Cardiovasc Revasc Med 2024:S1553-8389(24)00108-8. [PMID: 38555189 DOI: 10.1016/j.carrev.2024.03.020] [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] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 03/20/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Mir Babar Basir
- Henry Ford Hospital, Division of Cardiology, Detroit, MI, United States of America.
| | - Sarah Gorgis
- Henry Ford Hospital, Division of Cardiology, Detroit, MI, United States of America
| | - Lindsey Aurora
- Henry Ford Hospital, Division of Cardiology, Detroit, MI, United States of America
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3
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Alexandrou M, Rempakos A, Mutlu D, Ogaili AA, Choi JW, Poommipanit P, Alaswad K, Basir MB, Davies R, Benton S, Jaffer FA, Chandwaney RH, Kearney KE, ElGuindy AM, Rafeh NA, Goktekin O, Gorgulu S, Khatri JJ, Krestyaninov O, Khelimskii D, Rangan BV, Mastrodemos OC, Burke MN, Sandoval Y, Lombardi WL, Brilakis ES, Azzalini L. Comparative Analysis of Polymer Versus Non-Polymer Jacketed Wires in Chronic Total Occlusion Percutaneous Coronary Intervention. Am J Cardiol 2024; 215:10-18. [PMID: 38224729 DOI: 10.1016/j.amjcard.2024.01.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 01/17/2024]
Abstract
There is significant variation in wire utilization patterns for chronic total occlusion (CTO) percutaneous coronary intervention. This study aimed to compare the outcomes of polymer-jacketed wires (PJWs) versus non-PJWs in anterograde procedures. We analyzed clinical and angiographic characteristics, and procedural outcomes of 7,575 anterograde CTO percutaneous coronary interventions that were performed at 47 centers between 2012 and 2023. Cases in which PJWs were exclusively used were classified in the PJW group, whereas cases where at least one non-PJW was employed were classified in the non-PJW group. Study end points were as follows: technical success, coronary perforation, major adverse cardiac event. PJWs were exclusively used in 3,481 cases (46.0%). These cases had lower prevalence of proximal cap ambiguity, blunt stump, and moderate/severe calcification. They also had lower Japanese CTO (J-CTO), Prospective Global Registry for the Study of Chronic Total Occlusion (PROGRESS-CTO), and PROGRESS-CTO complications scores, higher technical success (94.3% vs 85.7%, p <0.001), and lower perforation rates (2.2% vs 3.2%, p = 0.013). Major adverse cardiac event rates did not differ between groups (1.3% vs 1.5%, p = 0.53). Exclusive use of PJWs was independently associated with higher technical success in both the multivariable (odds ratio [OR] 2.66, 95% confidence interval [CI] 2.13 to 3.36, p <0.001) and inverse probability of treatment weight analysis (OR 2.43, 95% CI 2.04 to 2.89, p <0.001). Exclusive use of PJWs was associated with lower risk of perforation in the multivariable analysis (OR 0.69, 95% CI 0.49 to 0.95, p = 0.02), and showed a similar trend in the inverse probability of treatment weight analysis (OR 0.77, 95% CI 0.57 to 1.04, p = 0.09). Exclusive use of PJWs is associated with higher technical success and lower perforation risk in this non-randomized series of patients.
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Affiliation(s)
- Michaella Alexandrou
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Athanasios Rempakos
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Deniz Mutlu
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Ahmed Al Ogaili
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - James W Choi
- Department of Cardiology, Texas Health Presbyterian Hospital, Dallas, Texas
| | - Paul Poommipanit
- Section of Cardiology, University Hospitals, Case Western Reserve University, Cleveland, Ohio
| | - Khaldoon Alaswad
- Department of Cardiology, Henry Ford Cardiovascular Division, Detroit, Michigan
| | - Mir Babar Basir
- Department of Cardiology, Henry Ford Cardiovascular Division, Detroit, Michigan
| | - Rhian Davies
- Department of Cardiology, WellSpan York Hospital, York, Pennsylvania
| | - Stewart Benton
- Department of Cardiology, WellSpan York Hospital, York, Pennsylvania
| | - Farouc A Jaffer
- Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts
| | - Raj H Chandwaney
- Department of Invasive Cardiology, Oklahoma Heart Institute, Tulsa, Oklahoma
| | - Kathleen E Kearney
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
| | - Ahmed M ElGuindy
- Department of Cardiology, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
| | - Nidal Abi Rafeh
- Department of Cardiology, North Oaks Health System, Hammond, Louisiana
| | - Omer Goktekin
- Department of Cardiology, Memorial Bahcelievler Hospital, Istanbul, Turkey
| | - Sevket Gorgulu
- Department of Cardiology, Biruni University Medical School, Istanbul, Turkey
| | | | - Oleg Krestyaninov
- Department of Invasive Cardiology, Meshalkin Novosibirsk Research Institute, Novosibirsk, Russian Federation
| | - Dmitrii Khelimskii
- Department of Invasive Cardiology, Meshalkin Novosibirsk Research Institute, Novosibirsk, Russian Federation
| | - Bavana V Rangan
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Olga C Mastrodemos
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - M Nicholas Burke
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Yader Sandoval
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - William L Lombardi
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
| | - Emmanouil S Brilakis
- Center of Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Lorenzo Azzalini
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington.
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Gupta R, Hosseinpour A, Patel C, Malik AH, Goel A, Bandyopadhyay D, Basir MB, Lavie CJ, Patel NC, Bhatt DL. Intravascular lithotripsy compared with rotational atherectomy for calcified coronary lesions: A meta-analysis of outcomes. Cardiovasc Revasc Med 2024:S1553-8389(24)00013-7. [PMID: 38307793 DOI: 10.1016/j.carrev.2024.01.012] [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] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 02/04/2024]
Affiliation(s)
- Rahul Gupta
- Lehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA, USA. https://twitter.com/rgupta8687
| | | | - Chirdeep Patel
- Lehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA, USA
| | - Aaqib H Malik
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Akshay Goel
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Dhrubajyoti Bandyopadhyay
- Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Mir Babar Basir
- Division of Cardiology, Department of Medicine, Henry Ford Health System, Detroit, MI, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Oshner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Nainesh C Patel
- Lehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA, USA
| | - Deepak L Bhatt
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System, New York, NY 10029, USA.
