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  1. Article ; Online: Compunction: The Present Tense of Physiology to Guide Coronary Revascularization in Severe Aortic Stenosis.

    Whiteside, Hoyle L / Sutton, Nadia R

    Circulation. Cardiovascular interventions

    2024  , Page(s) e014128

    Language English
    Publishing date 2024-04-17
    Publishing country United States
    Document type Editorial
    ZDB-ID 2450797-0
    ISSN 1941-7632 ; 1941-7640
    ISSN (online) 1941-7632
    ISSN 1941-7640
    DOI 10.1161/CIRCINTERVENTIONS.124.014128
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Coronary interventions among patients with hepatic insufficiency: Encouragement to avoid a jaundiced view.

    Whiteside, Hoyle L / Moliterno, David J

    Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

    2020  Volume 96, Issue 4, Page(s) 811–812

    MeSH term(s) Hepatic Insufficiency ; Humans ; Jaundice ; Liver Cirrhosis ; Percutaneous Coronary Intervention/adverse effects ; Treatment Outcome
    Language English
    Publishing date 2020-10-21
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1459995-8
    ISSN 1522-726X ; 1522-1946
    ISSN (online) 1522-726X
    ISSN 1522-1946
    DOI 10.1002/ccd.29277
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Prognostic Implication of Pre-Cannulation Cardiac Arrest in Patients Undergoing Extracorporeal Membrane Oxygenation for the Management of Cardiogenic Shock.

    Whiteside, Hoyle L / Hillerson, Dustin / Abdel-Latif, Ahmed / Gupta, Vedant A

    Journal of intensive care medicine

    2022  Volume 38, Issue 2, Page(s) 202–207

    Abstract: Background: The application of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in contemporary management of cardiogenic shock (CS) has dramatically increased. Despite increased utilization, few predictive models exist to estimate patient ... ...

    Abstract Background: The application of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in contemporary management of cardiogenic shock (CS) has dramatically increased. Despite increased utilization, few predictive models exist to estimate patient survival based on pre-ECMO characteristics. Furthermore, the prognostic implications of pre-ECMO cardiac arrest are not well defined.
    Methods: Utilizing an institutional VA-ECMO database, all consecutive patients undergoing VA-ECMO for the management of CS from January 1, 2014, to July 1, 2019, were identified. Survival to hospital discharge was analyzed based on cannulation indication in patients with and without pre-ECMO cardiac arrest. Patients who received extracorporeal cardiopulmonary resuscitation (eCPR) were analyzed separately.
    Results: Of the 214 patients identified, 110 did not suffer a cardiac arrest prior to cannulation (cohort 1), 57 patients had a cardiac arrest with sustained ROSC (cohort 2), and 47 were cannulated as a component of eCPR (cohort 3). Despite sustained ROSC (cohort 2), the presence of pre-ECMO cardiac arrest was associated with a significant reduction in survival to hospital discharge (22.8% vs. 55.5% in cohort 1; p < 0.001). Comparatively, survival to discharge was similar in patients undergoing eCPR (22.8% vs. 17.0%; p = 0.464). Finally, patients with a cardiac arrest were significantly more likely to have a neurological etiology death with VA-ECMO than patients supported prior to hemodynamic collapse (18.3% vs. 2.7%; p < 0.001). This result is seen in those with sustained ROSC (21.1% vs. 2.7%; p < 0.001) and those with eCPR (14.9% vs. 2.7%; p = 0.004).
    Conclusion: In our cohort, pre-ECMO cardiac arrest carries a negative prognostic value across all indications and is associated with an increased prevalence of neurological-etiology death. This finding is true in patients with sustained ROSC as well as those resuscitated with eCPR. Cardiac arrest can inform survival probability with VA-ECMO as early implementation of VA-ECMO may mitigate adverse outcomes in patients at the highest risk of hemodynamic collapse.
    MeSH term(s) Humans ; Shock, Cardiogenic/etiology ; Shock, Cardiogenic/therapy ; Extracorporeal Membrane Oxygenation ; Prognosis ; Heart Arrest/therapy
    Language English
    Publishing date 2022-07-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632828-3
    ISSN 1525-1489 ; 0885-0666
    ISSN (online) 1525-1489
    ISSN 0885-0666
    DOI 10.1177/08850666221115606
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  4. Article ; Online: Continuity of Critical Care: Establishing a Cardiac Intensive Care Unit Recovery Clinic.

