Alan M. Zunamon, M.D.

Alan M. Zunamon, M.D.

Alan M. Zunamon, M.D.

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Personal Bio

Treatment Philosophy

While I believe in the science of medicine and the importance of scientific data in guiding decision-making, I strive to provide an individualized approach that incorporates a patient's personal values.

Personal Interests

I have developed an independent but related interest in Medical Informatics including but not limited to the wise use of Electronic Health Records. I completed a Masters in Medical Informatics in 2013 and continue to look for opportunities to develop the role of clinician informaticist. I also play the piano (mostly jazz) and try to get as much exercise including tennis and running as my schedule allows. My wife and four children are last in this list but first in importance.

Conditions & Procedures

Conditions

Atrial Fibrillation, Cardiac Arrhythmias, Congestive Heart Failure (CHF), Coronary Disease, Hypertension, Preventive Cardiology, Valvular Heart Disease

Procedures

Arrhythmia Monitoring, Echocardiography, Stress Echocardiography

General Information

Gender

Male

Affiliation

NorthShore Medical Group

Expertise

Cardiology

Languages

English

Board Certified

Cardiovascular Disease, Clinical Cardiac Electrophysiology, Internal Medicine

Clinical Service

Cardiology

Education, Training & Fellowships

Medical School

Loyola University Stritch Schl of Medicine, 1983

Internship

Mercy Hospital and Medical Center

Residency

Mercy Hospital and Medical Center

Fellowship

Mercy Hospital and Medical Center, 1988
Northwestern Feinberg School of Medicine, 1989

Locations

A

NorthShore Medical Group

2501 Compass Rd.
Suite 135
Glenview, IL 60026
847.869.1499 847.901.5250 fax This location is not wheelchair accessible.
B

NorthShore Medical Group

9977 Woods Dr.
3rd Floor
Skokie, IL 60077
847.663.8410 847.663.8411 fax This location is wheelchair accessible.
C

NorthShore Medical Group

1000 Central St.
Suite 800
Evanston, IL 60201
847.869.1499 847.901.5250 fax This location is wheelchair accessible.

Insurance

Every effort has been made to ensure the accuracy of the information in this directory. However, some changes may occur between updates. Please check with your provider to ensure that he or she participates in your health plan.

Aetna HMO/PPO/POS
BCBS HMOI
BCBS PPO *except Blue Choice IL
Beechstreet PPO
CCN PPO
CIGNA Choice Fund
CIGNA Choice Fund PPO
CIGNA EPO
CIGNA Network
CIGNA Network Open Access
CIGNA POS
CIGNA POS Open Access
CIGNA PPO
CIGNA:Open Access Plus
First Health PPO
Galaxy PPO
Great West POS
Great West PPO
Healthcares Finest Network PPO
Humana Choice Care PPO
Humana IPA--HMO
Humana POS
Humana PPO
Land of Lincoln
Medicare
Multiplan Admar PPO
Multiplan Formost PPO
Multiplan Health Network PPO
Multiplan Wellmark PPO
NorthShore Employee Network I (EPO Option)
NorthShore Employee Network II (EPO Plus & CDHP)
PHCS PPO
Preferred Plan PPO
Railroad Medicare - Cook County
Railroad Medicare - Lake County
UHC *except Core & Navigate
Unicare PPO

Publications

  • Percutaneous repair or surgery for mitral regurgitation.

