Chronic Total Occlusion of the Coronary Artery

Guest: Abhiram Prasad, M.D.

Host: Malcolm R. Bell, M.D.

Chronic total occlusion percutaneous coronary intervention (CTO PCI) is a minimally invasive technique used to treat patients with chronic total occlusion (CTO), or complete blockages, of the coronary arteries.

Joining us today to discuss CTO PCI is Abhiram Prasad, M.D., an interventional cardiologist at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

Which patient should be referred for CTO PCI?

What’s are the current success rates

What has led to improved procedural success?

Are the risks different to non-CTO PCI?

Is restenosis/reocclusion inevitable?

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Remote Cardiac Monitoring

Guest: David E. Albert, M.D. (@DrDave01)

Hosts: Anthony H. Kashou, M.D. (@anthonykashoumd)

This episode will cover the role of personal and remote solutions in the current era of medical care, how the pandemic has impacted this field, the importance of FDA clearance on new technologies, and how an idea can be transformed into reality.

Joining us today to discuss remote cardiac monitoring is David E. Albert, M.D., physician, inventor and serial entrepreneur. He is the founder of InnovAlarm, Lifetone Technology and AliveCor.

Specific topics discussed:

The creation of the AliveCor device and bringing this idea into the current medical practice

The role personal and remote solutions play in medical care today

How the pandemic has impacted the use of remote cardiac care and monitoring solutions

The impact digital health solutions like remote monitoring plays in enhancing the doctor-patient relationship

The value of pursuing FDA clearance for fortifying patient-provider confidence in remote monitoring devices

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices.

Facebook: MayoCVservices

LinkedIn: Mayo Clinic Cardiovascular Services

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Ultrasound: Incorporate Into Your Critical Care Assessment

Guests: Courtney E. Bennett, D.O.

Host: Malcolm R. Bell, M.D.

In patients that get admitted to the Cardiac Intensive Care Unit (CICU) research has shown it is beneficial to perform a clinical assessment followed by a Point-of-Care Ultrasound (POCUS) exam. POCUS imaging may complement the clinical assessment to help guide the differential diagnosis. Ultimately, incorporating intervention protocol with diagnostic imaging, you can improve patient outcomes.  

Joining us today to discuss POCUS in critical care assessment is Courtney E. Bennett, D.O., a cardiologist and the director of the cardiac intensive care unit at Mayo Clinic in Rochester, Minnesota. 

Specific topics discussed:

What is Point-of-Care Ultrasound (POCUS)

Should we utilize POCUS instead of physical exam?

When should we perform POCUS?

Can POCUS improve outcomes?

Should we use POCUS in resuscitation/ACLS?

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Left Main Coronary Disease – Selecting the Best Treatment 

Guests: Malcolm R. Bell, M.D. and Juan A. Crestanello, M.D.

Host: Kyle W. Klarich, M.D. (@KyleWKlarich)

In patients with left main coronary artery disease of low or intermediate anatomical complexity, there was no significant difference between percutaneous coronary intervention and coronary-artery bypass grafting with respect to the rate of the composite outcome of death, stroke, or myocardial infarction at 5 years.

Joining us today to discuss the findings of the EXCEL Trail and how it has impacted clinical treatment is Juan A. Crestanello, M.D., a cardiovascular surgeon and Chair of the Department of Cardiovascular Surgery, and Malcolm R. Bell, M.D., an interventional cardiologist and Vice Chair of Cardiology at Mayo Clinic in Rochester, Minnesota. 

Specific topics discussed:

Patients studied in the EXCEL trial and major outcomes

5 year outcome of death, stroke, or myocardial infarction between coronary-artery bypass grafting or percutaneous coronary intervention

Patient differences in coronary-artery bypass grafting versus percutaneous coronary intervention

Impact the EXCEL trial has had in the clinical setting

What types of patients are recommend for coronary-artery bypass grafting versus percutaneous coronary intervention

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Prospective AI - ECG Trials

Guest: Peter A. Noseworthy, M.D. (@noseworthypeter)

Hosts: Anthony H. Kashou, M.D.

Mayo Clinic specialists use artificial intelligence (AI)-augmented electrocardiogram (ECG) algorithms to assess ejection fraction, atrial fibrillation, aortic stenosis, comprehensive ECG interpretation; and more. Clinical trials help determine where and how the algorithms can best be used in patient care.

Joining us today to discuss AI-augmented ECG algorithms prospective clinical trials is Peter A. Noseworthy, M.D., a cardiac electrophysiologist and director of the Heart Rhythm and Physiological Monitoring Laboratory at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

Next steps to ensure AI-augmented ECG algorithms reach clinical practice

Current use of AI-augmented ECG algorithms at Mayo Clinic

Models that have performed well and models that have not

How to measure and evaluate each model's success

What the clinical trials design looks like

Feedback obtained from providers using the tool

Rigorous evaluation required

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices.

