Publications by authors named "Mir Babar Basir"

14 Publications

  • Page 1 of 1

Reviving Invasive Hemodynamic Monitoring in Cardiogenic Shock. Invasive Hemodynamic Monitoring in Cardiogenic Shock.

Am J Cardiol 2021 Jul 8;150:128-129. Epub 2021 May 8.

Division of Cardiology, Department of Medicine, Henry Ford Health System, Detroit, Michigan.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amjcard.2021.03.033DOI Listing
July 2021

Antegrade versus Retrograde Techniques for Chronic Total Occlusions (CTO): A Review and Comparison of Techniques and Outcomes.

Expert Rev Cardiovasc Ther 2021 May 4. Epub 2021 May 4.

Division of Cardiology, Henry Ford Hospital, Detroit, MI.

: As the field of chronic total occlusion percutaneous coronary intervention has evolved, technical approaches have evolved and been refined.: In this review, we discuss the major techniques utilized in modern CTO PCI including antegrade wiring, antegrade dissection re-entry, retrograde wiring, and retrograde dissection re-entry. Retrograde techniques have been extensively studied in comparison to antegrade techniques. Retrograde techniques have contributed to increases in CTO PCI success rates and are generally used in higher complexity lesions. Observational data suggests increased short term complications in procedures requiring the use of retrograde techniques however long term CTO PCI durability and patient outcomes have been shown to be similar among procedures using antegrade only versus retrograde techniques.: Retrograde techniques play a vital role in the technical success of CTO PCI, particularly among more complex lesions and in patients with high burdens of comorbidities. Increases in procedural safety with equipment iteration and in the use of adjunctive imaging will play an important role in the selection of appropriate retrograde conduits and the overall success rates of CTO PCI.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/14779072.2021.1924677DOI Listing
May 2021

Pressure-Volume Analysis Illustrating the Mechanisms of Short-Term Hemodynamic Effects Produced by Premature Ventricular Contractions.

Circ Heart Fail 2021 Mar 11;14(3):e007766. Epub 2021 Mar 11.

Division of Cardiology, Henry Ford Hospital System, Detroit, MI (M.B.B., M.A.).

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1161/CIRCHEARTFAILURE.120.007766DOI Listing
March 2021

Unmasking right ventricular failure in cardiogenic shock: The importance of serial hemodynamics.

Catheter Cardiovasc Interv 2021 May 23;97(6):1209-1212. Epub 2021 Jan 23.

Department of Cardiology, Henry Ford Hospital, Detroit, Michigan.

A 65-year-old female was transferred with myocardial infarction, three-vessel coronary artery disease, cardiogenic shock and an intraaortic balloon pump. Given persistent shock, mechanical circulatory support (MCS) was upgraded using a left ventricular hemodynamic support device (Impella CP). The patient was monitored in the catheterization laboratory and serial hemodynamic measures were obtained. Initial hemodynamics showed relative improvement; however, serial assessments demonstrated worsening hemodynamics secondary to right ventricular failure, ultimately requiring a right ventricular hemodynamic support device. The case highlights the rapid changes that can occur with mechanical circulatory support devices and demonstrates the importance of obtaining serial hemodynamics in the cardiac catheterization laboratory.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ccd.29493DOI Listing
May 2021

Beyond the Coronary Arteries, Should We Be Shifting Our Focus to Mechanical Circulatory Support in Patients With Acute Myocardial Infarction and Cardiogenic Shock?

Authors:
Mir Babar Basir

Cardiovasc Revasc Med 2020 07 1;21(7):849-850. Epub 2020 May 1.

Director of Acute Mechanical Circulatory Support, Henry Ford Hospital, 2799 West Grand Blvd (K-2 Cath Lab), Detroit, MI 48202, United States of America. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.carrev.2020.04.039DOI Listing
July 2020

Pressure-Volume Analysis Illustrating Left Ventricular Unloading by a Percutaneous Transvalvular Left Ventricular to Aortic Pump.

Circ Heart Fail 2020 04 16;13(4):e006788. Epub 2020 Apr 16.

Division of Cardiology, Henry Ford Hospital System, Detroit, MI (M.B.B., M.A.).

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1161/CIRCHEARTFAILURE.119.006788DOI Listing
April 2020

Outcomes Among Patients Transferred for Revascularization With Impella for Acute Myocardial Infarction With Cardiogenic Shock from the cVAD Registry.

Am J Cardiol 2019 04 25;123(8):1214-1219. Epub 2019 Jan 25.

Department of Cardiology, Henry Ford Hospital, Detroit, Michigan.