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5
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Min S, Basir MB, Lemor A, Zhou Z, Abu-Much A, Redfors B, Thompson JB, Truesdell AG, Bharadwaj AS, Li Y, Kaki A, Brott BC, Wohns DH, Meraj PM, Daggubati R, Grines CL, O'Neill WW, Moses JW. Clinical characteristics and outcomes of patients requiring prolonged mechanical circulatory support after high-risk percutaneous coronary intervention. EUROINTERVENTION 2024; 20:e135-e145. [PMID: 38224254 PMCID: PMC10786176 DOI: 10.4244/eij-d-23-00512] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/26/2023] [Accepted: 10/12/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND There are limited data on the clinical characteristics and outcomes of patients who require prolonged mechanical circulatory support (MCS) after Impella-supported high-risk percutaneous coronary intervention (HR-PCI). AIMS The aim of this study is to describe the contemporary clinical characteristics, outcomes, and predictors associated with prolonged MCS support after assisted HR-PCI. METHODS Patients enrolled in the prospective, multicentre, clinical endpoint-adjudicated PROTECT III study who had undergone HR-PCI using Impella were evaluated. Patient and procedural characteristics and outcomes for those who received prolonged MCS beyond the duration of their index procedure were compared to those in whom MCS was successfully weaned and explanted at the conclusion of the index PCI. RESULTS Among 1,155 patients who underwent HR-PCI with Impella between 2017 and 2020 and had sufficient data to confirm the duration of Impella support, 16.5% received prolonged MCS (mean duration 25.2±31.1 hours compared with 1.8±5.8 hours for those who only received intraprocedural MCS). Patients receiving prolonged support presented with more urgent indications (e.g., acute coronary syndromes [ACS], lower ejection fraction [EF], elevated baseline heart rate and lower systolic blood pressure). Use of the Impella CP, intraprocedural complications, periprocedural complications and in-hospital mortality were all more common amongst the prolonged MCS group. Prolonged MCS was associated with increased rates of major adverse cardiovascular and cerebrovascular events, cardiovascular death, and all-cause mortality at 90-day follow-up. CONCLUSIONS Patients receiving prolonged MCS after Impella-supported HR-PCI presented with more ACS, reduced EF and less favourable haemodynamics. Additionally, they were more likely to experience intraprocedural and periprocedural complications as well as increased in-hospital and post-discharge mortality.
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Affiliation(s)
- Sugi Min
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Mir Babar Basir
- Division of Cardiology, Henry Ford Hospital, Detroit, MI, USA
| | - Alejandro Lemor
- Department of Cardiology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Zhipeng Zhou
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA
| | - Arsalan Abu-Much
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA
| | - Björn Redfors
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Julia B Thompson
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA
| | - Alexander G Truesdell
- Virginia Heart, Falls Church, VA, USA
- INOVA Heart and Vascular Institute, Falls Church, VA, USA
| | - Aditya S Bharadwaj
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Yanru Li
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA
| | - Amir Kaki
- Interventional Cardiology Department, Ascension St. John Hospital and Center, Detroit, MI, USA
| | - Brigitta C Brott
- Division of Cardiovascular Disease, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - David H Wohns
- Spectrum Health, Frederik Meijer Heart and Vascular Institute, Grand Rapids, MI, USA
| | - Perwaiz M Meraj
- Department of Cardiology, Zucker School of Medicine, Northwell Health, Manhasset, New York, NY, USA
| | - Ramesh Daggubati
- Division of Cardiology, West Virginia University, Morgantown, WV, USA
| | - Cindy L Grines
- Medical College of Georgia, Augusta, GA, USA
- Northside Hospital Cardiovascular Institute, Atlanta, GA, USA
| | - William W O'Neill
- Center for Structural Heart Disease, Department of Cardiology, Henry Ford Health Care System, Detroit, MI, USA
| | - Jeffrey W Moses
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
- St. Francis Heart Center, Roslyn, NY, USA
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6
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Henry TD, Basir MB. Editorial: Studying the past to direct the future in cardiogenic shock. Cardiovasc Revasc Med 2023; 57:91-92. [PMID: 37586998 DOI: 10.1016/j.carrev.2023.07.025] [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: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/18/2023]
Affiliation(s)
- Timothy D Henry
- The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital, Cincinnati, OH, United States of America.
| | - Mir Babar Basir
- Henry Ford Hospital, Division of Cardiovascular Medicine, Detroit, MI, United States of America
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7
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Kostantinis S, Rempakos A, Simsek B, Karacsonyi J, Allana SS, Alexandrou M, Gorgulu S, Alaswad K, Basir MB, Davies RE, Benton SM, Krestyaninov O, Khelimskii D, Frizzell J, Ybarra LF, Bagur R, Reddy N, Kerrigan JL, Haddad EV, Love M, Elbarouni B, Soylu K, Yildirim U, Dattilo P, Azzalini L, Kearney K, Sadek Y, ElGuindy AM, Abi Rafeh N, Goktekin O, Mastrodemos OC, Rangan BV, Sandoval Y, Burke MN, Brilakis ES. Impact of calcium on the procedural techniques and outcomes of chronic total occlusion percutaneous coronary intervention. Int J Cardiol 2023; 390:131254. [PMID: 37562751 DOI: 10.1016/j.ijcard.2023.131254] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Coronary calcification is common and increases the difficulty of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS We examined the impact of calcium on procedural outcomes of 13,079 CTO PCIs performed in 12,799 patients at 46 US and non-US centers between 2012 and 2023. RESULTS Moderate or severe calcification was present in 46.6% of CTO lesions. Patients whose lesions were calcified were older and more likely to have had prior coronary artery bypass graft surgery. Calcified lesions were more complex with higher J-CTO score (3.0 ± 1.1 vs. 1.9 ± 1.2; p < 0.001) and lower technical (83.0% vs. 89.9%; p < 0.001) and procedural (81.0% vs. 89.1%; p < 0.001) success rates compared with mildly calcified or non-calcified CTO lesions. The retrograde approach was more commonly used among cases with moderate/severe calcification (40.3% vs. 23.5%; p < 0.001). Balloon angioplasty (76.6%) was the most common lesion preparation technique for calcified lesions, followed by rotational atherectomy (7.3%), laser atherectomy (3.4%) and, intravascular lithotripsy (3.4%). The incidence of major adverse cardiovascular events (MACE) was higher in cases with moderate or severe calcification (3.0% vs. 1.2%; p < 0.001), as was the incidence of perforation (6.5% vs. 3.4%; p < 0.001). On multivariable analysis, the presence of moderate/severe calcification was independently associated with lower technical success (odds ratio, OR = 0.73, 95% CI: 0.63-0.84) and higher MACE (OR = 2.33, 95% CI: 1.66-3.27). CONCLUSIONS Moderate/severe calcification was present in nearly half of CTO lesions, and was associated with higher utilization of the retrograde approach, lower technical and procedural success rates, and higher incidence of in-hospital MACE.
