The safety of sodium glucose transporter 2 inhibitors and trends in clinical and hemodynamic parameters in patients with left ventricular assist devices.

Background: The safety and impact of sodium glucose transporter 2 inhibitors (SGLT2-I) in patients with left ventricular assist devices (LVAD) are unknown.

Methods: A retrospective analysis of all consecutive patients who underwent LVAD Heart Mate 3 (HM3) implantation at a single medical center and received SGLT2-I therapy following surgery was conducted. LVAD parameters, medical therapy, laboratory tests, echocardiography, and right heart catheterization (RHC) study results were recorded and compared before and after initiation of SGLT2-I.

Prophylactic atrial arrhythmia surgical procedures with congenital heart operations: review and recommendations.

Specific congenital heart anomalies significantly increase the risk for late atrial arrhythmias, raising the question whether prophylactic arrhythmia operations should be incorporated into reparative open heart procedures. Currently no consensus exists regarding standard prophylactic arrhythmia procedures. Questions remain concerning the arrhythmia-specific lesions to perform, energy sources to use, need for atrial appendectomy, and choosing a right, left, or biatrial Maze procedure.

Caring for high-need, high-cost patients: what makes for a successful care management program?

Provider groups taking on risk for the overall costs of care in accountable care organizations are developing care management programs to improve care and thereby control costs. Many such programs target "high-need, high-cost" patients: those with multiple or complex conditions, often combined with behavioral health problems or socioeconomic challenges. In this study we compared the operational approaches of 18 successful complex care management programs in order to offer guidance to providers, payers, and policymakers on best practices for complex care management.

Procedure-based complications to guide informed consent: analysis of society of thoracic surgeons-congenital heart surgery database.

Background: Informed consent refers to the process by which physicians and patients engage in a dialogue to explain and comprehend the nature, alternatives, and risks of a procedure or course of therapy. The goal of this study is to better "inform the process of informed consent" by offering empirically derived procedural complication lists that provide objective contemporary data that surgeons may share with patients and families.

Methods: The Society of Thoracic Surgeons Congenital Heart Surgery Database was queried for complications for 12 congenital heart operations (2010 to 2011) performed across all Society of Thoracic Surgeons-European Association of Cardio-Thoracic Surgery Congenital Heart Surgery (STAT) risk categories.

Revisiting the Baffes operation: its role in transposition of the great arteries.

Thomas Baffes developed one of the first operations for transposition of the great arteries directing inferior vena cava flow to the left atrium using an interposed homograft in the era before open heart surgery. He performed 117 Baffes operations from 1953 to 1960, with 30% overall mortality, and an additional 85 Baffes procedures before 1968, allowing many to survive until the atrial baffle operations. During the early days before hospitals had cardiopulmonary bypass machines, Tom Baffes and colleagues purchased a heart-lung machine and transported it to various Chicago hospitals to treat patients and stimulate interest in this emerging technology.

The role of research for sustainable paediatric cardiac programmes in developing countries.

Significant challenges face developing countries as a result of the maldistribution of access to healthcare throughout the world, specifically access to paediatric cardiac care. Sustainable paediatric cardiac programmes must be established in developing countries to provide care to all children with congenital heart disease. Education and research are essential components to sustainable paediatric cardiac programmes in developing countries to define local problems and the incidence of disease, and to generate solutions thereto related.

Diabetes group visits: integrated medical care and behavioral support to improve diabetes care and outcomes from a primary care perspective.

Of the many innovations in health care delivery proposed in the context of health reform for those with chronic diseases such as diabetes, the group visit model is relatively easy to implement and is effective for improving health outcomes and patient and provider satisfaction, with a neutral to positive effect on health care costs. This article describes the evolution of group visits for those with diabetes, the theory underlying group visits for patients with chronic medical conditions, and the existing evidence for the effectiveness of this model. It also addresses implementation of groups in practice, with an emphasis on the practical aspects of program implementation, integration of behavioral expertise into medical groups, individualization in various practice settings, and reimbursement issues.