Halifax Health’s Post

Great third option for aorta valve stenosis, especially for older patients who may not be able to get SAVR or TAVR treatment. It is very non invasive

DEDICATE-DZKH6 presented at the ACC.24 meeting and was promising. TAVR was found to bring no increased risks and was associated with substantially decreased rates of death or stroke at one year in low-risk patients, compared with surgical aortic valve replacement (SAVR). We may still need long-term data regarding the durability of the TAVR valves especially low risk patient population. Heart team approach still is the recommended way to decide TAVR vs SAVR in a patient centric approach, which should take patient preferences into consideration

Did you know that Persistent left superior vena cava (PLSVC) is the most common congenital malformation of thoracic venous return and is present in 0.3 to 0.5% of individuals in the general population? Recently, I had an interesting case where I suspected PLSVC after not seeing a good Intracavitary max p-wave. Second film was compared with Ic-ecg max p-wave thus, plsvc was suspected. After digging up old tests, it was confirmed that the patient had a past venogram. Roughly 10% to 20% of those with PLSVC drain to the left atrium via coronary sinus with the majority draining into the right atrium. This anomaly can lead to atrophy of the left atrium and ultimately cardiac outflow problems. Although it occurs in conjunction with right SVC in approximately 80-90% of the time, it can cause significant hemodynamic changes and clinical consequences if the PLSVC drains into the left atrium, resulting in right-to-left shunt and cyanosis. Surgical intervention is often necessary in such cases. It is fascinating to see how medical anomalies can impact the cardiovascular system and potentially Cental line placement.

RADPAD Reduces Radiation by More Than 68% During Complex PCI Procedures! A study published in the American Journal of Cardiology investigated the effectiveness of RADPAD® Radiation Protection Shields in minimizing radiation exposure for interventional cardiologists performing complex PCI procedures. The study focused on 60 patients undergoing complex PCI, including procedures with: - Rotational atherectomy - Multivessel PCI - Chronic total occlusions (CTOs) RADPAD® significantly reduced radiation exposure to operators compared to the control group, especially when considering radiation dose relative to procedure duration. The study found a significant difference in the rate of radiation dose increase between the groups: RADPAD Group: Slope = 1.44 No RADPAD Group: Slope = 4.60 This translates to a slower increase in radiation dose per minute of fluoroscopy for operators using RADPAD®. Choose RADPAD®, backed by more than 40 clinical studies, for a safer work environment and continued dedication to patient care. #RADPAD #RadiationProtection #Cardiology #PCI #MedEd #HealthcareSafety 

✔ A 78-year-old man presented to our Hospital with a Very High-Risk Non-ST-segment elevation myocardial infarction (NSTEMI). His ejection fraction was 30%, chronic renal failure Stage IIIb (GFR= 41 ml/min/1.73 m²) and he had a history of a conservative-treated MI six months ago.   ❌ His Angiography revealed a True Simple Left Main Bifurcation Medina 1-1-1, calcified vessels with a dominant LCX, and an extremely frail patient. In this context, I planned to adopt a stepwise provisional strategy of the Left main-LAD to tackle the situation.    ✔ I used radial approach, EBU 4, 6 F, and two guidewires ➿ , 0.014" BMW in LAD and 0.014" CROSS IT 200 in OM1 (BMW and PILOT 50 couldn't cross).   🔛 The procedure involved the following steps:    Step 1️⃣ : Dilating the Left Main-LAD using an SC 2.0 x 15 mm and an SC 1.5 x 15 mm in the Left Main-LCX for active side branch protection.    Step 2️⃣ : Prepare the plaque by dilating with an NC 4.0 x 15 mm in Left Main-LAD and NC 3.0 x 15 mm Left Main-LCX.    Step 3️⃣ : Cutting the plaque using a 3.0 x 10 mm Wolverine in the Left main and LAD at 6 atm, multiple times (no larger balloon was available at that moment).   Step 4️⃣ : Implant a 4.0 x 24 DES in the left main-LAD.    Step 5️⃣ : POT with an NC 4.5 x 15 mm.    Step 6️⃣ : Recrossing and sequentially kissing balloons 1:1 at 16 atm.    Step 7️⃣ : Re-POT with an NC 4.5 x 15 mm at very high pressures of 30 atm. 🔚       ❓ Should I have inflated the Wolverine to a high pressure in the Left Main? Based on the cut-and-crack approach, it should be safe, but I need to gain experience with it. What do you think?   ⭕ At that time, we didn't have OPN or Shockwave in our Lab.   ✔ The plan is to assess the patient's angiography again in three months and to use a Shockwave balloon to expand the stent properly. Alex Achim Nichita-Brendea Mihnea Florim Cuculi Claudiu Ungureanu Marin Postu