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Affiliation(s)
- Spyridon Kostantinis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Athanasios Rempakos
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Bahadir Simsek
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Judit Karacsonyi
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Salman S Allana
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Michaella Alexandrou
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | | | | | | | | | | | | | | | - Jarrod Frizzell
- The Christ Hospital, Ohio Heart and Vascular, Cincinnati, OH, USA
| | - Luiz F Ybarra
- London Health Sciences Center, Western University, London, ON, Canada
| | - Rodrigo Bagur
- London Health Sciences Center, Western University, London, ON, Canada
| | | | | | | | - Michael Love
- St. Boniface General Hospital, Winnipeg, Manitoba, Canada
| | | | - Korhan Soylu
- Ondokuz Mayis University Medical Faculty, Samsun, Turkey
| | - Ufuk Yildirim
- Ondokuz Mayis University Medical Faculty, Samsun, Turkey
| | - Philip Dattilo
- UC Health Medical Center of the Rockies, Loveland, CO, USA
| | | | | | | | | | | | | | - Olga C Mastrodemos
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Bavana V Rangan
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Yader Sandoval
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - M Nicholas Burke
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Emmanouil S Brilakis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA.
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8
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Kostantinis S, Rempakos A, Simsek B, Karacsonyi J, Allana SS, Alaswad K, Basir MB, Davies RE, Benton SM, Krestyaninov O, Khelimskii D, Jaber WA, Rinfret S, Nicholson W, Frizzell J, Jaffer FA, Khatri JJ, Poommipanit P, Choi JW, Chandwaney R, Jefferson BK, Patel TN, Al-Azizi KM, Potluri S, Aygul N, ElGuindy AM, Abi Rafeh N, Goktekin O, Alexandrou M, Mastrodemos OC, Rangan BV, Sandoval Y, Burke MN, Brilakis ES, Gorgulu S. Impact of target vessel on the procedural techniques and outcomes of chronic total occlusion percutaneous coronary intervention. J Invasive Cardiol 2023; 35. [PMID: 37983108 DOI: 10.25270/jic/23.00139] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND There is limited information on the impact of the target vessel on the procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS We analyzed the baseline clinical and angiographic characteristics and procedural outcomes of 11,580 CTO PCIs performed between 2012 and 2022 at 44 centers. RESULTS The most common CTO target vessel was the right coronary artery (RCA) (53.1%) followed by the left anterior descending artery (LAD) (26.0%) and the left circumflex artery (LCX) (19.8%). RCA CTOs were longer and more complex, with a higher Japanese CTO score compared with LAD or LCX CTOs. Technical success was higher among LAD (88.8%) lesions when compared with RCA (85.7%) or LCX (85.8%) lesions (P less than .001). The incidence of major adverse cardiovascular events (MACE) was overall 1.9% (n = 220) and was similar among target vessels (P=.916). There was a tendency toward more frequent utilization of the retrograde approach for more proximal occlusions in all 3 target vessels. When compared with all other RCA lesions combined, distal RCA lesions had higher technical success (87.7% vs 85.3%; P=.048). Technical success was similar between various locations of LAD CTOs (P=.704). First/second/third obtuse marginal branch had lower technical success when compared with all other LCX lesion locations (82.7% vs 86.8%; P=.014). There was no association between MACE and CTO location in all 3 target vessels. CONCLUSIONS LAD CTO PCIs had higher technical and procedural success rates among target vessels. The incidence of MACE was similar among target vessels and among various locations within the target vessel.
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Affiliation(s)
- Spyridon Kostantinis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Athanasios Rempakos
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Bahadir Simsek
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Judit Karacsonyi
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Salman S Allana
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | | | | | | | | | | | | | | | | | | | - Jarrod Frizzell
- The Christ Hospital, Ohio Heart and Vascular, Cincinnati, OH, USA
| | | | | | - Paul Poommipanit
- University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | - James W Choi
- Texas Health Presbyterian Hospital, Dallas, TX, USA
| | | | | | - Taral N Patel
- Tristar Centennial Medical Center, Nashville, TN, USA
| | | | | | - Nazif Aygul
- Selcuk University Medical Faculty, Konya, Turkey
| | | | | | | | - Michaella Alexandrou
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Olga C Mastrodemos
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Bavana V Rangan
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Yader Sandoval
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - M Nicholas Burke
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Emmanouil S Brilakis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Sevket Gorgulu
- Biruni University Medical School, Istanbul, Turkey. E-mail:
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9
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Kostantinis S, Rempakos A, Simsek B, Karacsonyi J, Allana SS, Alaswad K, Basir MB, Krestyaninov O, Khelimskii D, Gorgulu S, Davies RE, Benton SM, Khatri JJ, Poommipanit P, Choi JW, Jaber WA, Rinfret S, Nicholson W, Aygul N, Altunkeser BB, ElGuindy AM, Abi Rafeh N, Goktekin O, Mastrodemos OC, Rangan BV, Sandoval Y, Burke MN, Brilakis ES. Aortocoronary dissection during percutaneous coronary interventions for chronic total occlusion: Insights from the PROGRESS-CTO registry. Catheter Cardiovasc Interv 2023. [PMID: 37172209 DOI: 10.1002/ccd.30680] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/27/2023] [Accepted: 04/30/2023] [Indexed: 05/14/2023]
Abstract
BACKGROUND Aortocoronary dissection is a potentially serious complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS We examined the incidence, mechanisms, treatment, and outcomes of aortocoronary dissection among 12,117 CTO PCIs performed between 2012 and 2022 in a large multicenter CTO PCI registry. RESULTS The incidence of aortocoronary dissection was 0.2% (n = 27). Most aortocoronary dissections occurred in the right coronary artery (96.3%, n = 26). The baseline clinical characteristics of patients with and without aortocoronary dissection were similar, except for dyslipidemia, which was less common in patients with aortocoronary dissection (70.4% vs. 86.0%; p = 0.019). The retrograde approach was used more commonly among cases complicated by aortocoronary dissection (59.3% vs. 31.0%; p = 0.002). Technical (74.1% vs. 86.6%; p = 0.049) and procedural (70.4% vs. 85.2%; p = 0.031) success rates were lower among aortocoronary dissection cases, with a similar incidence of in-hospital major adverse cardiovascular events (3.7% vs. 2.0%; p = 0.541). Of the 27 patients with aortocoronary dissection, 19 (70.4%) were treated with ostial stenting and 8 (29.6%) were treated conservatively without subsequent adverse clinical outcomes. No patients required emergency surgery. Follow-up was available for 22 patients (81.5%): during a mean follow up of 767 (±562) days, the incidence of in-stent restenosis was 11.1% (n = 3). CONCLUSIONS Aortocoronary dissection occurred in 0.2% of CTO PCIs performed by experienced operators, was associated with lower technical and procedural success, and was treated most commonly with ostial stenting. None of the patients required emergency cardiac surgery.
