Publications by authors named "Eilon Ram"
This study evaluates the efficacy of annuloplasty repair as a standalone procedure for treating bileaflet mitral valve prolapse with mitral regurgitation (MR). Various flexible ring bands for MR of different severities were compared to assess their biomechanical impact and treatment outcomes. Computational beating heart models, based on the Living Heart Human Model, were utilized to simulate annuloplasty repairs.
View Article and Find Full Text PDFObjective: Reoperative aortic root replacement (ARR) is a technically challenging procedure. This study assesses the influence of reoperation on outcomes following ARR, particularly after prior acute type A aortic dissection repair.
Methods: Of the 1823 patients in this study, 1592 (87.
Objective: We sought to evaluate outcomes of valve-sparing root replacement (VSRR) in patients with bicuspid aortopathy (BAV) versus other connective tissue disorder (CTD).
Methods: This was a single-center cohort study of consecutive patients undergoing VSRR via reimplantation from 2000 to 2023 with BAV or CTD. Operative outcomes, Kaplan-Meier survival estimates, and cumulative risk of reoperation and recurrent aortic insufficiency (AI) with the competing risk of death were assessed.
Article Synopsis
- The war that started on October 7, 2023, has led to an unexpected rise in open-heart surgeries at Israel's largest cardiac surgery department, despite half of the surgeons being in military service.
- A study analyzed data from 275 patients who had cardiac surgeries or ECMO during the first two months of the war, comparing it to a similar period in 2022.
- Results showed a 33% increase in open-heart procedures and a significant rise in transplants in 2023, but patient outcomes, including complications and mortality rates, remained consistent with those from 2022.
Background: We compared the outcomes of aortic root replacement by composite valve grafts (CVG) and valve-sparing root replacement (VSRR) operations, with an emphasis on postoperative conduction block and the need for permanent pacemaker implantation (PPM).
Methods: From 1997 to 2023, 1712 consecutive patients underwent ARR by VSRR (501 [29%]) or CVG (1211 [71%]) at a high-volume aortic center.
Results: Patients undergoing CVG were older (59 ± 14 vs 49 ± 14 years, P < .
Article Synopsis
- Long-term support with the HeartMate 3 (HM3) left ventricular assist device (LVAD) has improved outcomes for end-stage heart failure patients, but there's limited data on those who had simultaneous cardiac surgeries during the procedure.
- In a study of 131 patients between December 2016 and April 2022, 23 underwent concomitant cardiac surgical procedures (CCSP) while receiving HM3-LVAD, while 108 had only the HM3-LVAD implanted.
- Results showed no significant differences in 30-day, 6-month, and 12-month mortality rates between the CCSP group and the HM3-only group, indicating that simultaneous surgeries do not adversely affect survival when getting an HM3-L
Continued circulation of severe acute respiratory syndrome coronavirus 2 has driven the selection of variants with improved ability to escape preexisting vaccine-induced responses, posing a persistent threat to heart transplant recipients (HTRs). The immunogenicity and safety of the updated XBB.1.
View Article and Find Full Text PDFBackground: Unfractionated heparin is the preferred anticoagulant used during open heart surgeries, including left ventricular assist device (LVAD) implantation. In cases in which patients are heparin-induced thrombocytopenia positive (HIT+), the accepted practice has been to substitute heparin with bivalirudin. This practice may be associated with significant bleeding and adverse outcomes.
View Article and Find Full Text PDFObjective: Total aortic arch replacement (TAR) after previous cardiovascular surgery is technically challenging and is becoming more frequent as outcomes for primary arch repair have improved. primary. We analyzed outcomes of reoperative compared with first-time TAR.
View Article and Find Full Text PDFBackground: Defining immune correlates of protection against COVID-19 is pivotal for optimizing the use of COVID-19 vaccines, predicting the impact of novel variants on clinical outcomes, and advancing the development of immunotherapies and next-generation vaccines. We aimed to identify vaccine-induced immune correlates of protection against COVID-19-related hospitalizations in a highly vaccinated heart transplant (HT) cohort.
Methods: In a case-control study of HT recipients vaccinated with the BNT162b2 vaccine, patients were prospectively assessed for vaccine-induced neutralization of the wild-type virus, and the Delta and Omicron BA.
Objective: The 2 most acceptable techniques for reimplantation of the supra-aortic vessels in total arch replacement include the branched graft technique (debranching) or en bloc technique (island). We aim to review our experience with total arch replacement and report short- and long-term outcomes from a high-volume center dedicated to surgery for the thoracic aorta.
Methods: The aortic surgery database was queried to identify all consecutive patients undergoing total arch replacement between 1997 and 2022.
Background: Both valve-sparing root replacement and composite valve graft (CVG) are acceptable options in aortic root replacement. We compare outcomes of these 2 approaches and durability of the aortic valve.
Methods: A consecutive 1635 patients without acute dissection underwent primary aortic root replacement from 1997 to 2022; 473 (29%) underwent valve-sparing root replacement, and 1162 (71%) received CVG.
