Emerging trends in mediastinitis: National Veterans Health Administration experience with methicillin-resistant Staphylococcus aureus prevention.

Objectives: Perioperative bacterial decolonization and prophylactic antibiotic therapy at the Veterans Affairs Health Care System have changed over the past decade. Our objectives were to identify associated changes in the microbiology of mediastinitis and to perform a contemporary survival analysis in patients with mediastinitis after isolated coronary artery bypass grafting procedure.

Methods: From January 2006 to December 2015, 45,323 consecutive patients underwent coronary artery bypass grafting at 83 medical centers.

Cardioplegia prevents ischemia-induced transcriptional alterations of cytoprotective genes in rat hearts: a DNA microarray study.

Background: Energy conservation and calcium homeostasis contribute to myocardial protection provided by hyperkalemic cardioplegia during ischemia. Complimenting these established mechanisms of protection, previous work suggested that activation of cytoprotective signaling pathways also contributes to reduced injury with cardioplegia. We proposed that cardioplegia would recruit cytoprotective pathways and investigated the transcriptional response of the heart after cardioplegia-protected ischemia compared with that after ischemia alone.

Cardioprotection by St Thomas' solution is mediated by protein kinase C and tyrosine kinase.

Background: Intracellular signaling pathways, specifically the activation of protein kinase C and tyrosine kinase, are essential to the cardioprotection of ischemic preconditioning. We proposed that activation of PKC and TK contribute to the myocardial protection of St. Thomas' No.

Aortomyoplasty: hemodynamics and comparison to the intraaortic balloon pump.

Background: Aortomyoplasty (AMP), a procedure in which the latissimus dorsi muscle (LDM) is wrapped around the aorta and stimulated during diastole, is a potential method of chronic counterpulsation. Counterpulsation by the intraaortic balloon pump (IABP) is a proven treatment for ischemic coronary syndrome and heart failure but cannot be used chronically. This study examined the long-term potential of a unique AMP configuration and compared its performance to the IABP.

Circulatory benefits of diastolic counterpulsation in an ischemic heart failure model after aortomyoplasty.

Objective: Aortomyoplasty is an experimental surgical procedure in which the latissimus dorsi muscle is wrapped around the thoracic aorta and stimulated to contract during diastole, providing diastolic counterpulsation. We hypothesized that aortomyoplasty could improve cardiac function in a chronic ischemic heart failure model, similar to the improvement seen with the intra-aortic balloon pump.

Methods: Six dogs (25-30 kg) successfully underwent aortomyoplasty followed by serial coronary microembolization.

Reducing Mortality Among Elderly Patients Undergoing Urgent Surgical Revascularization for Acute Myocardial Infarction.

INTRODUCTION: Elderly patients undergoing coronary bypass surgery after acute myocardial infarction represent a distinct, high risk subgroup. We sought to identify independent risk factors for mortality in a series of patients operated on in our hospital. METHODS: The case records of 499 consecutive patients greater than 70 years were identified, and 94 of these patients underwent urgent/emergent coronary bypass surgery within 7 days of acute myocardial infarction.