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Affiliation(s)
- Spyridon Kostantinis
- Department of Cardiology, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Athanasios Rempakos
- Department of Cardiology, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Bahadir Simsek
- Department of Cardiology, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Judit Karacsonyi
- Department of Cardiology, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Salman S Allana
- Department of Cardiology, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Khaldoon Alaswad
- Department of Cardiology, Henry Ford Cardiovascular Division, Detroit, Michigan, USA
| | - Mir Babar Basir
- Department of Cardiology, Henry Ford Cardiovascular Division, Detroit, Michigan, USA
| | - Oleg Krestyaninov
- Department of Cardiology, Meshalkin Novosibirsk Research Institute, Novosibirsk, Russia
| | - Dmitrii Khelimskii
- Department of Cardiology, Meshalkin Novosibirsk Research Institute, Novosibirsk, Russia
| | - Sevket Gorgulu
- Department of Cardiology, Biruni University Medical School, Istanbul, Turkey
| | - Rhian E Davies
- Department of Cardiology, Wellspan York Hospital, York, Pennsylvania, USA
| | - Stewart M Benton
- Department of Cardiology, Wellspan York Hospital, York, Pennsylvania, USA
| | | | - Paul Poommipanit
- Department of Cardiology, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA
| | - James W Choi
- Department of Cardiology, Texas Health Presbyterian Hospital, Dallas, Texas, USA
| | - Wissam A Jaber
- Department of Cardiology, Emory University Hospital Midtown, Atlanta, Georgia, USA
| | - Stephane Rinfret
- Department of Cardiology, Emory University Hospital Midtown, Atlanta, Georgia, USA
| | - William Nicholson
- Department of Cardiology, Emory University Hospital Midtown, Atlanta, Georgia, USA
| | - Nazif Aygul
- Department of Cardiology, Selcuk University Medical Faculty, Konya, Turkey
| | | | - Ahmed M ElGuindy
- Department of Cardiology, Aswan Heart Center, Magdi Yacoub Foundation, Cairo, Egypt
| | - Nidal Abi Rafeh
- Department of Cardiology, North Oaks Health System, Hammond, Louisiana, USA
| | - Omer Goktekin
- Department of Cardiology, Memorial Bahcelievler Hospital, Istanbul, Turkey
| | - Olga C Mastrodemos
- Department of Cardiology, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Bavana V Rangan
- Department of Cardiology, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Yader Sandoval
- Department of Cardiology, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - M Nicholas Burke
- Department of Cardiology, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Emmanouil S Brilakis
- Department of Cardiology, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
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10
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Shah T, Grines CL, Baron S, Li Y, Much AA, Hussain Y, Wollmuth JR, Batchelor WB, Basir MB, O'Neill WW, Lansky AJ. SEX DIFFERENCES IN IMPELLA SUPPORTED HIGH RISK PERCUTANEOUS CORONARY INTERVENTION OUTCOMES. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01328-1] [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: 03/06/2023]
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11
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Sukul D, Seth M, Madder R, Basir MB, Menees DS, Kaki A, Azzalini L, Lee DT, Gurm HS. THE REAL-WORLD SAFETY AND EFFECTIVENESS OF CORONARY INTRAVASCULAR LITHOTRIPSY: INSIGHTS FROM THE BMC2 REGISTRY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01496-1] [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: 03/06/2023]
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12
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Hussain B, Basir MB, Mahmood A, Belur A, Alexander T. CRT-700.66 Principal Diagnosis and Independent Predictors for 30-Day Readmissions in Primary Cardiac Tumor Patients. JACC Cardiovasc Interv 2023. [DOI: 10.1016/j.jcin.2023.01.344] [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: 02/22/2023]
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13
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Hussain B, Basir MB, Paul T. CRT-101.10 Outcomes of Underlying Infiltrative Cardiomyopathy in Percutaneous Coronary Intervention. JACC Cardiovasc Interv 2023. [DOI: 10.1016/j.jcin.2023.01.044] [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: 02/22/2023]
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14
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Ya'Qoub L, Lemor A, Basir MB, Alqarqaz M, Villablanca P. A Visual Depiction of Left Ventricular Unloading in Veno-Arterial ExtraCorporeal Membrane Oxygenation With Impella. J Invasive Cardiol 2022; 34:E825. [PMID: 36318465] [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] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Left ventricular (LV) unloading has been associated with improved survival in patients treated with venoarterial extracorporeal membrane oxygenation. This case describes a patient with a COVID-19 infection who subsequently developed non-ischemic cardiomyopathy with an LV ejection fraction of 10% to 15% (baseline echocardiography). He did poorly in the outpatient setting and was admitted to an outside hospital with heart failure symptoms and was subsequently transferred to our hospital for escalation of care and consideration of advanced heart failure therapies. This clinical image and related video series help to visually demonstrate the effect of LV unloading in a 30-year-old male with a history of COVID-19 myocarditis.
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Affiliation(s)
- Lina Ya'Qoub
- Henry Ford Hospital, 2799 E. Grand Boulevard, Detroit, MI 48202 USA.
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15
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Iannaccone M, Franchin L, Hanson ID, Boccuzzi GG, Basir MB, Truesdell AG, O'Neil WW. Door to support in acute myocardial infarction complicated by cardiogenic shock: an updated meta-analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The impact of time to hemodynamic support in acute myocardial infarction complicated by cardiogenic shock (AMICS) has yet to be defined. The aim of this meta-analysis was to evaluate the impact of timing of Impella mechanical circulatory support (MCS) initiation on early and midterm mortality.
Methods
A systematic literature review and meta-analysis was conducted using PubMed and Cochrane databases. All studies reporting short-term mortality rates and timing of Impella placement in AMICS were included. Meta-regression analysis and sensitivity analysis were performed on the primary endpoint, short-term mortality (≤30 days), and secondary endpoints (midterm mortality, device-related bleeding, and limb ischemia).
Results
Of 1289 studies identified, 13 studies (6810 patients; 2970 patients identified as receiving Impella pre-PCI and 3840 patients receiving Impella during/post-PCI) were included in this analysis. Median age was 63.8 years (IQR, 63–65.7); 76% of patients were male, and a high prevalence of cardiovascular risk factors was noted across the entire population. Short-term mortality was significantly reduced in those receiving pre-PCI vs. during/post-PCI Impella support (37.2% vs 53.6%, RR 0.7; CI 0.56–0.88). Midterm mortality was also lower in the pre-PCI Impella group (47.9% vs 73%, RR 0.81; CI 0.68–0.97). The rate of device-related bleeding (RR 1.05; CI 0.47–2.33) and limb ischemia (RR 1.16; CI 0.63–2.15) were similar between the two groups.
Conclusion
This analysis suggests that Impella MCS placement prior to PCI in AMICS may have a positive impact on short- and midterm mortality compared with post-PCI, with similar safety outcomes.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Iannaccone
- Torino North Emergency San Giovanni Bosco , Turin , Italy
| | - L Franchin
- Torino North Emergency San Giovanni Bosco , Turin , Italy
| | - I D Hanson
- William Beaumont Hospital, Cardiology , Royal Oak , United States of America
| | - G G Boccuzzi
- Torino North Emergency San Giovanni Bosco , Turin , Italy
| | - M B Basir
- Henry Ford Hospital, Cardiology , Detroit , United States of America
| | - A G Truesdell
- Inova Heart and Vascular Institute , Falls Church , United States of America
| | - W W O'Neil
- Henry Ford Hospital, Cardiology , Detroit , United States of America
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16
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Buda KG, Sedhom R, Elbadawi A, Louka L, Mukundan S, Garcia S, Brilakis ES, Alaswad K, Basir MB, Megaly MS. Trends and outcomes of veno-arterial extracorporeal membrane oxygenation for acute myocardial infarction-cardiogenic shock. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Mortality for acute myocardial infarction-cardiogenic shock (AMI-CS) remains high. Trends of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) use and outcomes as a function of ECMO requirement are not well described.
