Long-term Results of Valve-Sparing Aortic Root Replacement in Acute Type A Aortic Dissection.

Background: Valve preservation in acute type A aortic dissection (ATAAD) can be accomplished with root repair or replacement. Long-term valve durability with root repair has been established, but limited data exist regarding long-term durability of valve-sparing root replacement (VSRR). In this study, long-term results of VSRR were compared with root repair in ATAAD.

A novel hybrid prosthesis for open repair of acute DeBakey type I dissection with malperfusion: Early results from the PERSEVERE trial.

Background: Outcomes after hemiarch repair for acute DeBakey type I aortic dissection (ADTI) remain unfavorable, with high rates of major adverse events and negative aortic remodeling. The PERSEVERE study evaluates the safety and effectiveness of the AMDS Hybrid prosthesis, a novel bare metal stent, in patients presenting with preoperative malperfusion.

Methods: PERSEVERE is a prospective single-arm investigational study conducted at 26 sites in the United States.

Acute Type B Intramural Hematoma: Novel Insights in the Endovascular Era.

Background: The pathophysiology and behavior of acute type B intramural hematoma (TBIMH) is poorly understood. The purpose of this study is to characterize the pathophysiology, fate, and outcomes of TBIMH in the endovascular era.

Methods: A retrospective analysis of a US Aortic Database identified 70 patients with TBIMH from 2008 to 2022.

Retrograde Cerebral Perfusion May Decrease Stroke Risk During Elective Aortic Arch Surgery.

Objective: Controversy remains regarding the optimal neuroprotection strategy for elective hemiarch replacement (HEMI). This study sought to compare outcomes in patients who underwent HEMI utilizing the 2 most common contemporary methods of cerebral protection.

Methods: The ARCH international aortic database was queried, and 782 patients undergoing elective HEMI with circulatory arrest from 2007 to 2012 were identified.

Multiple coinfections and Guillain Barré syndrome following outdoor travel to the American Northeast.

A 66-year-old immunocompetent man with preceding travel through the Northeastern United States developed Guillain-Barré syndrome. A broad search for infections revealed intraerythrocytic parasites on blood smear and positive polymerase chain reaction for ; elevated IgM/IgG serologies for ; elevated IgM/IgG serologies and qualitative polymerase chain reaction for Epstein-Barr virus; and fecal culture growth of . In this report, we discuss the known or suspected association of these infectious agents with Guillain-Barré syndrome.

Prolonged Periods of Antegrade Cerebral Perfusion Are Safe During Elective Arch Surgery.

Background: Cerebral circulatory arrest times >40 minutes during aortic surgery have previously been shown to be associated with increased morbidity and mortality. The purpose of this study was to redefine what would constitute a safe period of circulatory arrest for patients who underwent elective proximal aortic operations requiring antegrade cerebral perfusion (ACP).

Methods: The ARCH International aortic database was queried, and 2008 patients undergoing elective arch operations with circulatory arrest using ACP were identified.

Liner type has no impact on bone mineral density changes around a 3D printed trabecular titanium acetabular component.

Background: Three-dimensional printing of implants allows the ability to produce implants and interfaces which theoretically better mimic "normal" bone behaviour, leading to a possible reduction in stress shielding thus maintaining bone mineral density (BMD). This issue was not investigated in vivo using bone scan and different bearings; therefore, we did a prospective study aiming to answer: 1) is there a loss of BMD around the 3D printed trabecular titanium cup, when compared to the native hip?; 2) does liner type influence the BMD changes around the acetabulum when a 3D printed trabecular titanium cup is used?

Hypothesis: BMD changes around the acetabulum are not influenced by the liner type, and the cup will be associated with a reduction in BMD when compared to the native hip.

Material And Methods: This is a prospective observational study of patients receiving a primary total hip arthroplasty.

A tailored strategy for repair of acute type A aortic dissection.

Objective: Innumerable surgical techniques are currently deployed for repairing acute type A aortic dissection (ATAAD). We analyzed our results using a conservative approach of root-sparing and hemiarch techniques in higher-risk patients and root and total arch replacement for lower-risk patients.

Methods: We queried our aortic database for consecutive patients who underwent ATAAD repair.

Cardiac Surgery Outcomes in an Epicenter of the COVID-19 Pandemic.

As New York State quickly became the epicenter of the COVID-19 pandemic, innovative strategies to provide care for the COVID-19 negative patients with urgent or immediately life threatening cardiovascular conditions became imperative. To date, there has not been a focused analysis of patients undergoing cardiothoracic surgery in the United States during the COVID-19 pandemic. Therefore, we seek to summarize the selection, screening, exposure/conversion, and recovery of patients undergoing cardiac surgery during the peak of the COVID-19 pandemic.