    Hillerson, Dustin / Whiteside, Hoyle L / Gupta, Vedant A

    JACC. Case reports

    2021  Volume 3, Issue 18, Page(s) 1932–1935

    Language English
    Publishing date 2021-12-15
    Publishing country Netherlands
    Document type Editorial
    ISSN 2666-0849
    ISSN (online) 2666-0849
    DOI 10.1016/j.jaccas.2021.09.009
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  5. Article ; Online: Safety and Efficacy of Stentablation with Rotational Atherectomy for the Management of Underexpanded and Undilatable Coronary Stents.

    Whiteside, Hoyle L / Nagabandi, Arun / Kapoor, Deepak

    Cardiovascular revascularization medicine : including molecular interventions

    2019  Volume 20, Issue 11, Page(s) 985–989

    Abstract: Introduction: Coronary stent underexpansion is associated with in-stent restenosis and few interventions are available for the management of undilatable underexpanded stents. Stentablation (SA) with rotational atherectomy (RA) is a unique application ... ...

    Abstract Introduction: Coronary stent underexpansion is associated with in-stent restenosis and few interventions are available for the management of undilatable underexpanded stents. Stentablation (SA) with rotational atherectomy (RA) is a unique application and has previously been described with encouraging results. Data regarding SA is limited to case reports and small case series; therefore, reasonable concern persists regarding procedural safety and long-term outcomes.
    Methods: This is a single-center retrospective study analyzing twenty consecutive patients who underwent SA with RA. The primary endpoint was procedural success and secondary endpoints included procedural safety outcomes and major adverse cardiac events (MACE) over a 12-month follow-up period.
    Results: Stentablation and secondary stenting were guided by intravascular ultrasound and procedural success was achieved in all cases. No in-hospital death or MACE was observed. The prevalence of MACE was 5% at 30 days as one patient developed recurrent MI without target lesion revascularization (TLR). At 12 months, MACE had occurred in 40% of patients, however this was strongly driven by a high prevalence of TLR (30%). Only one cardiac death (5%) and one additional NSTEMI were observed during the 11 additional months of follow up.
    Conclusion: Stentablation with RA is a feasible and effective option for the acute management of symptomatic, underexpanded, and undilatable coronary stents. SA is associated with a high rate of procedural success as well as excellent in-hospital and short-term outcomes. However, our study population demonstrated substantial MACE at 12 months which was strongly driven by TLR and associated with minimal mortality.
    MeSH term(s) Aged ; Atherectomy, Coronary/adverse effects ; Atherectomy, Coronary/mortality ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/mortality ; Coronary Artery Disease/therapy ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention/adverse effects ; Percutaneous Coronary Intervention/instrumentation ; Percutaneous Coronary Intervention/mortality ; Prosthesis Design ; Prosthesis Failure ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stents ; Time Factors ; Treatment Outcome ; Ultrasonography, Interventional
    Language English
    Publishing date 2019-01-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2212113-4
    ISSN 1878-0938 ; 1553-8389
    ISSN (online) 1878-0938
    ISSN 1553-8389
    DOI 10.1016/j.carrev.2019.01.013
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  6. Article ; Online: Stentablation with Rotational Atherectomy for the Management of Underexpanded and Undilatable Coronary Stents.

    Whiteside, Hoyle L / Nagabandi, Arun / Kapoor, Deepak

    Cardiovascular revascularization medicine : including molecular interventions

    2019  Volume 20, Issue 12, Page(s) 1203–1208

    Abstract: Stentablation with rotational atherectomy for the management of undilatable underexpanded coronary stents is a unique application associated with excellent periprocedural and in-hospital outcomes. Data regarding long-term outcomes remains limited, ... ...

