Advanced Circulatory Support and Lung Transplantation in Pulmonary Hypertension
Pulmonary arterial hypertension (PAH) is a progressive fatal disease. Although medical therapies have improved the outlook for these patients, there still exists a cohort of patients with PAH who are refractory to these therapies. Lung transplantation (LT), and in certain cases heart –lung transplantation (HLT), is a therapeutic option for patients with severe PAH who are receiving optimal therapy yet declining. ECMO may serve as a bridge to transplant or recovery in appropriate patients. Although, the mortality within the first 3 months after transplant is higher in PAH recip ients than the other indications for LT, and...
Source: Cardiology Clinics - November 20, 2021 Category: Cardiology Authors: Marie M. Budev, James J. Yun Source Type: research
Pulmonary Hypertension
I was a recently minted fellow at Duke University Medical Center in early 1998 when my mentor, Dr Bashore, asked me to come up with a research project utilizing a device he had just purchased for the catheterization laboratory. The INOvent Delivery System (Ohmeda Medical, Laurel, MD, USA) facilitated the controlled delivery of nitric oxide blended with oxygen through a ventilator circuit.1 I immediately began working on my institutional review board submission with a goal to study patients with what was then known as “primary pulmonary hypertension” and compare them with patients with “secondary pulmonary hypertensio...
Source: Cardiology Clinics - November 20, 2021 Category: Cardiology Authors: Richard A. Krasuski Tags: Preface Source Type: research
Pulmonary Hypertension
CARDIOLOGY CLINICS (Source: Cardiology Clinics)
Source: Cardiology Clinics - November 20, 2021 Category: Cardiology Authors: Richard A. Krasuski Source Type: research
Copyright
ELSEVIER (Source: Cardiology Clinics)
Source: Cardiology Clinics - November 20, 2021 Category: Cardiology Source Type: research
Contributors
JAMIL A. ABOULHOSN, MD, FACC, FSCAI (Source: Cardiology Clinics)
Source: Cardiology Clinics - November 20, 2021 Category: Cardiology Source Type: research
Contents
Richard A. Krasuski (Source: Cardiology Clinics)
Source: Cardiology Clinics - November 20, 2021 Category: Cardiology Source Type: research
Forthcoming Issues
Emerging Comorbidities in Heart Failure (Source: Cardiology Clinics)
Source: Cardiology Clinics - November 20, 2021 Category: Cardiology Source Type: research
Medical Management of Peripheral Artery Disease
Peripheral artery disease is a highly morbid yet undertreated atherosclerotic disease. The cornerstones of peripheral artery disease therapy consist of smoking cessation, lipid-lowering therapy, and hypertension treatment. More recently, clinical trials have demonstrated that novel antiplatelet and antithrombotic therapies reduce the risk of both cardiovascular and limb events in this patient population. In this review, we highlight the components of optimal medical therapy of peripheral artery disease and the evidence base for these therapies. (Source: Cardiology Clinics)
Source: Cardiology Clinics - October 20, 2021 Category: Cardiology Authors: Tara A. Holder, J. Antonio Gutierrez, Aaron W. Aday Source Type: research
Acute Aortic Syndromes
Acute aortic syndromes, classified into aortic dissection, intramural hematoma, and penetrating aortic ulcer, are associated with high early mortality for which early diagnosis and management are crucial to optimize outcomes. Patients often present with nonspecific clinical symptoms and signs; therefore, it is important for providers to maintain a high index of suspicion for acute aortic syndromes. Electrocardiogram-gated computed tomographic angiography of the chest, abdomen, and pelvis is currently the most practical imaging modality for diagnosis and identification of complications. Evolution in surgical techniques and ...