Diaphragm Preservation Reduces Respiratory Failure After Extent I Thoracoabdominal Aneurysm Repair.

Background: We sought to evaluate the impact of surgical approach (thoracophrenolaparotomy vs thoracotomy crura splitting) on the outcomes of extent I thoracoabdominal aortic aneurysm repair.

Methods: Patient data were extracted from our aortic surgery database. The primary endpoint was need for tracheostomy, and secondary endpoints were operative mortality, myocardial infarction, stroke, spinal cord injury, de novo dialysis, and major adverse events (composite of secondary endpoints and tracheostomy).

A Perspective from New York of COVID 19: Effect and impact on cardiac surgery.

Background And Aim: First reported in December of 2019, the COVID-19 pandemic caused by SARS-CoV-2 has had a profound impact on the implementation of care. Here, we describe our institutional experience with a rapid influx of patients at the epicenter of the pandemic.

Methods: We retrospectively review our experience with the departments of cardiology, cardiothoracic surgery, anesthesia, and critical care medicine and summarize protocols developed in the midst of the pandemic.

Fat Embolism Syndrome: The Ambiguity of Diagnosis in the Postarthroplasty Patient: A Case Report.

Case: We present the case of an otherwise healthy, 74-year-old woman, who underwent bilateral hip arthroplasty and subsequently presented with decreased level of consciousness, mimicking a severe postoperative delirium. After several days and investigations, the diagnosis of fat embolism syndrome (FES) was reached, and appropriate management was given.

Conclusion: Orthopedic surgeons and their teams should consider FES as a differential diagnosis of prolonged post-operative delirium.

Medium Term Outcome For A Constrained Acetabular Component At A Single Institution: What Is Important For Success?

Background: The use of constrained Total Hip Replacements (THR) is controversial due to lack of definite indications and potentially high failure rates because of mechanical loosening or component failure. A review was performed to assess a departmental use of a single constrained acetabular component over a ten years period.

Methods: Patient demographics, operative indications, complications and patient follow-up were recorded.

Impact of left ventricular ejection fraction on the outcomes of open repair of descending thoracic and thoracoabdominal aneurysms.

Objective: To discern the impact of depressed left ventricular ejection fraction (LVEF) on the outcomes of open descending thoracic aneurysm (DTA) and thoracoabdominal aneurysms (TAAA) repair.

Methods: Restricted cubic spline analysis was used to identify a threshold of LVEF, which corresponded to an increase in operative mortality and major adverse events (MAE: operative death, myocardial infarction, stroke, spinal cord injury, need for tracheostomy or dialysis). Logistic and Cox regression were performed to identify independent predictors of MAE, operative mortality, and survival.

Post-operative mortality rates for neck of femur fracture at Waitemata District Health Board.

Aim: Mortality rates of up to 38% at one year have been reported following surgery for neck of femur fractures. The aim of this review is to evaluate the post-operative mortality rates and trends over time for patients with fractured neck of femur at Waitemata District Health Board.

Method: A retrospective cohort study of all patients who received surgery following a neck of femur fracture at Waitemata District Health Board between 2009 and 2016.

Unicompartmental knee replacement in the elderly: a systematic review.

Unicompartmental knee replacement in the elderly may be associated with a better outcome than total knee replacement. The purpose of this review was to assess the clinical outcome in patients over the age of 70. A computerised search was performed using Pubmed and Embase.

Relationships between the posterior interosseous nerve and the supinator muscle: application to peripheral nerve compression syndromes and nerve transfer procedures.

Background And Study Aims: Little information can be found in the literature regarding the relationships of the posterior interosseous nerve (PIN) while it traverses the supinator muscle. Because compression syndromes may involve this nerve at this site and researchers have investigated using branches of the PIN to the supinator for neurotization procedures, the authors' aim was to elucidate information about this anatomy.

Materials And Methods: Dissection was performed on 52 cadaveric limbs to investigate branching patterns of the PIN within the supinator muscle.

An overview of epigenetic assays.

A significant portion of ongoing epigenetic research involves the investigation of DNA methylation and chromatin modification patterns seen throughout many biological processes. Over the last few years, epigenetic research has undergone a gradual shift and recent studies have been directed toward a genome-wide assessment. DNA methylation and chromatin modifications are essential components of the regulation of gene activity.