Browsing by Author "Morris, Michelle C."

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    A Vascular Plug for Persistent Shock Following Transcatheter Mitral Valve Replacement
    (Elsevier, 2024-09-04) Torabi, Asad J.; Patel, Purva; Reborido, Natalia; Morris, Michelle C.; Everett, Jeffrey; Sinha, Anjan; Medicine, School of Medicine
    A 78-year-old woman with severe bioprosthetic mitral valve degeneration underwent successful transcatheter mitral valve replacement with a valve-in-valve procedure. This case postprocedure was complicated by cardiogenic shock from left ventricular perforation and underscores the importance of the accurate assessment and treatment of patients following transcatheter valvular procedures.
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    Coronary Calcification: Types, Morphology and Distribution
    (Radcliffe Medical Media, 2025-04-07) Morris, Michelle C.; Kreutz, Rolf P.; Medicine, School of Medicine
    The development and progression of coronary calcification is of growing interest with the emergence of new imaging modalities and calcium modifying technologies that can facilitate optimal results during complex percutaneous coronary intervention (PCI). Coronary atherosclerotic disease typically begins within the intima with pathological intimal thickening and microcalcifications (>0.5 μm and <15 μm). These microcalcifications can coalesce into larger areas of calcification, including sheet calcium, which is typically seen in fibrocalcific plaque, nodular calcification and calcified nodules. Calcified nodules typically protrude into the vessel lumen. Erosive calcified nodules lack the coverage of protective anti-aggregatory endothelium and frequently show adherence of intraluminal thrombus. Greater calcification within coronary plaque does not correlate with an increased risk of acute coronary syndrome, however, coronary calcium can lead to challenges with stent delivery and full stent expansion during PCI. An understanding of plaque morphology, distribution of calcium, degree of calcification and underlying shape will enable interventional cardiologists to appropriately interpret intravascular ultrasound and optical coherence tomography imaging findings and optimise results during complex PCI.
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    Impact of Sex on Outcomes With Femoral Artery Closure Devices Versus Manual Compression in Patients Undergoing Percutaneous Coronary Intervention
    (Wiley, 2024-12-19) Anderson, Wesley L.; Torabi, Asad J.; O'leary, Brian A.; Breall, Jeffrey A.; Sinha, Anjan K.; Jaradat, Ziad A.; Morris, Michelle C.; Frick, Kyle A.; Romeh, Ibrahim A.; Iqtidar, Ali F.; von der Lohe, Elisabeth; Kreutz, Rolf P.; Medicine, School of Medicine
    Background and aims: Femoral artery access is widely used despite recent increase in radial access for percutaneous coronary interventions (PCI). Femoral artery closure devices are used to shorten vascular closure time and reduce bleeding. We sought to examine sex-based outcomes of femoral artery vascular closure devices (VCD) in patients undergoing PCI. Methods: We identified patients who had undergone PCI (n = 11,415) in the Indiana University Health Multicenter Cardiac Cath registry using femoral artery access. Clinical outcomes were compared between VCD and manual compression and analyzed according to sex. Patients with cardiogenic shock and left ventricular support devices were excluded. Results: The use of any vascular closure device as compared to femoral artery manual compression was associated with a reduction in 72-h bleeding events (adjusted odds ratio [OR]: 0.64; 95% confidence interval [CI]: 0.46-0.87). With manual compression, women had higher rates of 72-h bleeding as compared to men (4.5% vs. 1.6%, p < 0.001). Women demonstrated greater absolute risk reduction in 72-h bleeding events with use of VCD as compared to men (2.8% vs. 0.8%, p < 0.001). For women, VCD were associated with lower risk of access site bleeding (OR: 0.43; 95% CI: 0.24-0.8), hematoma (OR: 0.36; 95% CI: 0.2-0.63), and vascular complications (OR: 0.25, 95% CI: 0.09-0.72). Use of VCD was associated with lower risk of in-hospital death (adjusted OR: 0.4; 95% CI: 0.28-0.58; p < 0.001) in multivariable regression analysis. Conclusion: Women derive more benefit from use of femoral artery VCD during PCI than men with greater reduction in bleeding rates, access site hematoma, and vascular complications.