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Advances in Cardiac Interventions and Surgery in the COVID-19 Era

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A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (20 April 2024) | Viewed by 6839

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Special Issue Editor

Dr. Attila Roka

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Guest Editor

Division of Cardiology, Creighton University, Omaha, NE, USA
Interests: cardiology; cardiac electrophysiology; catheter ablation; quality improvement

Special Issue Information

Dear Colleagues,

Cardiovascular disease remains the leading cause of mortality worldwide. Timely screening, diagnosis and treatment is essential to reduce its impact. The COVID-19 pandemic and the implemented countermeasures affected cardiovascular care at many levels: decreased access to outpatient preventive and maintenance care due to lockdown measures led to difficulties in inpatient care as hospitals were overburdened by the pandemic, and decreased access to research due to the shift of focus and funding. Pandemic countermeasures were heterogenous, and their effect on cardiovascular care should be evaluated in the context of regional differences in healthcare systems. Many hospitals, physician practices, academic institutions, as well as insurance and governmental organizations implemented effective measures that allowed continued high-quality research and the delivery of patient care.

The purpose of this Special Issue is to encourage researchers, clinicians and administrators to share their latest research and most effective practices which allowed them to maintain high-quality patient care and research during the pandemic. Practices which remained effective after recovery may be of special interest, as these may increase productivity, quality of patient care and research; in addition, they may decrease susceptibility of cardiovascular care to the next pandemic.

We invite authors to submit original research or review articles focusing on practices used to combat the effects of the COVID-19 pandemic and countermeasures on cardiovascular care and research.

We are looking for submissions in the following areas:

Interventional cardiology;
Structural cardiology;
Cardiac electrophysiology;
Cardiovascular surgery;
Cardiac critical/intensive care;
Anesthesia during cardiovascular interventions;
Ancillary services essential for cardiovascular interventions;
Postgraduate education in cardiovascular disease.

We look forward to receiving your contributions.

Dr. Attila Roka
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

interventional cardiology
cardiac electrophysiology
cardiovascular surgery
quality improvement
outcomes analysis
COVID-19

Published Papers (4 papers)

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Research

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14 pages, 1371 KiB

Open AccessArticle

The Cardiac Comeback-Beating Stronger: Exploring the Remarkable Resilience of the Heart in COVID-19 Recovery through Cardiac Autonomic Analysis

by Sakshi Garg, Preeti Saini, Moattar Raza Rizvi, Fuzail Ahmad, Mohammed AlTaweel, Zia Ul Sabah, Humayoun K. Durrani, Shatha A. Almasswary, Mohamed K. Seyam, Ankita Sharma, Irshad Ahmad, Sara Al Marzoogi, Mohammad A. Shaphe, Shadab Uddin and Irshad Ahmad

Medicina 2023, 59(8), 1397; https://doi.org/10.3390/medicina59081397 - 30 Jul 2023

Cited by 3 | Viewed by 1238

Abstract

Background and Objectives: Analyzing the cardiac autonomic function in COVID-19 patients can provide insights into the impact of the virus on the heart’s regulatory mechanisms and its recovery. The autonomic nervous system plays a crucial role in regulating the heart’s functions, such as heart rate, blood pressure, and cardiac output. This study aimed to investigate the impact of COVID-19 on heart rate variability (HRV) during a 6-min walk test (6MWT). Materials and Methods: The study included 74 participants, consisting of 37 individuals who had recovered from mild to moderate COVID-19 and 37 healthy controls. The study assessed heart rate variability (HRV) and blood pressure both before and after a 6-min walk test (6MWT). Results: The study found significant differences in a few time domains (SDNN and pNN50) and all frequency domain measures, whereas there were no significant differences in demographic characteristics or blood pressure between COVID-19-recovered individuals and healthy controls at rest. There were significant 6MWT effects on average HR, time-domain (SDNN and pNN50) measures of HRV, and all frequency domain measures of HRV. A significant group × 6MWT interaction was found for SDNN, pNN50, total power, Ln total power, LF, HF, Ln LF, Ln HF, and LF nu. Conclusions: Cardiac Autonomic analysis through HRV is essential to ensure the continued health and well-being of COVID-19 survivors and to minimize the potential long-term impacts of the disease on their cardiovascular system. This suggests that HRV analysis during the recovery phase following exercise could serve as a valuable tool for evaluating the physiological effects of COVID-19 and monitoring the recovery process. Full article

(This article belongs to the Special Issue Advances in Cardiac Interventions and Surgery in the COVID-19 Era)

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10 pages, 592 KiB

Open AccessArticle

The Prognostic Significance of Uric Acid/Albumin Ratio in Patients with Aortic Stenosis Following Transcatheter Aortic Valve Implantation for Major Adverse Cardiac and Cerebral Events

by Halil Ibrahim Biter and Aydin Rodi Tosu

Medicina 2023, 59(4), 686; https://doi.org/10.3390/medicina59040686 - 30 Mar 2023

