Shuangbo Liu

The Utility of Systolic and Diastolic Echocardiographic Parameters for Predicting Coronary Artery Disease Burden as Defined by the SYNTAX Score

Early identification of high‐grade ischemia based on echocardiographic diastolic abnormalities may be clinically useful in the acute coronary syndrome (ACS) setting. This could provide the clinician with an awareness of the burden of coronary artery disease (CAD) before angiography is performed to allow for early intervention of suspected ischemic lesions. The objective of the study was to assess whether 2D transthoracic echocardiography (TTE)‐derived tissue Doppler imaging parameters can predict the severity of CAD in comparison with the cardiac catheterization‐derived SYNTAX score.

IMPACT OF A PHYSICIAN-GUIDED VERSUS STANDARD MINIMUM 24 HOUR CORONARY CARE UNIT STAY ON OUTCOMES IN STABLE PATIENTS WHO HAVE RECEIVED PRIMARY PERCUTANEOUS CORONARY INTERVENTION FOR ST-ELEVATION MYOCARDIAL INFARCTION

With the routine use of primary percutaneous coronary intervention (PCI) for ST-Elevation Myocardial Infarction (STEMI), the rate of short-term complications is low and the optimal length-of-stay in the Coronary Care Unit (CCU) following reperfusion is unknown. We hypothesized that the rate of

A Case Of Awake Percutaneous Extracorporeal Membrane Oxygenation For High-risk Percutaneous Coronary Intervention

With significant improvements in percutaneous coronary intervention (PCI) technology, complex high risk PCI is increasingly offered to patients with limited revascularization options. Percutaneous mechanical circulatory support devices are often utilized for hemodynamic support during these complex procedures. Veno-arterial extracorporeal membrane oxygenation (ECMO) allows full hemodynamic support and provides systemic oxygenation. We describe a case of left main bifurcation stenting performed at our center with ECMO support in an awake patient without general anesthesia.

Transcatheter Aortic Valve Implantation in an Extremely Tortuous S-Shaped Aorta

Transcatheter aortic valve implantation (TAVI) has emerged as an alternative technique to treating aortic stenosis in patients with high surgical risk. We present a case of a successful transfemoral TAVI in a high-risk patient with an extremely tortuous iliofemoral system and a significant S-type bend in the descending aorta. With careful preprocedure planning and using all the techniques available, TAVI can be performed in the most challenging patients.

It’s not just the snow; it’s also the cold

Our group found the CMAJ article by Auger and colleagues very interesting.[1][1] We performed a retrospective analysis of all ST-segment elevation myocardial infarction (STEMI) patients between 2009–2014 who presented to St. Boniface Hospital in Winnipeg, Manitoba.[2][2] Temperature and snowfall

Relationship of Extreme Cold Weather and Implantable Cardioverter Defibrillator Shocks

Cold weather to 0°C has been implicated as a risk factor for ventricular arrhythmias and implantable cardioverter defibrillator (ICD) shocks. The effect of more extreme cold weather on the risk of ventricular arrhythmias and ICD shocks is unknown. We sought to describe the relationship between extreme cold weather and the risk of ICD shocks. We retrospectively identified patients seen at the Pacemaker and Defibrillator Clinic at St. Boniface Hospital in Winnipeg, Manitoba, Canada between 2010 and 2015 with an ICD shock. We excluded multiple shocks occurring on the same day in a single patient. We collected weather data, and evaluated the relationship between ICD shocks and weather on the same day as the shock using Negative Binomial regression. Three hundred and sixty patients experienced a total of 1,355 shocks. When excluding multiple shocks occurring in a single patient on the same day, there were 756 unique shocks. The daily high (DH) was the strongest predictor of receiving an ICD shock. Compared with the warmest days (DH above 10°C), shocks were 25% more common on the coldest days (DH below -10°C), and 8% more common on cold days (DH between -10°C and 10°C). This linear trend was statistically significant, with a p-value of 0.04. In conclusion, we found an association between extreme cold weather and ICD shocks.

Partial PFO Closure for Persistent Hypoxemia in a Patient with Ebstein Anomaly

Ebstein anomaly is characterized by deformities of the anterior leaflet of the tricuspid valve and atrialization of the right ventricle. Patients with severe tricuspid regurgitation are recommended to have tricuspid valve surgery with concomitant atrial septal defect closure. A 73-year-old female with Ebstein anomaly presented with severe hypoxemia. Transthoracic echocardiography revealed severe tricuspid regurgitation and a patent foramen ovale with right-to-left shunting. Complete percutaneous patent foramen ovale closure led to acute decompensation; however, partial closure led to hemodynamic stability and improved oxygenation. In conclusion, similar patients with “patent foramen ovale dependency” from longstanding shunts may benefit from partial patent foramen ovale closure.

Multimodality Imaging of a Cardiac Pheochromocytoma

![Figure][1] [![Graphic][3] ][3][![Graphic][4] ][4] A 50-year-old man presented with difficult-to-control hypertension. In the work-up for secondary causes of hypertension, the patient was found to have elevated levels of normetanephrine. Computed tomography of the chest