Does obesity matter in patients receiving venoarterial extracorporeal membrane oxygenation? The U-shaped relationship between body mass index and mortality after extracorporeal cardiopulmonary resuscitation.

Background: The impact of obesity on the prognosis of patients receiving venoarterial extracorporeal membrane oxygenation remains unclear. This study examines the association between body mass index and in-hospital mortality among patients on venoarterial extracorporeal membrane oxygenation support.

Methods: This retrospective study enrolled adult patients who received venoarterial extracorporeal membrane oxygenation support, which included extracorporeal cardiopulmonary resuscitation, at National Taiwan University Hospital between 2010 and 2021.

Effects and trend of steroid dosage reduction during cardiac surgery: A three-year retrospective analysis at a tertiary medical center.

Background: Current adult cardiac surgery guidelines recommend against the routine use of prophylactic intravenous corticosteroids during cardiopulmonary bypass (CPB) due to concerns about myocardial injury, despite their potential to reduce postoperative atrial fibrillation. Traditionally, a high dose of 1,000 mg of methylprednisolone was used to attenuate the inflammatory response associated with CPB. Our institution aligned with guideline recommendations and gradually reduced methylprednisolone dosages; thus, we reevaluated the impact on postoperative clinical outcomes.

Emergent coronary revascularization with percutaneous coronary intervention and coronary artery bypass grafting in patients receiving extracorporeal cardiopulmonary resuscitation.

Objectives: Extracorporeal cardiopulmonary resuscitation (ECPR) has emerged as a rescue for refractory cardiac arrest, of which acute coronary syndrome is a common cause. Data on the coronary revascularization strategy in patients receiving ECPR remain limited.

Methods: The ECPR databases from two referral hospitals were screened for patients who underwent emergent revascularization.

End-stage renal disease should not Be considered a contraindication for veno-arterial extracorporeal membrane oxygenation.

Background: This study aims to determine whether end-stage renal disease (ESRD) is a true contraindication for extracorporeal membrane oxygenation in adult patients.

Materials And Methods: Adult patients who received VA-ECMO at National Taiwan University Hospital between January 2010 and December 2021 were included. Patients who received regular dialysis before the index admission were included in the ESRD group.

Computer-assisted image analysis of preexisting histological patterns of the cephalic vein to predict wrist arteriovenous fistula non-maturation.

Background: We used computer-assisted image analysis to determine whether preexisting histological features of the cephalic vein influence the risk of non-maturation of wrist fistulas.

Methods: This study focused on patients aged 20-80 years who underwent their first wrist fistula creation. A total of 206 patients participated, and vein samples for Masson's trichrome staining were collected from 134 patients.

Selective placement of novel compression suture technique to reduce pacemaker implantation rate following surgical aortic valve replacement with rapid deployment INTUITY valve.

Objective: The use of RDV in SAVR is associated with risk of conduction abnormality requiring PPM implantation, when compared to conventional bioprosthetic valves. We aimed to evaluate the outcome after selective placement of annular compression sutures during surgical aortic valve replacement (SAVR) using Intuity rapid deployment valve (RDV).

Methods: This is a retrospective study of prospectively enrolled patients receiving SAVR using Intuity RDV.

Impact of Previous Conventional Cardiac Surgery on the Clinical Outcomes After Heart Transplantation.

The impact of the type, purpose, and timing of prior surgery on heart transplantation (HT) remains unclear. This study investigated the influence of conventional cardiac surgery (PCCS) on HT outcomes. This study analyzed HTs performed between 1999 and 2019 at a single institution.

Long-term outcomes of mitral valve replacement in dialysis patients: evidence from a nationwide database.

Background: To compare the late outcomes between mechanical and bioprostheses after isolated mitral valve replacement (MVR) in dialysis-dependent patients.

Methods: A nationwide propensity-matched retrospective cohort study was conducted involving dialysis patients who underwent primary mitral replacement between 2001 and 2018. Ten-year postoperative outcomes were compared between mitral bioprosthesis and mechanical prosthesis using the Cox proportional hazard model and restricted mean survival time (RMST).

Case report: Total arch replacement with a frozen elephant trunk utilizing open hybrid in-situ fenestration technique for thoracic aortic arch aneurysm.

Introduction: The frozen elephant trunk technique is a surgical procedure developed for concomitant repair of downstream descending thoracic aorta as a first stage operation for arch resections. Proximalization of the sutured anastomosis reduces technical difficulty of total arch replacement. In this procedure, an anastomosis is performed more proximally using a stent graft.

Long-term outcomes of aortic valve replacement in dialysis patients - a nationwide retrospective cohort study.

