20 Years of triple-valve surgery in the UK: demographic and outcome trends.

Objectives: To describe evolving demographic trends and early outcomes in patients undergoing triple-valve surgery in the UK between 2000 and 2019.

Methods: We planned a retrospective analysis of national registry data including patients undergoing triple-valve surgery for all aetiologies of disease. We excluded patients in a critical preoperative state and those with missing admission dates.

Early experience of a new national lung allocation scheme in the UK based on clinical urgency.

Introduction: A new UK Lung Allocation Scheme (UKLAS) was introduced in 2017, replacing the previous geographic allocation system. Patients are prioritised according to predefined clinical criteria into a three-tier system: the super-urgent lung allocation scheme (SULAS), the urgent lung allocation scheme (ULAS) and the non-urgent lung allocation scheme (NULAS). This study assessed the early impact of this scheme on waiting-list and post-transplant outcomes.

Primary graft dysfunction following lung transplantation: From pathogenesis to future frontiers.

Lung transplantation is the treatment of choice for patients with end-stage lung disease. Currently, just under 5000 lung transplants are performed worldwide annually. However, a major scourge leading to 90-d and 1-year mortality remains primary graft dysfunction.

Primary Graft Dysfunction after Heart Transplantation - Unravelling the Enigma.

Primary graft dysfunction (PGD) remains the main cause of early mortality following heart transplantation despite several advances in donor preservation techniques and therapeutic strategies for PGD. With that aim of establishing the aetiopathogenesis of PGD and the preferred management strategies, the new consensus definition has paved the way for multiple contemporaneous studies to be undertaken and accurately compared. This review aims to provide a broad-based understanding of the pathophysiology, clinical presentation and management of PGD.

Rare case of diaphragmatic rupture following resuscitation in a pregnant woman first in literature.

Introduction: Complications following Cardiopulmonary resuscitation (CPR) are rare and usually follows a vigorous CPR or in special cases like pregnancy are due to lack of knowledge and clinical practice of how to preform CPR in pregnancy. One of this complication is diaphragmatic rupture with herniation of abdominal organs. Surgical intervention needs to be planned carefully in multidisciplinary team approach and requires fine surgical techniques for better outcome.

Aortic endovascular stenting in patients with systemic connective tissue disorders: does the prohibitive dogma still stand tall?

Endovascular repair of thoracic aortic diseases can provide satisfactory outcomes in elective and certain emergency cases involving the descending thoracic and aortic arch. However, open repair remains the gold standard method of aortic root pathologies and certain aortic arch pathologies, such as extended dissection. Nevertheless, the use of endovascular stenting in patients with connective tissue disorders has not been fully explored because the aortic tissues are fragile and the likelihood of keeping the stent in place is low because of its progressive dilatation and subsequent requirement for open repair at a later stage when the stent graft fails.

Replacing the ascending aorta in the elderly: do or do not.

Advanced age is a proven independent factor for perioperative morbidity and mortality in all forms of aortic surgery and forms an important variable in most available risk scores. Improvements in selection and perioperative management of high-risk elderly cohorts have reduced the incidence of adverse outcomes. Concerns remain however in the surgical and anesthesiology community that exposing elderly frail patients to ascending aortic surgery is associated with significant risk.

Mechanical circulatory support for refractory cardiogenic shock post-acute myocardial infarction-a decade of lessons.

Background: There are 0.9 catheterization labs per 100,000 inhabitants in Scotland for percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI), which are much less accessible to patients in remote and rural areas. An uncommon but sinister sequalae following AMI is cardiogenic shock (CS) that could be refractory to inotropic support.

Minimally Invasive Versus Conventional Aortic Root Replacement - A Systematic Review and Meta-Analysis.

Background: Mini-sternotomy has been proven superior to full sternotomy in aortic valve replacement by providing better perioperative outcomes. We investigated whether such technique provides better outcomes in patients undergoing aortic root surgery.

Methods: A comprehensive electronic literature search was undertaken among the four major databases (PubMed, Ovid, Scopus and EMBASE) to identify all published studies up to June 2018.

Recent advances in aortic valve replacement for aortic stenosis.

Aortic valve replacement is no longer an operation that is approached solely through a median sternotomy. Recent advances in the fields of transcatheter valves have expanded the proportion of patients eligible for intervention. Comparisons between transcatheter valves and conventional surgery have shown non-inferiority of transcatheter valve implants in patients with a high or intermediate pre-operative predictive risk.

Ventricular assist devices as rescue therapy in cardiogenic shock after subarachnoid hemorrhage.

We review the journey to myocardial and neurologic recovery of a 42-year-old mother with severe acute cardiogenic shock and multiorgan failure after extensive subarachnoid hemorrhage, who was salvaged successfully using a CentriMag short-term biventricular assist device.

Changing trends in surgery for Graves' disease: a cohort comparison of those having surgery intended to preserve thyroid function with those having ablative surgery.

Background: Surgery for Graves' disease may be performed with the intent of preserving thyroid function (subtotal thyroidectomy) or ablating thyroid function (total thyroidectomy). This study examines the evolving practice in a specialist endocrine surgical unit.

Method: Longitudinal cohort study of patients undergoing surgery for Graves' disease between 1986 and 2008.

Coblation adenotonsillectomy in children.

Objective: To determine re-admission rate for post-tonsillectomy pain; the primary and secondary post-tonsillectomy bleeding rate; the percentage requiring control of post-tonsillectomy bleeding in children undergoing coblation tonsillectomy.

Study Design: A descriptive study.

Place And Duration Of Study: Royal Hospital for Sick Children (Yorkhill Hospital) between 2004 and 2006.

Retrospective review of three antiemetic regimens versus no therapy in the prevention of postoperative and vomiting following adenotonsillar surgery.

Objective: To study the effect of intraoperative ondansetron and dexamethasone on postoperative vomiting in children undergoing tonsillectomy, adenotonsillectomy, or adenoidectomy.

Study Design: Retrospective chart review.

Setting: Academic tertiary care referral centre in the west of Scotland.

Quality of life after surgery for Graves' disease: comparison of those having surgery intended to preserve thyroid function with those having ablative surgery.

Background: Postoperative quality of life (QoL) after surgery for Graves' disease is not well documented, and the effect of different surgical operations has not been compared. This study examines the impact on QoL of a shift in policy from operations intended to preserve thyroid function (PF) to those ablating thyroid function (AF).

Methods: A cross-sectional assessment was performed on patients who underwent surgery for Graves' disease between 1986 and 2008 in a tertiary endocrine surgical unit.

Intraoperative dexamethasone and the risk of secondary posttonsillectomy hemorrhage.

Objective: to determine whether intraoperative dexamethasone is a risk factor for secondary posttonsillectomy bleeding.

Design: retrospective chart review.

Setting: tertiary care referral centres in Scotland.