Joseph F. Malouf

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CONTEXT Acute aortic dissection is a life-threatening medical emergency associated with high rates of morbidity and mortality. Data are limited regarding the effect of recent imaging and therapeutic advances on patient care and outcomes in this setting. OBJECTIVE To assess the presentation, management, and outcomes of acute aortic dissection. DESIGN(More)
BACKGROUND Obstructive sleep apnea (OSA) is associated with recurrent atrial fibrillation (AF) after electrocardioversion. OSA is highly prevalent in patients who are male, obese, and/or hypertensive, but its prevalence in patients with AF is unknown. METHODS AND RESULTS We prospectively studied consecutive patients undergoing electrocardioversion for AF(More)
BACKGROUND This study assessed the long-term outcome of a large, asymptomatic population with hemodynamically significant aortic stenosis (AS). METHODS AND RESULTS We identified 622 patients with isolated, asymptomatic AS and peak systolic velocity > or =4 m/s by Doppler echocardiography who did not undergo surgery at the initial evaluation and obtained(More)
BACKGROUND Cardiac pseudoaneurysm, a contained cardiac rupture, predisposes patients to further rupture. However, knowledge of the clinical profile and natural history of this cardiac complication is limited. OBJECTIVE To study the clinical features and outcomes of patients with cardiac pseudoaneurysm. DESIGN Retrospective analysis of patients with(More)
OBJECTIVES We analyzed the clinical characteristics and outcomes of 47 patients with severe pulmonary hypertension (PHT) and severe aortic valve stenosis (AS) from 1987 to 1999. BACKGROUND The prognostic implications of severe pulmonary hypertension in patients with severe AS are poorly understood. METHODS The mean age of patients was 78 years (range 47(More)
BACKGROUND The impact of aortic prosthesis-patient mismatch (P-PtM) on long-term survival is unclear. METHODS AND RESULTS Between 1985 and 2000, 388 patients at Mayo Clinic in Rochester, Minn, underwent aortic valve replacement (AVR) with 19- or 21-mm St Jude Medical prostheses and had transthoracic echocardiography within 1 year after AVR. Mean age of(More)
OBJECTIVES We sought to: 1) identify trends in the diagnostic testing of patients with prosthetic aortic valve (AVR) obstruction who undergo reoperation and 2) compare diagnostic test results with pathologic findings at surgery. BACKGROUND It is unclear whether Doppler transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) have(More)
There is increasing interest in the association between patent foramen ovale (PFO) and documented stroke of unknown cause, commonly referred to as cryptogenic stroke. We reviewed the literature and, on the basis of the available data, designed a diagnostic and treatment algorithm for patients with PFO and cryptogenic stroke. Patent foramen ovale is(More)
OBJECTIVES This study was conducted to define the association between serum B-type natriuretic peptide (BNP) activation and survival after the diagnosis of aortic stenosis (AS). BACKGROUND In AS, the link between BNP levels and clinical outcome is in dispute. Failure to account for the normal shifting of BNP ranges with aging in men and women, not using(More)
We present two sisters with tetralogy of Fallot and pulmonary valve atresia. Both had identical anatomical findings as seen at cardiac catheterization and angiography and verified operatively, with, in particular, identical bronchial circulation and pulmonary valve structure. The parents are first cousins and there is no history of other affected relatives.(More)