Calcified amorphous tumor attached to the membranous septum: a rare clinical entity.

We report a rare case of a pedunculated calcified amorphous tumor (CAT) of the left ventricle attached by a stalk to the membranous septum in a 74-year-old woman who presented with a cerebrovascular accident. We believe this is the first report of a CAT attached to the membranous septum.

Multilayer Perceptron Neural Network Analysis of Fluoroscopic Working Angle on Transcatheter Aortic Valve Implantation Complications.

Background: We sought to determine whether there is a relationship between the fluoroscopic working angle used to achieve a co-planar view during the deployment of the prosthesis during transcatheter aortic valve implantation (TAVI) and rates of complications, including paravalvular leaks, complete heart block, annular rupture, stroke, valve embolization, discharge to a skilled nursing facility and death within thirty days.

Methods: All patients undergoing TAVI at our institution from 2015 to 2022 were retrospectively analyzed. Images were reviewed to determine the fluoroscopic working angle during deployment, and medical records were used to determine the incidence and type of complication.

Mitral Regurgitation due to Entrapment of Cut Mitral Chordal Apparatus in a Bileaflet Disk Prosthesis.

• TEE is essential for the assessment of MVR dysfunction. • TEE can comprehensively assess paravalvular or central MR. • Understanding the pathophysiology of MR after MVR is essential.

Outcomes of coronary artery bypass surgery using modified del Nido cardioplegia in patients with poor ventricular function.

Background: del Nido cardioplegia (DN) has been shown to be safe in adult patients undergoing isolated coronary artery bypass grafting with normal left ventricular ejection fraction. We sought to determine whether it was also safe in adult patients with diminished left ventricular function.

Methods: All patients with preoperative left ventricular ejection fraction ≤ 40% undergoing isolated coronary artery bypass grafting between 1/1/2019 and 7/10/2022 were retrospectively analyzed.

Giant Aneurysm of Left Main Coronary Artery in a Patient With Prior Operation for 4-Valve Endocarditis.

Left main coronary artery aneurysm is an unusual complication of infective endocarditis. Although this type of aneurysm is often asymptomatic, rupture and thrombus formation that result in myocardial infarction are known complications; therefore, prompt recognition and surgical intervention are warranted. This report describes a patient who presented with a giant left main coronary artery aneurysm 3.

Experience, exposure, and attitudes regarding off-pump coronary artery bypass grafting techniques in US cardiothoracic surgical residents: Results of a survey.

Background: We sought to determine the current level of exposure to and interest in off-pump coronary artery bypass and beating heart surgery techniques regarding cardiothoracic surgical residents in the United States.

Methods: An email survey consisting of 6 questions was sent to all cardiothoracic surgery residents of approved cardiothoracic training programs in the United States. The survey was emailed using the Qualtrics XM cloud-based survey platform.

Impact of the heart transplant allocation policy change on inpatient cost of index hospitalization.

Background: We sought to determine the financial impact of the United Network for Organ Sharing heart transplant (HT) allocation policy change of October 2018.

Methods: Using the Nationwide Inpatient Sample we retrospectively analyzed hospital discharge data between January 1, 2016 and December 31, 2019. ICD-10-CM procedure codes were used to identify hospitalizations of patients undergoing HT as well as the use of temporary mechanical circulatory support (MCS) during the HT hospitalization.

The effect of recipient BMI on waitlist and post-transplant outcomes after the 2018 heart transplant allocation policy change.

Objective: The effects of recipient body mass index (BMI) on waitlist strategies, waitlist outcomes, and post-transplant outcomes among adult patients listed for heart transplantation under the updated 2018 allocation system have not been well characterized.

Methods: The United Network of Organ Sharing data set between October 2015 and March 2021 was analyzed, and patients were grouped based on recipient BMI and whether listing occurred in the old (pre-October 2018) or new allocation system.

Results: Listing strategies differed by BMI group, but trends of increased use of temporary mechanical support and decreased use of durable support remained among all BMI groups, except those with BMI > 35 kg/m .

Hemorrhagic pericardial effusion resulting in constriction in hereditary hemorrhagic telangiectasia.

Background: We report the first ante-mortem diagnosis of hemorrhagic pericardial effusion in hereditary hemorrhagic telangiectasia resulting in constriction; the case also demonstrates the unusual but well-described complication of right-sided heart failure requiring extracorporeal membrane oxygenation (ECMO) support after pericardiectomy.

Case Presentation: A previously healthy 48 year old man with a strong family history of Osler-Weber-Rendu disease presented to our institution with signs and symptoms of advance heart failure. His workup demonstrated a thickened pericardium and constrictive physiology.

Coronary artery aneurysm, ectasia and stenosis in a 53-year-old man with HIV infection.

