Permanent pacemaker insertion postmitral surgery: Do the atrial access and the origin of the sinoatrial node artery matter?

Background And Aim Of The Study: To determine whether the type of atrial access to the mitral valve (left atriotomy, superior trans-septal, or limited trans-septal) influenced postoperative permanent pacemaker implantation and to investigate the effect of the sinoatrial (SA) node artery origin (right coronary or circumflex arteries) on the rate of pacemaker insertion.

Methods: We retrospectively reviewed consecutive cases of patients who had mitral valve surgery at the Trent Cardiac Centre (2008-2016). The primary outcome was the incidence of permanent pacemaker insertion.

Atrial approaches to the mitral valve: is there a difference in postoperative rhythm disturbance and permanent pacemaker implantation?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether there was a difference in postoperative outcomes [namely permanent pacemaker (PPM) insertion, rhythm disturbance, reoperation for bleeding, hospital stay and in-hospital mortality] between trans-septal or superior (extended) trans-septal (STS) approaches in comparison with the conventional left atriotomy (LA) used in mitral valve surgery. Using the reported search strategy, 353 papers were found of which 11 represented the best evidence to answer the clinical question.

Prosthetic Valve Endocarditis Following Dental Extractions.

Early-onset prosthetic valve endocarditis is a serious complication of valve replacement. We present two cases of early-onset prosthetic valve endocarditis caused by species of the anaerobic organism Prevotella, and discuss the issue of dental extraction prior to valve surgery. doi: 10.

Cost analysis of gentamicin-impregnated collagen sponges in preventing sternal wound infection post cardiac surgery.

Objective: The use of antibiotic-impregnated sponges (Collatamp) during cardiac surgery is controversial. We analysed the cost-effectiveness of its selective use in patients at high-risk of sternal wound infection (SWI).

Method: Postoperative costs were analysed in two groups of patients undergoing heart surgery between 2011 and 2013: those with SWI (group 1) and in high-risk patients without SWI (group 2).