Endothelial cell damage related to coronavirus disease 2019 (COVID‐19) has been described in multiple vascular beds, and many survivors of COVID‐19 report chest pain. This case series describes two previously healthy middle‐aged individuals who survived COVID‐19 and were subsequently found to have symptomatic coronary endothelial dysfunction months after initial infection.

Background The VASCADE closure device deploys an extravascular collagen plug. Its use in those with access site disease undergoing peripheral vascular intervention (PVI) is unknown. We aimed to evaluate the efficacy and safety of the VASCADE closure device compared to manual compression (MC) in patients with moderate femoral access site disease. Methods We performed a single‐center, retrospective review of patients undergoing PVI with at least moderate access site disease. Our institutional database was linked to the Vascular Quality Initiative database, and 200 patients were selected from a 1:1 propensity‐matched cohort. Data on procedural metrics and outcomes up to 30‐days were abstracted. Results There were 103 procedures that used VASCADE and 97 used MC. Baseline variables were similar between groups. The mean age was 68.2 ± 11.2 years and 37.6% were women. Closing mean activated clotting time (ACT) was shorter in VASCADE (198 s VASCADE vs. 213 s MC; p = 0.018). There was a nonsignificant decrease in external compression device use with VASCADE (VASCADE 19.0% vs. MC 28.1%; p = 0.15). At 30‐days, there was a nonsignificant reduction in hematoma with VASCADE (3.8% vs. 7.8% MC; p = 0.25) and no difference in retroperitoneal bleeding (0.5%). Pseudoaneurysm rate was similar (1.3% VASCADE vs. 1.7% MC; p = 0.79). The 30‐day mortality rate was similar between the two groups and not related to the procedure (1.3% VASCADE vs. 0.9% MC; p = 0.79). Conclusion In patients undergoing PVI with at least moderate access site disease, safety and efficacy after using VASCADE was comparable with MC.

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Purpose: Repeated invasive cardiac output testing in patients supported by a ventricular assist device (VAD) with right heart catheterization carries an increased risk of pump thrombosis during times of reduced anticoagulation, and come at considerable healthcare costs. There are inherent flaws in measuring cardiac output by fick and thermal method. Insufficient data exists on non-invasive assessment of cardiac output in these patients. We hypothesize that in clinically stable patients, flow on axial VAD consoles and Doppler derived cardiac outputs (measured through right ventricular outflow tract on transthoracic echocardiograph) can be used to estimate the cardiac output. Methods: We retrospectively assessed right heart catheterization results to obtain fick and thermal cardiac outputs of stable patients supported by the axial continuous-flow VAD (HeartMate II, Thoratec Inc) between April 2011 and September 2014. At the time of their right heart catheterization, flow estimations were obtained from their VAD console (VF). Correlations coefficients (r) were obtained to assess relationships between VF and cardiac outputs by fick and thermal method. Additionally, echocardiograms at the time of right heart catheterization were assessed, and Doppler derived cardiac outputs measured through the right ventricular outflow tract (rCO) and assessed for correlation with fick and thermal cardiac outputs. Results: Forty-two subjects were assessed with mean VAD speed 9081+/-181 rpm. Fick cardiac output (5.13+/-1.4 L/min) and VF (5.31+/-0.9 L/min) had a correlated well; r of 0.43 (p= 0.0048). In 35 subjects, thermal cardiac outputs (5.19+/-1.5 L/min) were available and also correlated with VF (5.42+/-0.96 L/min, r= 0.43, p= 0.0097). No correlation was found between 27 assessments of rCO (3.83+/-1.6 L/min, r= 0.20, p= 0.303) and fick cardiac output (5.28+/-1.4 L/min). Likewise, there was no significant correlation between 22 values of rCO (4.10+/-1.6 L/min, r= 0.13, p= 0.564) and thermal cardiac output (5.28+/-1.3 L/min). Conclusion: Flow estimates from the HeartMate II console correlate with cardiac outputs derived invasively by the fick and thermal methods in stable patients without concern for pump thrombosis. Doppler derived cardiac outputs from the right ventricular outflow tract were inaccurate in patients on VAD support.