Purpose
To identify the trends and outcomes of VA-ECMO use for AMI-CS in the United States.
Methods
We used the Nationwide Readmissions Database (NRD) and the Healthcare Cost and Utilization Project (HCUP) to obtain our cohort. We identified patients with AMI-CS requiring VA-ECMO using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD 10 CM) and procedure (ICD 10-PCS) codes. We excluded patients with missing data on in-hospital mortality.
Results
During the study period (2016–2019), 2,005,607 records with myocardial infarction (ST-elevation myocardial infarction [STEMI] and non-ST-elevation myocardial infarction [NSTEMI]) were identified (national estimate of 3,674,083 records), 127,939 records (6.4%) had concomitant CS (national estimate of 234,630 patients), and 3,469 records (national estimate of 6,365 records) (2.7%) received VA-ECMO for CS support. Impella and Intra-aortic balloon pump were used within the same admission in 34.5% and 38.1% of VA-ECMO cases, respectively. VA-ECMO use for AMI-CS significantly increased over the study period (from 2.3% in the first quarter of 2016 to 3.3% in the last quarter of 2019, p=0.001) (Figure 1).
In unadjusted analysis, patients undergoing VA-ECMO for AMI-CS were more likely to be male, have hypertension, congestive heart failure, and coagulopathy, present with STEMI, and receive multivessel PCI. Other comorbid conditions including diabetes, atrial fibrillation, end-stage renal disease, and prior MI, CABG, and stroke were less common in the VA-ECMO cohort. Medicare patients were less likely to receive VA-ECMO (39.4% vs. 63.8%, p<0.001), whereas patients at large or teaching hospitals were more likely. Patients requiring VA-ECMO had higher in-hospital mortality, length of stay, and rates of complications (Table 1).
Conclusion
Utilization of VA-ECMO for AMI-CS is increasing, and in one out three patients, VA-ECMO is used in combination with other MCS devices. Patients with underlying medical comorbidities and Medicare are less likely to receive VA-ECMO. Critically ill patients requiring VA-ECMO for AMI-CS are more likely to present with STEMI and have high morbidity and mortality.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K G Buda
- Hennepin Healthcare , Minneapolis , United States of America
| | - R Sedhom
- Albert Einstein Medical Center , Philadelphia , United States of America
| | - A Elbadawi
- University of Texas Medical Branch , Galveston , United States of America
| | - L Louka
- Willis-Knighton Health System , Shreveport , United States of America
| | - S Mukundan
- Oregon Health and Science University , Portland , United States of America
| | - S Garcia
- Minneapolis Heart Institute Foundation , Minneapolis , United States of America
| | - E S Brilakis
- Minneapolis Heart Institute Foundation , Minneapolis , United States of America
| | - K Alaswad
- Henry Ford Hospital , Detroit , United States of America
| | - M B Basir
- Henry Ford Hospital , Detroit , United States of America
| | - M S Megaly
- Henry Ford Hospital , Detroit , United States of America
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17
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Kostantinis S, Simsek B, Karacsonyi J, Davies RE, Benton S, Nicholson W, Rinfret S, Jaber WA, Raj L, Sandesara PB, Alaswad K, Basir MB, Megaly M, Khatri JJ, Young LD, Jaffer FA, Abi Rafeh N, Patel MP, Kerrigan JL, Haddad EV, Dattilo P, Sandoval Y, Schimmel DR, Sheikh AM, ElGuindy AM, Goktekin O, Mastrodemos OC, Rangan BV, Burke MN, Brilakis ES. Intravascular lithotripsy in chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS-CTO registry. Catheter Cardiovasc Interv 2022; 100:512-519. [PMID: 35916076 DOI: 10.1002/ccd.30354] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/11/2022] [Accepted: 07/16/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The use of intravascular lithotripsy (IVL) in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS We analyzed the baseline clinical and angiographic characteristics and procedural outcomes of 82 CTO PCIs that required IVL at 14 centers between 2020 and 2022. RESULTS During the study period, IVL was used in 82 of 3301 (2.5%) CTO PCI procedures (0.4% in 2020 and 7% in 2022; p for trend < 0.001). Mean patient age was 69 ± 11 years and 79% were men. The prevalence of hypertension (95%), diabetes mellitus (62%), and prior PCI (61%) was high. The most common target vessel was the right coronary artery (54%), followed by the left circumflex (23%). The mean J-CTO and PROGRESS-CTO scores were 2.8 ± 1.1 and 1.3 ± 1.0, respectively. Antegrade wiring was the final successful crossing strategy in 65% and the retrograde approach was used in 22%. IVL was used in 10% of all heavily calcified lesions and 11% of all balloon undilatable lesions. The 3.5 mm lithotripsy balloon was the most commonly used balloon (28%). The mean number of pulses per lithotripsy run was 33 ± 32 and the median duration of lithotripsy was 80 (interquartile range: 40-103) seconds. Technical and procedural success was achieved in 77 (94%) and 74 (90%) cases, respectively. Two (2.4%) Ellis Class 2 perforations occurred after IVL use and were managed conservatively. CONCLUSION IVL is increasingly being used in CTO PCI with encouraging outcomes.
