F. Mason Sones Jr.: The Serendipitous Discovery of Coronary Angiography and Its Lasting Impact on Cardiology.

F. Mason Sones Jr. (1918-1985) was a pioneering cardiologist whose groundbreaking work revolutionized the field of cardiology. His accidental discovery of coronary angiography in 1958 at the Cleveland Clinic provided physicians with the first clear visualization of coronary arteries in living patients, paving the way for the development of coronary artery bypass surgery and interventional cardiology. This review article explores F. Mason Sones Jr.'s life and career, and his lasting impact on the field of cardiology. Born in Noxapater, MS, in 1918, F. Mason Sones Jr. attended Western Maryland College (Westminster, MD) and the University of Maryland School of Medicine (Baltimore, MD) before completing his internship and residency at the University Hospital (Baltimore, MD) and Henry Ford Hospital (Detroit, MI), respectively. After serving in the U.S. Army Air Corps during World War II, F. Mason Sones Jr. joined the Cleveland Clinic (Cleveland, OH), in 1950, as the head of pediatric cardiology, where he combined his expertise in cardiac catheterization with his interest in congenital heart disease. F. Mason Sones Jr.'s serendipitous discovery of coronary angiography occurred during a routine cardiac catheterization procedure when he inadvertently injected contrast dye directly into the right coronary artery. Realizing that smaller amounts of dye could safely opacify the coronary arteries, F. Mason Sones Jr. refined and standardized the technique of selective coronary angiography, collaborating with engineers to improve X-ray imaging and establishing protocols that remain the standard of care today. F. Mason Sones Jr.'s work provided the foundation for the development of coronary artery bypass surgery by Dr. René Favaloro and the birth of interventional cardiology, as pioneered by Dr. Andreas Gruentzig. As the director of cardiovascular disease at the Cleveland Clinic (1966-1975), F. Mason Sones Jr. mentored and inspired a generation of cardiologists, cementing his legacy as a visionary leader in the field. Throughout his career, F. Mason Sones Jr. received numerous awards and honors, including the American Medical Association's Scientific Achievement Award and the Gairdner Foundation International Award. He co-founded and served as the first president of the Society for Cardiac Angiography (now SCAI), an organization dedicated to advancing the field of interventional cardiology. This review article pays tribute to F. Mason Sones Jr.'s enduring contributions to the field of cardiology, highlighting his role as a pioneer, innovator, and mentor. His legacy continues to inspire and guide generations of cardiologists in their pursuit of improving patient care and pushing the boundaries of cardiovascular medicine.

Ibrutinib and atrial fibrillation: An in-depth review of clinical implications and management strategies.

Ibrutinib, a targeted therapy for B-cell malignancies, has shown remarkable efficacy in treating various hematologic cancers. However, its clinical use has raised concerns regarding cardiovascular complications, notably atrial fibrillation (AF). This comprehensive review critically evaluates the association between ibrutinib and AF by examining incidence, risk factors, mechanistic links, and management strategies. Through an extensive analysis of original research articles, this review elucidates the complex interplay between ibrutinib's therapeutic benefits and cardiovascular risks. Moreover, it highlights the need for personalized treatment approaches, vigilant monitoring, and interdisciplinary collaboration to optimize patient outcomes and safety in the context of ibrutinib therapy. The review provides a valuable resource for healthcare professionals aiming to navigate the intricacies of ibrutinib's therapeutic landscape while prioritizing patient well-being.

Advancements in MitraClip Intervention for Mitral Regurgitation: A Comprehensive Review and Comparative Analysis of Clinical Trials.

This comprehensive review explores the evolution and clinical impact of MitraClip intervention in the management of mitral regurgitation. Mitral regurgitation results from dysfunction in the mitral valve (MV) apparatus. The MitraClip Clip Delivery System was approved by the Food and Drug Administration (FDA) in 2013. The discussion delves into the procedural foundation of MitraClip intervention, primarily based on Alfieri's technique of edge-to-edge leaflet approximation. As highlighted by key clinical trials, including Endovascular Valve Edge-to-Edge Repair (EVEREST) II Trial, Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) Trial, and Percutaneous Repair with the MitraClip Device for Severe Functional/Secondary Mitral Regurgitation (MITRA-FR) trial, the efficacy and safety of MitraClip were evaluated in comparison to surgical interventions and guideline-directed medical therapy. Notably, the COAPT demonstrated significant benefits in reducing all-cause mortality and heart failure hospitalization, while the MITRA-FR presented contrasting results, emphasizing the importance of patient selection. An analysis of the EVEREST II trial underscores MitraClip's potential to achieve comparable outcomes to surgical intervention, emphasizing its role in reducing mitral regurgitation and improving clinical status. However, limitations and complications, such as device-related issues and the potential impact on future MV surgery, are discussed. The study also explores the evolving landscape of MV interventions, reflecting advancements and the growing acceptance of MitraClip. In conclusion, the MitraClip device represents a significant advancement in the treatment of mitral regurgitation. The data presented highlights its promising results in terms of reduced hospitalization rates, improved in-hospital mortality, and enhanced quality of life for patients. However, challenges remain, and careful consideration of patient selection and underlying pathology is crucial in determining the optimal treatment approach. Ongoing research and clinical experience will continue to refine our understanding of MitraClip's role in the evolving landscape of MV interventions.