Background: Improved durability of modern biologic prostheses and growing experience with the transcatheter valve-in-valve technique have contributed to a substantial increase in the use of bioprostheses in younger patients. However, discussion of prosthetic valve selection in dialysis patients remains scarce as the guidelines are updated. This study aims to compare long-term outcomes between propensity score-matched cohorts of dialysis patients who underwent primary aortic valve replacement with a mechanical prosthesis or a bioprosthesis.

Validation of the European system for cardiac operative risk evaluation II in a large Taiwan cardiac surgical centre.

Background: The European System for Cardiac Operative Risk Evaluation (EuroSCORE II) is a well-established scoring system for predicting mortality in cardiac surgery. This system was derived predominantly from a European patient cohort; however, no validation of this system has been conducted in Taiwan. We sought to assess the performance of EuroSCORE II at a tertiary centre.

Robotic mitral valve repair in National Taiwan University Hospital: 10-year results.

Background: With the help of robotic surgical systems and their 3-dimensional, high-resolution imaging, mitral repair with long shaft instruments and endo-wrist functionality has become a feasible reality. Patients benefit from maintained thoracic cage integrity, reduced surgical trauma, and faster return to normal functional activity. We describe National Taiwan University Hospital's 10-year experience with robotic-assisted mitral valve repair procedures for repairing mitral regurgitation.

Role of percutaneous pulmonary artery cannulation in extracorporeal life support for acute cardiac failure: A single-center case series.

Background: Pulmonary artery (PA) cannulation is an effective extracorporeal life support (ECLS) management for left ventricular (LV) decompression or right ventricular (RV) support. This case series explores the results of PA cannulation during ECLS for acute cardiac failure.

Methods: Patients receiving percutaneous PA cannulation between January 2017 and December 2020 in a single institution were retrospectively reviewed.

Association between SLICC/ACR damage index and outcomes for lupus patients after cardiac valve surgery.

Systemic lupus erythematosus (SLE) is associated with multi-organ damage including cardiac valve, which may need valvular operation. However, methods for outcome prediction and prosthetic valve selection are unclear in SLE patients undergoing cardiac valve surgery. Twenty-five SLE patients receiving valvular operation in a single institute between 2002 and 2020 were enrolled.

Impact of duration of mechanical support on heart transplantation: Hasty transplantation may not have a good long-term outcome.

Background: Mechanical circulatory support (MCS) has been widely utilized in critically ill cardiac transplant candidates. Few studies have investigated the impact of duration of MCS before heart transplantation (HTx) on long-term patient survival.

Methods: A retrospective HTx database was reviewed between 2009 and 2019.

Aortic remodeling after endovascular aortic repair and tailored distal entry tears exclusion in Crawford type III or IV dissection aneurysm.

Background: Thoracic endovascular aortic repair (TEVAR) can only promote 55-80% false lumen (FL) thrombosis when only the proximal primary tear is covered during the repair of type B aortic dissection (TBAD). This study evaluated the effectiveness and clinical outcome of tailored exclusion of the primary entry tear with TEVAR and distal fenestrations with ancillary devices in patients with subacute or chronic Crawford type III and IV aortic dissection aneurysm.

Methods: All patients underwent either TEVAR for primary entry tear; subsequently, various ancillary devices were applied on each distal fenestration.

Impact of pre-transplant bloodstream infection on clinical outcomes after heart transplantation.

Background: Active bloodstream infection (BSI) is a contraindication for heart transplantation (HT). However, some critical patients with BSI may undergo HT as a life-saving procedure. We aimed to investigate the impact of pre-transplant BSI on the clinical outcomes after HT.

Impact of Pretransplant Renal Replacement Therapy on Clinical Outcome After Isolated Heart Transplantation.

End stage renal disease (ESRD) is a contraindication to isolated heart transplantation (HT). However, heart candidates with cardiogenic shock may experience acute kidney injury and require renal replacement therapy (RRT) and isolated HT as a life-saving operation. The outcomes, including survival and renal function, are rarely reported.

Extracorporeal Membrane Oxygenation in Immunocompromised Patients With Acute Respiratory Distress Syndrome-A Retrospective Cohort Study.

Although the negative impact of immunosuppression on survival in patients with acute respiratory distress syndrome (ARDS) treated by extracorporeal membrane oxygenation (ECMO) is well known, short-term outcomes such as successful weaning rate from ECMO and subgroups benefit most from ECMO remain to be determined. The aims of this study were (1) to identify the association between immunocompromised status and weaning from ECMO in patients of ARDS, and (2) to identify subgroups of immunocompromised patients who may benefit from ECMO. This retrospective cohort study enrolled patients who received ECMO for ARDS from 2010 to 2020.

Retrograde arterial perfusion and its outcome in robotic mitral-valve surgery.

Objective: Retrograde arterial perfusion is frequently used in minimally invasive cardiac surgery. However, there are concerns about its safety.

Methods: A prospective observational cohort study was conducted in a tertiary university affiliated medical center during 2016-2018.