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Affiliation(s)
- Spyridon Kostantinis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Bahadir Simsek
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Judit Karacsonyi
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | | | | | | | | | - Wissam A Jaber
- Emory University Hospital Midtown, Atlanta, Georgia, USA
| | - Leah Raj
- Emory University Hospital Midtown, Atlanta, Georgia, USA
| | | | | | | | - Michael Megaly
- Henry Ford Cardiovascular Division, Detroit, Michigan, USA
| | | | | | | | | | | | | | | | - Phil Dattilo
- Medical Center of the Rockies, Loveland, Colorado, USA
| | | | | | | | | | | | - Olga C Mastrodemos
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Bavana V Rangan
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - M Nicholas Burke
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Emmanouil S Brilakis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
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18
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Chiang M, Gonzalez PE, Basir MB, O’Neill BP, Lee J, Frisoli T, Wang DD, O’Neill WW, Villablanca PA. Modified Transcaval Left Atrial Venoarterial Extracorporeal Membrane Oxygenation Without Preplanning Contrast CT. JACC Cardiovasc Interv 2022; 15:e181-e185. [DOI: 10.1016/j.jcin.2022.05.033] [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] [Received: 05/01/2022] [Revised: 05/17/2022] [Accepted: 05/24/2022] [Indexed: 10/17/2022]
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19
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Kunkel K, Brice L, Arnautovic J, Kaushik M, Desai P, Alaswad K, Basir MB. Safety and Efficacy of Aminophylline in the Prevention of Bradyarrhythmias During Coronary Atherectomy. Cardiovascular Revascularization Medicine 2022. [DOI: 10.1016/j.carrev.2022.06.082] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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20
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Simsek B, Kostantinis S, Karacsonyi J, Basir MB, Megaly M, Masoumi A, Jaffer FA, Gorgulu S, Brilakis ES, Alaswad K. Temporal Trends in Retrograde Crossing of Epicardial Collaterals in Chronic Total Occlusion Percutaneous Coronary Intervention. J Invasive Cardiol 2022; 34:E294-E295. [PMID: 35302949] [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] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
BACKGROUND The use of retrograde crossings in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) provides higher technical success rates in CTO-PCI. However, the use of epicardial collaterals carries a higher complication risk. METHODS AND RESULTS In this study, we aimed to investigate the temporal trends in retrograde crossing of epicardial collaterals, introduction of new guidewires, in-hospital major adverse cardiovascular events (MACE), and technical success rates in a large, multinational registry. We demonstrate that technical success rates increased substantially from about 5%-10% to 76% in the past decade without a concomitant increase in MACE rate (~3% to 4%), likely associated with increased operator experience and introduction of new guidewires. In addition, we show that while high-volume centers have higher technical success, they also have higher perforation rates.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Khaldoon Alaswad
- Edith and Benson Ford Heart and Vascular Institute, Henry Ford Hospital & Health System, 2799 W. Grand Blvd Detroit, MI 48202 USA.
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21
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Kunkel K, Brice L, Arnautovic J, Kaushik M, Desai P, Alaswad K, Basir MB. CRT-100.62 Safety and Efficacy of Aminophylline in the Prevention of Bradyarrhythmias During Coronary Atherectomy. JACC Cardiovasc Interv 2022. [DOI: 10.1016/j.jcin.2022.01.118] [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: 11/25/2022]
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22
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Osman M, Syed M, Patel B, Munir MB, Kheiri B, Caccamo M, Sokos G, Balla S, Basir MB, Kapur NK, Mamas MA, Bianco CM. Invasive Hemodynamic Monitoring in Cardiogenic Shock Is Associated With Lower In-Hospital Mortality. J Am Heart Assoc 2021; 10:e021808. [PMID: 34514850 PMCID: PMC8649539 DOI: 10.1161/jaha.121.021808] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background There is increasing utilization of cardiogenic shock treatment algorithms. The cornerstone of these algorithms is the use of invasive hemodynamic monitoring (IHM). We sought to compare the in‐hospital outcomes in patients who received IHM versus no IHM in a real‐world contemporary database. Methods and Results Patients with cardiogenic shock admitted during October 1, 2015 to December 31, 2018, were identified from the National Inpatient Sample. Among this group, we compared the outcomes among patients who received IHM versus no IHM. The primary end point was in‐hospital mortality. Secondary end points included vascular complications, major bleeding, need for renal replacement therapy, length of stay, cost of hospitalization, and rate of utilization of left ventricular assist devices and heart transplantation. Propensity score matching was used for covariate adjustment. A total of 394 635 (IHM=62 565; no IHM=332 070) patients were included. After propensity score matching, 2 well‐matched groups were compared (IHM=62 220; no IHM=62 220). The IHM group had lower in‐hospital mortality (24.1% versus 30.6%, P<0.01), higher percentages of left ventricular assist devices (4.4% versus 1.3%, P<0.01) and heart transplantation (1.3% versus 0.7%, P<0.01) utilization, longer length of hospitalization and higher costs. There was no difference between the 2 groups in terms of vascular complications, major bleeding, and the need for renal replacement therapy. Conclusions Among patients with cardiogenic shock, the use of IHM is associated with a reduction in in‐hospital mortality and increased utilization of advanced heart failure therapies. Due to the observational nature of the current study, the results should be considered hypothesis‐generating, and future prospective studies confirming these findings are needed.
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Affiliation(s)
- Mohammed Osman
- Division of Cardiology West Virginia University School of Medicine Morgantown WV.,Knight Cardiovascular InstituteOregon Health and Science University Portland OR
| | - Moinuddin Syed
- Division of Cardiology West Virginia University School of Medicine Morgantown WV
| | - Brijesh Patel
- Division of Cardiology West Virginia University School of Medicine Morgantown WV
| | - Muhammad Bilal Munir
- Division of Cardiovascular Medicine University of California San Diego La Jolla CA
| | - Babikir Kheiri
- Knight Cardiovascular InstituteOregon Health and Science University Portland OR
| | - Marco Caccamo
- Division of Cardiology West Virginia University School of Medicine Morgantown WV
| | - George Sokos
- Division of Cardiology West Virginia University School of Medicine Morgantown WV
| | - Sudarshan Balla
- Division of Cardiology West Virginia University School of Medicine Morgantown WV
| | - Mir Babar Basir
- Division of Cardiology Department of Medicine Henry Ford Health System Detroit MI
| | - Navin K Kapur
- The Cardiovascular Center Tufts Medical Center Boston MA
| | - Mamas A Mamas
- Keele Cardiovascular Research Group Keele University Keele United Kingdom.,Royal Stoke University Hospital, Division of Cardiology Stoke-on-Trent United Kingdom
| | - Christopher M Bianco
- Division of Cardiology West Virginia University School of Medicine Morgantown WV
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23
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Osman M, Balla S, Dupont A, O'Neill WW, Basir MB. Reviving Invasive Hemodynamic Monitoring in Cardiogenic Shock. Invasive Hemodynamic Monitoring in Cardiogenic Shock. Am J Cardiol 2021; 150:128-129. [PMID: 33972078 DOI: 10.1016/j.amjcard.2021.03.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 01/02/2023]
Affiliation(s)
- Mohammed Osman
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia.
| | - Sudarshan Balla
- Division of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Allison Dupont
- Division of Cardiology, Northside Cardiovascular Institute, Atlanta, Georgia
| | - William W O'Neill
- Division of Cardiology, Department of Medicine, Henry Ford Health System, Detroit, Michigan
| | - Mir Babar Basir
- Division of Cardiology, Department of Medicine, Henry Ford Health System, Detroit, Michigan
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Kunkel KJ, Neupane S, Gupta A, Basir MB, Alaswad K. Antegrade versus retrograde techniques for Chronic Total Occlusions (CTO): a review and comparison of techniques and outcomes. Expert Rev Cardiovasc Ther 2021; 19:465-473. [PMID: 33945367 DOI: 10.1080/14779072.2021.1924677] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: As the field of chronic total occlusion percutaneous coronary intervention has evolved, technical approaches have evolved and been refined.Areas covered: In this review, we discuss the major techniques utilized in modern CTO PCI including antegrade wiring, antegrade dissection reentry, retrograde wiring, and retrograde dissection reentry. Retrograde techniques have been extensively studied in comparison to antegrade techniques. Retrograde techniques have contributed to increases in CTO PCI success rates and are generally used in higher complexity lesions. Observational data ssuggestincreased sshort-termcomplications in procedures requiring the use of retrograde techniques; however, llong-termCTO PCI durability and patient outcomes have been shown to be similar among procedures using antegrade only versus retrograde techniques.Expert opinion: Retrograde techniques play a vital role in the technical success of CTO PCI, particularly among more complex lesions and in patients with high burdens of comorbidities. Increases in procedural safety with equipment iteration and in the use of adjunctive imaging will play an important role in the selection of appropriate retrograde conduits and the overall success rates of CTO PCI.