Cited by 1 | Viewed by 1268

Abstract

Background: The goal of this study was to examine if the uric acid/albumin ratio (UAR) could predict major adverse cardiac and cerebral events (MACCEs) such as stroke, readmission, and short-term all-cause death in aortic stenosis (AS) patients, after transcatheter aortic valve implantation (TAVI). Material and Methods: A total of 150 patients who had TAVI for AS between 2013 and 2022 were included in our study, retrospectively. Before the TAVI, each patient’s baseline uric acid/albumin was determined. The study’s major endpoint was MACCEs, which included stroke, re-hospitalization, and 12-month all-cause death. Results: The UAR was found to be higher in TAVI patients who developed MACCEs than in those who did not develop them. Multivariate Cox regression analysis revealed that the UAR (HR: 95% CI; 2.478 (1.779–3.453) p < 0.01), was an independent predictor of MACCEs in AS patients after TAVI. The optimal value of the UAR for MACCEs in AS patients following TAVI was >1.68 with 88% sensitivity and 66% specificity (AUC (the area under the curve): 0.899, p < 0.01). We noted that the AUC of UAR in predicting MACCEs was significantly higher than the AUC of albumin (AUC: 0.823) and uric acid (AUC: 0.805, respectively). Conclusion: MACCEs in AS patients who received TAVI may be predicted by high pre-procedural uric acid/albumin levels. The uric acid/albumin ratio (UAR) can be used to determine MACCEs in such patients following TAVI because it is inexpensive and straightforward to calculate inflammatory parameters. Full article

(This article belongs to the Special Issue Advances in Cardiac Interventions and Surgery in the COVID-19 Era)

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Other

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14 pages, 6384 KiB

Open AccessCase Report

Pregnancy-Associated Spontaneous Coronary Acute Dissection as a Cause of Sudden Cardiac Death—Autopsy Findings and Literature Review: Is COVID-19 Related?

by Timur Hogea, Bogdan Andrei Suciu, Laura Chinezu, Klara Brinzaniuc, Emil Marian Arbănași, Ancuța Ungureanu, Réka Kaller, Cosmin Carașca, Eliza Mihaela Arbănași, Vlad Vunvulea, Ioana Hălmaciu, Adrian Vasile Mureșan, Eliza Russu, Claudiu Constantin Ciucanu, Casandra Maria Radu and Carmen Corina Radu

Medicina 2023, 59(7), 1257; https://doi.org/10.3390/medicina59071257 - 07 Jul 2023

Viewed by 2518

Abstract

Sudden cardiac death (SCD) is the leading cause of mortality globally (violent or non-violent), with few to no feasible remedies. The etiopathogenesis of SCD involves a complex and multilayered substrate in which dynamic factors interact with a preexistent cardiovascular pathology, which is often undiagnosed and untreated, leading to the rapid development of cardiac rhythm disorders and cardiac arrest. Cardiovascular disease is a rare but emerging factor in maternal mortality that can be justified by an upward trend in the mean age of pregnant individuals. Spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic and non-iatrogenic separation of the coronary arterial wall by intramural hemorrhage with or without an intimal tear. The resulting intramural hematoma compresses the coronary arteries, reducing blood flow and causing myocardial ischemia. SCAD continues to be misdiagnosed, underdiagnosed, and managed as an atherosclerotic acute coronary syndrome, which may harm patients with SCAD. The latest research shows that individuals who have or have had coronavirus disease 2019 (COVID-19) may also present coagulation abnormalities, so infection with COVID-19 during pregnancy can increase this hypercoagulable condition, thus increasing the risk of SCAD and SCD. This present study reports two cases over 35 years, one being infected with SARS-COV2 one month before the event and the other being tested positive during admission, both asymptomatic, who were declared healthy on periodic clinical evaluations, with pregnancies over 35 weeks, with normal fetal development, which suddenly caused chest pain, dyspnea, and loss of consciousness, required emergency c-sections, and died suddenly after they were performed. In both cases, the cause of death was SCAD on the anterior-descending artery. In both cases, emergency percutaneous coronary intervention was performed. The second part of the study represents a literature overview of SCAD during COVID-19. In addition to pregnancy hormonal changes, other potential hormone-mediated SCAD triggers are still under discussion. Full article

(This article belongs to the Special Issue Advances in Cardiac Interventions and Surgery in the COVID-19 Era)

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6 pages, 847 KiB

Open AccessCase Report

Acute Myocardial Infarction, Subclavian Vein Thrombosis, and Pulmonary Embolism Secondary to COVID-19—A Case Report

by Nevena Georgieva Ivanova

Medicina 2023, 59(4), 656; https://doi.org/10.3390/medicina59040656 - 26 Mar 2023

Viewed by 1443

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The majority of infected patients develop the clinical picture of a respiratory disease, although some may develop various complications, such as arterial or venous thrombosis. The clinical case presented herein is a rare example of sequential development and combination of acute myocardial infarction, subclavian vein thrombosis (Paget Schroetter syndrome), and pulmonary embolism in the same patient after COVID-19. Case presentation: A 57-year-old man with a 10-day history of a SARS-CoV-2 infection was hospitalized with a clinical, electrocardiographic, and laboratory constellation of an acute inferior-lateral myocardial infarction. He was treated invasively and had one stent implanted. Three days after implantation, the patient developed shortness of breath and palpitation on the background of a swollen and painful right hand. The signs of acute right-sided heart strain observed on the electrocardiogram and the elevated D-dimer levels strongly suggested pulmonary embolism. A Doppler ultrasound and invasive evaluation demonstrated thrombosis of the right subclavian vein. The patient was administered pharmacomechanical and systemic thrombolysis and heparin infusion. Revascularization was achieved 24 h later via successful balloon dilatation of the occluded vessel. Conclusion: Thrombotic complications of COVID-19 can develop in a significant proportion of patients. Concomitant manifestation of these complications in the same patient is extremely rare, presenting at the same time, quite a therapeutic challenge to clinicians due to the need for invasive techniques and simultaneous administration of dual antiaggregant therapy combined with an anticoagulant treatment. Such a combined treatment increases the hemorrhagic risk and requires a serious accumulation of data for the purpose of a long-term antithrombotic prophylaxis in patients with such pathology. Full article

(This article belongs to the Special Issue Advances in Cardiac Interventions and Surgery in the COVID-19 Era)

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