8 results on '"Shabana Shahanavaz"'
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2. The Need for Surgery After Vascular or Cardiac Trauma, or Technical Adverse Events in the Congenital Cardiac Catheterization Laboratory
- Author
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Ralf Holzer, Sarosh P. Batlivala, Brian Boe, Bryan Goldstein, Todd Gudausky, Babar Hasan, Michael O’Byrne, Brian Quinn, Shyam Sathanadam, Shabana Shahanavaz, Sara M. Trucco, Jeffrey D. Zampi, and Lisa Bergersen
- Subjects
Pediatrics, Perinatology and Child Health ,Cardiology and Cardiovascular Medicine - Published
- 2023
- Full Text
- View/download PDF
3. Retrograde Pulmonary Valve Perforation and Stenting through a Major Aorto-Pulmonary Collateral Artery
- Author
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Christopher Herron, Eimear McGovern, and Shabana Shahanavaz
- Subjects
Pediatrics, Perinatology and Child Health ,Cardiology and Cardiovascular Medicine - Published
- 2023
- Full Text
- View/download PDF
4. Safety and Short-Term Outcomes for Infants < 2.5 kg Undergoing PDA Device Closure: A C3PO Registry Study
- Author
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Oliver M. Barry, Todd M. Gudausky, David T. Balzer, Martin L. Bocks, Brian A. Boe, Ryan Callahan, Howaida El-Said, Michael J. Farias, Susan Foerster, Bryan H. Goldstein, Ralf J. Holzer, Dana Janssen, Philip Levy, Michael L. O’Byrne, Grace Rahman, Shyam Sathanandam, Shabana Shahanavaz, Wendy Whiteside, and Mariel E. Turner
- Subjects
Pediatrics, Perinatology and Child Health ,Cardiology and Cardiovascular Medicine - Published
- 2023
- Full Text
- View/download PDF
5. Interpreting Quality Improvement When Introducing New Technology: A Collaborative Experience in ASD Device Closures
- Author
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Lauren Shirley, Howaida El-Said, Sara M. Trucco, George T. Nicholson, Michael R. Hainstock, Shabana Shahanavaz, Susan R. Foerster, David T. Balzer, Nicola Maschietto, Wendy Whiteside, Todd M. Gudausky, Brian P. Quinn, Kimberlee Gauvreau, Lisa Bergersen, Mary J. Yeh, and Brian A. Boe
- Subjects
medicine.medical_specialty ,Quality management ,medicine.diagnostic_test ,business.industry ,Cardiac catheterization lab ,Outcome assessment ,Vascular surgery ,Cardiac surgery ,Public reporting ,Dose area product ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Medicine ,Fluoroscopy ,Cardiology and Cardiovascular Medicine ,business - Abstract
The objective of this study was to evaluate the impact of the regular introduction of new technologies into interventional cardiac catheterization procedures, in this case new atrial septal defect (ASD) closure devices, while conducting a multi-center collaborative initiative to reduce radiation usage during all procedures. Data were collected prospectively by 8 C3PO institutions between January 1, 2014 and December 31, 2017 for ASD device closure procedures in the cardiac catheterization lab during a quality improvement (QI) initiative aimed at reducing patient radiation exposure. Radiation exposure was measured in dose area product per body weight (µGy*m2/kg). Use of proposed practice change strategies at the beginning and end of the QI intervention period was assessed. Radiation exposure was summarized by institution and by initial type of device used for closure. This study included 602 ASD device closures. Without changes in patient characteristics, total fluoroscopy duration, or number of digital acquisitions, median radiation exposure decreased from 37 DAP/kg to 14 DAP/kg from 2014 to 2017. While all individual centers decreased overall median DAP/kg, the use of novel devices for ASD closure correlated with a temporary period of worsening institutional radiation exposure and increased fluoroscopy time. The introduction of new ASD closure devices resulted in increased radiation exposure during a QI project designed to reduce radiation exposure. Therefore, outcome assessment must be contextualized in QI projects, hospital evaluation, and public reporting, to acknowledge the expected variation during innovation and introduction of novel therapies.
- Published
- 2021
- Full Text
- View/download PDF
6. Total Transcatheter Stage 1: A Word of Caution
- Author
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Stephen Nageotte, Pirooz Eghtesady, David T. Balzer, and Shabana Shahanavaz
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Male ,Cardiac Catheterization ,Pulmonary Circulation ,medicine.medical_specialty ,Time Factors ,Percutaneous ,medicine.medical_treatment ,Percutaneous modified stage 1 ,Pulmonary Artery ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Ductus arteriosus ,medicine ,Humans ,Stage (cooking) ,Ductus Arteriosus, Patent ,Cardiac catheterization ,business.industry ,Hemodynamics ,Infant, Newborn ,Infant ,Ductus Arteriosus ,Vascular surgery ,medicine.disease ,Right pulmonary artery ,Flow restrictor ,Cardiac surgery ,Surgery ,Stenosis ,Treatment Outcome ,medicine.anatomical_structure ,030228 respiratory system ,Single ventricle ,Pediatrics, Perinatology and Child Health ,Original Article ,Female ,Stents ,Cardiology and Cardiovascular Medicine ,business - Abstract
For patients with single ventricle physiology, being able to initially establish systemic blood flow and control pulmonary blood flow is critical to their long-term health. Recently, there have been descriptions in achieving this by a purely transcatheter approach with stenting of the ductus arteriosus and implanting pulmonary flow restrictors, a very appealing prospect. We review a case series of 6 patients who underwent a percutaneous modified stage 1 approach using modified Microvascular plugs (MVP) at our center between September 2019 and December 2019. The initial procedure was technically successful in all patients with single-stage ductal stenting and placement of bilateral modified MVP via femoral access. Four patients underwent repeat cardiac catheterization prior to subsequent surgery that demonstrated elevated Qp:Qs (> 2:1) in 3 of the 4 patients with an elevated mean distal PA pressure > 20 mmHg in all patients. In some patients, the device migrated into the distal right pulmonary artery. One patient after Glenn shunt was found to have significant LPA stenosis requiring stenting. While the percutaneous modified stage 1 approach is a promising approach, we offer a word of caution against widespread adoption of this technique with the currently available devices.