Various modalities are utilized in percutaneous coronary intervention (PCI) for severe calcified lesions, with IVL and atherectomy as primary methods, followed by balloon expansion. This study assesses the safety and efficacy of the orbital atherectomy system (OAS) in treating such lesions. OPN NC® Super High-Pressure PTCA Balloons, now available in the U.S., are reshaping PCI/PTCA procedures. With a burst pressure of 35 atmospheres, OPN NC® effectively cracks calcified lesions, manages restenosis, aids in stent dilation, and addresses post-IVL/atherectomy scenarios. This modality significantly saves costs and time by reducing the need for multiple devices. OPN NC® Super High-Pressure PTCA Balloons can be obtained through Worldwide Innovations & Technologies Inc. and RADPAD® Radiation Protection. For inquiries, contact us at [email protected] or via LinkedIn/Twitter. #OPN #OPNNC #PCI #PTCA #CTO #IVL #OAS #RADPAD® #balloon #healthcare #Cardiology

Among patients undergoing mitral valve repair, the addition of tricuspid annuloplasty is associated with a higher incidence of permanent pacemaker implantation, and subsequently linked with reduced long-term survival and higher rates of heart failure hospitalization and infective endocarditis, an analysis of patient data shows. Read more on #CRTonline. https://ow.ly/RFR450RG70z #cardiacnurse #cardiologists #cardiology #cardiologyfellow #cardiologyfellows #cardiologynurse #cardiologynurses #cathlab #cathlabnurse #cathlabtech #interventionalcardiologists #interventionalcardiology #interventionalcardiologyfellow #interventionalcardiologyfellows #MCRN #medicalequity

IABP: Intra Aortic Balloon Pump Intra-Aortic Balloon Pump (IABP) is a device widely used in cardiology to support patients with severe cardiac conditions. 📉 What is IABP? IABP is a mechanical device that helps the heart pump blood more effectively using a method called counterpulsation. 💡 What is Counterpulsation? Counterpulsation is the synchronized inflation and deflation of the balloon with the cardiac cycle. By inflating during diastole and deflating just before systole, it: - Enhances coronary perfusion: By increasing blood flow to the heart during diastole. - Reduces cardiac workload: By decreasing resistance against which the heart pumps during systole. ⚙️ How Does IABP Work? 1. Placement: A balloon catheter is placed in the aorta positioned above the renal arteries and below the left subclavian. 2. Timing with the Heartbeat: The IABP inflates and deflates in sync with the cardiac cycle, which is controlled by an external console. 3. Inflation: During diastole (when the heart relaxes and fills with blood), the balloon inflates. This increases blood flow to the coronary arteries, improving oxygen supply to the heart muscle. 4. Deflation: Just before systole (when the heart contracts to pump blood out), the balloon deflates rapidly. This creates a vacuum effect, reducing the workload on the heart and increasing cardiac output. 💡 Benefits of IABP: •Enhances coronary perfusion. •Reduces myocardial oxygen demand. •Stabilizes hemodynamics in critically ill patients. 👩⚕️ Clinical Impact: The use of IABP can be crucial in stabilizing patients, allowing time for further intervention, and improving overall outcomes. #Cardiology #IABP #MedicalDevices #HeartHealth #HealthcareInnovation #DontMissABeat #CardiacCare #CriticalCare #InterventionalCardiology Teleflex Getinge

During #HospitalWeek, we’re celebrating the innovative care our Heart and Vascular team provides to the community. The world's first transcatheter aortic valve replacement (TAVR) using the new, FDA-approved Evolut™ FX TAVR system was successfully performed right here in Pennsylvania at the UPMC Heart and Vascular Institute. This breakthrough procedure not only offers hope to patients suffering from severe aortic stenosis but also sets a new standard in cardiac procedures. The patient, an 82-year-old woman from Elliottsburg, Pa. with aortic valve stenosis, was the first person in the world to undergo this new type of transcatheter aortic valve replacement and has been discharged and is recovering well. Hemal Gada, MD, president, UPMC Heart and Vascular Institute in Central Pa. performed the procedure using the newest-generation FDA approved Evolut™ FX TAVR system for the treatment of symptomatic severe aortic stenosis. Dr. Gada is the first interventional cardiologist in the world to use this latest Evolut FX TAVR system. "This is a significant achievement for patient care in our region," said Gada. "The primary distinguishing feature of the Evolut FX and the previous Evolut system is the ease of accessing the coronary arteries, facilitated by the large openings in the valve frame. This system's improved lifetime management is highly beneficial to patients undergoing the TAVR procedure, especially younger patients who may require additional procedures in the future.” The latest Evolut FX TAVR system maintains the valve performance benefits of the legacy Evolut TAVR platform but allows larger coronary access windows through a modified diamond-shaped frame design, which is four times larger than previous iterations of the Evolut TAVR system. Evolut FX provides increased space for catheter maneuverability to facilitate access to coronary arteries of varying patient anatomies.

In this cohort study comprising 375 propensity-matched pairs of individuals, valve-in-valve transcatheter aortic valve replacement was associated with a lower risk of postprocedural complications, faster recovery times, and a similar incidence of short- to mid-term mortality but with a higher incidence of mortality beyond 2-year follow-up compared with repeat surgical aortic valve replacement