BMI disparities in coronary artery bypass grafting outcomes: A single center Society of Thoracic Surgeons (STS) database analysis.

Introduction: Disparities in Body Mass Index (BMI) has been a potential risk factor for intraoperative outcomes, postoperative morbidity and mortality after coronary artery bypass graft (CABG). This study aims to quantify the effect of BMI on early clinical outcomes following CABG.

Method: The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database was queried for adult patients who underwent first-time Coronary Artery Bypass Graft (CABG) patients in our center from 2014 to 2020.

Tips and Tricks for Successful Trans-EVAR TAVR: Buddy up!

Described is challenging trans-catheter aortic valve replacement (TAVR) procedure done via tortuous iliofemoral access with prior endovascular aneurysm repair. Detailed pre-procedural planning enabled the operators to overcome the challenges while employing the following 4 strategies: Although trans-EVAR TAVR remains somewhat unpredictable, especially these 4 strategies may simplify and reduce the inherent failure rate of such procedures.

Transcatheter valve-in-valve aortic valve replacement with bioprosthetic valve Fracture/Stretching technique in a degenerated mitroflow valve.

We describe a successful bioprosthetic annular stretching in a patient with severe prosthetic aortic valve stenosis from a degenerated 19-mm Mitroflow valve (Sorin Group USA Inc, Arvada, CO, USA). This technique allowed for implantation of a 23-mm Evolut-R Pro valve (Medtronic, Minneapolis, MN, USA) with significant improvement in hemodynamics after prosthetic annular stretching. We have also summarized other case series and case reports which have previously described similar techniques.

How Should I Manage a Challenging Aortic Prosthesis Angle During Valve-in-Valve Implantation?

Valve-in-valve TAVR procedure stalled due to challenging aortic to prosthesis angle not allowing the advancement of the Evolut R into the failing 25 mm Magna prosthesis. Efforts to better align the TAVR device with the valve prosthesis by using conventional methods failed. Eventually, a buddy wire allowed advancement and successful deployment of the Evolut R 26 mm within the stenosed surgical valve.

Iliofemoral peripheral orbital atherectomy for optimizing TAVR access: An innovative strategy in the absence of alternative access options.

Suboptimal iliofemoral artery access requiring alternative trans-catheter aortic valve replacement (TAVR) access is still encountered in 10-20% of subjects undergoing TAVR. Attempting suboptimal vascular access may result in excessive vessel injury, bleeding and even death. Reported is an innovative procedure to address suboptimal heavily calcified iliofemoral access by using Diamondback 360 peripheral orbital atherectomy (POA) to ablate heavy endoluminal vascular calcifications followed by balloon angioplasty.