Thrombocytopenia after sutureless and standard stented aortic valve replacement: a retrospective analysis of risk factors, clinical course, and early outcome.

Objectives: Thrombocytopenia following Perceval aortic valve replacement has been described previously with variable outcome. Studies have lacked a robust analysis of platelet fluctuation and factors affecting it. We aimed to statistically describe the trend in thrombocyte variability as compared with conventional aortic valve replacement, and to assess predictors as well as impact on associated outcomes.

Sutureless Biological Aortic Valve Replacement (Su-AVR) in Redo operations: a retrospective real-world experience report of clinical and echocardiographic outcomes.

Objective: This retrospective study aimed to compare the outcomes of sutureless aortic valve replacement (su-AVR) and conventional bioprosthetic sutured AVR (cAVR) in high-risk patients undergoing redo surgery.

Methods: A total of 79 patients who underwent redo AVR between 2014 and 2021 were included in the study. Of these, 27 patients underwent su-AVR and 52 underwent cAVR.

Destructive Aorto-Mitral Endocarditis: Two Valves for One Annulus.

Surgery for endocarditis of the aorto-mitral continuity can be a challenge in case of extensive tissue destruction. We report two cases of a modified monobloc reconstruction of the aortic and mitral valves and of the aorto-mitral fibrous body. Two valve bioprostheses were sutured to each other and implanted as a composite graft.

Predicting local material thickness from steady-state ultrasonic wavefield measurements using a convolutional neural network.

Acoustic steady-state excitation spatial spectroscopy (ASSESS) is a full-field, ultrasonic non-destructive evaluation (NDE) technique used to locate and characterize defects in plate-like structures. ASSESS generates a steady-state, single-tone ultrasonic excitation in a structure and a scanning laser Doppler Vibrometer (LDV) measures the resulting full-field surface velocity response. Traditional processing techniques for ASSESS data rely on wavenumber domain analysis.

Ten-year improved survival in patients with multi-vessel coronary disease and poor left ventricular function following surgery: A retrospective cohort study.

Objective: Patients with multi-vessel coronary artery disease and poor left ventricular (LV) function (ejection fraction [EF] < 30%) requiring revascularization are considered 'high-risk'. Limited long-term survival data exists comparing percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DES) versus surgery for this cohort of patients.

Methods: We retrospectively reviewed our data for 321 patients with EF < 30% who underwent multi-vessel revascularization from January 2005 to December 2015 using Cox regression analyses and inverse probability treatment weighted (IPTW) methods.

Coronary artery bypass confers intermediate-term survival benefit over percutaneous coronary intervention with new-generation stents in real-world patients with multivessel coronary artery disease, including left main disease: a retrospective analysis of 6383 patients.

Objectives: The intermediate-term all-cause mortality rate of real-world patients with multivessel disease (MVD) treated with percutaneous coronary intervention (PCI) with new-generation drug-eluting stents or coronary artery bypass grafting (CABG) remains unknown. We sought to compare the intermediate-term all-cause mortality rates of real-world patients with MVD including left main stem disease, treated with CABG or PCI.

Methods: All consecutive all-comer patients with MVD undergoing CABG or PCI with second/third generation drug-eluting stents from 2007 to 2015 in Harefield Hospital, UK were included in this study.

A Simple and Effective Technique for Anatomical Approximation of the Upper Pericardium Using Hemostatic Clips.

Closure of the pericardium is important to protect bypass grafts, the great vessels, and the heart from injury due to sternal dehiscence. Furthermore, it is reported to reduce the formation of pericardial adhesions and thus facilitate entry into the chest at resternotomy. We here describe a simple, reproducible, and effective technique for tension-free approximation of the upper pericardium by applying small hemostatic clips to the preserved thymic fascia overlying the pericardium.

Does surgery improve prognosis in patients with small-cell lung carcinoma?

A best evidence topic was written according to a structured protocol, asking 'does surgery improve prognosis in patients with small-cell lung carcinoma (SCLC)?' One hundred and thirteen papers were identified, of which the nine papers best able to answer the question were selected and the details of each tabulated. The prohibitive attitude of clinicians toward surgery in SCLC has prevailed since the 1960s, informed by a prospective randomized trial in which 144 patients were assigned to surgical treatment or to radical radiotherapy. Surgery conferred no survival benefit when compared with radical radiotherapy as assessed at 6 monthly intervals up to 10 years post-treatment.

Is heparin needed for patients with an intra-aortic balloon pump?

We addressed the question of whether or not the currently available evidence base supports heparinization in the context of a patient requiring cardiovascular support with an intra-aortic balloon pump (IABP). A best evidence topic was written according to a previously defined structured protocol. A literature search returned 443 papers, 3 of which were deemed relevant.

Surgery and tuberculosis.

Purpose Of Review: Tuberculosis (TB) remains a global emergency and continues to kill 1.7 million people globally each year. In the UK, figures for TB are increasing especially in urban areas.

Are there any good treatments for keloid scarring after sternotomy?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: in patients with hypertrophic and keloid scarring of the sternotomy wound, is surgical excision with or without adjuvant treatment of any benefit in reducing the size of the scar? Altogether, more than 15 papers were found using the reported search, of which nine represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated.

Tissue-engineered vascular graft remodeling in a growing lamb model: expression of matrix metalloproteinases.

Objectives: We have previously demonstrated the functionality and growth of autologous, living, tissue-engineered vascular grafts (TEVGs) in long-term animal studies. These grafts showed substantial in vivo tissue remodeling and approximation to native arterial wall characteristics. Based on this, in vitro and in vivo matrix metalloproteinase (MMP) activity of TEVGs is investigated as a key marker of matrix remodeling.

Red to far-red ratio correction in plant growth chambers - growth responses and influence of thermal load on garden pea.

Plant growth chambers are commonly used to minimize environmental variation but the light sources used vary considerably from natural light and from each other. Incandescent globes are often used to add more far-red light, with the aim of producing a more natural red to far-red ratio (R:FR), but also add to thermal load. High-intensity discharge lamps are often used to produce higher irradiances, more akin to natural light, but the thermal implications are rarely considered because air temperature is controlled.

Differential induction of glutathione transferases and glucosyltransferases in wheat, maize and Arabidopsis thaliana by herbicide safeners.

By learning lessons from weed science we have adopted three approaches to make plants more effective in phytoremediation: (1) The application of functional genomics to identify key components involved in the detoxification of, or tolerance to, xenobiotics for use in subsequent genetic engineering/breeding programmes. (2) The rational metabolic engineering of plants through the use of forced evolution of protective enzymes, or alternatively transgenesis of detoxification pathways. (3) The use of chemical treatments which protect plants from herbicide injury.