The outcomes for patients transferred with cardiogenic shock and later treated with revascularization and Impella support have not previously been studied. To evaluate these outcomes, patients in cardiogenic shock were recruited from the catheter-based ventricular assist device registry, a prospective registry enrolling patients who underwent percutaneous coronary intervention with hemodynamic support using Impella 2.5 or CP. Analysis was performed on subgroups of patients who were characterized as those directly admitted to a tertiary care hospital (direct), or those transferred from an outside hospital (transfer). Patients who were transferred with acute myocardial infarction with cardiogenic shock (AMICS) more often presented in shock were in shock longer than 24 hours, and were more likely to be on intra-aortic balloon pump but were less likely to sustain cardiac arrest. The number of pressors, EF, diseased, and treated vessels were similar between the 2 groups. Despite baseline differences, the mortality was similar in the transfer versus direct patients (47.0% vs 53.5% p = 0.19). In a multivariate model, the factors independently associated with 30-day mortality in AMICS treated with revascularization and Impella support were cardiopulmonary resuscitation (CPR) (p <0.01), age (p <0.01), and ST-segment elevation myocardial infarction (STEMI) (p = 0.02). Whether the patient was transferred or directly admittedly with AMICS was not an independent predictor of death. In conclusion, these findings suggest that considerations should be given to transfer patients with AMICS to allow them to be treated in a contemporary manner.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amjcard.2019.01.029DOI Listing
April 2019

Cardiac Shock Care Centers: JACC Review Topic of the Week.

J Am Coll Cardiol 2018 10;72(16):1972-1980

Henry Ford Health Care System, Detroit, Michigan.

Despite advances over the past decade, the incidence of cardiogenic shock secondary to acute myocardial infarction has increased, with an unchanged mortality near 50%. Recent trials have not clarified the best strategies in treatment. While dedicated cardiac shock centers are being established, there are no standardized agreements on the utilization of mechanical circulatory support and the timeliness of percutaneous coronary intervention strategies. In some centers and prospective registries, outcomes after placement of advanced mechanical circulatory support prior to reperfusion therapy with percutaneous coronary intervention have been encouraging with improved survival. Here, we suggest systems of care with a treatment pathway for patients with acute myocardial infarction complicated by cardiogenic shock.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jacc.2018.07.074DOI Listing
October 2018

Correction to: Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients.

Intensive Care Med 2018 11;44(11):2022-2023

Department of Anesthesiology and Critical Care, APHP - Saint Louis Lariboisière University Hospitals, University Paris Diderot and INSERM UMR-S 942, Paris, France.

Because of a technical error, the code corresponding to the outcome for the Basir et al. cohort was mis-implemented in the original version of our article. Characteristics of the cohort are in fact the followings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00134-018-5372-9DOI Listing
November 2018

Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients.

Intensive Care Med 2018 06 1;44(6):847-856. Epub 2018 Jun 1.

Department of Anesthesiology and Critical Care, APHP - Saint Louis Lariboisière University Hospitals, University Paris Diderot and INSERM UMR-S 942, Paris, France.

Objective: Catecholamines have been the mainstay of pharmacological treatment of cardiogenic shock (CS). Recently, use of epinephrine has been associated with detrimental outcomes. In the present study we aimed to evaluate the association between epinephrine use and short-term mortality in all-cause CS patients.

Design: We performed a meta-analysis of individual data with prespecified inclusion criteria: (1) patients in non-surgical CS treated with inotropes and/or vasopressors and (2) at least 15% of patients treated with epinephrine administrated alone or in association with other inotropes/vasopressors. The primary outcome was short-term mortality.

Measurements And Results: Fourteen published cohorts and two unpublished data sets were included. We studied 2583 patients. Across all cohorts of patients, the incidence of epinephrine use was 37% (17-76%) and short-term mortality rate was 49% (21-69%). A positive correlation was found between percentages of epinephrine use and short-term mortality in the CS cohort. The risk of death was higher in epinephrine-treated CS patients (OR [CI] = 3.3 [2.8-3.9]) compared to patients treated with other drug regimens. Adjusted mortality risk remained striking in epinephrine-treated patients (n = 1227) (adjusted OR = 4.7 [3.4-6.4]). After propensity score matching, two sets of 338 matched patients were identified and epinephrine use remained associated with a strong detrimental impact on short-term mortality (OR = 4.2 [3.0-6.0]).