Source: Cardiology Clinics - October 20, 2021 Category: Cardiology Authors: R. Kevin Rogers, T. Brett Reece, Marc P. Bonaca, Connie N. Hess Source Type: research
Thoracic Aortic Aneurysm
Thoracic aortic aneurysms are common. Most thoracic aortic aneurysms are degenerative. However, some are associated with connective tissue disorders, bicuspid aortic valves, or familial/genetic predisposition. Most are asymptomatic, discovered incidentally on imaging. Aortic diameter is the best predictor of the natural history and risk of complications. Treating hypertension and smoking cessation can slow their growth. Surveillance imaging and referral for prophylactic aortic repair based on absolute aneurysm diameter is the primary means to decrease mortality from thoracic aortic aneurysm. We provide a practical evidence...
Source: Cardiology Clinics - October 20, 2021 Category: Cardiology Authors: Ethan M. Senser, Shantum Misra, Stanislav Henkin Source Type: research
Abdominal Aortic and Visceral Artery Aneurysms
Abdominal aortic aneurysms account for nearly 9000 deaths annually, with ruptured abdominal aortic aneurysms being the thirteenth leading cause of death in the United States. Abdominal aortic aneurysms can be detected by screening, but a majority are detected incidentally. Visceral artery aneurysms are often discovered incidentally, and treatment is guided by symptoms, etiology, and size. A timely diagnosis and referral to a vascular specialist are essential for timely open or endovascular repair and to ensure successful patient outcomes. (Source: Cardiology Clinics)
Source: Cardiology Clinics - October 20, 2021 Category: Cardiology Authors: Indrani Sen, Camila Franco-Mesa, Young Erben, Randall R. DeMartino Source Type: research
Renovascular Disease and Mesenteric Vascular Disease
This article reviews the epidemiology, pathophysiology, diagnosis, and management of these two conditions. (Source: Cardiology Clinics)
Source: Cardiology Clinics - October 20, 2021 Category: Cardiology Authors: Swapna Sharma, Stanislav Henkin, Michael N. Young Source Type: research
Revascularization Strategies for Acute and Chronic Limb Ischemia
Chronic limb-threatening ischemia requires aggressive risk factor management and a thoughtful approach to the complex decision of best strategy for revascularization. Patients often have multilevel disease amenable to endovascular, open surgical, or hybrid approaches. Limited high-quality evidence is available to support a specific strategy; randomized trials are ongoing. Acute limb ischemia is associated with a high risk of limb loss and mortality. Catheter-directed thrombolysis is mainstay of therapy in patients with marginally threatened limbs, whereas those immediately threatened with motor deficits require more rapid ...
Source: Cardiology Clinics - October 20, 2021 Category: Cardiology Authors: Jocelyn M. Beach Source Type: research
Risk Stratification and Management of Extracranial Carotid Artery Disease
Stroke is the fifth leading cause of death in the United States and is a leading cause of disability. Extracranial internal carotid artery stenosis is a major cause of ischemic stroke, as it is estimated to cause 8% to 15% of ischemic strokes. It is critical to improve our strategies for stroke prevention and treatment in order to reduce the burden of this disease. Herein, we review approaches for the diagnosis and risk stratification of carotid artery disease as well as interventional strategies for the prevention and treatment of strokes caused by carotid artery disease. (Source: Cardiology Clinics)
Source: Cardiology Clinics - October 20, 2021 Category: Cardiology Authors: Anna K. Krawisz, Brett J. Carroll, Eric A. Secemsky Source Type: research
Venous Thromboembolism for the Practicing Cardiologist
Venous thromboembolism (VTE), encompassing pulmonary embolism (PE) and deep vein thrombosis (DVT), is encountered commonly. Acute PE may present as a high-risk cardiovascular emergency, and acute DVT can cause acute and chronic vascular complications. The goal of this review is to ensure that cardiologists are comfortable managing VTE —including risk stratification, anticoagulation therapy, and familiarity with primary reperfusion therapy. Clinical assessment and determination of degree of right ventricular dysfunction are critical in initial risk stratification of PE and determination of parenteral versus oral anticoagu...
Source: Cardiology Clinics - October 20, 2021 Category: Cardiology Authors: Abby M. Pribish, Eric A. Secemsky, Alec A. Schmaier Source Type: research
