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Transcatheter Aortic Valve Replacement in High-Risk Surgical Patient with Severe Aortic Insufficiency

World Journal of Cardiovascular Diseases 2022年第7期12卷 382-389页

作者： farid khan Danielle Cannon Alon Yarkoni UHS Heart & Vascular Institute Wilson Medical Center Johnson City NY USA College of Medicine SUNY Upstate Medical University Syracuse NY USA

Background: Transcatheter aortic valve replacement (TAVR) is approved by the FDA for severe aortic stenosis (AS) in patients of all surgical risk categories but has yet to be studied for its utility in aortic insufficiency (AI), despite the need for a safe alternative to surgery for prohibitive surgical risk patients. Case Report: We describe a case of a female patient who presented with acute decompensated congestive heart failure (CHF) with New York Heart Association (NYHA) Class IV symptoms. She was found to have severe AI leading to acute decompensation. Two years prior to this, she had aortic valve endocarditis that had potentially resulted in severe AI. Considering her underling comorbidities including diabetes mellitus, hypertension, morbid obesity and multiple myeloma on active chemotherapy at the time of evaluation, the patient was a high-risk surgical candidate for surgical aortic valve repair (SAVR) in view of elevated risk of mortality, infection, and poor wound healing. After critical and comprehensive assessment, transcatheter aortic valve intervention was considered to be an appropriate choice of treatment. TAVR was successfully performed that resulted in immediate improvement of aortic valve function. On subsequent follow-ups, she demonstrated markedly improved symptoms and reduced status to NYHA Class II HF symptoms. Conclusion: TAVR is a potential treatment modality for patients with severe AI who are poor surgical candidates for SAVR. We hope our case contributes to the growing pool of studies investigating the utility of TAVR procedure in patients with severe AI.

关键词： TAVR Aortic Insufficiency Aortic Sclerosis Congestive Heart Failure Infective Endocarditis

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A Troika of Tricuspid Valve Thrombus, Bilateral Upper Extremity Deep Venous Thrombosis and Pulmonary Embolism

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World Journal of Cardiovascular Diseases 2022年第4期12卷 191-198页

作者： farid khan Keyoor Patel Muhammad Imran Ali Internal Medicine Residency Program UHS Wilson Medical Center Johnson City NY USA UHS Heart & Vascular Institute Johnson City NY USA

Background: Tricuspid valve thrombus with concomitant bilateral pulmonary embolism (PE) and right heart strain poses a significant risk of hemodynamic instability and increased mortality. Case Report: We report the unique case of a female who presented with dyspnea and tachycardia, and was subsequently found to have a structure attached to the tricuspid valve. Concomitantly, she also had bilateral upper extremity deep venous thrombosis (UEDVT) and bilateral sub-massive PE. Thorough clinical assessment, and diagnostic and risk stratification tools were applied to guide the management and disposition. Tricuspid valve thrombus resolved after unfractionated heparin therapy followed by oral anticoagulation as seen on repeat transthoracic echocardiography. We think the readership will benefit from our experience of managing an uncommon and critical clinical presentation of tricuspid valve thrombus in the setting of extensive venous thromboembolism. Conclusion: Careful clinical assessment, risk stratification tools, and close monitoring are needed to guide the management of tricuspid valve thrombus with concomitant bilateral PE and UEDVT.

关键词： Pulmonary Embolism Tricuspid Valve Thrombus Deep Venous Thrombus Heparin

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Alcohol-Induced Cardiomyopathy Presenting with Left Ventricular Apical Thrombus

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World Journal of Cardiovascular Diseases 2022年第7期12卷 353-359页

作者： farid khan Casey Manzanero Amit Bansal Sreekanth Kondareddy UHS Heart & Vascular Institute Wilson Medical Center Johnson City NY USA Upstate Clinical Campus Binghamton NY USA

