Background: Indwelling pleural catheter (IPC) insertion is associated with fewer subsequent procedures and higher rates of spontaneous pleurodesis (SP) in patients with malignant pleural effusion (MPE). However, long-term pleural drains may cause psychological and physical distress. Additionally, only a portion of patients can benefit from IPC insertion and ultimately have them removed.
View Article and Find Full Text PDFIntroduction: Solid organ transplant (SOT) recipients were among the first individuals in the UK identified as 'clinically extremely vulnerable' (CEV) to COVID-19 and asked to 'shield' at the beginning of the pandemic in March 2020. This qualitative study explores the attitudes of SOT recipients towards COVID-19 shielding communications and the language used.
Methods: Semistructured interviews were conducted with 43 adult heart, liver and kidney transplant recipients in England between January 2022 and May 2023.
Hybrid coronary revascularisation (HCR) integrates coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) to combine the benefits of minimally invasive surgery and advanced stent technology. Typically, HCR involves off-pump left internal mammary artery (LIMA) to left anterior descending artery (LAD) bypass via minimally invasive direct coronary artery bypass (MIDCAB), complemented by PCI to non-LAD vessels. This approach avoids a full sternotomy and cardiopulmonary bypass while preserving the advantages of surgical revascularisation.
View Article and Find Full Text PDFBackground And Objective: The global prevalence of diabetes mellitus has markedly risen in recent years. Consequently, there has been a rise in the number of patients with diabetes undergoing cardiac surgery. Despite the existence of national and international guidelines to improve surgical outcomes in patients with diabetes, perioperative diabetes management optimisation remains inadequate resulting in these patients experiencing increased rates of surgical morbidity and mortality.
View Article and Find Full Text PDFCochrane Database Syst Rev
December 2024
Transcatheter aortic valve implantation (TAVI) has revolutionised the management of severe aortic stenosis, particularly for patients deemed high risk or inoperable for traditional surgical aortic valve replacement. The transfemoral approach is the preferred route whenever feasible, attributed to its minimally invasive nature, reduced procedural morbidity, and shorter recovery times. In total, 80-90% of TAVI procedures are performed via the transfemoral route.
View Article and Find Full Text PDFBackground: The cardiac surgery-associated acute kidney injury (CSA-AKI) occurs in up to 1 out of 3 patients. Off-pump coronary artery bypass grafting (OPCABG) is one of the major cardiac surgeries leading to CSA-AKI. Early identification and timely intervention are of clinical significance for CSA-AKI.
View Article and Find Full Text PDFAnn Rev Mar Sci
January 2025
Madagascar's celebrated land-vertebrate assemblage has long been studied and discussed. How the ancestors of the 30 different lineages arrived on the island, which has existed since 85 Mya and is separated from neighboring Africa by 430 km of water, is a deeply important question. Did the colonizations take place when the landmass formed part of Gondwana, or did they occur later and involve either now-drowned causeways or overwater dispersal (on vegetation rafts or by floating/swimming)? Following a historical review, we appraise the geological-geophysical evidence and the faunal-suite colonization record.
View Article and Find Full Text PDFBackground: The mortality rate of coronary artery disease ranks first in developed countries, and coronary revascularization therapy is an important cornerstone of its treatment. The postoperative pulmonary complications (PPCs) in patients receiving one-stop hybrid coronary revascularization (HCR) aggravate the dysfunction of multiple organs such as the heart and lungs, therefore increasing mortality. However, the risk factors are still unclear.
View Article and Find Full Text PDFBackground: The role of aprotinin in modern cardiac surgery is not well defined. While licensed for use in isolated coronary artery bypass grafting it is more commonly used for cases deemed to be at an increased risk of bleeding. The relative efficacy, and safety profile, of aprotinin as compared to other antifibrinolytics in these high-risk cases is uncertain.