    The New England journal of medicine 2011 Apr 14

    Authors: Feldman T,
    Abstract
    Mitral-valve repair can be accomplished with an investigational procedure that involves the percutaneous implantation of a clip that grasps and approximates the edges of the mitral leaflets at the origin of the regurgitant jet.
    We randomly assigned 279 patients with moderately severe or severe (grade 3+ or 4+) mitral regurgitation in a 2:1 ratio to undergo either percutaneous repair or conventional surgery for repair or replacement of the mitral valve. The primary composite end point for efficacy was freedom from death, from surgery for mitral-valve dysfunction, and from grade 3+ or 4+ mitral regurgitation at 12 months. The primary safety end point was a composite of major adverse events within 30 days.
    At 12 months, the rates of the primary end point for efficacy were 55% in the percutaneous-repair group and 73% in the surgery group (P=0.007). The respective rates of the components of the primary end point were as follows: death, 6% in each group; surgery for mitral-valve dysfunction, 20% versus 2%; and grade 3+ or 4+ mitral regurgitation, 21% versus 20%. Major adverse events occurred in 15% of patients in the percutaneous-repair group and 48% of patients in the surgery group at 30 days (P<0.001). At 12 months, both groups had improved left ventricular size, New York Heart Association functional class, and quality-of-life measures, as compared with baseline.
    Although percutaneous repair was less effective at reducing mitral regurgitation than conventional surgery, the procedure was associated with superior safety and similar improvements in clinical outcomes. (Funded by Abbott Vascular; EVEREST II ClinicalTrials.gov number, NCT00209274.).
    PMID: 21463154 [PubMed - as supplied by publisher]
  • The impact of cognitive behavioral group training on event-free survival in patients with myocardial infarction: the ENRICHD experience.

    Journal of psychosomatic research 2009 Jul

    Authors: Saab PG,
    Abstract
    Although the Enhancing Recovery in Coronary Heart Disease (ENRICHD) treatment was designed to include individual therapy and cognitive behavioral group training for patients with depression and/or low perceived social support, only 31% of treated participants received group training. Secondary analyses classified intervention participants into two subgroups, (1) individual therapy only or (2) group training (i.e., coping skills training) plus individual therapy, to determine whether medical outcomes differed in participants who received the combination of group training and individual therapy compared to participants who received individual therapy only or usual care.
    Secondary analyses of 1243 usual care, 781 individual therapy only, and 356 group plus individual therapy myocardial infarction (MI) patients were performed. Depression was diagnosed using modified Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria; low perceived social support was determined by the ENRICHD Social Support Instrument. Psychosocial treatment followed MI, and for participants with severe or unremitting depression, was supplemented with a selective serotonin reuptake inhibitor. Cox proportional hazards regression was used to estimate intervention effects on time to first occurrence of the composite end point of death plus nonfatal MI. To control for confounding of group participation with survival (because individual sessions preceded group), we used risk set sampling to match minimal survival time of those receiving or not receiving group training.
    Analyses correcting for differential survival among comparison groups showed that group plus individual therapy was associated with a 33% reduction (hazard ratio=0.67; 95% confidence interval, 0.49-0.92, P=.01) in medical outcome compared to usual care. No significant effect on event-free survival was associated with individual therapy alone. The group training benefit was reduced to 23% (hazard ratio=0.77; 95% confidence interval: 0.56-1.07, P=.11) in the multivariate-adjusted model.
    Findings suggest that adding group training to individual therapy may be associated with reduction in the composite end point. A randomized controlled trial is warranted to definitively resolve this issue.
    PMID: 19539818 [PubMed - as supplied by publisher]
  • Quantitative assessment of severity of mitral regurgitation by serial echocardiography in a multicenter clinical trial of percutaneous mitral valve repair.

