Intraoperative Inversion of the Left Atrial Appendage Following Ligation.

• Intraoperative TEE improves the diagnosis of LAA inversion. • Excess negative pressure causes inversion at predictable points in cardiac surgery. • Structural characteristics of the LAA may influence inversion susceptibility.

Group B streptococcal conjugate vaccines elicit functional antibodies independent of strain O-acetylation.

Recently, it was discovered that sialic acid residues on group B streptococcal (GBS) capsular polysaccharides (CPS) are O-acetylated. Since GBS vaccine development has focused on de-O-acetylated CPS, it became germane to investigate the influence of de-O-acetylated GBS vaccine formulations on functional activity of sera against strains that bear the O-acetyl modification. Post-immunization sera from healthy adult recipients of de-O-acetylated GBS CPS-tetanus toxoid conjugate vaccines were evaluated in opsonophagocytosis assays using 20 GBS clinical isolates representing type Ia, Ib, II, III, or V CPS that varied in amount of O-acetylation from 2% to 40%.