View Article and Find Full Text PDFJ Vasc Access
November 2024
Tunnelled central venous dialysis catheters can usually be removed easily. However, their removal can become rarely complicated requiring more invasive techniques. We report a case in which cardiopulmonary bypass and repair of great veins was required for safe removal.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
September 2023
Prosthesis-patient mismatch (PPM) is defined as implanting a prosthetic that is insufficiently sized for the patient receiving it. PPM leads to high residual transvalvular gradients post-aortic valve replacement and consequently results in left ventricular dysfunction, morbidity and mortality in both the short and long term. Younger patients and patients with poor preoperative left ventricular function are more vulnerable to increased mortality secondary to PPM.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
July 2023
Minimal-access cardiac surgery appears to be the future. It is increasingly desired by cardiologists and demanded by patients who perceive superiority. Minimal-access coronary artery revascularisation has been increasingly adopted throughout the world.
View Article and Find Full Text PDFExperience in donation after circulatory-determined death (DCD) heart transplantation (HTx) is expanding. There is limited information on the functional outcomes of DCD HTx recipients. We sought to evaluate functional outcomes in our cohort of DCD recipients.
View Article and Find Full Text PDFDespite discussions extending back almost 160 years, the means by which Madagascar's iconic land vertebrates arrived on the island remains the focus of active debate. Three options have been considered: vicariance, range expansion across land bridges, and dispersal over water. The first assumes that a group (clade/lineage) occupied the island when it was connected with the other Gondwana landmasses in the Mesozoic.
View Article and Find Full Text PDFBackground: Ex-situ heart perfusion (ESHP) is commonly used for the reanimation and preservation of hearts following donation after circulatory determined death (DCD). The only commercially available existing ESHP device promotes perfusate lactate levels for assessment of heart viability. The reliability of this marker is yet to be confirmed for DCD heart transplantation.
View Article and Find Full Text PDFA 60-year-old male presented with sudden onset chest pain and pulmonary edema. The investigation confirmed torrential aortic regurgitation of a bicuspid valve. At surgery, a ruptured fibrous strand was identified which had been supporting the left-right cusp commissure with loss of attachment to the aortic wall.
View Article and Find Full Text PDFBackground: Pulmonary thromboendarterectomy (PTE) was first introduced to the UK 25 years ago, and the UK national service is provided by a single hospital. The aim of this work is to summarize our experience and review activity and outcomes by era at a high-volume PTE center. During this period the understanding of chronic thromboembolic pulmonary hypertension (CTEPH) increased and drug treatments and balloon angioplasty were developed.
View Article and Find Full Text PDFJ R Coll Physicians Edinb
January 2022
Background: Significant bleeding following cardiac surgery is a recognised complication, associated with a requirement for re-exploration and blood transfusion, both associated with increased morbidity and early mortality. The aim of this study was to examine the impact of the volume of early postoperative bleeding on long-term survival for patients undergoing coronary artery bypass grafting (CABG).
Methods: A retrospective analysis was performed of patients undergoing first-time isolated CABG at a single centre between January 2003 and April 2013, conditional from 30-day survival.
Surgical approaches to major pulmonary resections have evolved from thoracotomy to multiportal video-assisted thoracoscopy (VATS) and subsequently uniportal VATS. The efficacy of this progress has been validated in a multitude of publications demonstrating reductions in complications, patient perception of pain, and postoperative length of stay. More recent advances include subxiphoid extrathoracic access and nonintubated, opioid-free anesthesia.
View Article and Find Full Text PDFThere is considerable interest and demand in the application of minimally invasive techniques in cardiac surgery driven by multiple factors including patient cosmesis and satisfaction, reduction of surgical trauma and the development of specialized instrumentation that allows these procedures to be performed safely. Minimally invasive mitral valve surgery (MIMVS) has been conducted for more than 25 years and has been shown to offer multiple benefits including better cosmetic results, enhanced post-operative recovery, improved patient satisfaction and most importantly, equivalent clinical outcomes with regards to quality and safety when compared to the standard sternotomy approach. MIMVS may be particularly beneficial in certain subgroups of patients, for example patients undergoing redo mitral valve surgery.
View Article and Find Full Text PDF