Hudsongunn7059
This is the first report to evaluate endothelialization in vivo; the evidence of endothelialization on the venous stent in the early phase suggests that antithrombotic therapy could be stopped in some patients with high risk of bleeding in the chronic phase.We demonstrate the percutaneous closure of a coronary fistula and subsequent utilization of a vascular plug in a patient with challenging anatomy.Interventional cardiologists should maintain awareness of extracardiac structures when undertaking cardiac catheterization, as pathology outside of the coronary arteries may be identified.A 10-year-old girl with pulmonary atresia status post transannular patch repair and secundum atrial septal defect (ASD) underwent percutaneous ASD closure 5 years earlier. There was improvement in arterial saturation from 86% to 98% with minimal residual right-to-left shunt. Despite subsequent medical therapy, she developed recurrent migraines, which led us to pursue percutaneous closure of the shunt.Coronary artery vasospasm, or Prinzmetal angina, remains a challenging diagnosis. Prinzmetal angina usually affects only one coronary vessel; however, in this case, it occurred simultaneously in three coronary arteries, and was totally relieved after nitrate administration.Distal TRA is a novel access site in the interventional cardiology field, with current data demonstrating high success and infrequent complication rates - global procedural metrics that are comparable with historical proximal TRA. Distal TRA may conversely provide important advantages over proximal TRA, including patient comfort, shorter hemostasis time, and lower radial artery occlusion rates.We present two cases where a right heart catheterization was performed from the anatomical snuffbox through the distal cephalic vein along with a left heart catheterization from the distal radial artery.Hypertrophic cardiomyopathy (HCM) is frequently associated with abnormalities of the mitral valve; these commonly include systolic anterior motion (SAM) of anterior mitral leaflets that contribute to dynamic left ventricular outflow tract (LVOT) obstruction and secondary mitral regurgitation (MR). In patients with severe HCM, LVOT obstruction due to SAM, and debilitating symptoms refractory to medical therapy, the current standard of care involves a surgical approach. This involves targeting the ventricular septum through resection or ablation, combined at times with mitral valve replacement or plication of the valve leaflet to relieve LVOT obstruction. In patients with symptoms refractory to medical management who are at prohibitive surgical risk, additional options for less-invasive approaches for the management of HCM are needed. We describe here the successful non-surgical catheter-based management of a 72-year-old woman at high surgical risk, debilitating symptoms refractory to maximal medical management, and severe, diffuse-type HCM. learn more Edge-to-edge repair with MitraClip (Abbott Vascular) was used to target SAM causing dynamic LVOT obstruction, with resulting significant reduction in LVOT gradient and dramatic clinical improvement. Her postprocedure outcomes to 2 years are reported herein. Additionally, we review the current management strategies for HCM management, and include a discussion of minimally invasive options.
To compare and contrast the indications, clinical and procedural characteristics, and periprocedural outcomes of patients with cardiac transplant undergoing percutaneous coronary intervention (PCI) in the United States and United Kingdom.
The British Cardiovascular Intervention Society Registry (BCIS) (2007-2014) and the United States National Inpatient Sample (NIS) (2004-2014) data were utilized for this analysis. There were 466 PCIs (0.09%) and 1122 PCIs (0.02%) performed in cardiac transplant patients in the BCIS and NIS registries, respectively. The cardiac transplant PCI cohort was younger and mostly men, with an increased prevalence of chronic kidney disease, left main PCI, and multivessel disease, and with lower use of newer antiplatelets agents, antithrombotics, and radial artery access vs the non-cardiac transplant PCI cohort. In the BCIS registry, the cardiac transplant PCI cohort had similar in-hospital mortality (odds ratio [OR], 1.05; P=.91), 30-day mortality (OR, 1.38; P=.31), vascular complications (OR, 0.69; P=.46), and major adverse cardiovascular event (OR, 1.41; P=.26) vs the non-cardiac transplant PCI cohort. However, the cardiac transplant group had higher 1-year mortality (OR, 2.30; P<.001). The NIS data analysis revealed similar rates of in-hospital mortality (OR, 2.40; P=.14), cardiac complications (OR, 0.26; P=.17), major bleeding (OR, 0.36; P=.16), vascular complications (OR, 0.46; P=.45), and stroke (OR, 0.50; P=.40) in the cardiac transplant PCI cohort vs the non-cardiac transplant PCI cohort.
PCI in cardiac transplant recipients was associated with similar short-term mortality and vascular complications compared with PCI in the general populace. However, a higher 1-year morality was observed in the BCIS cohort.
PCI in cardiac transplant recipients was associated with similar short-term mortality and vascular complications compared with PCI in the general populace. However, a higher 1-year morality was observed in the BCIS cohort.
Schizophrenia spectrum disorders (SSDs) are chronic conditions, but the severity of symptomatic experiences and functional impairments vacillate over the course of illness. Developing unobtrusive remote monitoring systems to detect early warning signs of impending symptomatic relapses would allow clinicians to intervene before the patient's condition worsens.
In this study, we aim to create the first models, exclusively using passive sensing data from a smartphone, to predict behavioral anomalies that could indicate early warning signs of a psychotic relapse.
Data used to train and test the models were collected during the CrossCheck study. Hourly features derived from smartphone passive sensing data were extracted from 60 patients with SSDs (42 nonrelapse and 18 relapse >1 time throughout the study) and used to train models and test performance. We trained 2 types of encoder-decoder neural network models and a clustering-based local outlier factor model to predict behavioral anomalies that occurred within the 30-day period before a participant's date of relapse (the near relapse period).