Conclusions: In this very large cohort, epinephrine use for hemodynamic management of CS patients is associated with a threefold increase of risk of death.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00134-018-5222-9DOI Listing
June 2018

The Role of Mechanical Circulatory Support During Percutaneous Coronary Intervention in Patients Without Severely Depressed Left Ventricular Function.

Am J Cardiol 2018 03 25;121(6):703-708. Epub 2017 Dec 25.

Henry Ford Health System, Detroit, Michigan.

Currently, there are no data on the use of mechanical circulatory support (MCS) in patients without severely depressed left ventricular ejection fraction (LVEF) during high-risk percutaneous coronary intervention (PCI). We analyzed data from the global catheter-based ventricular assist device (cVAD) registry on the clinical use of MCS in high-risk PCI in patients without severely depressed LVEF, defined as LVEF > 35%. Patients without cardiogenic shock from the catheter-based ventricular assist device registry, who underwent elective or urgent PCI with an Impella 2.5 or Impella CP, were included. Patients who received MCS after the start of the PCI were excluded. A total of 891 patients were included, of whom 661 had LVEF ≤ 35% and 230 had LVEF > 35%. Patients with LVEF > 35% compared with patients with LVEF ≤ 35% were older (72.12 ± 11.70 years vs 68.68 ± 11.01 years; p <0.001), had more extensive coronary artery disease with more diseased vessels (1.90 ± 0.71 vs 1.73 ± 0.79; p = 0.005), more multivessel intervention (1.74 ± 0.69 vs 1.55 ± 0.73; p <0.001), and more use of rotational atherectomy (21.21% vs 14.90%; p = 0.046), respectively. Additionally, they had a high prevalence of high-risk clinical features such as renal failure (24.89%) and diabetes mellitus (45.37%). Despite these high-risk features, the major adverse cardiovascular and cerebral event rates were favorable overall, with no differences between the 2 groups (3.48% vs 4.54%; p = 0.574). Despite having LVEF > 35%, this selected group of patients had severe co-morbidities and complex angiographic features; hence, PCI with hemodynamic support was deemed necessary. In addition, PCI with elective MCS was feasible and safe in this patient population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amjcard.2017.11.045DOI Listing
March 2018

Rates of vascular access use in transcatheter aortic valve replacement: A look into the next generation.

Catheter Cardiovasc Interv 2016 Mar 10;87(4):E166-71. Epub 2015 Aug 10.

Division of Cardiology, Henry Ford Hospital, Wayne State University, 2799 W. Grand Blvd - K14, Detroit, Michigan.

Objective/background: As smaller TAVR delivery systems emerge we sought to identify differences in vascular access use.

Methods: We analyzed all patients who had undergone TAVR in a single-center from March 2012 to May 2014. We identified all patients who had undergone nonfemoral TAVR and reviewed their femoral dimensions using CT imaging taking into vascular pathology and minimal lumen diameter (MLD). We then identified those patients in whom a smaller delivery system could have been used if such technology was available at that time.

Results: In total 208 consecutive TAVRs were performed, 129 cases using femoral arterial access and 75 cases using non-femoral access; 28 transapical, 27 transcaval, 12 transaortic, and 8 via an antegrade transseptal venous approach. Of the 75 nonfemoral access cases, 63 were completed using commercially available first-generation valves (Sapien Valve) and 12 using second-generation valves under research protocols (Sapien XT Valve). Of the 63 cases performed via a non-femoral route using a first generation valve, 31 cases could have been approached via a transfemoral (TF) route using second-generation delivery systems; and 48 cases could have been approached via a TF route using third generation delivery systems (S3 Valve). Of the 12 cases performed via a nonfemoral route using a second-generation valve, 4 cases could have been approached via a TF route using a third-generation delivery system. In total, only 11% of patients undergoing TAVR could not accommodate smaller second and third generation devices.

Conclusions: As second and third generation devices become commercially available, we anticipate that 89% of cases will be preformed using a TF approach.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ccd.26116DOI Listing
March 2016

Unjailing of the septal perforator using a rotational atherectomy device prior to alcohol septal ablation in a patient with symptomatic hypertrophic obstructive cardiomyopathy.

Catheter Cardiovasc Interv 2014 Sep 13;84(3):E26-9. Epub 2014 May 13.

Division of Cardiology, Henry Ford Hospital, Detroit, Michigan, 48202.

We report a novel approach in which successful unjailing of the septal perforator was performed through the side branch of a coronary stent using a rotational atherectomy device for the purpose of alcohol septal ablation in a patient with symptomatic hypertrophic obstructive cardiomyopathy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ccd.25511DOI Listing
September 2014