Coronary artery bypass grafting in octogenarians: an Australian experience.

Background: The aims of this study were to describe early and mid-term morbidity and mortality in octogenarian patients undergoing CABG, to determine if outcomes are comparable to younger patients undergoing the same procedure.

Methods: We conducted a retrospective analysis of the first 901 patients who underwent cardiac surgery at a large newly established tertiary hospital in Western Australia from February 2015 to September 2019. Inclusion criteria involved all patients undergoing coronary artery bypass grafting.

Hypothermic oxygenated perfusion (HOPE) safely and effectively extends acceptable donor heart preservation times: Results of the Australian and New Zealand trial.

Background: Cold static storage preservation of donor hearts for periods longer than 4 hours increases the risk of primary graft dysfunction (PGD). The aim of the study was to determine if hypothermic oxygenated perfusion (HOPE) could safely prolong the preservation time of donor hearts.

Methods: We conducted a nonrandomized, single arm, multicenter investigation of the effect of HOPE using the XVIVO Heart Preservation System on donor hearts with a projected preservation time of 6 to 8 hours on 30-day recipient survival and allograft function post-transplant.

Outcomes of Cardiac Transplantation in Western Australia - A Contemporary Single Centre Experience.

Background: Cardiac transplantation remains the gold standard therapy for select patients with end-stage heart failure and outcomes have improved significantly over the past few decades. We report the 5-year contemporary experience of cardiac transplantation in Western Australia, one of the most remote transplant centres worldwide.

Methods: Patients undergoing isolated cardiac transplant at Fiona Stanley Hospital (FSH) from February 2015 until April 2021 were included.

Preoperative Intra-Aortic Balloon Pumps in Cardiac Surgery: A Propensity Score Analysis.

Introduction: The role of intra-aortic balloon pumps (IABP) in high-risk patients undergoing coronary artery bypass graft (CABG) surgery remains controversial. We report the 5-year experience from a new Australian centre.

Methods: We retrospectively analysed 690 patients undergoing urgent isolated CABG surgery at a Western Australian tertiary centre from February 2015 to May 2020.

Deep Sternal Wound Infections After Cardiac Surgery: A New Australian Tertiary Centre Experience.

Background: Deep sternal wound infections (DSWI) after cardiac surgery impose a significant burden to patient outcomes and health care costs. The objective of this study is to identify risk factors, microbiological characteristics and protective factors for deep sternal wound infections following cardiac surgery in an Australian hospital.

Methods: We performed a retrospective study on 1,902 patients who underwent cardiac surgery at Fiona Stanley Hospital, a tertiary hospital in Western Australia from February 2015 to April 2019.

A Rare Pulmonary Artery Sarcoma Masquerading as Pulmonary Embolus.

We present the case of a 46-year-old woman with a presumed diagnosis of multiple unprovoked pulmonary emboli. Her cardiorespiratory function continued to deteriorate despite optimal medical therapy. At surgical thrombectomy she was identified to have an intimal soft tissue lesion arising from the right pulmonary artery.

Large air-filled intrapulmonary bronchogenic cyst associated with tension pneumothorax during air travel.

A 38-year-old woman developed a spontaneous right-sided tension pneumothorax during light aircraft travel. The aircraft was diverted to a regional centre, where emergent needle thoracostomy and chest tube insertion were performed. History suggested that this was the second episode of pneumothorax, with an untreated event with similar symptomatology during air travel 1 year ago.

Delayed presentation of pulmonary artery perforation by an Amulet left atrial appendage closure device.

Left atrial appendage occlusion (LAAO) devices offer stroke prevention in atrial fibrillation for patients intolerant of anticoagulation. Device placement leading to bleeding and cardiac tamponade have been reported periprocedurally but delayed presentations have not been reported in the literature. We present the case of an Amulet LAAO device causing erosion and bleeding from the main pulmonary artery that presented with cardiac tamponade 6 months after device placement.

Impact of body mass index on adverse events after implantation of left ventricular assist devices: An IMACS registry analysis.

Background: Limited data exist describing impact of body mass index (BMI) on post‒left ventricular assist device (post-LVAD) outcomes. We sought to define the relationship between body mass index (BMI) and adverse events (AEs) after LVAD implantation by examining the ISHLT Mechanically Assisted Circulatory Support (IMACS) registry.

Methods: Patients implanted with a contemporary continuous flow (CF)-LVAD were stratified into 4 groups using pre-operative BMI: underweight (UW; BMI ≤18.

Penetrating Cardiac Injury Managed Without Surgery but with Systemic Heparinisation.

A 36-year-old woman presented to hospital after a penetrating chest injury. She was haemodynamically stable. Echocardiography revealed left ventricular thrombus, with minimal pericardial effusion and no associated cardiac injuries.

Carbon dioxide insufflation in open-chamber cardiac surgery: a double-blind, randomized clinical trial of neurocognitive effects.

Objective: The aims of this study were first to analyze neurocognitive outcomes of patients after open-chamber cardiac surgery to determine whether carbon dioxide pericardial insufflation reduces incidence of neurocognitive decline (primary end point) as measured 6 weeks postoperatively and second to assess the utility of carbon dioxide insufflation in cardiac chamber deairing as assessed by transesophageal echocardiography.

Methods: A multicenter, prospective, double-blind, randomized, controlled trial compared neurocognitive outcomes in patients undergoing open-chamber (left-sided) cardiac surgery who were assigned carbon dioxide insufflation or placebo (control group) in addition to standardized mechanical deairing maneuvers.

Results: One hundred twenty-five patients underwent surgery and were randomly allocated.

Spinal cord ischemia following coronary artery bypass surgery.

Coronary artery bypass graft (CABG) surgery is associated with a low risk of paraplegia. Spinal cord ischemia causing paraplegia following off-pump coronary artery bypass (OPCAB) surgery has not been described previously. We now describe a patient who developed paraplegia following OPCAB and review the literature on spinal cord ischemia following CABG surgery.

Is informed consent in cardiac surgery and percutaneous coronary intervention achievable?

Background: Medical and legal published work regularly discusses informed consent and patient autonomy before medical interventions. Recent discussions have suggested that Cardiothoracic surgeons' risk adjusted mortality data should be published to facilitate the informed consent process. However, as to which aspects of medicine, procedures and the associated risks patients understand is unknown.

The surgical trainee log we need: minimum of work, maximum of output.

Background: The objective of this study was to design a trainee logbook suitable for both surgical training and surgical audit. The fields of the logbook should conform to both the current requirements for surgical trainee logbooks and the minimum and recommended datasets for surgical audit. The database should be able to share information with other databases including hospital information systems.