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The Living Donor Navigator (LDN) Program pairs kidney transplant candidates (TC) with a friend or family member for advocacy training to help identify donors and achieve living donor kidney transplantation (LDKT). However, some TCs participate alone as self-advocates.

In this retrospective cohort study of TCs in the LDN program (04/2017-06/2019), we evaluated the likelihood of LDKT using Cox proportional hazards regression and rate of donor screenings using ordered events conditional models by advocate type.

Self-advocates (25/127) had lower likelihood of LDKT compared to patients with an advocate (adjusted hazard ratio (aHR) 0.22, 95% confidence interval (CI) 0.03-1.66, p=0.14). After LDN enrollment, rate of donor screenings increased 2.5-fold for self-advocates (aHR 2.48, 95%CI 1.26-4.90, p=0.009) and 3.4-fold for TCs with an advocate (aHR 3.39, 95%CI 2.20-5.24, p<0.0001).

Advocacy training was beneficial for self-advocates, but having an independent advocate may increase the likelihood of LDKT.

Advocacy training was beneficial for self-advocates, but having an independent advocate may increase the likelihood of LDKT.The Publisher regrets that this article is an accidental duplication of an article that has already been published,https//doi.org/10.1016/j.amjsurg.2020.09.030.The duplicate article has therefore been withdrawn. selleckchem The full Elsevier Policy on Article Withdrawal can be found at https//www.elsevier.com/about/our-business/policies/article-withdrawal.The field of interventional cardiology has expanded rapidly. As a result, four evolving areas have evolved - peripheral vascular interventions, structural heart interventions, adult congenital heart intervention, and chronic total occlusion. The complexity of these procedures and the number of devices available has grown rapidly. In addition, the professional and public expectations of procedural success and of minimizing case-avoidance have also grown. Specific issues include volume-outcome relationships, maintaining currency and proficiency, accessibility to specialized procedures, and the need to maintain a fundamental level of expertise in acute coronary interventions.

This study aimed to investigate cardiac computed tomography (CT) and transesophageal echocardiography (TEE) peridevice leak (PDL) assessments, and the clinical relevance of PDL.

PDL assessment is integral during follow-up after left atrial appendage (LAA) occlusion. Comparative studies of TEE and cardiac CT are sparse, and the clinical relevance of PDL is uncertain.

This was a single-center observational study of consecutive patients undergoing LAA occlusion with Amplatzer devices (Amplatzer Cardiac Plug/Amulet) between 2010 and 2018 (N=415). Patients with both 8-week CT and TEE were included for analysis (n=346). Images were analyzed by blinded investigators (K.K. and A.S.). PDL on cardiac CT was classified from grade 1 to 3, based on PDL at the device disc, device lobe, and LAA contrast patency. Primary clinical outcome was a composite of ischemic stroke, transient ischemic attack, systemic embolism, or all-cause death.

PDL was present in 110 patients (32%) by TEE, with 29 (8%) >3mm. By cardiac CT, 210 patients (61%) had PDL at the disc, with contrast patency in 204 patients (59%). A grade 3 PDL (gap at disc, lobe, and LAA contrast patency) was present in 63 patients (18%). Bland-Altman analysis showed poor agreement between CT and TEE for leak sizing. CT and TEE detected PDL was not significantly associated with worse outcome, hazard ratio 1.82 (95 % confidence interval 0.95 to 3.50); p=0.07 and hazard ratio 1.43 (95% confidence interval 0.74 to 2.76); p=0.28, respectively.

PDL occurrence is substantially higher with CT compared with TEE, with a large discrepancy between modalities in leak quantification. A novel CT-based classification is proposed, yet PDL was not associated with worse clinical outcome.

PDL occurrence is substantially higher with CT compared with TEE, with a large discrepancy between modalities in leak quantification. A novel CT-based classification is proposed, yet PDL was not associated with worse clinical outcome.

This study sought to investigate clinical outcomes associated with left atrial appendage occlusion (LAAO) versus direct oral anticoagulants (DOACs) in patients with high-risk atrial fibrillation (AF).

LAAO has been shown to be noninferior to warfarin for stroke prevention in AF. However, anticoagulation with DOACs is now preferred over warfarin as thromboprophylaxis in AF.

Patients with AF enrolled in the Amulet Observational Registry (n=1,088) who had successful LAAO with the Amplatzer Amulet device (n=1,078) were compared with a propensity score-matched control cohort of incident AF patients (n=1,184) treated by DOACs identified from Danish national patient registries. Propensity score matching was based on the covariates of the CHA

DS

-VASc (congestive heart failure, hypertension, age≥75 years, diabetes mellitus, prior stroke or transient ischemic attack or thromboembolism, vascular disease, age 65-74 years, sex category) and HAS-BLED (hypertension, abnormal renal or liver function, stroke, bleedingh-risk AF patients, LAAO in comparison with DOACs may have similar stroke prevention efficacy but lower risk of major bleeding and mortality.

The study sought to assess the acute hemodynamic effects of iatrogenic atrial septal defect (iASD) closure following transcatheter mitral valve edge-to-edge repair (TMVR).

The potential hemodynamic and clinical consequences of an iASD following TMVR are currently subject to controversial debates.

In 21 patients with relevant left-to-right shunt flow (50% [IQR 38% to 60%] of systemic perfusion volume) across an iASD following TMVR, interventional closure was performed with recordings of left ventricular (LV) and right ventricular (RV) pressure-volume loops during iASD occlusion.

iASD occlusion led to a volume shift from the RV (RV end-diastolic volume index pre 102 [IQR 80 to 120] ml/m

, post 92 [IQR 70 to 111] ml/m

 ; p<0.001) to the LV (LV end-diastolic volume index pre 91 [IQR 74 to 124] ml/m

, post 97 [IQR 77 to 127] ml/m

 ; p<0.001) with reduced RV (3.49 [IQR 2.07 to 3.58] l/min/m

vs. 2.68 [IQR 2.07 to 3.58] l/min/m

 ; p<0.001) but increased LV cardiac index (2.25 [IQR 1.80 to 3.28] l/min/m

vs.