    Abstract Stentablation with rotational atherectomy for the management of undilatable underexpanded coronary stents is a unique application associated with excellent periprocedural and in-hospital outcomes. Data regarding long-term outcomes remains limited, however the procedure appears to be associated with high prevalence of target lesion revascularization. Given the complexity of such lesions and few available interventional remedies; it is a reasonably safe and widely available approach of which operators should be aware. When stentablation is performed, the principles which guide contemporary rotational atherectomy and percutaneous coronary intervention, including intravascular imaging, should be applied.
    MeSH term(s) Aged ; Aged, 80 and over ; Atherectomy, Coronary/adverse effects ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/physiopathology ; Coronary Artery Disease/therapy ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention/adverse effects ; Percutaneous Coronary Intervention/instrumentation ; Prosthesis Design ; Prosthesis Failure ; Risk Factors ; Stents ; Treatment Outcome ; Vascular Calcification/diagnostic imaging ; Vascular Calcification/physiopathology ; Vascular Calcification/therapy
    Language English
    Publishing date 2019-03-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2212113-4
    ISSN 1878-0938 ; 1553-8389
    ISSN (online) 1878-0938
    ISSN 1553-8389
    DOI 10.1016/j.carrev.2019.02.025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Establishing a Cardiac ICU Recovery Clinic: Characterizing a Model for Continuity of Cardiac Critical Care.

    Whiteside, Hoyle L / Hillerson, Dustin / Buescher, Victoria / Kreft, Kayla / Mayer, Kirby P / Montgomery-Yates, Ashley / Gupta, Vedant A

    Critical pathways in cardiology

    2022  Volume 21, Issue 3, Page(s) 135–140

    Abstract: Background: Care in the cardiovascular intensive care unit (CICU) has become increasingly intricate due to a temporal rise in noncardiac diagnoses and overall clinical complexity with high risk for short-term rehospitalization and mortality. Survivors ... ...

    Abstract Background: Care in the cardiovascular intensive care unit (CICU) has become increasingly intricate due to a temporal rise in noncardiac diagnoses and overall clinical complexity with high risk for short-term rehospitalization and mortality. Survivors of critical illness are often faced with debility and limitations extending beyond the index hospitalization. Comprehensive ICU recovery programs have demonstrated some efficacy but have primarily targeted survivors of acute respiratory distress syndrome or sepsis. The efficacy of dedicated ICU recovery programs on the CICU population is not defined.
    Methods: We aim to describe the design and initial experience of a novel CICU-recovery clinic (CICURC). The primary outcome was death or rehospitalization in the first 30 days following hospital discharge. Self-reported outcome measures were performed to assess symptom burden and independence in activities of daily living.
    Results: Using standardized criteria, 41 patients were referred to CICURC of which 78.1% established care and were followed for a median of 88 (56-122) days. On intake, patients reported a high burden of heart failure symptoms (KCCQ overall summary score 29.8 [18.0-47.5]), and nearly half (46.4%) were dependent on caretakers for activities of daily living. Thirty days postdischarge, no deaths were observed and the rate of rehospitalization for any cause was 12.2%.
    Conclusions: CICU survivors are faced with significant residual symptom burden, dependence upon caretakers, and impairments in mental health. Dedicated CICURCs may help prioritize treatment of ICU related illness, reduce symptom burden, and improve outcomes. Interventions delivered in ICU recovery clinic for patients surviving the CICU warrant further investigation.
    MeSH term(s) Activities of Daily Living ; Aftercare ; Critical Care ; Heart Diseases/therapy ; Hospital Mortality ; Humans ; Intensive Care Units ; Patient Discharge
    Language English
    Publishing date 2022-08-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2079676-6
    ISSN 1535-2811 ; 1535-282X
    ISSN (online) 1535-2811
    ISSN 1535-282X
    DOI 10.1097/HPC.0000000000000294
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  8. Article ; Online: Outcomes of rotational atherectomy in patients with severe left ventricular dysfunction without hemodynamic support.

    Whiteside, Hoyle L / Ratanapo, Supawat / Nagabandi, Arun / Kapoor, Deepak

    Cardiovascular revascularization medicine : including molecular interventions

    2018  Volume 19, Issue 6, Page(s) 660–665

    Abstract: Introduction: Elective insertion of a percutaneous circulatory assist device (PCAD) in high-risk patients is considered a reasonable adjunct to percutaneous coronary intervention (PCI). There is limited data examining the safety and efficacy of ... ...