Facebook: MayoCVservices

LinkedIn: Mayo Clinic Cardiovascular Services

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Effects of a Low-Carbohydrate Diet on Insulin-Resistant Dyslipoproteinemia - A Randomized Controlled Feeding Trial

Guest: Stephen Kopecky, M.D. (@DrSteveKopecky)

Host: Paul A. Friedman, M.D. (@drpaulfriedman)

Research supports that a Mediterranean diet that's low in carbohydrates is a good diet for most people to consider to avoid heart risk factors and stay healthy.

Joining us today to discuss a study of the effects of diet on insulin-resistant dyslipoproteinemia is Stephen Kopecky, M.D., a preventive cardiologist at Mayo Clinic in Rochester, Minnesota. Dr. Kopecky is the author of Live Younger Longer, which describes how to use lifestyle to prevent heart disease.

Specific topics discussed:

Goals and importance of a study on the effects of a low-carbohydrate diet on insulin-resistant dyslipoproteinemia

Three diet variations

Diets' effects on total cholesterol, low-density lipoprotein and other risk markers

Possible effects of lifestyle changes on lipoprotein (a)

How this diet differs from other low-carbohydrate diets

Separating the impact of fats and carbohydrates from the impact of processed foods

How this diet differs from a ketogenic diet or the Atkin's diet

Why the three diets were applied after initial weight loss

Patient characteristics and comorbidities to consider in diet selection

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Percutaneous Mitral Valve Replacement

Guest: Mayra Guerrero, M.D. (@MayraGuerreroMD)

Host: Paul A. Friedman, M.D. (@drpaulfriedman)

Transcatheter mitral valve replacement is a minimally invasive procedure that allows specialists to replace the mitral valve without the need for standard open-heart surgery.

Joining us today to discuss transcatheter mitral valve replacement is Mayra Guerrero, M.D., an interventional cardiologist at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

Explanation of transcatheter mitral valve replacement

Transfemoral and transapical approaches

Transcatheter versus standard mitral surgery

Valve type, reliability and durability

Transcatheter mitral valve replacement in clinical trials

Candidates for transcatheter mitral valve replacement

Patient evaluation process

Valve replacement versus valve repair

Mitral clip considerations

Complications and post-procedure management

Care of the transseptal puncture

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

ECG Education: Where Are We and Where Do We Go?

 Guest: Nandan S. Anavekar, M.B., B.Ch. (@nandananavekar)

Host: Anthony H. Kashou, M.D.

Despite the clinical importance and broad use of the electrocardiogram (ECG), ECG literacy is uncommon among medical providers. Why is ECG competency uncommon? Does the lack of ECG literacy have unintended consequences? How can education in the art of the ECG be revitalized?  

Joining us today to discuss ECG competency is Nandan S. Anavekar, M.B., B.Ch., Cardiovascular Medicine and Radiology, at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

Anavekar's experience learning ECG skills

Training and reviews that make Dr. Anavekar's skills "stick" — a work in progress

Disconnect between perceived and actual ECG competency among general medical professionals

Impact of computerized interpretation of ECG on provider competency

Recommended improvements in early training for ECG interpretation

Thoughts on the delivery, assessment and measurement of competency

Career and personal advice for medical learners

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices.

Facebook: MayoCVservices

LinkedIn: Mayo Clinic Cardiovascular Services

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

High Sensitivity Troponin

Guest: Allan S. Jaffe, M.D.

Host: Malcolm R. Bell, M.D.

High-sensitivity troponin assays improve detection of myocardial infarction (MI). The assays detect low concentrations of the troponin protein, shortening the time interval required to identify myocardial injury and MI.

Joining us today to discuss the role of the high-sensitivity troponin assay in the setting of MI is Allan S. Jaffe, M.D., a cardiologist at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

How the high-sensitivity troponin assay differs from previous assays of sensitive cardiac troponin

Principles to guide clinicians in the use of the high-sensitivity troponin assay

Troponin T assay or troponin I assay to detect myocardial injury vs. MI

Utility of the high-sensitivity troponin assay in the emergency department

Rapid rule-in and rapid rule-out protocols

Patient flow and efficiency in the emergency department

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

New Standard Therapy for Heart Failure with Reduced Ejection Fraction - When and How to Introduce SGLT2 Inhibitors

Guest: Margaret M. Redfield, M.D.

Host: Malcolm R. Bell, M.D.

A new class of agents with powerful effects on cardiovascular outcomes has quickly amassed a compelling body of evidence for its use: sodium-glucose cotransporter-2 (SGLT2) inhibitors.

Joining us today to discuss the use of SGLT2 inhibitors for the treatment of patients with heart failure with reduced ejection fraction (HFrEF) is Margaret M. Redfield, M.D., a cardiologist and heart failure specialist at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

Evidence supporting the use of SGLT2 inhibitors in patients with HFrEF

Treatment impact on patients with heart and renal failure

Patients who are ineligible for use of SGLT2 inhibitors

How to select patients and begin treatment in the outpatient setting, including titration requirements

Collaboration with specialists managing care for patients with diabetes

Inpatient treatment

Overcoming hesitation among cardiologists in prescribing SGLT2 inhibitors

Considerations for the treatment of patients who present with diabetic ketoacidosis

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.