Background: Chronic excessive alcohol consumption has been strongly associated with alcohol-induced cardiomyopathy (AC) in patients with no evidence of coronary artery disease (CAD). AC may cause cardiovascular complications and significant impact on the quality of life. We discuss an interesting case of dilated cardiomyopathy, associated complication, diagnostic work-up and management. Case Report: A young male presented to our service with worsening dyspnea, orthopnea, and scrotal and lower extremity edema. On average, he consumed a pack of 12 beers every day and had a 30-pack-years smoking history. He was found to be in acute heart failure with evidence of pulmonary edema and cardiomegaly on chest imaging. He had biventricular dilatation and severely reduced left ventricular ejection fraction (LVEF) 15% in addition to a thrombus in the LV apex. The cardiac catheterization was unremarkable for CAD. He was diuresed appropriately resulting in significant weight loss and resolution of symptoms. LV thrombus was treated with unfractionated heparin infusion that was transitioned to warfarin. He was maintained on guidelines-directed medical therapy for heart failure. Extensive counseling was provided regarding alcohol and tobacco cessation. On follow-up echocardiogram, his LVEF improved and there was no evidence of LV thrombus. We think, the readership will benefit from our experience of treating a case of AC, and the importance of clinical history. Conclusion: Chronic excessive alcohol use is detrimental to cardiac function leading to alcohol-induced cardiomyopathy. A careful approach to clinical history of alcohol consumption and prompt diagnostic workup negative for ischemic causes may confirm the diagnosis. Cardiac function improves with guidelines-directed medical therapy for heart failure and abstinence from alcohol.

关键词： Alcohol-Induced Cardiomyopathy Heart Failure Echocardiography Thrombus Diuresis

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Lady Windermere Syndrome: An Interesting Clinical and Radiological Presentation

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Case Reports in Clinical Medicine 2022年第9期11卷 364-369页

作者： farid khan Wajiha Ali Muhammad Imtiaz Uzma Sana Ullah Internal Medicine UHS Wilson Medical Center Johnson City USA UHS Pulmonology & Critical Care Wilson Medical Center Johnson City USA

Lady Windermere Syndrome is an uncommon pulmonary disease characteristically observed in elderly white females with chronic cough suppression and dyspnea. It is classically associated with Mycobacterium avium complex (MAC) species. An 84-year-old female was evaluated for longstanding non-productive cough and intermittent dyspnea. A chest computed tomography scan revealed densities in the right upper lobe and scattered nodular-cystic bronchiectasis. Biopsy was negative for malignancy;however, bronchioalveolar lavage studies showed presence of MAC. Patient was treated with a 12-month course of azithromycin, rifampin and ethambutol resulting in resolution of her symptoms.

关键词： Lady Windermere Syndrome Mycobacterium Avium Complex Dyspnea Bronchiectasis

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Nexus between foreign direct investment and economic growth in Bangladesh: an augmented autoregressive distributed lag bounds testing approach

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Financial Innovation 2020年第1期6卷 173-190页

作者： Bibhuti Sarker farid khan Department of Economics University of ManitobaWinnipegManitobaCanada Department of Economics Bangabandhu Sheikh Mujibur Rahman Science and Technology UniversityGopalganj 8100Bangladesh Department of Economics Rajshahi UniversityRajshahi 6205Bangladesh

The relationship between foreign direct investment(FDI)inflows and economic growth in host countries is a heavily debated *** some studies have found evidence of the positive impact of FDI on economic growth,others have revealed the opposite *** that examined the causality between FDI and gross domestic product(GDP)also have found evidence of unidirectional causality and,in some cases,a bidirectional *** study investigated the causal nexus between FDI and GDP in Bangladesh by employing standard time-series econometric tools,namely,augmented Dickey-Fuller,augmented Dickey-Fuller generalized least square,Kwiatkowski-Phillips-Schmidt-Shin,and Lee-Strazicich unit root tests to check stationarity,augmented autoregressive distributed lag(augmented ARDL)bounds testing approach to check cointegration,and Granger causality to explore the direction of *** augmented ARDL model found a long-run relationship between FDI and *** addition,the error correction model and Granger causality results indicated the presence of a unidirectional causality running from GDP to FDI.

