The Impact of Donor Obesity on Outcomes of Donation After Circulatory Death Heart Transplantation.

Objectives: In the setting of the obesity epidemic and donor organ shortage in the United States, there's a growing need to expand the donor organ eligibility criteria for orthotopic heart transplantation (OHT). Donation after circulatory death (DCD) has emerged as a promising solution, but the outcomes with obese donor hearts in DCD remains unknown.

Methods: Using the UNOS registry between 2019 and 2024, recipients of DCD OHT were stratified into three donor obesity categories by body mass index (BMI): underweight/normal (BMI <25kg/m), overweight (BMI 25-30kg/m), and obese (BMI >30kg/m).

A meta-analysis on the effect of proximal landing zone location on stroke and mortality in thoracic endovascular aortic repair.

Background: Thoracic endovascular aortic repair (TEVAR) involving the aortic arch may increase the opportunity for stroke owing to disruption of cerebral circulation and embolization. In this study, a systematic meta-analysis was performed to examine the impact of proximal landing zone location on stroke and 30-day mortality after TEVAR.

Methods: MEDLINE and Cochrane Library were searched for all original studies of TEVAR reporting outcomes of stroke or 30-day mortality for at least two adjacent proximal landing zones, based on the Ishimaru classification scheme.

Interposition Technique for Pulmonary Valve Replacement.

Background: Stented bioprosthesis implant at surgical pulmonary valve replacement (PVR) ideally should be 25 to 27 mm to facilitate future percutaneous PVR. This often requires accommodating 35 to 37 mm diameter sewing ring in the pulmonary position and requires anterior patch augmentation of the right ventricular outflow tract (RVOT). We present a novel "interposition" technique of PVR that allows upsizing the valve without RVOT patch augmentation.

Modified Warden Operation With the Use of Femoral Vein Homograft for Repair of a Variant of Right-Sided Partial Anomalous Pulmonary Venous Connection.

Surgical repair of right-sided partial anomalous pulmonary venous return (PAPVR) involves baffling the pulmonary vein across a naturally occurring or surgically created atrial septal defect without causing pulmonary venous or superior vena cava obstruction. A nine-year-old male presented to us with an unusual anatomical variant of right-sided partial anomalous pulmonary venous connection. The pulmonary veins draining the right upper and middle lobes connected to the azygous vein that drained in the usual fashion into the superior vena cava.

Human Neonatal Thymus Mesenchymal Stem/Stromal Cells and Chronic Right Ventricle Pressure Overload.

Right ventricle (RV) failure secondary to pressure overload is associated with a loss of myocardial capillary density and an increase in oxidative stress. We have previously found that human neonatal thymus mesenchymal stem cells (ntMSCs) promote neovascularization, but the ability of ntMSCs to express the antioxidant extracellular superoxide dismutase (SOD3) is unknown. We hypothesized that ntMSCs express and secrete SOD3 as well as improve survival in the setting of chronic pressure overload.

Regenerative Medicine Strategies for Hypoplastic Left Heart Syndrome.

Hypoplastic left heart syndrome (HLHS), the most severe and common form of single ventricle congenital heart lesions, is characterized by hypoplasia of the mitral valve, left ventricle (LV), and all LV outflow structures. While advances in surgical technique and medical management have allowed survival into adulthood, HLHS patients have severe morbidities, decreased quality of life, and a shortened lifespan. The single right ventricle (RV) is especially prone to early failure because of its vulnerability to chronic pressure overload, a mode of failure distinct from ischemic cardiomyopathy encountered in acquired heart disease.

Intraabdominal partitioning of the laparoscopic sleeve gastrectomy remnant optimizes the specimen extraction ergonomics and postoperative pain and is an attractive technique in teenage patients.

Introduction: Laparoscopic sleeve gastrectomy (LSG) has become an increasingly popular bariatric procedure in the pediatric population worldwide. The fear of complications, postoperative pain, and recovery remain the reservations for wider application of surgery in morbidly obese children. We present a novel technique for LSG remnant retrieval.

Impact of regional versus general anesthesia on the clinical outcomes of patients undergoing major lower extremity amputation.

Background: Patients undergoing major lower extremity amputation (MLEA) for peripheral arterial disease are often elderly, debilitated, and fraught with medical comorbid conditions that place them at high risk for surgical intervention. Data from lower extremity revascularization surgeries are often extrapolated to determine which anesthetic modality to use for amputations, with preference given to regional anesthesia. However, there is little evidence to support the use of one mode of anesthesia over another.

Malignant hyperthermia during laparoscopic adjustable gastric banding.

Background: We report a rare case of malignant hyperthermia during laparoscopic adjustable gastric banding.

Case Description: A 32-y-old female with no previous history of adverse reaction to general anesthesia underwent laparoscopic adjustable gastric banding. Intraoperative monitoring revealed a sharp increase in end-tidal carbon dioxide, autonomic instability, and metabolic and respiratory acidosis, along with other metabolic and biochemical derangements.

Lactobacillus fermentum, a pathogen in documented cholecystitis.

Introduction: Lactobacillus species are probiotics proven to exhibit various preventative as well as therapeutic properties. While lactobacillus species have been implicated in the formation of dental caries, endocarditis and bacteremia, their role as pathogens in cholecystitis has not been reported. We present a rare case of Lactobacillus fermentum working as a pathogen in cholecystitis.