Durability of annuloplasty in patients with atrial functional mitral regurgitation associated with atrial fibrillation.

Objective: To determine the durability of mitral valve repair (MVr) with complete ring or flexible band annuloplasty in patients with atrial functional mitral regurgitation (AFMR) due to atrial fibrillation (AF) and identify risk factors associated with postoperative recurrence of mitral regurgitation.

Methods: Between January 1, 2000, and January 1, 2023, 194 adults with a history of AF underwent MVr with annuloplasty alone for moderate/severe AFMR. Exclusion criteria were prior cardiac surgery, additional repair techniques, ejection fraction <45%, ischemic heart disease, aortic valve disease, mitral annular calcification, and concomitant procedures other than surgical ablation or tricuspid repair/replacement.

American Association for Thoracic Surgery Quality Gateway: A surgeon case study of its application in adult cardiac surgery for quality assurance.

Objective: To demonstrate the application of American Association for Thoracic Surgery Quality Gateway (AQG) outcomes models to a Surgeon Case Study of quality assurance in adult cardiac surgery.

Methods: The case study includes 6989 cardiac and thoracic aorta operations performed in adults at Cleveland Clinic by a single surgeon between 2001 and 2023. AQG models were used to predict expected probabilities for operative mortality and major morbidity and to compare hospital outcomes, surgery type, risk profile, and individual risk factor levels using virtual (digital) twin causal inference.

Outcomes of culprit versus multivessel PCI in patients with multivessel coronary artery disease presenting with ST-elevation myocardial infarction complicated by shock.

Background: The optimal revascularization strategy in patients with multivessel coronary artery disease (MVCAD) who present with ST-elevation myocardial infarction (STEMI) and shock is undefined. We aimed to determine differences in survival among patients with MVCAD presenting with STEMI complicated by shock treated with percutaneous coronary intervention (PCI) of the infarct-related artery alone (culprit-only PCI) versus multivessel PCI (MVPCI).

Methods: Patients with MVCAD and STEMI complicated by shock who underwent PCI between January 1, 2002 and May 31, 2010 were identified (n = 199).

Mitral valve abnormalities in hypertrophic cardiomyopathy: echocardiographic features and surgical outcomes.

Background: Functional and intrinsic mitral valve (MV) abnormalities are common in hypertrophic cardiomyopathy (HCM); however, morphologic characteristics constituting indications for surgical intervention are incompletely defined. This study was conducted to define the echocardiographic features of MV pathology in patients with HCM and relate these to repairability of the MV, MV procedures performed, durability of repair, and survival.

Methods: From 1986 to 2003, 851 patients with HCM underwent operation, and 115 had a concomitant MV procedure.

Serum testosterone associates with lower high-density lipoprotein cholesterol in black and white males, 10 to 15 years of age, through lowered apolipoprotein AI and AII concentrations.

High-density lipoprotein cholesterol (HDL-C) concentrations decrease during adolescence in males in association with increasing pubertal maturation and free testosterone (F-T). To determine whether F-T effects lower HDL-C levels by decreasing the amount of cholesterol associated with the major protein moeities associated with HDL-C (apolipoprotein [apo]AI and AII) or by decreasing the concentrations of these proteins, we studied 251 black and 285 white boys, ages 10 to 15 years. In cross-sectional analysis, advancing puberty associated with decreasing HDL-C, apoAI, and apoAII in boys of each ethnic group.