Transcatheter Closure of Atrial Septal Defect: A Review of Currently Used Devices.

Over the past seven decades, significant advancements and innovations have occurred in the field of percutaneous atrial septal defect (ASD) closure using transcatheter-based devices. This article focuses on the current literature surrounding the three Food and Drug Administration (FDA)-approved devices for ASD and patent foramen ovale (PFO) closure in the United States, namely, the Amplatzer Septal Occluder (ASO), Amplatzer Cribriform Occluder, and Gore Cardioform ASD Occluder. The ASO has been widely used since its FDA approval in 2001. Studies have shown its high success rate in closing ASDs, especially small-sized defects. The RESPECT trial demonstrated that PFO closure using the ASO reduced the risk of recurrent ischemic stroke compared to medical therapy alone. The Closure of Atrial Septal Defects With the Amplatzer Septal Occluder Post-Approval Study (ASD PMS II) evaluated the safety and effectiveness of ASO in a large cohort of patients, reporting a high closure success rate and rare hemodynamic compromise. The Amplatzer Cribriform Occluder is designed for the closure of multifenestrated ASDs and has shown promising results in small-scale studies. It successfully closed the majority of fenestrated ASDs, leading to improved right ventricular diastolic pressure without major complications. The REDUCE trial compared PFO closure using the Gore Helex Septal Occluder and Gore Cardioform Septal Occluder with antiplatelet therapy alone. The study demonstrated that PFO closure significantly reduced the risk of recurrent stroke and brain infarction compared to antiplatelet therapy alone. However, the closure group had a higher incidence of atrial fibrillation or atrial flutter. There is a risk of atrial fibrillation with the use of ASO as well. The FDA-approved Gore Cardioform ASD Occluder showed excellent performance in the ASSURED clinical study. The device achieved high technical success and closure rates, with low rates of serious adverse events and device-related complications. A meta-analysis comparing transcatheter ASD closure with surgical closure revealed that the transcatheter approach had a high success rate, lower rates of adverse events, and shorter hospital stays compared to surgery, without any mortality. Complications associated with transcatheter ASD closure have been reported, including femoral arteriovenous fistulas, device embolization, cardiac erosion, aortic incompetence, and new-onset migraine. However, these complications are relatively rare. In conclusion, transcatheter ASD closure using FDA-approved devices has proven to be safe and effective in the majority of cases. These devices offer excellent closure rates, reduced risk of recurrent stroke, and shorter hospital stays compared to surgery. However, careful patient selection and follow-up are necessary to minimize complications and ensure optimal outcomes.

Evolving Indications of Transcatheter Aortic Valve Replacement Compared to Surgical Valve Replacement: A Review of the Current Literature.

Patients with severe symptomatic aortic stenosis (AS) are categorized into high risk, intermediate risk, and low risk. The identification of risk status is done using the Society of Thoracic Surgeons mortality score. Various factors are considered such as clinical symptoms, ejection fraction, age, left ventricle measurements, severity of AS, associated comorbid factors, and any other associated cardiac diseases. Surgery is still a standard practice in many countries. However, it has its own complications, especially in high-risk patients. Transcatheter intervention is getting precipitous recognition as an alternative mode of treatment in selected cases to mitigate complication rates and improve quality of life. In this article, transcatheter aortic valve replacement and surgical aortic valve replacement are compared in patients with different surgical risks. The impact of the cost of the procedure and quality of life are of paramount importance in choosing the type of intervention. Structural valve degeneration is an independent risk factor affecting patient outcomes. Modifications in valve designs are being constantly implemented as well. The standard analytical methods are in accordance with randomized clinical trials to determine the efficacy and outcome of procedures. Primary and secondary endpoints were considered to evaluate the data. The results were tabulated to derive statistical significance of the studies. In high-risk surgical patients, transcatheter intervention has been proven as the procedure of choice for valve replacement. However, intermediate-risk and low-risk categories need further studies.