Surgical or Transcatheter Mitral Valve Replacement After Prior Bioprosthesis or Ring Implantation: A Landmark Analysis of Early and Long-Term Outcomes.

In recent years, the use of transcatheter valve-in-valve implantation in the mitral position (TMVI) for the treatment of mitral valve pathology following ring or bioprosthetic implantation has emerged as a less invasive option in comparison to repeated mitral valve surgery (RMVS). We aimed to compare the early and mid-term results of these two strategies. We retrospectively analyzed all patients who underwent a mitral intervention in our institution between 2005 and 2022.

A Machine Learning Model for the Accurate Prediction of 1-Year Survival in TAVI Patients: A Retrospective Observational Cohort Study.

Background: predicting the 1-year survival of patients undergoing transcatheter aortic valve implantation (TAVI) is indispensable for managing safe early discharge strategies and resource optimization.

Methods: Routinely acquired data (134 variables) were used from 629 patients, who underwent transfemoral TAVI from 2012 up to 2018. Support vector machines, neuronal networks, random forests, nearest neighbour and Bayes models were used with new, previously unseen patients to predict 1-year mortality in TAVI patients.

Management of closed sternal incision after bilateral internal thoracic artery grafting with a single-use negative pressure system.

Single-use, closed incision management (CIM) systems offer a practical means of delivering negative pressure wound therapy to patients. This prospective study evaluates the Prevena™ Therapy system in a cohort of coronary patients at high risk of deep sternal wound infection (DSWI). Fifty-three consecutive patients undergoing bilateral internal thoracic artery (BITA) grafting were preoperatively elected for CIM with the Prevena™ Therapy system, which was applied immediately after surgery.

A Retrospective Study to Evaluate Use of Negative Pressure Wound Therapy in Patients Undergoing Bilateral Internal Thoracic Artery Grafting.

Bilateral internal thoracic artery (BITA) grafting may be associated with a higher risk of postoperative deep sternal wound infection than monolateral internal thoracic artery grafting due to a limited blood supply to the thoracic chest wall. Because preliminary studies suggest negative pressure wound therapy (NPWT) may reduce the risk of infection, a retrospective chart review of 129 patients who underwent BITA between February 2003 and October 2014 was conducted. Of those, 21 patients received NPWT for 5 days immediately following surgery and the incisions of 108 patients were covered with a conventional gauze dressing.

Active clearance of chest drainage catheters reduces retained blood.

Objective: Chest tubes are used to clear blood from around the heart and lungs after heart surgery, but they can be obstructed by a blood clot, leading to retained blood syndrome (RBS). We sought to examine the frequency of RBS and associated morbidity, and to determine the influence of a preventative active chest tube clearance (ATC) protocol on these outcomes.

Methods: A multidisciplinary team developed a simple protocol to institute ATC to preventatively clear chest tubes of clot during the first 24 hours after heart surgery.