The impact of long-standing human immunodeficiency virus infection (HIV) and potent anti-retroviral therapy on the coronary circulation is unknown; however, scattered reports are emerging of coronary aneurysms in this population. We report what we believe to be the first described case of both coronary stenosis and coronary artery aneurysms in a person living with HIV and discuss management options.

The heart transplant allocation change attenuates but does not eliminate blood group O waitlist outcome disadvantage.

Background: Patients with blood group O have historically been disadvantaged in the United Network for Organ Sharing (UNOS) heart transplant allocation system. We sought to determine whether the new UNOS allocation system implemented in 2018 had an impact on waitlist and post-transplant outcomes among blood groups.

Methods: Using the UNOS database we included all adult patients listed and transplanted with first-time single-organ heart transplant between 10/17/15 and 10/1/21.

Center-Level Variation in Transplant Rates Following the Heart Allocation Policy Change.

Importance: Wide state-level variability in waiting list outcomes have been noted for patients listed for heart transplant in the US, but little is known regarding center-level transplant rates since the heart allocation policy change.

Objective: To evaluate center-level transplant rates following the recent allocation policy change for heart transplant.

Design, Setting, And Participants: This cohort study used data from the United Network for Organ Sharing database from October 18, 2015, to March 1, 2020, for a nationwide analysis of transplant centers in the US.

Unroofed Coronary Sinus Discovered Incidentally during Cardiac Surgery: Systematic Approach to Diagnosis by Transesophageal Echocardiography.

• We report repaired URCS defect concomitant with coronary bypass surgery. • Systematic TEE was used to determine the etiology of isolated dilatation of right heart. • A diagram including the complete spectrum of URCS is provided.

Impact of transplant center volume on donor heart offer utilization rates in the United States.

Background: We tested the hypothesis that transplant centers (TCs) with higher volumes have higher donor heart (DH) offer utilization rates.

Methods: Using the Annual Data reports of the US Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients (SRTR) we reviewed all adult heart transplant offers between July 1, 2016 and June 29, 2019. Unadjusted donor offer utilization rates and observed to expected (O/E) DH utilization ratios adjusted using the SRTR model were calculated for each TC for all DH offers and for the following sub-categories: DH with left ventricular ejection fraction <60%, DH >40 years, DH >500 miles from TC, "hard-to-place hearts" (defined as those offered to >50 TCs) and DH designated as increased infectious risk.

Impact of heart transplant allocation change on competing waitlist outcomes among listing strategies.

In 2018, the United Network for Organ Sharing (UNOS) adopted a 6-tier system for heart allocation which shifted patterns in listing strategies. The effects of the change on waitlist survival and transplantation rates have yet to be substantiated by analysis of competing outcomes among various listing strategies. This study included all adult patients listed for first-time heart transplantation in UNOS between 10/17/15 and 6/12/20.

Early modified primary closure for treatment of cardiac implantable electronic device pocket infections.

Background: Guidance for wound management of the vacated generator pocket in cardiac implantable electronic device (CIED) pocket infections after removal of all hardware and tissue debridement is limited. The typical surgical technique for management of a purulent wound is to allow healing by secondary intention. An alternative approach uses negative pressure wound therapy with or without delayed primary closure.

Likelihood of Aortic Valve Preservation During Repair of Acute Type A Aortic Dissection.

Background: We sought risk factors for replacement of the aortic valve with or without the root (AVR/root) in the setting of acute type A aortic dissection (ATAD) repair.

Methods: All ATAD repairs at our institution from January 2005 to June 2018 were reviewed. Baseline characteristics were recorded.

Likelihood of Aortic Valve Preservation During Repair of Acute Type A Aortic Dissection.

Background: We sought risk factors for replacement of the aortic valve with or without the root (AVR/root) in the setting of acute type A aortic dissection (ATAD) repair.

Methods: All ATAD repairs at our institution from January 2005 to June 2018 were reviewed. Baseline characteristics were recorded.

Understanding lung transplant listing practices: Survival in lung transplant candidates who improve clinically to delisting.

Background: Occasionally, lung transplant candidates improve to the point where they are removed from the transplant list. We sought to determine the characteristics and outcomes of lung transplant candidates who improved to delisting both before and after implementation of the lung allocation score.

Methods: Using the United Network for Organ Sharing database, we reviewed all adult patients listed for lung transplant between 1987 and 2012.

Interaction Between Ischemic Time and Donor Age on Adult Heart Transplant Outcomes in the Modern Era.

Background: We examined the effect of cold ischemic interval on modern outcomes to determine whether advances in patient management have made an impact.

Methods: Using the United Network of Organ Sharing database, we reviewed adult heart transplants between January 2000 and March 2016. We divided donor age into terciles: younger than 18 years, 18 to 33 years, and 34 years and older.