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Affiliation(s)
| | - Saroj Neupane
- Department of General and Interventional Cardiology, WakeMed Heart Center, WakeMed Hospital, Raleigh, North Carolina, US
| | - Ankur Gupta
- Cardiovascular Consultants Medical Group, Los Angeles, California, US
| | - Mir Babar Basir
- Division of Cardiology, Henry Ford Hospital, Detroit, Michigan, US
| | - Khaldoon Alaswad
- Division of Cardiology, Henry Ford Hospital, Detroit, Michigan, US
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Lemor A, Al-Darzi W, O'Neill W, Basir MB. Unmasking right ventricular failure in cardiogenic shock: The importance of serial hemodynamics. Catheter Cardiovasc Interv 2021; 97:1209-1212. [PMID: 33484043 DOI: 10.1002/ccd.29493] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/15/2020] [Accepted: 01/10/2021] [Indexed: 11/08/2022]
Abstract
A 65-year-old female was transferred with myocardial infarction, three-vessel coronary artery disease, cardiogenic shock and an intraaortic balloon pump. Given persistent shock, mechanical circulatory support (MCS) was upgraded using a left ventricular hemodynamic support device (Impella CP). The patient was monitored in the catheterization laboratory and serial hemodynamic measures were obtained. Initial hemodynamics showed relative improvement; however, serial assessments demonstrated worsening hemodynamics secondary to right ventricular failure, ultimately requiring a right ventricular hemodynamic support device. The case highlights the rapid changes that can occur with mechanical circulatory support devices and demonstrates the importance of obtaining serial hemodynamics in the cardiac catheterization laboratory.
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Affiliation(s)
- Alejandro Lemor
- Department of Cardiology, Henry Ford Hospital, Detroit, Michigan.,Universidad de San Martín de Porres, Facultad de Medicina, Centro de Investigación de Epidemiología Clínica y Medicina Basada en la Evidencia Lima, Peru
| | - Waleed Al-Darzi
- Department of Cardiology, Henry Ford Hospital, Detroit, Michigan
| | - William O'Neill
- Department of Cardiology, Henry Ford Hospital, Detroit, Michigan
| | - Mir Babar Basir
- Department of Cardiology, Henry Ford Hospital, Detroit, Michigan
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Brener MI, Burkhoff D, Basir MB, Alqarqaz M. Pressure-Volume Analysis Illustrating the Mechanisms of Short-Term Hemodynamic Effects Produced by Premature Ventricular Contractions. Circ Heart Fail 2021; 14:e007766. [PMID: 33691463 DOI: 10.1161/circheartfailure.120.007766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 11/16/2022]
Affiliation(s)
- Michael I Brener
- Division of Cardiology, Columbia University Medical Center, New York, NY (M.I.B.)
| | | | - Mir Babar Basir
- Division of Cardiology, Henry Ford Hospital System, Detroit, MI (M.B.B., M.A.)
| | - Mohammad Alqarqaz
- Division of Cardiology, Henry Ford Hospital System, Detroit, MI (M.B.B., M.A.)
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Isseh IN, Gorgis S, Dagher C, Sharma S, Basir MB, Parikh S. Escalating Temporary Mechanical Circulatory Support In Worsening Cardiogenic Shock: Feasibility In Advanced Heart Failure Therapy Candidates. J Card Fail 2020. [DOI: 10.1016/j.cardfail.2020.09.162] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Basir MB. Beyond the Coronary Arteries, Should We Be Shifting Our Focus to Mechanical Circulatory Support in Patients With Acute Myocardial Infarction and Cardiogenic Shock? Cardiovasc Revasc Med 2020; 21:849-850. [PMID: 32387218 DOI: 10.1016/j.carrev.2020.04.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 04/28/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Mir Babar Basir
- Director of Acute Mechanical Circulatory Support, Henry Ford Hospital, 2799 West Grand Blvd (K-2 Cath Lab), Detroit, MI 48202, United States of America.
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Brener MI, Burkhoff D, Basir MB, Alqarqaz M. Pressure-Volume Analysis Illustrating Left Ventricular Unloading by a Percutaneous Transvalvular Left Ventricular to Aortic Pump. Circ Heart Fail 2020; 13:e006788. [PMID: 32295408 DOI: 10.1161/circheartfailure.119.006788] [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] [Indexed: 11/16/2022]
Affiliation(s)
- Michael I Brener
- Division of Cardiology, Columbia University Medical Center, New York, NY (M.I.B.)
| | | | - Mir Babar Basir
- Division of Cardiology, Henry Ford Hospital System, Detroit, MI (M.B.B., M.A.)
| | - Mohammad Alqarqaz
- Division of Cardiology, Henry Ford Hospital System, Detroit, MI (M.B.B., M.A.)
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Rab T, Abbott JD, Basir MB, Latib A, Kumar G, Meraj P, Croce K, Davé R. Summary of Practice Considerations for Percutaneous Coronary Intervention of Left Main Bifurcation Disease. Heart Int 2020; 14:69-72. [PMID: 36276505 PMCID: PMC9524749 DOI: 10.17925/hi.2020.14.2.69] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/05/2020] [Accepted: 12/17/2020] [Indexed: 09/16/2023] Open
Abstract
Left main bifurcation percutaneous coronary intervention is a challenging subset that requires expertise in techniques that are in constant modification. Imaging is important in lesion preparation and optimising outcomes. The interventionalist needs to be highly skilled in the different techniques, as missteps may lead to stent thrombosis and critical in-stent restenosis. Lesion classification between simple and complex identifies those who would best benefit from a two-stent technique. Current technical approaches and practice considerations are summarised in this manuscript.
