Compartmentalization of the Inflammatory Response in the Pericardial Cavity in Patients Undergoing Cardiac Surgery.

The systemic inflammatory response after cardiopulmonary bypass has been widely studied. However, there is a paucity of studies that focus on the local inflammatory changes that occur in the pericardial cavity. The purpose of this study is to assess the inflammatory mediators in the pericardial fluid of patients undergoing cardiac surgery.

The Role of Natriuretic Peptides in Pericardial Fluid in Predicting Cardiovascular Disorders: A Systematic Review.

Atrial and ventricular natriuretic peptides play an important role in the neurohormonal regulation of cardiac function. Plasma levels of these peptides may aid in the diagnosis and prognosis of different cardiac disorders, such as congestive heart failure, ischemic heart disease, and atrial fibrillation. However, the association between elevated pericardial fluid levels of natriuretic peptides and these clinical conditions has not been proven.

Purulent Pericarditis as the First Manifestation of Esophageal Carcinoma.

Purulent pericarditis secondary to esophago-pericardial fistula is a serious complication that has been previously reported in patients with esophageal cancer treated with radio/chemotherapy and esophageal stenting. However, the presence of esophago-pericardial fistula as the first manifestation of advanced carcinoma of the esophagus is exceedingly infrequent. We report the case of a 61-year-old male who presented with sepsis, cardiac tamponade and septic shock who was found to have an esophago-pericardial fistula secondary to squamous carcinoma of the esophagus.

Accumulation of Inflammatory Mediators in the Normal Pericardial Fluid.

There is paucity of studies that focus on the composition of pericardial fluid under resting conditions. The purpose of this study is to determine the levels of inflammatory mediators in pericardial fluid and their correlation with plasma levels in patients undergoing elective cardiac surgery. We conducted a prospective cohort study on candidates for elective aortic valve replacement surgery.

Semaglutide modulates prothrombotic and atherosclerotic mechanisms, associated with epicardial fat, neutrophils and endothelial cells network.

Background: Obesity has increased in recent years with consequences on diabetes and other comorbidities. Thus, 1 out of 3 diabetic patients suffers cardiovascular disease (CVD). The network among glucose, immune system, endothelium and epicardial fat has an important role on pro-inflammatory and thrombotic mechanisms of atherogenesis.

Edoxaban treatment in a post-infarction experimental model.

Background: The sequelae of myocardial infarction (MI) require specific pharmacological therapy to minimise the post-MI remodelling, which in many cases evolves into cardiovascular complications. The aim of this study was to analyse the effect of edoxaban, an oral anticoagulant, on cardiac recovery in a rat model of permanent coronary artery ligation.

Methods: An experimental method to assess the post-MI remodelling in rats for 4 weeks, based on cardiac magnetic resonance imaging (MRI) and final histological analysis of the hearts was performed.

Outcomes of rapid deployment aortic valve replacement with concomitant cardiac procedures.

Background: Rapid deployment aortic valve replacement (RD-AVR) has been recently introduced with encouraging results. Outcomes of isolated RD-AVR include good hemodynamic profile, facilitation of minimally invasive techniques, and reduction of surgical times. However, role of this prosthesis in concomitant surgery is not well known.

Enhanced Levels of Adiposity, Stretch and Fibrosis Markers in Patients with Coexistent Heart Failure and Atrial Fibrillation.

The coexistence of heart failure (HF) and atrial fibrillation (AF) worsens the prognosis of patients. We aimed to study the inflammation, metabolism, adiposity, and fibrosis markers on epicardial and subcutaneous fat and blood, and their relationship with HF and AF. Samples from 185 patients undergoing cardiac surgery were collected.

Left Ventricular Papillary Fibroelastoma.

Cardiac papillary fibroelastoma is a rare benign primary cardiac tumor typically found on the valvular structures of the heart. Nonvalvular papillary fibroelastomas are exceedingly rare. We report the case of a 66-year-old male who presented with cerebellar infarctions and was found to have a mobile mass attached to the endocardial surface of the anteroseptal wall of the left ventricle.

The role of pericardial fluid biomarkers in predicting post-operative atrial fibrillation, a comprehensive review of current literature.

Post-operative atrial fibrillation (POAF) is a common complication of cardiac surgery which is associated with longer hospital stay, diminished quality of life, and increased mortality. Yet, the pathophysiology of POAF is poorly understood and it is unclear which patients are at highest risk. Pericardial fluid (PCF) analysis is emerging as an important tool for the early detection of biochemical and molecular changes in the cardiac tissue.

Effectiveness of intra-operative topical amiodarone for prevention of postcardiac surgery new-onset atrial fibrillation: A review of current evidence.

Background: Postoperative atrial fibrillation (POAF) is one of the most common complications following cardiac surgery and is associated with increased morbidity. Intraoperative topical amiodarone application on epicardial tissue has been shown to reduce systemic concentrations while maintaining therapeutic myocardial concentrations, thereby, lowering the risk of extracardiac adverse effects associated with oral and intravenous amiodarone therapy. However, the efficacy and safety of topical amiodarone in preventing POAF is unclear.

Does Pacemaker Implantation After Surgical Aortic Valve Replacement Impact Long-Term Morbidity and Mortality? A Focused Review.

Permanent pacing remains a serious complication that can occur in the postoperative period of surgical aortic valve replacement. The reported incidence is variable, and there are many perioperative factors that have been linked with a greater need for permanent pacing. Permanent pacing can also be associated with late lead-related and cardiac complications that can affect late outcome.

Biomechanical characteristics of different methods of neo-chordal fixation to the papillary muscles.

Background And Aim Of The Study: Several techniques have been described for neo-chordal fixation to the papillary muscles without any reported clinical differences. The objective of this study is to compare in vitro the biomechanical properties of four of these common techniques.

