Morphing the left atrium geometry: The role of the pulmonary veins on flow patterns and thrombus formation.

Background: Despite the significant advances made in the field of computational fluid dynamics (CFD) to simulate the left atrium (LA) in atrial fibrillation (AF) conditions, the connection between atrial structure, flow dynamics, and blood stagnation in the left atrial appendage (LAA) remains unclear. Deepening our understanding of this relationship would have important clinical implications, as the thrombi formed within the LAA are one of the main causes of stroke.

Aim: To highlight and better understand the fundamental role of the PV orientation in forming atrial flow patterns and systematically quantifying its effect on blood stasis within the LAA.

Recent Advances of PDMS In Vitro Biomodels for Flow Visualizations and Measurements: From Macro to Nanoscale Applications.

Polydimethylsiloxane (PDMS) has become a popular material in microfluidic and macroscale in vitro models due to its elastomeric properties and versatility. PDMS-based biomodels are widely used in blood flow studies, offering a platform for improving flow models and validating numerical simulations. This review highlights recent advances in bioflow studies conducted using both PDMS microfluidic devices and macroscale biomodels, particularly in replicating physiological environments.

New risk classification adapting SCAI shock stages to patients with pulmonary embolism (RISA-PE).

Background: Pulmonary embolism (PE) treatment is based on risk stratification according to European Society of Cardiology (ESC) guidelines. However, emerging therapies in acute PE may require a more granular risk classification. Therefore, the objective of the present study was to propose a new RIsk claSsification Adapting the SCAI shock stages to right ventricular failure due to acute PE (RISA-PE).

Influence of the flow split ratio on the position of the main atrial vortex: Implications for stasis on the left atrial appendage.

Background: Despite the recent advances in computational fluid dynamics (CFD) techniques applied to blood flow within the left atrium (LA), the relationship between atrial geometry, flow patterns, and blood stasis within the left atrial appendage (LAA) remains unclear. A better understanding of this relationship would have important clinical implications, as thrombi originating in the LAA are a common cause of stroke in patients with atrial fibrillation (AF).

Aim: To identify the most representative atrial flow patterns on a patient-specific basis and study their influence on LAA blood stasis by varying the flow split ratio and some common atrial modeling assumptions.

Prognostic impact of shock in patients with type A acute aortic syndrome. Results of a nationwide multicenter study.

Objective: To evaluate the clinical characteristics, imaging findings, treatment, and prognosis of patients with type A acute aortic syndrome (AAS-A) presenting with shock. To assess the impact of surgery on this patient population.

Methods: The study included 521 patients with A-AAS enrolled in the Spanish Registry of Acute Aortic Syndrome (RESA-III) from January 2018 to December 2019.

Impact of minimal lumen segmentation uncertainty on patient-specific coronary simulations: A look at FFR.

We examined the effect of minimal lumen segmentation uncertainty on Fractional Flow Reserve obtained from Coronary Computed Tomography Angiography . A total of 14 patient-specific coronary models with different stenosis locations and degrees of severity were enrolled in this study. The optimal segmented coronary lumens were disturbed using intra and inter-operator variations on the segmentation threshold.

A multi-framework analysis of stakeholders' perceptions in developing a localized blue carbon ecosystems strategy in Eastern Samar, Philippines.

Blue carbon ecosystems (BCEs) are vital for global climate change mitigation and offer diverse local ecosystem co-benefits. Despite existing literatures on integrating national and international BCE agendas at the local level, the development and implementation of localized BCE strategies often lag behind. To provide insights on this knowledge gap, we present a case study conducted in Eastern Samar, Philippines.

Reduced-order models of wall shear stress patterns in the left atrial appendage from a data-augmented atrial database.

Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, affecting over 1% of the population. It is usually triggered by irregular electrical impulses that cause the atria to contract irregularly and ineffectively. It increases blood stasis and the risk of thrombus formation within the left atrial appendage (LAA) and aggravates adverse atrial remodeling.

Acute aortic syndrome.

Acute aortic syndrome embraces a group of heterogenous pathological entities involving the aortic wall with a common clinical profile. The current epidemiology, clinical presentation, diagnosis and treatment strategy are discussed in this review. Besides, the importance of multidisciplinary aortic teams, aortic centers and the implementation of an aortic code are emphasized.

Improvement of Early Outcomes in Type A Acute Aortic Syndrome After an Aorta Code Implementation.