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Affiliation(s)
| | | | | | - Azeem Latib
- Montefiore Medical Center, New York, NY, USA
| | | | | | - Kevin Croce
- Brigham and Women’s Hospital, Boston, MA, USA
| | - Rajesh Davé
- Ortenzio Heart Center, Holy Spirit Hospital, Camp Hill, PA, USA
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Rab T, Ratanapo S, Kern KB, Basir MB, McDaniel M, Meraj P, King SB, O'Neill W. Cardiac Shock Care Centers: JACC Review Topic of the Week. J Am Coll Cardiol 2019; 72:1972-1980. [PMID: 30309475 DOI: 10.1016/j.jacc.2018.07.074] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 12/17/2022]
Abstract
Despite advances over the past decade, the incidence of cardiogenic shock secondary to acute myocardial infarction has increased, with an unchanged mortality near 50%. Recent trials have not clarified the best strategies in treatment. While dedicated cardiac shock centers are being established, there are no standardized agreements on the utilization of mechanical circulatory support and the timeliness of percutaneous coronary intervention strategies. In some centers and prospective registries, outcomes after placement of advanced mechanical circulatory support prior to reperfusion therapy with percutaneous coronary intervention have been encouraging with improved survival. Here, we suggest systems of care with a treatment pathway for patients with acute myocardial infarction complicated by cardiogenic shock.
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Affiliation(s)
- Tanveer Rab
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
| | - Supawat Ratanapo
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Karl B Kern
- Division of Cardiology, University of Arizona, Tucson, Arizona
| | | | - Michael McDaniel
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Perwaiz Meraj
- Division of Cardiology, Northwell Health, New York, New York
| | - Spencer B King
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
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O'Neill BP, Cohen MG, Basir MB, Schreiber T, Kapur NK, Dixon S, Khandelwal AK, Grines C, Ohman EM, O'Neill WW. Outcomes Among Patients Transferred for Revascularization With Impella for Acute Myocardial Infarction With Cardiogenic Shock from the cVAD Registry. Am J Cardiol 2019; 123:1214-1219. [PMID: 30777319 DOI: 10.1016/j.amjcard.2019.01.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 11/27/2018] [Revised: 01/05/2019] [Accepted: 01/09/2019] [Indexed: 11/28/2022]
Abstract
The outcomes for patients transferred with cardiogenic shock and later treated with revascularization and Impella support have not previously been studied. To evaluate these outcomes, patients in cardiogenic shock were recruited from the catheter-based ventricular assist device registry, a prospective registry enrolling patients who underwent percutaneous coronary intervention with hemodynamic support using Impella 2.5 or CP. Analysis was performed on subgroups of patients who were characterized as those directly admitted to a tertiary care hospital (direct), or those transferred from an outside hospital (transfer). Patients who were transferred with acute myocardial infarction with cardiogenic shock (AMICS) more often presented in shock were in shock longer than 24 hours, and were more likely to be on intra-aortic balloon pump but were less likely to sustain cardiac arrest. The number of pressors, EF, diseased, and treated vessels were similar between the 2 groups. Despite baseline differences, the mortality was similar in the transfer versus direct patients (47.0% vs 53.5% p = 0.19). In a multivariate model, the factors independently associated with 30-day mortality in AMICS treated with revascularization and Impella support were cardiopulmonary resuscitation (CPR) (p <0.01), age (p <0.01), and ST-segment elevation myocardial infarction (STEMI) (p = 0.02). Whether the patient was transferred or directly admittedly with AMICS was not an independent predictor of death. In conclusion, these findings suggest that considerations should be given to transfer patients with AMICS to allow them to be treated in a contemporary manner.
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Affiliation(s)
- Brian P O'Neill
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania. Brian.O'
| | - Mauricio G Cohen
- Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | - Mir Babar Basir
- Department of Cardiology, Henry Ford Hospital, Detroit, Michigan
| | | | - Navin K Kapur
- The Cardiovascular Center, Tufts Medical Center, Boston, MA
| | - Simon Dixon
- Department of Cardiology, Beaumont Hospital, Royal Oak, Michigan
| | | | - Cindy Grines
- Northwell Health, North Shore University Hospital, Manhasset, New York
| | - Erik Magnus Ohman
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
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Léopold V, Gayat E, Pirracchio R, Spinar J, Parenica J, Tarvasmäki T, Lassus J, Harjola VP, Champion S, Zannad F, Valente S, Urban P, Chua HR, Bellomo R, Popovic B, Ouweneel DM, Henriques JPS, Simonis G, Lévy B, Kimmoun A, Gaudard P, Basir MB, Markota A, Adler C, Reuter H, Mebazaa A, Chouihed T. Correction to: Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients. Intensive Care Med 2018; 44:2022-2023. [DOI: 10.1007/s00134-018-5372-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Basir MB, Velez C, Fuller B, Wyman J, Paone G, Wang DD, Guerrero M, Greenbaum A, O'Neill W. Rates of vascular access use in transcatheter aortic valve replacement: A look into the next generation. Catheter Cardiovasc Interv 2015; 87:E166-71. [DOI: 10.1002/ccd.26116] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 07/05/2015] [Indexed: 12/19/2022]
Affiliation(s)
- Mir Babar Basir
- Division of Cardiology; Henry Ford Hospital, Wayne State University; 2799 W. Grand Blvd - K14 Detroit Michigan
| | - Carlos Velez
- Division of Cardiology; Henry Ford Hospital, Wayne State University; 2799 W. Grand Blvd - K14 Detroit Michigan
| | - Brittany Fuller
- Division of Cardiology; Henry Ford Hospital, Wayne State University; 2799 W. Grand Blvd - K14 Detroit Michigan
| | - Janet Wyman
- Division of Cardiology; Henry Ford Hospital, Wayne State University; 2799 W. Grand Blvd - K14 Detroit Michigan
| | - Gaetano Paone
- Division of Cardiology; Henry Ford Hospital, Wayne State University; 2799 W. Grand Blvd - K14 Detroit Michigan
| | - Dee Dee Wang
- Division of Cardiology; Henry Ford Hospital, Wayne State University; 2799 W. Grand Blvd - K14 Detroit Michigan
| | - Mayra Guerrero
- Division of Cardiology; Henry Ford Hospital, Wayne State University; 2799 W. Grand Blvd - K14 Detroit Michigan
| | - Adam Greenbaum
- Division of Cardiology; Henry Ford Hospital, Wayne State University; 2799 W. Grand Blvd - K14 Detroit Michigan
| | - William O'Neill
- Division of Cardiology; Henry Ford Hospital, Wayne State University; 2799 W. Grand Blvd - K14 Detroit Michigan
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Basir MB, Greenbaum A, O'Neill W. Unjailing of the septal perforator using a rotational atherectomy device prior to alcohol septal ablation in a patient with symptomatic hypertrophic obstructive cardiomyopathy. Catheter Cardiovasc Interv 2014; 84:E26-9. [PMID: 24740801 DOI: 10.1002/ccd.25511] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 02/23/2014] [Accepted: 04/06/2014] [Indexed: 11/10/2022]
Abstract
We report a novel approach in which successful unjailing of the septal perforator was performed through the side branch of a coronary stent using a rotational atherectomy device for the purpose of alcohol septal ablation in a patient with symptomatic hypertrophic obstructive cardiomyopathy.
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Affiliation(s)
- Mir Babar Basir
- Division of Cardiology, Henry Ford Hospital, Detroit, Michigan, 48202
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