关键词： FDI GDP Augmented ARDL Causality Economic growth

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The Single Cusp of Life: A Case Report

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World Journal of Cardiovascular Diseases 2022年第7期12卷 367-373页

作者： farid khan Amit Bansal Laurene Tuider Michail Vitellas Sreekanth Kondareddy UHS Heart & Vascular Institute Johnson City NY USA Internal Medicine UHS Wilson Medical Center Johnson City NY USA

Background: Anomalous coronary artery (CAA) is a rare condition occurring in less than 1% of individuals. The most common form consists of the left circumflex artery (LCx) arising from the right coronary sinus. These vascular anomalies have been associated with an increased risk of sudden cardiac death. We present a rare case of an anomalous coronary artery in a patient with all three coronary arteries arising from a shared ostium. Case presentation: A 67-year-old transgender Caucasian male with medical history of dyslipidemia and hypertension presented for ischemic workup due to occasional chest pain prior to undergoing male to female gender reassignment surgery. A Regadenosan stress test with SPECT myocardial perfusion imaging revealed moderate sized, moderate intensity perfusion defect reversible in inferolateral wall and fixed in inferior wall. Coronary angiography revealed anomalous origin of the coronary arteries, with all three major coronary arteries arising from a shared, single, ostium originating from the right coronary cusp. Coronary computed tomographic angiography (CCTA) showed a “malignant course” of LAD running between the pulmonary artery and aorta. A conservative management was pursued in view of mild symptoms with close follow ups. Conclusion: It is important to evaluate all coronary artery anomalies (CAA) for a “malignant” course due to its associated risk for various cardiac events including sudden cardiac death. Surgical management is indicated in high-risk patients with malignant courses. However, asymptomatic patients and those with mild symptoms with or without malignant course can be followed closely.

关键词： Coronary Artery Anomaly Malignant Course Angiography Sudden Cardiac Death

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Numerical study of the near-wall vortical structures in particle-laden turbulent flow by a new vortex identification method-Liutex

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Journal of Hydrodynamics 2024年第1期36卷 53-60页

作者： farid Rousta Goodarz Ahmadi Bamdad Lessani Chaoqun Liu Department of Mechanical and Aerospace Engineering Clarkson UniversityPotsdamNYUSA Mechanical Engineering and Engineering Science The University of North Carolina at CharlotteNCUSA Department of Mathematics University of Texas at ArlingtonArlingtonTXUSA

This study investigates turbulent particle-laden channel flows using direct numerical simulations employing the Eulerian-Lagrangian method.A two-way coupling approach is adopted to explore the mutual interaction between particles and fluid *** considered cases include flow with particle Stokes number varying from St=2 up to St=100 while maintaining a constant Reynolds number of Reτ=180 across all cases.A novel vortex identification method,Liutex(Rortex),is employed to assess its efficacy in capturing near-wall turbulent coherent structures and their interactions with *** Liutex method provides valuable information on vortex strength and vectors at each location,enabling a detailed examination of the complex interaction between fluid and particulate *** widely acknowledged,the interplay between clockwise and counterclockwise vortices in the near-wall region gives rise to low-speed streaks along the *** low-speed streaks serve as preferential zones for particle concentration,depending upon the particle Stokes *** is shown that the Liutex method can capture these vortices and identify the location of low-speed ***,it is observed that the particle Stokes number(size)significantly affects both the strength of these vortices and the streaky structure exhibited by ***,a quantitative analysis of particle behavior in the near-wall region and the formation of elongated particle lines was carried *** involved examining the average fluid streamwise velocity fluctuations at particle locations,average particle concentration,and the normal velocity of particles for each set of particle Stokes *** investigation reveals the intricate interplay between particles and near-wall structures and the significant influence of particles Stokes *** study contributes to a deeper understanding of turbulent particle-laden channel flow dynamics.

关键词： Turbulent channel flow particle-laden flow direct numerical simulation(DNS) Eulerian-Lagrangian vortex identification turbulence coherent structures Liutex

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Oval-Shaped Radiographic Opacity Mimicking a Lung Mass

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World Journal of Cardiovascular Diseases 2022年第9期12卷 439-443页

作者： farid khan Muhammad Imtiaz Keyoor Patel Owais Ahmed Rasha Aurshiya Pranava Ganesh UHS Heart & Vascular Institute Wilson Medical Center Johnson City NY USA UHS Pulmonology & Critical Care Wilson Medical Center Johnson City NY USA

Phantom tumor of the lung is an infrequent presentation of volume overload in congestive heart failure. This finding is often mistaken for a lung mass that leads to extensive workup and unnecessary treatments. A 75-year-old male was evaluated for a right lower lobe rounded opacity. A transthoracic echocardiogram showed normal left ventricular function. Biopsy of the mass was unremarkable. Patient was managed with diuretics, and subsequent lung imaging revealed resolution of the opacity.