Objective: The goal of this study was to evaluate the long-term outcomes of valve-sparing root replacement in patients with connective tissue disease (CTD) and compare them with patients without CTD who underwent valve-sparing root replacement for root aneurysm.
Methods: Of 487 patients, 380 (78%) did not have CTD and 107 (22%) had CTD; 97 (91%) with Marfan syndrome, 8 (7%) with Loeys-Dietz syndrome, and 2 (2%) with Vascular Ehlers-Danlos syndrome. Operative and long-term outcomes were compared.
In 2022, the antigenically divergent SARS-CoV-2 omicron variants (BA.1, BA.2, BA.
View Article and Find Full Text PDFArticle Synopsis
- - A study was conducted to validate a new automatic urine output monitoring device (Serenno Medical) against standard methods (urometer) in three ICUs, aiming to assess its accuracy in measuring urine output for evaluating fluid status and acute kidney injury (AKI).
- - The results showed that the Serenno device had a strong agreement with the camera-derived measurements, with a bias of -0.4 ml/h and a concordance rate of 92%, while the correlation with hourly nursing assessments was significantly poorer.
- - The findings indicated that the Serenno device could effectively monitor urine output with minimal supervision needed, and it highlighted issues with nursing staff missing severe oliguria events, suggesting it may enhance patient care in ICU settings.
Surgical ablation for atrial fibrillation: impact of Diabetes Mellitus type 2.
Cardiovasc Diabetol
March 2023
Article Synopsis
- Diabetes type 2 is associated with higher health risks and complications in patients undergoing surgical ablation for atrial fibrillation (AF), particularly older age and higher rates of conditions like hypertension and stroke.
- A study involving 606 patients compared outcomes between non-diabetic and diabetic patients after AF ablation, revealing similar short-term AF recurrence and mortality rates within the first 3 years, but a notably higher 5-year mortality rate in diabetic patients.
- The findings suggest that while surgical ablation is effective for both groups, long-term outcomes may be less favorable for patients with diabetes type 2.
Early tracheostomy after cardiac surgery improves intermediate- and long-term survival.
Med Intensiva (Engl Ed)
September 2023
Article Synopsis
- This study looked at how the timing of a procedure called tracheostomy (a way to help people breathe after heart surgery) affects how long patients live after surgery.
- It found that having this procedure done early (within 4-10 days) is linked to better survival compared to those who had it done later.
- The study also kept track of infections in patients' wounds, but the main finding was that getting the tracheostomy sooner helps patients live longer after their surgery.
Background: Either deep hypothermia with circulatory arrest or hypothermic perfusion with antegrade selective cerebral perfusion is used during the Norwood procedure for hypoplastic left heart syndrome. Normothermic perfusion has been described for pediatric patients. The aim of this study was to compare the early outcomes of patients undergoing the Norwood procedure with antegrade selective cerebral perfusion under hypothermia with the procedure under normothermia.
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- Ventricular tachycardia ablation (VTA) is challenging when patients have low blood pressure, but using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can help complete the procedure safely.
- A study gathered data from 46 patients who underwent VA-ECMO-assisted VTA, focusing on their medical history, procedure details, and outcomes, comparing those who were weaned off VA-ECMO immediately versus those who were not.
- Results showed that early de-cannulation from VA-ECMO was linked to significantly better survival rates after one year, highlighting the importance of timely weaning to reduce mortality risk.
Article Synopsis
- The study analyzed the outcomes of 1,987 diabetic patients hospitalized for non-ST elevation myocardial infarction (NSTEMI) or unstable angina (UA) who underwent either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) between 2000 and 2016.
- Results indicated that while no significant differences in mortality were observed at 2 years between CABG and PCI, CABG showed a significant survival advantage after 2 years of follow-up.
- The findings suggest that CABG may lead to better long-term outcomes for these diabetic patients, highlighting the need for more prospective randomized studies to refine treatment guidelines.
Article Synopsis
- The Norton score is a scale used to assess frailty, which is linked to complications and mortality in hospitalized patients, especially those undergoing aortic valve replacement (AVR).
- In a study of 1,469 patients who underwent AVR between 2004 and 2020, it was found that patients with a low Norton score (<18) had significantly higher in-hospital mortality rates compared to those with a high score (≥18).
- The Norton score effectively predicted both short-term (1-year) and long-term (10-year) mortality, suggesting it should be used as a key risk assessment tool for patients undergoing AVR.
Article Synopsis
- This study examines the impact of renal function on mortality risk in patients undergoing coronary artery bypass grafting (CABG) using various eGFR formulas from a cohort of 3,744 patients between 2004 and 2020.
- Results indicate that the Mayo eGFR formula yields the highest mean values, classifying more patients as having normal renal function compared to others, and shows a strong correlation with mortality prediction.
- The study concludes that the Mayo formula appears to be the most effective in assessing mortality risks, as it identifies fewer patients with renal dysfunction while providing a more accurate prognosis than other eGFR formulas.