    Abstract Introduction: Elective insertion of a percutaneous circulatory assist device (PCAD) in high-risk patients is considered a reasonable adjunct to percutaneous coronary intervention (PCI). There is limited data examining the safety and efficacy of rotational atherectomy (RA) without hemodynamic support in patients with reduced left ventricular ejection fraction (LVEF).
    Methods: We retrospectively identified 131 consecutive patients undergoing RA without elective PCAD over a three-year period. Patients were categorized into three groups: LVEF ≤30%, LVEF 31-50%, and LVEF >50%. The incidence of procedural hypotension, major adverse cardiac events (MACE), and mortality were recorded.
    Results: Statistical analysis included 18, 42, and 71 patients with LVEF ≤30%, 31-50%, and >50%, respectively. Bailout hemodynamic support was required in four cases. Analysis revealed a significant trend as bailout hemodynamic support was required in 11.1% vs 2.4% (P = 0.1551) in the ≤30% vs 31-50% and 11.1% vs 1.4% (P = 0.0416) in the ≤30% vs >50% subgroups. Combined subgroup analysis also demonstrated statistical significance 11.1% vs 1.8% (P = 0.0324) in the ≤30% vs >30% subgroups. No-reflow phenomenon was more prevalent in patients with reduced LVEF (LVEF ≤30%: 11.1%, LVEF 31-50%: 2.4%, LVEF >50%: 0%; P = 0.0190). Otherwise, no significant differences in in-hospital MACE, or mortality were observed.
    Conclusion: RA can be effectively utilized in patients with severely reduced LVEF; however, these patients are at increased risk of prolonged procedural hypotension requiring bailout hemodynamic support. If indicated, prompt implementation of hemodynamic support mitigated any impact of procedural hypotension on in-hospital MACE and mortality.
    MeSH term(s) Acute Coronary Syndrome/diagnostic imaging ; Acute Coronary Syndrome/mortality ; Acute Coronary Syndrome/physiopathology ; Acute Coronary Syndrome/surgery ; Aged ; Aged, 80 and over ; Atherectomy, Coronary/adverse effects ; Atherectomy, Coronary/mortality ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/mortality ; Coronary Artery Disease/physiopathology ; Coronary Artery Disease/surgery ; Female ; Hemodynamics ; Hospital Mortality ; Humans ; Hypotension/mortality ; Hypotension/physiopathology ; Hypotension/therapy ; Male ; Middle Aged ; Myocardial Infarction/diagnostic imaging ; Myocardial Infarction/mortality ; Myocardial Infarction/physiopathology ; Myocardial Infarction/surgery ; Percutaneous Coronary Intervention/adverse effects ; Percutaneous Coronary Intervention/instrumentation ; Percutaneous Coronary Intervention/mortality ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Stents ; Time Factors ; Treatment Outcome ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Dysfunction, Left/mortality ; Ventricular Dysfunction, Left/physiopathology ; Ventricular Function, Left
    Language English
    Publishing date 2018-02-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2212113-4
    ISSN 1878-0938 ; 1553-8389
    ISSN (online) 1878-0938
    ISSN 1553-8389
    DOI 10.1016/j.carrev.2018.02.008
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  9. Article: Prevalence and clinical characteristics associated with left atrial thrombus detection: Apixaban.

    Whiteside, Hoyle L / Nagabandi, Arun / Brown, Kristen / Ayyala, Deepak N / Sharma, Gyanendra K

    World journal of cardiology

    2019  Volume 11, Issue 2, Page(s) 84–93

    Abstract: Background: The prevalence of left atrial appendage (LAA) thrombus detection by transesophageal echocardiogram (TEE) in patients with non-valvular atrial fibrillation (AF) anticoagulated with apixaban is not well defined and identification of additional ...