    The American journal of cardiology 2007 Nov 15

    Authors: Foster E,
    Abstract
    The aims of the echocardiographic substudy of this multicenter trial were to evaluate the use of quantitative assessment of mitral regurgitation (MR) severity using serial echocardiography and to assess the efficacy of percutaneous mitral valve repair. Previous surgical repair studies did not use quantitative echocardiographic methods. Results of a percutaneous mitral valve repair clip device in a core echocardiographic laboratory were evaluated. Published parameters for quantifying MR were used in a systematic protocol to qualify patients for study entry and evaluate treatment efficacy at discharge and 6 months after clip repair. Baseline results were presented for 55 patients, and follow-up results, for 49. Ninety-eight percent of required echocardiographic studies were submitted to the core laboratory, and >85% of required measurements were possible. At baseline, mean regurgitant volume was 54.8 +/- 24 ml, regurgitant fraction was 46.9 +/-16.2%, effective regurgitant orifice area was 0.71 +/- 0.40 cm(2), and vena contracta width was 0.66 +/- 0.20 cm. Based on a severity scale of 1 to 4, mean color flow grade was 3.4 +/- 0.7, and mean pulmonary vein flow was 2.8 +/- 1.2. In patients with a clip at 6 months, all measurements of MR severity were significantly decreased versus baseline, with mean regurgitant volume decreased from 50.3 to 27.5 ml (change -22.8 ml; p <0.0001), regurgitant fraction from 44.6% to 28.9% (change -15.7%; p <0.0001), color flow grade from an average of 3.4 to 1.8 (change -1.6; p <0.0001), and pulmonary vein flow from 2.8 to 1.8 (change -1.0; p <0.0018). In conclusion, quantitative assessment of MR is feasible in a multicenter trial, and percutaneous mitral repair with the MitraClip produces a sustained decrease in MR severity to moderate or less for > or =6 months.
    PMID: 17996523 [PubMed - as supplied by publisher]
  • Severe reversible left ventricular dysfunction associated with multiple cardiac myxomata.

    Wiadomości lekarskie (Warsaw, Poland : 1960) 2007

    Authors: Kuźniar TJ,
    Abstract
    A 22-year-old Caucasian woman presented with acrocyanosis of fingers and toes and dyspnea on exertion. Initial echocardiography showed multiple right and left atrial myxomata, mild enlargement of the left ventricle and severely depressed left ventricular systolic function. Resection of the tumors and replacement of the myxomatous mitral valve led to a complete resolution of echocardiographic evidence of left ventricular dysfunction, and was accompanied by disappearance of skin findings and symptoms of asthma.
    PMID: 17966897 [PubMed - as supplied by publisher]
  • Echocardiographic guidance and assessment of percutaneous repair for mitral regurgitation with the Evalve MitraClip: lessons learned from EVEREST I.

    Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 2007 Oct

    Authors: Silvestry FE,
    Abstract
    Percutaneous mitral repair is rapidly developing as an alternative to cardiac surgery in select patients. The Evalve percutaneous E2E system uses the MitraClip to replicate the surgical suture-based approach. This procedure requires real-time echocardiographic guidance in a unique and significant collaboration between echocardiographer and interventionalist. transesophageal echocardiography (TEE) is used as the primary imaging modality to guide this procedure and is essential to its success.
    In EVEREST I, the US multicenter phase I safety and feasibility trial, 47 patients with 3 or 4+ mitral regurgitation (MR) were enrolled. The trial involved a standardized echocardiographic imaging protocol with a standardized anatomic-based vocabulary, predetermined standard TEE views, preprocedural strategy meetings, and display of echocardiographic aids to optimize communication and procedural efficiency during placement of the clip.
    TEE guidance facilitated the creation of a double-orifice mitral valve in all 47 patients enrolled (100%), and 40 patients were discharged with 1 or more clips (85%). At discharge, successful placement of a clip and TEE is essential to the guidance of percutaneous MitraClip E2E repair. A streamlined approach to echocardiographic guidance, using predetermined standardized views, a common anatomic-based vocabulary, preprocedural strategy meetings, and a display of echocardiographic aids in the catheterization laboratory shortens the procedure time and allows for efficient percutaneous repair.
    PMID: 17570634 [PubMed - as supplied by publisher]
  • Mitral valve hemodynamic effects of percutaneous edge-to-edge repair with the MitraClip device for mitral regurgitation.

    Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2006 Dec

    Authors: Herrmann HC,
    Abstract
    The Endovascular Valve Edge-to-Edge REpair STudies (EVEREST) are investigating a percutaneous technique for edge-to-edge mitral valve repair with a repositionable clip. The effects on the mitral valve gradient (MVG) and mitral valve area (MVA) are not known.
    Twenty seven patients with moderate to severe or severe mitral regurgitation (MR) were enrolled. Echocardiography was performed preprocedure, at discharge, and at 1, 6, and 12 months. Mean MVG was measured by Doppler and MVA by planimetry and pressure half-time, and evaluated in a central core laboratory. Pre- and postclip deployment, simultaneous left atrial/pulmonary capillary wedge and left ventricular pressures were obtained in eight patients.
    Three patients did not receive a clip, six patients had their clip(s) explanted by 6 months (none for mitral stenosis), and four were repaired with two clips. Results are notable for a slight increase in mean MVG by Doppler postclip deployment (1.79 +/- 0.89 to 3.31 +/- 2.09 mm Hg, P < 0.01) and an expected decrease in MVA by planimetry (6.49 +/- 1.61 to 4.46 +/- 2.14 cm(2), P < 0.001) and by pressure half time (4.35 +/- 0.98 to 3.01 +/- 1.42 cm(2), P < 0.05). There were no significant changes in hemodynamic parameters postclip deployment by direct pressure measurements. There was no change in MVA by planimetry from discharge to 12 months (3.90 +/- 1.90 to 3.79 +/- 1.54 cm(2), P = 0.78).
    Echocardiographic and hemodynamic measurements after percutaneous mitral valve repair with the MitraClip show an expected decrease in mitral valve area with no evidence of clinically significant mitral stenosis either immediately after clip deployment or after 12 months of follow-up.
    PMID: 17080467 [PubMed - as supplied by publisher]
  • Mutation of perinatal myosin heavy chain associated with a Carney complex variant.

    The New England journal of medicine 2004 Jul 29

    Authors: Veugelers M,
    Abstract
    Familial cardiac myxomas occur in the hereditary syndrome Carney complex. Although PRKAR1A mutations can cause the Carney complex, the disorder is genetically heterogeneous. To identify the cause of a Carney complex variant associated with distal arthrogryposis (the trismus-pseudocamptodactyly syndrome), we performed clinical and genetic studies.
    A large family with familial cardiac myxomas and the trismus-pseudocamptodactyly syndrome (Family 1) was identified and clinically evaluated along with two families with trismus and pseudocamptodactyly. Genetic linkage analyses were performed with the use of microsatellite polymorphisms to determine a locus for this Carney complex variant. Positional cloning and mutational analyses of candidate genes were performed to identify the genetic cause of disease in the family with the Carney complex as well as in the families with the trismus-pseudocamptodactyly syndrome.
    Clinical evaluations demonstrated that the Carney complex cosegregated with the trismus-pseudocamptodactyly syndrome in Family 1, and genetic analyses demonstrated linkage of the disease to chromosome 17p12-p13.1 (maximum multipoint lod score, 4.39). Sequence analysis revealed a missense mutation (Arg674Gln) in the perinatal myosin heavy-chain gene (MYH8). The same mutation was also found in the two families with the trismus-pseudocamptodactyly syndrome. Arg674 is highly conserved evolutionarily, localizes to the actin-binding domain of the perinatal myosin head, and is close to the ATP-binding site. We identified nonsynonymous MYH8 polymorphisms in patients with cardiac myxoma syndromes but without arthrogryposis.
    We describe a novel heart-hand syndrome involving familial cardiac myxomas and distal arthrogryposis and demonstrate that these disorders are caused by a founder mutation in the MYH8 gene. Our findings demonstrate novel roles for perinatal myosin in both the development of skeletal muscle and cardiac tumorigenesis.
    PMID: 15282353 [PubMed - as supplied by publisher]
  • Transglutaminases in mammalian reproductive tissues and fluids: relation to polyamine metabolism and semen coagulation.

    Advances in enzyme regulation 1980

    Authors:
    Abstract
    PMID: 6108700 [PubMed - as supplied by publisher]

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Jan 2014

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