Methods: We studied the biomechanical properties of expanded polytetrafluoroethylene neo-chordal fixation using four techniques: nonknotted simple stitch, nonknotted figure-of-eight stitch, knotted pledgeted mattress stitch, and knotted pledgeted stitch using commercially available prefabricated loops.

The use of sutureless and rapid-deployment aortic valve prosthesis in patients with bicuspid aortic valve: A focused review.

Objective: The objective of this scoping review is to describe the postoperative outcomes and complications of patients with bicuspid aortic valve (BAV) treated with sutureless or rapid-deployment prosthesis.

Background: The use of sutureless and rapid-deployment prostheses is generally avoided in patients with BAV due to anatomical concerns and the elevated risk of para-prosthetic leaks. Multiple studies have reported the use of these prostheses into patients with BAV with varying degrees of success.

Synergism between obesity and HFpEF on neutrophils phenotype and its regulation by adipose tissue-molecules and SGLT2i dapagliflozin.

The adiposity invokes innate immune activity, coronary microvascular dysfunction and consequently heart failure preserved ejection fraction (HFpEF). Our aim was to study the neutrophils profile on obesity and cardiovascular disease and its regulation by adipose tissue-secretome and dapagliflozin. We have isolated neutrophils from patients undergoing open heart surgery (19 women and 51 men).

Ischemic ventricular septal rupture with patent coronary bypass grafts due to occluded septal branch, a case report.

Background: Ischemic ventricular septal rupture (VSR) is a lethal complication that occurs either after spontaneous or iatrogenic occlusion of one of the major epicardial coronary vessels. To the best of our knowledge, this is the first reported case of a VSD after a septal branch occlusion in a patient with patent coronary artery grafts to both the left anterior descending and posterior descending arteries.

Methods: We present a rare case of anterior ischemic VSR due to the occlusion of a major septal branch.

The Effect of Mineralocorticoid Receptor 3 Antagonists on Anti-Inflammatory and Anti-Fatty Acid Transport Profile in Patients with Heart Failure.

Epicardial fat thickness is associated with cardiovascular disease. Mineralocorticoid receptor antagonist (MRA), a pharmaceutical treatment for CVD, was found to have an effect on adipose tissue. Our aim was to analyse the main epicardial fat genesis and inflammation-involved cell markers and their regulation by risk factors and MRA.

ASCENDING AORTA PSEUDOANEURYSM PRESENTING AS A PRESTERNAL PULSATILE MASS.

Sixteen months after the replacement of the ascending aorta an 80-year-old lady was referred to our center for a presternal pulsatile mass. Computed tomography scan showed an ascending aorta pseudaneurysm extended through the sternum and filling the subcutaneous space. Surgical correction was successful.

Surgicel-Related Uptake on Positron Emission Tomography Scan Mimicking Prosthetic Valve Endocarditis.

A 78-year-old patient who underwent an aortic valve replacement presented 6 months later with clinical symptoms suspicious for prosthetic valve endocarditis. Echocardiography showed no features suggestive of endocarditis, but a positron emission tomography/computed tomography with fluorine-18-fluorodeoxyglucose (F-FDG PET/CT) scan showed an area of hyper-uptake around the ascending aorta. We realized that the sheet of Surgicel (Ethicon, Bridgewater, NJ) hemostat had been placed over the aortotomy suture line at the time of surgery.

Inflammatory and lipid regulation by cholinergic activity in epicardial stromal cells from patients who underwent open-heart surgery.

The modulation of acetylcholine (ACh) release by botulinum toxin injection into epicardial fat diminishes atrial fibrillation (AF) recurrence. These results suggest an interaction between autonomic imbalance and epicardial fat as risk factors of AF. Our aim was to study the inflammatory, lipidic and fibroblastic profile of epicardial stroma from patients who underwent open-heart surgery, their regulation by cholinergic activity and its association with AF.

Aortic Valve Replacement In Alkaptonuric Ochronosis.

Alkaptonuria is an autosomal recessive inborn error of metabolism of the aromatic amino acids. Deficiency of the homogentisate1,2-dioxygenase leads to an increased blood and urinary concentration of homogentisc acid resulting in a slow accumulation of its oxidation products in the connective tissues (ochronosis). The most common clinical manifestation of ochronosis is arthropathy whereas cardiac involvement is very infrequent.

CD5L, Macrophage Apoptosis Inhibitor, Was Identified in Epicardial Fat-Secretome and Regulated by Isoproterenol From Patients With Heart Failure.

Objectives: Neurohormonal dysfunction, which can regulate epicardial fat activity, is one of the main promoters of atrial fibrillation (AF) in patients with heart failure (HF). Our aim was to study the epicardial fat mediators for AF in patients with HF and its catecholaminergic regulation.

Methods: We have included 29 patients with HF who underwent cardiac surgery and were followed up for 5 years.

Acute Bioprosthetic Mitral Valve Thrombosis During Venoarterial Extracorporeal Membrane.

Bioprosthetic valve thrombosis is a rare complication. Left atrial dilatation, atrial fibrillation, hypercoagulability and low cardiac output are known risk factors. We report the case of a patient undergoing a bioprosthetic mitral valve replacement who required postoperative circulatory support with extracorporeal membrane oxygenation and presented acute bioprosthetic valve thrombosis.

Clinical study of an outbreak of postoperative mediastinitis caused by Serratia marcescens in adult cardiac surgery.

Objectives: Nosocomial infection caused by Serratia marcescens after cardiac surgery is rare but causes high rates of morbidity and mortality. Knowledge about postoperative mediastinitis due to S. marcescens is limited.