Background: Reduction of variability through process reengineering can improve surgical results for patients with type A acute aortic syndrome. We compare short-term results before and after implementation of an Aorta Code for patients with type A acute aortic syndrome who underwent surgery.

Methods: The Aorta Code was implemented in a 5-hospital healthcare network in 2019.

Impact of annual volume of cases and intensive cardiac care unit availability on mortality of patients with acute myocardial infarction-related cardiogenic shock treated at revascularization capable centres.

Aims: Cardiogenic shock (CS) is associated with high mortality. The purpose of this study was to assess the impact of hospital structure-related variables on mortality in patients with CS treated at percutaneous and surgical revascularization capable centres (psRCC) from a large nationwide registry.

Methods And Results: Retrospective observational study including consecutive patients with main or secondary diagnosis of CS and ST elevation myocardial infarction (STEMI).

Impact of a pulmonary embolism response team initiative on hospital mortality of patients with bilateral pulmonary embolism.

Introduction: Pulmonary embolism (PE) response teams (PERT) for the management of high-risk PE (HR-PE) and intermediate-high risk PE (IHR-PE) are encouraged in PE guidelines. We aimed to assess the impact of a PERT initiative on mortality in these groups of patients, compared with standard care.

Methods: We conducted a prospective, single-center registry, including consecutive patients with HR-PE and IHR-PE with PERT activation from February-2018 to December-2020 (PERT group, n=78 patients) and compared it with an historic cohort of patients admitted to our hospital in a previous 2-year period (2014-2016), managed with standard of care (SC-group, n=108 patients).

Assessment of valve implantation in the descending aorta as an alternative for aortic regurgitation patients not treatable with conventional procedures.

Background: Aortic Regurgitation (AR) produces the entrance of an abnormal amount of blood in the left ventricle. This disease is responsible for high morbidity and mortality worldwide and may be caused by an aortic valve dysfunction. Surgical and transcatheter aortic valve replacement (TAVR) are the current options for treating AR.

Spanish Registry of Acute Aortic Syndrome (RESA). Changes in therapeutic management and lower mortality in acute aortic syndrome.

Introduction And Objectives: The Spanish Registry of Acute Aortic Syndrome (RESA) was launched in 2005 to identify the characteristics of acute aortic syndrome (AAS) in Spain. The aim of this study was to analyze the differences in management and mortality in the 3 RESA iterations.

Methods: We analyzed data from patients with AAS prospectively included by 24 to 30 tertiary centers during the 3 iterations of the registry: RESA I (2005-2006), RESA-II (2012-2013), and RESA III (2018-2019).

Does infection predispose to thrombosis during long-term ventricular assist device support?

Background: Infections and thrombotic events remain life-threatening complications in patients with ventricular assist devices (VAD).

Methods: We describe the relationship between both events in our cohort of patients (n = 220) supported with the HeartWare VAD (HVAD). This is a retrospective analysis of patients undergoing HVAD implantation between July 2009 and March 2019 at the Freeman Hospital, Newcastle upon Tyne, United Kingdom.

Acute Aortic Syndrome Revisited: JACC State-of-the-Art Review.

The purpose of this paper is to describe all available evidence on the distinctive features of a group of 4 life-threatening acute aortic pathologies gathered under the name of acute aortic syndrome (AAS). The epidemiology, diagnostic strategy, and management of these patients has been updated. The authors propose a new and simple diagnostic algorithm to support clinical decision making in cases of suspected AAS, thereby minimizing diagnostic delays, misdiagnoses, and unnecessary advanced imaging.

A comprehensive comparison of various patient-specific CFD models of the left atrium for atrial fibrillation patients.

Background: Recently, advances in medical imaging, segmentation techniques, and high-performance computing have supported the use of patient-specific computational fluid dynamics (CFD) simulations. At present, CFD-compatible atrium geometries can be easily reconstructed from atrium images, providing important insight into the atrial fibrillation (AF) phenomenon, and assistance during therapy selection and surgical procedures. However, the hypothesis assumed for such CFD models should be adequately validated.

Percutaneous mitral valve repair with MitraClip device in hemodynamically unstable patients: A systematic review.

Background: Very few data exist on percutaneous mitral valve repair (PMVr) in unstable patients with concomitant moderate-severe mitral regurgitation (MR). The purpose of this systematic review was to evaluate baseline characteristics, management and clinical outcomes of critically ill patients undergoing PMVr with MitraClip.

Methods: We conducted a systematic review of the published data on MitraClip from its first use in 2003 to December 2020.