    Abstract Background: The prevalence of left atrial appendage (LAA) thrombus detection by transesophageal echocardiogram (TEE) in patients with non-valvular atrial fibrillation (AF) anticoagulated with apixaban is not well defined and identification of additional risk factors may help guide the selection process for pre-procedural TEE. The purpose of our study was to retrospectively analyze the prevalence of LAA thrombus detection by TEE in patients continuously anticoagulated with apixaban for ≥ 4 wk and evaluate for any cardiac risk factors or echocardiographic characteristics which may serve as predictors of thrombus formation.
    Aim: To retrospectively analyze the prevalence of LAA thrombus detection by TEE in patients continuously anticoagulated with apixaban.
    Methods: Clinical and echocardiographic data for 820 consecutive patients with AF undergoing TEE at Augusta University Medical Center over a four-year period were retrospectively analyzed. All patients (apixaban: 226) with non-valvular AF and documented compliance with apixaban for ≥ 4 wk prior to index TEE were included.
    Results: Following ≥ 4 wk of continuous anticoagulation with apixaban, the prevalence of LAA thrombus and LAA thrombus/dense spontaneous echocardiographic contrast was 3.1% and 6.6%, respectively. Persistent AF, left ventricular ejection fraction < 30%, severe LA dilation, and reduced LAA velocity were associated with thrombus formation. Following multivariate logistic regression, persistent AF (OR: 7.427; 95%CI: 1.02 to 53.92;
    Conclusion: Among patients with non-valvular AF and ≥ 4 wk of anticoagulation with apixaban, the prevalence of LAA thrombus detected by TEE was 3.1%. This suggests that continuous therapy with apixaban does not completely eliminate the risk of LAA thrombus and that TEE prior to cardioversion or catheter ablation may be of benefit in patients with multiple risk factors.
    Language English
    Publishing date 2019-02-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2573665-6
    ISSN 1949-8462
    ISSN 1949-8462
    DOI 10.4330/wjc.v11.i2.84
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  10. Article ; Online: Predicting mortality in nonsurgical patients before cannulation for veno-arterial extracorporeal life support: Development and validation of the LACT-8 score.

    Hillerson, Dustin / Whiteside, Hoyle L / Dugan, Adam J / Coots, Riley D / Tribble, Thomas A / Abdel-Latif, Ahmed / Ogunbayo, Gbolahan O / Duncan, Meredith S / Gupta, Vedant A

    Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

    2022  Volume 99, Issue 4, Page(s) 1115–1124

    Abstract: Objectives: We sought to derive and validate a model to predict inpatient mortality after veno-arterial extracorporeal life support (VA-ECLS) based on readily available, precannulation clinical data.: Background: Refractory cardiogenic shock ... ...

    Abstract Objectives: We sought to derive and validate a model to predict inpatient mortality after veno-arterial extracorporeal life support (VA-ECLS) based on readily available, precannulation clinical data.
    Background: Refractory cardiogenic shock supported by VA-ECLS is associated with high morbidity and mortality.
    Methods: VA-ECLS cases at our institution from January 2014 through July 2019 were retrospectively reviewed. Exclusion criteria were cannulation: (1) at another institution; (2) for primary surgical indication; or (3) for extracorporeal cardiopulmonary resuscitation. Multivariable logistic regression compared those with and without inpatient mortality. Multiple imputation was performed and optimism-adjusted area under the curve (oAUC) values were computed.
    Results: VA-ECLS cases from August 2019 through November 2020 were identified as a validation cohort. In the derivation cohort (n = 135), the final model included Lactate (mmol/L), hemoglobin (g/dl; Anemia), Coma (Glasgow Coma Scale [GCS] < 8) and resusciTATEd cardiac arrest (LACTATE score; oAUC = 0.760). In the validation cohort (n = 30, LACTATE showed similar predictability [AUC = 0.710]). A simplified (LACT-8) score was derived by dichotomizing lactate (>8) and hemoglobin (<8) and summing together the number of components for each patient. LACT-8 performed similarly (derivation, oAUC = 0.724; validation, AUC = 0.725). In the derivation cohort, both scores outperformed SAVE (oAUC = 0.568) and SOFA (oAUC = 0.699) scores. A LACT-8 ≥ 3 had a specificity for mortality of 97.9% and 92.9%, in the derivation and validation cohorts, respectively.
    Conclusions: The LACT-8 score can predict inpatient mortality prior to before cannulation for VA-ECLS. LACT-8 can be implemented utilizing clinical data without the need for an online calculator.
    MeSH term(s) Catheterization ; Hospital Mortality ; Humans ; Lactic Acid ; Retrospective Studies ; Shock, Cardiogenic/diagnosis ; Shock, Cardiogenic/therapy ; Treatment Outcome
    Chemical Substances Lactic Acid (33X04XA5AT)
    Language English
    Publishing date 2022-02-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1459995-8
    ISSN 1522-726X ; 1522-1946
    ISSN (online) 1522-726X
    ISSN 1522-1946
    DOI 10.1002/ccd.30106
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