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- 2021
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7. Post-operative Catheterization Interventions at the Site of Surgery: An Application of the CRISP Scoring System
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Toby Rockefeller, Shabana Shahanavaz, Katie L. Mowers, Ramzi Nicolas, and David T. Balzer
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Reoperation ,Cardiac Catheterization ,medicine.medical_specialty ,Scoring system ,Adolescent ,Psychological intervention ,030204 cardiovascular system & hematology ,Risk Assessment ,Cohort Studies ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,medicine ,Humans ,In patient ,Postoperative Period ,030212 general & internal medicine ,Cardiac Surgical Procedures ,Post operative ,Child ,Adverse effect ,Retrospective Studies ,Postoperative Care ,business.industry ,Infant ,Vascular surgery ,Survival Analysis ,Surgery ,Cardiac surgery ,Catheter ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Cardiology and Cardiovascular Medicine ,business - Abstract
Catheter-based interventions in the early post-operative period are performed with caution due to concerns for increased procedural risk, particularly across fresh suture lines. The recently published CRISP scoring system provides prospective risk stratification based on pre-procedural criterion. In an effort to refine the assessment of risk in patients undergoing post-operative catheter-based interventions, the predicted risk of an adverse event based on CRISP scores was compared to actual adverse event rates. A single-center, retrospective review of patients undergoing catheterization interventions within 6 weeks of cardiac surgery was conducted between Jan 2004 and Dec 2014. Patients who underwent dilation interventions across fresh suture lines (group 1) were compared to patients who underwent interventional procedures at other sites (group 2), and a CRISP score was calculated for all patients. Patients receiving only surveillance biopsies were excluded. Sixty-eight patients underwent 100 interventional procedures. Group 1 was composed of 44 patients receiving 64 interventions, while group 2 had 24 patients who underwent 36 interventions. Group 1 was comprised significantly more single ventricles and patients were smaller/younger. Group 1 had a significantly higher median CRISP score, but both groups were within Category 4. The rates of adverse events were similar between groups and comparable to predicted rates with the CRISP scoring system. Catheter-based interventions in the early post-operative period can be performed with no significant increase in the risk of serious adverse events when intervening across fresh suture lines. The CRISP scoring system can be a valuable tool in pre-procedural counseling of high-risk post-operative patients.
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- 2018
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8. Radiation Exposure by Three-Dimensional Rotational Angiography (3DRA) During Trans-catheter Melody Pulmonary Valve Procedures (TMPV) in a Pediatric Cardiac Catheterization Laboratory
- Author
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David T. Balzer, Hoang H. Nguyen, Joshua Murphy, Shabana Shahanavaz, and Ramzi Nicolas
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Cardiac Catheterization ,medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Radiation Dosage ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Angioplasty ,medicine ,Humans ,Fluoroscopy ,Child ,Retrospective Studies ,Cardiac catheterization ,Pulmonary Valve ,medicine.diagnostic_test ,business.industry ,Angiography ,Radiation Exposure ,Vascular surgery ,Cardiac surgery ,medicine.anatomical_structure ,Rotational angiography ,Pulmonary valve ,Pediatrics, Perinatology and Child Health ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
This retrospective study aims to evaluate radiation exposure by three-dimensional rotational angiography (3DRA) during trans-catheter Melody pulmonary valve (TMPV) procedures. 3DRA has been reported to have added value in the management of complex congenital heart disease aiding in the performance of interventional procedures albeit with concerns of higher radiation exposure. We test the hypothesis that 3DRA does not cause additional radiation exposure during TMPV procedures. We analyzed all 81 TMPV procedures performed at St. Louis Children's Hospital, MO, USA, from January 1, 2011 to December 31, 2014. Dose-area product (DAP), DAP indexed to body weight (DAP/BW), fluoroscopy time (FT), and weight-fluoroscopy time product of each procedure were recorded. We reviewed each procedure's images to determine whether additional interventions were performed (e.g., pulmonary artery angioplasty or treatment of conduit pseudo-aneurysm). 3DRA was used in 36 % of the procedures. 3DRA group had a higher number of additional procedures performed. The 3DRA group did not differ from the non-3DRA group in DAP, DAP/BW, and weight-fluoroscopy time product. 3DRA does not cause greater radiation exposure during TMPV procedures.
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- 2016
- Full Text
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