Heart Failure


Mortality Rates in Aortic Valve Replacement: Are Rapid-Deployment Valves like LivaNova Perceval Cost-Effective?

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By: James Pitt  Oct. 15, 2018

Heart valve replacement is a competitive field, with many competing options. A recently developed category is rapid deployment valves, which do not require suturing. This allows for much faster implantation. Payors class these valves as experimental, under ICD-10 procedure codes like X2RF032 for open-approach implantation, rather than under the ICD-10 codes like 02RF08Z that conventional heart valves are assigned.

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Stent Thrombosis and Bleeding Highest within 30 Days of Procedure; Cobra PzF Stent Shows Promise as Means to Address

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By: James Pitt  Sep. 06, 2018

In Dexur's national data, there were about 150,000 Percutaneous Cardiovascular Procedures With Coronary Artery Stent each year from 2013-2016 in Medicare-eligible inpatients. Stents are a diverse and fast-moving market. The most common devices are bare-metal or drug-eluting, but innovations like CeloNova's polymer-coated Cobra PzF stent may have advantages for patients at high risk of bleeding. This advantage comes indirectly, through reducing the risk of stent thrombosis.

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69,000 Transcatheter Aortic Valve Replacements from 2013-2017; 60,000 Used Zooplastic Tissue

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By: James Pitt  Aug. 27, 2018

Transcatheter aortic valve replacement (TAVR, aka TAVI or PAVR) is a procedure to replace the valve between the largest blood vessel and the heart. In this procedure, a replacement valve is passed along through a blood vessel to the heart. This allows surgeons to replace the valve in patients who would face too many risks in open-heart surgery.

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Heart Valve Replacement Surgeries Have a Higher Case Mix Index When There is Cardiac Catheterization

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By: James Pitt  Aug. 17, 2018

The Centers for Medicare and Medicaid Services reimburses heart valve procedures based on which of six diagnosis-related groups (DRGs) they fall in. These groups are based on whether there were complications/ comorbidities (CCs) and on whether cardiac catheterization was used.

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TCAR May Have Potential For Reducing Carotid Artery Readmissions

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By: James Pitt  Aug. 16, 2018

When plaque builds up in the arteries that carry blood to the brain, the patient has carotid artery disease. This disease creates a great risk of stroke, because plaque can break off and cause an obstruction in vessels in the brain. Carotid artery disease is involved in 8% of ischemic strokes. Per Weber and Clair 2014, “Carotid artery disease leading to stroke is one [of] the primary causes of serious long-term disability in the United States today.”

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30% of Peripheral Vascular Disorders in Texas Hospitals involve Major Complications; Fort Worth Case Study

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By: James Pitt  Aug. 15, 2018

Peripheral artery disease (PAD) is a common condition in which narrowed blood vessels reduce blood flow to the limbs. Calcium buildups on the vessel walls frequently complicate treatment. Rocha-Singh et. al write “The prevalence of VC [vascular calcification] in lower extremity PAD is inadequately defined, but data extrapolated from other vascular beds provide evidence that 30-50% of patients may manifest some degree of VC.”

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Using Mortality to Assess Potential of Baroreflex Activation Therapy

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By: James Pitt  Aug. 10, 2018

Baroreflex activation therapy is an experimental treatment for heart failure with reduced ejection fraction. A device called the BAROSTIM NEO, developed by CVRx, is currently recruiting for clinical trial (NCT02627196), with final results on heart failure morbidity and mortality expected in 2021. Preliminary results as of August 2017 include reduced heart failure hospitalization and reduced blood pressure.

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Orlando’s Two Largest Hospitals Implant Cardiovascular Devices at Similar Rates

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By: James Pitt  Jul. 18, 2018

Heart failure is the most common cause of death in the US, and the variety of treatments may seem intimidating. Even in a seemingly specific category like implants, options range from monitors to electric stimulators to total artificial hearts.

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How can Hospitals & Physicians Evaluate the Benefit of Wearable Cardiac Defibrillators (WCDs)?

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By: James Pitt  Jul. 09, 2018

Hospitals and physicians often struggle with how to evaluate the economic & quality benefits of WCDs. Hospitals & physicians face a number of challenges including:

  1. What should be the appropriate measure that measures the quality & economic benefits of WCDs?

  2. How does one get the data to measure the benefit?

  3. Can we even get the right resources & teams to analyze the data?

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At Stony Brook Hospital, High Proportion of Preserved Ejection Fraction in Heart Failure Readmissions

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By: James Pitt  Jul. 06, 2018

Heart failure can be classified by ejection fraction. In heart failure with reduced ejection fraction (HFrEF, aka LVEF), the left ventricle pumps out an unusually low fraction of the blood that enters it. HFrEF has been a focus of research efforts, because most studies find it is associated with higher mortality than heart failure with preserved ejection fraction (HFpEF).

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