Participants in this arm will undergo invasive hemodynamic monitoring using a Swan-Ganz catheter upon admission to the intensive care unit. Hemodynamic variables, including right atrial pressure (RAP), pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP), cardiac output (CO), cardiac power output (CPO), and mixed venous oxygen saturation (SvO₂) will be continuously measured and used to guide resuscitation. Management will follow a goal-directed algorithm targeting predefined thresholds for preload, afterload, contractility, and oxygen delivery. All patients will receive standard care for acute myocardial infarction, and no control or comparator arm is included in this study.

A pulmonary artery catheter (Swan-Ganz catheter) will be inserted via the right internal jugular or subclavian vein using a sterile technique and ultrasound guidance. The catheter is advanced into the pulmonary artery with real-time pressure waveform monitoring to confirm accurate positioning.

Once inserted, the catheter provides continuous invasive hemodynamic monitoring, including measurements of: Right atrial pressure (RAP), Pulmonary artery pressure (PAP), Pulmonary capillary wedge pressure (PCWP), Cardiac output (CO) by thermodilution, Mixed venous oxygen saturation (SvO₂).

These parameters are recorded at predefined intervals and used to guide goal-directed hemodynamic resuscitation. Clinical interventions such as vasopressor/inotrope titration, fluid resuscitation, or ventilatory support will be adjusted accordingly. All procedures will follow institutional protocols and safety standards. Complications (e.g., arrhythmias, infection) will be monitored and managed per protocol.

Swan-Ganz IQ Pulmonary Arterial catheter

A pulmonary artery catheter (Swan-Ganz catheter) will be inserted via the right internal jugular or subclavian vein using a sterile technique and ultrasound guidance. The catheter is advanced into the pulmonary artery with real-time pressure waveform monitoring to confirm accurate positioning.

Once inserted, the catheter provides continuous invasive hemodynamic monitoring, including measurements of: Right atrial pressure (RAP), Pulmonary artery pressure (PAP), Pulmonary capillary wedge pressure (PCWP), Cardiac output (CO) by thermodilution, Mixed venous oxygen saturation (SvO₂). These parameters are recorded at predefined intervals and used to guide goal-directed hemodynamic resuscitation. Clinical interventions such as vasopressor/inotrope titration, fluid resuscitation, or ventilatory support will be adjusted accordingly. All procedures will follow institutional protocols and safety standards. Complications (e.g., arrhythmias, infection) will be monitored and managed per protocol.

Swan-Ganz IQ catheter

Thang Pham, MD, PhD Candidate

Participants in this arm will undergo standard peroral endoscopic myotomy (POEM), including myotomy of circular and sling muscle fibers at the gastric side.

Standard posterior POEM with full-thickness myotomy, including both circular and gastric sling muscle fibers.

Conventional POEM

Participants in this arm will undergo posterior POEM with selective preservation of the gastric sling fibers. Myotomy is performed to the right of the second penetrating vessel to spare the sling fibers. The double scope technique will be employed to confirm that the tunnel ends on the lesser curve, which confirms sparing of the sling fibers.

Posterior POEM with selective preservation of gastric sling fibers by limiting myotomy to the right of the second penetrating vessel.

Sling Fiber-Preserving POEM

Frances Dang, MD

Jason Samarasena, MD, MBA

Treatment with the Aria CV Pulmonary Hypertension System

The Aria CV PH System is indicated for the treatment of adult patients diagnosed with Pulmonary Hypertension in World Health Organization (WHO) Groups I, II, and III who remain symptomatic despite treatment with optimal medical therapy.

Aria CV Pulmonary Hypertension System

Lloyd Liang

Richard Channick, MD

Rajan Saggar, MD

Alexander Sherman, MD

Peyman Benharash, MD

Ali Nsair, MD

Allyn (Ryn) Harker

Ashwin Ravichandran, MD

Scott Hittinger, MD

Amit Patel, MD

Olivia Vayer

Eileen Harder, MD

Aaron Waxman, MD

Edgar Ross, MD

Jane Leopold, MD

Gretchen Peichel, RN

Thenappan Thenappan, MD

Louise Durst

Robert Frantz

Adrian da Silva de Abreu

Joseph Lohmann

Evelyn Horn, MD

Harsimran Singh, MD

Maria Karas, MD

Berhane Worku, MD

George Thomas, MD

Yoshifumi Naka, MD

Andrew Mintz

Jim White, MD

Dan Lachant, DO

Fred Ling, MD

Kazuhiro Hisamoto, MD

Sanchita Krishna

Lindsay Castle, MD

Steven Yakubov, MD

Anupam Basuray, MD

Daniel Gorbett, MD

Shaquanda Goodwine

Michelle Esposito, MD

폐동맥 고혈압 환자를 대상으로 새 설문지를 개발하고 환자 지식과 건강 상태의 관계를 분석하는 연구입니다.

Participants in this arm will take part in one of three phases of the questionnaire validation study:

1. content validation by expert judges,
2. semantic validation by patients with pulmonary arterial hypertension (PAH),
3. psychometric validation in a larger sample of up to 200 patients with confirmed PAH.

In the psychometric phase, participants will complete the final version of the DICTA questionnaire. Additional clinical and functional data will be collected from medical records, including:

risk stratification using the COMPERA 2.0 method, number of PAH-related hospitalizations, and quality of life scores measured by the CAMPHOR (Cambridge Pulmonary Hypertension Outcome Review), SF-36 (Short Form Health Survey), and MBG (Global Well-Being Measure).

These data will be used to explore associations between patient knowledge and clinical/functional outcomes.

Participants will complete one version of the DICTA questionnaire, developed to assess patient knowledge about pulmonary arterial hypertension. Depending on the study phase, participants will contribute to content validation (expert judges), semantic validation (patients), or psychometric validation (patients). In the final phase, additional data including risk stratification (COMPERA 2.0), hospitalizations, and quality of life scores (CAMPHOR, SF-36, MBG) will be collected for correlational analysis.

Application of Patient Knowledge Questionnaire on Pulmonary Hypertension

Caio Fernandes, PhD

Pulsta® Transcatheter Pulmonary Valve (TaeWoong Medical Co., Ltd. Korea)

Pulsta® Transcatheter Pulmonary Valve Replacement

Pulsta® Transcatheter Pulmonary Valve (TPV) Replacement

In patients randomized to Intervention, a Contrast pulmonary artery (PA) angiography will be performed to identify the pulmonary artery bifurcation and measure the PA diameter. Once the anatomy is deemed suitable, a radiofrequency ablation catheter will be introduced into the ostium of the left PA and the distal bifurcation of the main PA. The catheter will be maneuvered within the PA to deliver energy circumferentially, ensuring tight electrode contact with the endovascular surface. Approximately three ablations will be performed at a target temperature of 50 °C (range 45-55 °C) for 120 seconds each at both the left PA ostium and the distal main PA bifurcation.

All patients enrolled in this clinical study will following the Guideline-Directed Medical Therapy (GDMT)

Pulmonary Artery Denervation (PADN)

In patients randomized to a placebo-procedure, a script will be followed for approximately 20 minutes to simulate the PADN procedure. All patients enrolled in this clinical study will following the Guideline-Directed Medical Therapy (GDMT)

Swan-Ganz IQ 폐동맥 카테터, Swan-Ganz IQ 카테터

기존 POEM, 슬링 섬유 보존 POEM

Aria CV 폐동맥 고혈압 시스템

폐동맥 고혈압에 대한 환자 지식 설문지 적용

Pulsta® 경피적 폐동맥판막(TPV) 교체

폐동맥 변성술(PADN), 가짜 시술 제어