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2013 Physician eNewsletter

Knowing When to Transfuse: Blood Conservation Strategies Gain Momentum

A recent study published in The Lancet found that a restrictive approach to blood transfusion has emerged nationally as a best practice, supported by clinical guidelines and evidence-based research. However, researchers identified a high degree of variability from institution to institution for certain procedures such as cardiothoracic surgery.

Staged Carotid Stenting Is the Most Effective Treatment for Open Heart Surgery Patients with Severe Coronary and Carotid Disease

When it comes to carotid revascularization in the open heart surgery (OHS) population, the newest and least used alternative — staged carotid artery stenting (CAS) followed by OHS — edged out more widely used approaches beyond the short term.

A Biologic to Treat Dyslipidemia?

Cleveland Clinic studies focus on PCSK9 inhibition

While statin therapy is an effective first-line treatment for patients diagnosed with high cholesterol and with coronary artery disease (CAD), many patients fail to achieve adequate LDL-C reduction despite maximally tolerated statin treatment, and others are intolerant to statins.

Case Study: An 85 Year-Old Male with Hemodynamic Decompensation After an Acute Myocardial Infarction

Hemodynamic instability following an acute myocardial infarction (AMI) is a medical emergency, which must be dealt with immediately. While LV dysfunction is the most common cause of cardiogenic shock, appropriately treated with inotropes, afterload reduction, and IABP, one must be vigilant for mechanical complications of AMI (ruptured papillary muscle, ventricular septal defect, LV pseudoaneurysm and rupture), which need to be treated surgically.

Resources: CME Calendar

9th Annual Pulmonary Hypertension Symposium: Translating Discoveries into Patient Care

Available Courses
November 15-16, 2013
Intercontinental Hotel & Bank of America Conference Center
Cleveland, Ohio

Register Now

2013 Preceptorship in Carotid Ultrasound Interpretation

December 2 – 6, 2013
Cleveland Clinic
Miller Family Heart & Vascular Institute
Noninvasive Vascular Laboratory | Cleveland, Ohio

(class size is limited to six participants)

Register Now

17th Annual Diastology and Valve Summit

February 27 – March 2, 2014
Eden Roc Hotel
Miami Beach, Florida

Register Now

Newer Oral Antithrombotics Add Complexity to Bridging Strategies

Dabigatran, rivaroxaban and apixaban are so new that none of the major clinical guidelines address oral anticoagulant bridging recommendations prior to surgery. There is no monitoring test or reversal agent for these oral anticoagulants.

A-fib and Stroke Prevention: Innovative Devices Expand Treatment Options

We now know patients with a-fib are five times more likely to suffer a stroke, which means that risk reduction has taken center stage. Newer oral anticoagulants and enhanced surgical techniques have provided more treatment options than ever before - and when it comes to medical devices, a new era is dawning.

Study Confirms Niacin’s Limited Utility in the Era of High-Dose Statin Therapy

HPS2-THRIVE, the largest niacin trial to date, found that in patients with a history of cardiovascular disease whose cholesterol levels are well controlled, niacin really doesn’t add anything and it may even cause harm.

Image of the Issue: TAVR

Amar Krishnaswamy, MD, interventional cardiologist in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine, shares images of a successful transcatheter aortic valve replacement.

Case Study: Post-Thrombotic Syndrome

Post-thrombotic syndrome (PTS) occurs in 20 to 50 percent of patients with proximal deep vein thrombosis despite standard anticoagulant therapy.Treating patients with PTS can be discouraging, because treatment options are limited.

Resources: CME Calendar

2013 Preceptorship in Carotid Ultrasound Interpretation

Available Courses
August 26 - 30, 2013 | December 2 - 6, 2013
Cleveland Clinic Heart & Vascular Institute, Noninvasive Vascular Laboratory
Cleveland, Ohio

Register Now

Addressing Advanced Heart Failure with LVADs

Left-ventricular assist devices (LVADs) are a viable alternative to transplant for some patients, and today's smaller devices make these an option for more patients with heart failure.

Undercover ICDs

Subcutaneous implantable cardioverter defibrillators (ICDs) are less invasive and don't overreact to arrhythmia, which means reduced risk for the patient.

Image of the Issue

Heather L. Gornik, MD, medical director of the Non-Invasive Vascular Laboratory at Cleveland Clinic, shares this image of classic medial fibroplasia type fibromuscular dysplasia (FMD) of the right renal artery in a patient with difficult to manage hypertension.

Case Study: Occluded Stent Removal for Revascularization in Setting of Infection

Remote endarterectomy is a minimally invasive adaptation of an established revascularization technique that accommodates using a single incision. It also avoids prosthetic graft materials, making it an ideal technique for infected graft cases.

Resources: CME Calendar

2013 Preceptorship in Carotid Ultrasound Interpretation

Available Courses
April 29 - May 3, 2013 | August 26 - 30, 2013 | December 2 - 6, 2013
Cleveland Clinic Heart & Vascular Institute, Noninvasive Vascular Laboratory
Cleveland, Ohio

Register Now
Reviewed: 09/13

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This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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