Cardiovascular revascularization medicine : including molecular interventions
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Cardiovasc Revasc Med · Sep 2020
ReviewImplementation of Institutional Discharge Protocols and Transition of Care Following Acute Coronary Syndrome.
Despite improvements in acute care and survival following acute coronary syndrome (ACS) hospitalization, readmission remains common. In response, individual institutions have begun to develop their own protocols to reduce variability of care and readmission rates. ⋯ TABLE OF CONTENTS This review discusses approaches for developing and implementing institutional discharge protocols for continuity of care for patients with acute coronary syndrome. The discussion revolves around key components and objectives of a discharge protocol for facilitating successful transition of care.
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Cardiovasc Revasc Med · Aug 2020
Case ReportsTranscatheter Mitral Valve Repair with MitraClip for Severe Mitral Regurgitation and Cardiogenic Shock During the COVID-19 Pandemic.
Transcatheter mitral valve repair with MitraClip (Abbott) is largely an elective procedure. The ongoing coronavirus disease 2019 (COVID-19) pandemic has posed challenges to health care systems; in many cases elective interventions have been curtailed. ⋯ The American College of Cardiology (ACC) and the Society of Coronary Angiography and Interventions (SCAI) recently proposed joint guidance on triage of structural heart disease (SHD) interventions during the COVID-19 pandemic. We present two illustrative cases of severe MR and cardiogenic shock that were successfully treated with MitraClip amidst the COVID-19 pandemic with good outcomes at short term follow-up.
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Cardiovasc Revasc Med · Aug 2020
ReviewTreatment of ST-Segment Elevation Myocardial Infarction During COVID-19 Pandemic.
The number of cases of the coronavirus-induced disease-2019 (COVID-19) continues to increase exponentially worldwide. In this crisis situation, the management of ST-segment elevation myocardial infarction (STEMI) is challenging. ⋯ While thrombolysis may seem like a good choice, many patients have a contraindication and could end up using more resources. Also, with a high probability of the angiogram showing non-obstructed coronary arteries during acute infections, primary PCI should be the preferred strategy.
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Cardiovasc Revasc Med · Aug 2020
ReviewGuidelines for Balancing Priorities in Structural Heart Disease During the COVID-19 Pandemic.
During the novel coronavirus disease 2019 (COVID-19) pandemic, many hospitals have been asked to postpone elective and surgical cases. This begs the question, "What is elective in structural heart disease intervention?" The recently proposed Society for Cardiovascular Angiography and Interventions/American College of Cardiology consensus statement is, unfortunately, non-specific and insufficient in its scope and scale of response to the COVID-19 pandemic. We propose guidelines that are practical, multidisciplinary, implementable, and urgent. ⋯ During the surge phase, treatment should broadly be limited to those at increased risk of complications in the near term. During the peak phase, treatment should be limited to inpatients for whom it may facilitate discharge. Keeping our patients and ourselves safe is paramount, as well as justly rationing resources.
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Cardiovasc Revasc Med · Aug 2020
Multicenter StudyCoronary and Structural Heart Disease Interventions During COVID-19 Pandemic: A Road Map for Clinicians and Health Care Delivery Systems.
Because of the COVID-19 pandemic, cath labs have had to modify their workflow for elective and urgent patients. ⋯ Our survey of an experienced team of clinicians yielded concise guidelines to direct the management of CAD and structural heart disease patients during the initial phases of the COVID-19 pandemic.