关键词： Dyspnea Lung Mass Interlobar Effusion Diuresis Heart Failure

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Integrated hazard assessment of rockfall incidents in the Cap Aokas Cliff Region

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Journal of Mountain Science 2024年第6期21卷 1916-1929页

作者： Zohra LADJEL farid ZAHRI Riheb HADJI Younes HAMED Karim ZIGHMI Kaddour BENMARCE Department of Earth Sciences Institute of Architecture and Earth SciencesFerhat Abbas UniversitySetif 19137Algeria Unit of Emerging Materials Research Ferhat Abbes UniversitySétif 19137Algeria Laboratory of Applied Research in Engineering Geology GeotechnicsWater Sciencesand EnvironmentFerhat Abbas UniversitySetif 19137Algeria International Association of Water Resources in the Southern Mediterranean Basin Gafsa 2112Tunisia Department of Earth Sciences Faculty of SciencesUniversity of GafsaGafsa 2112Tunisia

Rock fall accidents in mountainous cliff areas have significant consequences for human life and *** study aimed to evaluate the rockfall hazard in the Cap Aokas cliff region located along the northeast coast of Algeria by identifying the key factors contributing to rockfall *** employed a combination of kinematic analysis,Matterocking method,and 3D trajectory simulations to determine zones that are susceptible to rockfall *** using a probabilistic and structural approach in conjunction with photogrammetry,we identified the controlling *** kinematic analysis revealed the presence of five discontinuity families,which indicated both plane and wedge failure *** 3D trajectory simulations demonstrated that the falling blocks followed the stream *** then validated the susceptibility maps generated from the analysis using aerial photos and historical rockfall *** findings of this study enhance our understanding of rockfall phenomena and provide valuable insights for the development of effective strategies to mitigate rockfall hazards.

关键词： Trajectory simulations Probabilistic analysis Structural approach Rockfall hazard Cap Aokas cliff

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Addressing metallosis in knee arthroplasty:From diagnostic challenges to innovative treatments

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World Journal of Orthopedics 2024年第5期15卷 386-389页

作者： Yvon Maurice Bogdonoff farid Amirouche Department of Orthopedics Surgery University of Illinois at ChicagoChicagoIL 60612United States Department of Orthopedics Surgery Northshore University Health SystemSkokieIL 60076United States

In this editorial,we comment on the article by Toro et al published in the recent issue of World Journal of *** editorial review provides a comprehensive exploration of the landscape surrounding knee arthroplasty metallosis,focusing on key aspects ranging from the mechanisms influencing susceptibility to clinical implications and advanced treatment *** elucidate the complex interplay of implant design,patient-specific variables,and wear-related processes contributing to ***,we seek to shed light on diagnostic challenges,the necessity of a multidisciplinary approach,and the imperative for vigilant implant ***-on-uni revision,as a targeted treatment modality,is discussed,highlighting its potential to address metallosis in unicompartmental knee arthroplasty(UKA).There is a need for heightened awareness among clinicians regarding the subtle presentations of metallosis,coupled with the limitations of traditional imaging *** metallosis requires a collaborative,multidisciplinary approach to effectively navigate the complexities associated with this ***,the review emphasizes the evolving paradigm of personalized care,with uni-on-uni revision emerging as a promising surgical *** conclusion,the editorial outlines the dynamic nature of knee arthroplasty metallosis and its multifaceted impact on clinical *** calls for ongoing collaboration,education,and integration of innovative solutions to enhance diagnostic accuracy,proactive management,and overall patient outcomes in the realm of UKA.

关键词： Ultrasound X-ray Total knee arthroplasty Case report Review Editorial

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