Type A intramural hematoma over 21 years: A single center's experience.

Objective: To evaluate the differences in short- and mid-term outcomes for intramural hematoma in the type A distribution (TAIMH) and acute type A aortic dissection (ATAAD) patients treated at a single institution between 2000 and 2020 to provide insight into whether an emergent surgical treatment strategy for TAIMH is an acceptable treatment option.

Methods: Between January 2000 and December 2020, a total of 903 patients were treated for acute aortic syndrome at Stanford Hospital. Baseline characteristics, operative details, short-term postoperative outcomes, mid-term survival, and reoperation rates were examined for this cohort.

Stromal cell-derived factor-encapsulated nanoparticles target ischemic myocardium and attenuate myocardial injury via proangiogenic effects.

Lipid bilayer nanoparticles (NPs) with and without stromal cell-derived factor (SDF) were created to target and treat ischemia/reperfusion (I/R)-injured myocardium. Male Wistar rats were subjected to myocardial I/R insult and, at reperfusion, randomized to receive systemic injections of 5 mL/kg PBS, 6 μg/kg of NPs, SDF, or SDF-NPs. Four days after treatment, SDF-NPs circulated and accumulated selectively in the ischemic myocardium, with an SDF concentration roughly three times that of the other three treatments.

An axis-specific mitral annuloplasty ring eliminates mitral regurgitation allowing mitral annular motion in an ovine model.

Introduction: Current mitral annuloplasty rings fail to restrict the anteroposterior distance while allowing dynamic mitral annular changes. We designed and manufactured a mitral annuloplasty ring that demonstrated axis-specific, selective flexibility to meet this clinical need. The objectives were to evaluate ex vivo biomechanics of this ring and to validate the annular dynamics and safety after ring implantation in vivo.

Single cell RNA sequencing of hematopoietic cells in fresh and frozen human atheroma tissue.

Aims: Single-cell RNA sequencing (scRNA-seq) is a powerful method for exploring the cellular heterogeneity within human atheroma but typically requires fresh tissue to preserve cell membrane integrity, limiting the feasibility of large-scale biobanking for later analysis. The aim of this study was to determine whether cryopreservation of fragile and necrotic atheroma tissue affects the viability and transcriptomic profiles of hematopoietic cells in subsequent scRNA-seq analysis, enabling the use of cryopreserved atheroma samples for future research.

Methods And Results: We performed scRNA-seq on five paired fresh and cryopreserved atheroma samples - three from coronary arteries and two from carotid arteries.

A Novel Transcatheter Posterior Ventricular Anchoring Neochordoplasty Mitral Valve Repair Device.

Purpose: Advancements in minimally invasive technologies to decrease postoperative morbidity and recovery times represent a large opportunity for mitral valve repair operations. However, current technologies are unable to replicate gold standard surgical neochord implantation.

Methods: We developed a novel neochordal repair device, Minimally Invasive Ventricular Anchoring Neochordoplasty (MIVAN), which operates via transcatheter, trans-septal anchoring to the posterior ventricular wall.

Sex Differences in Patients Undergoing FFR-Guided PCI or CABG in the FAME 3 Trial.

Background: Outcomes in women after fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) using current-generation drug-eluting stents (DES) compared with coronary artery bypass grafting (CABG) are unknown.

Objectives: This study sought to evaluate differences in clinical outcomes according to sex after FFR-guided PCI with current generation DES compared with CABG.

Methods: The FAME 3 (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) trial was an investigator-initiated, randomized controlled trial, comparing FFR-guided PCI with current generation DES or CABG in patients with 3-vessel coronary artery disease.

Extracorporeal membrane oxygenation as a bridge to thoracic multiorgan transplantation.

Background: Extracorporeal membrane oxygenation (ECMO) has emerged as a crucial tool in the care of patients with multiorgan failure and is increasingly utilized as a bridge to transplantation. While data on ECMO as a bridge to isolated heart and lung transplantation have been described, our emerging experience with ECMO as a bridge to thoracic multiorgan transplantation is not yet well understood.

Methods: The United Network for Organ Sharing database was used to identify adult patients undergoing thoracic multiorgan transplantation between 1987 and 2022.

Outcomes According to Coronary Disease Complexity and Optimal Thresholds to Guide Revascularization Approach: FAME 3 Trial.

Background: Coronary disease complexity is commonly used to guide revascularization strategy in patients with multivessel disease (MVD).

Objectives: The aim of this study was to assess the interactive effects of coronary complexity on percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) outcomes and identify the optimal threshold at which PCI can be considered a reasonable option.

Methods: A total of 1,444 of 1,500 patients with MVD from the FAME (Fractional Flow Reserve versus Angiography for Multi-vessel Evaluation) 3 randomized trial were included in the analysis (710 CABG vs 734 PCI).

Heart-liver transplantation using the en bloc technique: A single-center experience over two decades.

Background: Combined heart-liver transplantation (CHLT) is a definitive therapy reserved for patients with concomitant heart failure and advanced liver disease. A limited number of centers perform CHLT, and even fewer use the en bloc implantation technique. Here we review clinical outcomes and immunoprotective effects following CHLT and describe our institution's more than two decades of experience in performing the en bloc technique.