Type A Aortic Dissection in Heart Transplantation Recipients in the United States.

Background: Type A aortic dissection in heart transplantation recipients is rare and lethal, with limited research beyond case reports. This study aimed to analyze patient characteristics and clinical outcomes of this condition through a US national database.

Methods: The National Inpatient Sample database (2002-2018) was used to identify all type A aortic dissection in heart transplantation recipients aged >18 years.

Management of penetrating cardiac injury and tricuspid regurgitation with extracorporeal-membrane oxygenation (ECMO): a case report.

Background: Gunshot wounds (GSW) to the heart are lethal, and most patients die before they arrive to the hospital. Survival decreases with number of cardiac chambers involved. We report a case of a 17-year-old male who survived a GSW injury involving two cardiac chambers with acute severe tricuspid regurgitation (TR) who subsequently developed cardiogenic shock requiring extracorporeal membrane oxygenation (ECMO) support.

Pericardial Adipose Tissue Thrombospondin-1 Associates With Antiangiogenesis in Ischemic Heart Disease.

Accumulation of ectopic pericardial adipose tissue has been associated with cardiovascular complications which, in part, may relate to adipose-derived factors that regulate vascular responses and angiogenesis. We sought to characterize adipose tissue microvascular angiogenic capacity in subjects who underwent elective cardiac surgeries including aortic, valvular, and coronary artery bypass grafting. Pericardial adipose tissue was collected intraoperatively and examined for angiogenic capacity.

Aortic Dissection During Pregnancy and Puerperium: Contemporary Incidence and Outcomes in the United States.

Background Aortic dissection (AD) during pregnancy and puerperium is a rare catastrophe with devastating consequences for both parent and fetus. Population-level incidence trends and outcomes remain relatively undetermined. Methods and Results We queried a US population-based health care database, the National Inpatient Sample, and identified all patients with a pregnancy-related AD hospitalization from 2002 to 2017.

Association of Intravenous Drug Use and Length of Stay Following Infective Endocarditis.

Introduction: Intravenous drug use (IVDU) and associated infective endocarditis (IE) has been on the rise in the US since the beginning of the opioid epidemic. IVDU-IE has high morbidity and mortality, and treatment can be lengthy. We aim to quantify the association between IVDU and length of stay (LOS) in IE patients.

Surgical outcomes of pulmonary valve infective endocarditis: A US population-based analysis.

Background: Pulmonary valve infective endocarditis (PVIE) represents a rare subset of right-sided IE. This study aimed to evaluate the population-level surgical outcomes of PVIE in the United States.

Methods: We performed a retrospective observational study using the 2002-2017 National Inpatient Sample database.

Sex-based outcomes in surgical repair of acute type A aortic dissection: A meta-analysis and meta-regression.

Objective: Epidemiologic variation with respect to sex has been established in aortic dissection. However, current literature on sex-based outcomes in patients with aortic dissection is conflicting. In this study we aimed to compare perioperative outcomes according to sex in patients treated surgically for acute type A aortic dissection.

Primary Pericardial Mesothelioma: A Population-Based Propensity Score-Matched Analysis.

Primary pericardial mesothelioma is a rare malignancy of the mesothelial lining of the pericardium. This study aimed to evaluate the clinical characteristics and survival outcomes of these patients using a United States population-based cancer database. We queried the Surveillance, Epidemiology, and End Results program (1973-2015).

Traumatic thoracic rib cage and chest wall hernias: A review and discussion of management principles.

Traumatic thoracic or chest wall hernias are relatively uncommon but highly challenging injuries that can be seen after a variety of injury mechanisms. Despite their description throughout history there remains scant literature on this topic that is primarily limited to case reports or series. Until recently, there also has been no effort to create a reliable grading system that can assess severity, predict outcomes, and guide the choice of surgical repair.

Extracorporeal membrane oxygenation in the management of granulomatosis with polyangiitis.

Granulomatosis with polyangiitis (GPA, also known as Wegener's granulomatosis) is a type of systematic vasculitis that primarily involves the lung and kidney. Diffuse alveolar hemorrhage (DAH) and associated acute respiratory failure are uncommon but devastating complications of GPA. Experience in using extracorporeal membrane oxygenation (ECMO) to manage DAH caused by GPA is limited.

Primary cardiac lymphoma.

Objective: This study aimed to understand the population-level treatment modalities and to evaluate the survival benefits of surgical resection in primary cardiac lymphoma.

Methods: We queried the Surveillance, Epidemiology, and End Results Program database, which covers 35% of the US population. Patients with a histologic diagnosis of primary cardiac lymphoma from 1973 to 2015 were included.

Aortoventricular Dissociation and Refractory Fungal Endocarditis Caused by a Rare Pathogen Lichtheimia: A Surgical and Medical Management Strategy.

We report a rare case of prosthetic valve fungal endocarditis caused by Lichtheimia, a subspecies of the order Mucorales. The patient experienced complicated prosthetic valve endocarditis less than 2 months after uneventful coronary artery bypass grafting (CABG) and 2 aortic valve replacements. Ultimately surgical management required aortic root replacement and lifelong antimicrobial agents.

Acuity adaptable patient care unit system shortens length of stay and improves outcomes in adult cardiac surgery: University of Wisconsin experience.

Objectives: The Acuity Adaptable Patient Care (AAC) unit system allows all beds within a nursing unit to negate the need for transfer with changes in patient status. The unit is specialty specific to all levels of patient care. This system was implemented in March 2006 for cardiothoracic surgery at our institution.

Delayed selective cerebral hypothermia decreases infarct volume after reperfused stroke in baboons.

Background: Hypothermia is known to provide neuroprotection from focal ischemia. However, lethal cardiovascular complications resulting from total body cooling have greatly restricted hypothermia as a therapy for stroke. This study determined whether selective cerebral cooling induced after reversible cerebral artery occlusion would decrease the infarct volume.

Transapical mitral valved stent implantation: a survival series in swine.

Objective: To assess short-term survival after transcatheter mitral valve replacement using a unique mitral valved stent design and anchoring system.

Methods: The new nitinol self-expandable valved stent houses a trileaflet glutaraldehyde-preserved bioprosthesis and contains atrial and ventricular fixation systems. Eight pigs underwent transesophageal echocardiogram-guided transapical mitral valved stent implantation through a lower mini-sternotomy.

The potential of cardiac allografts from donors after cardiac death at the University of Wisconsin Organ Procurement Organization.

Objective: The purpose of this study is to investigate the potential availability of hearts from adult donation after cardiac death (DCD) donors within an acceptable hypoxic period.

Methods: We retrospectively reviewed a donor database from the University of Wisconsin Organ Procurement Organization Donor Tracking System between 2004 and 2006. The DCD population (n=78) was screened using our inclusion criteria for DCD cardiac donor suitability, including warm ischaemic time (WIT) limit of 30 min.

Improved survival after heart transplantation in patients with bridge to transplant in the recent era: a 17-year single-center experience.

Background: Ventricular assist device (VAD) implantation as a bridge to transplant (BTT) has become an important approach for heart transplant candidates. In this study we document our institutional long-term results and recent improvements in BTT therapy.

Methods: We retrospectively studied 531 consecutive heart transplant recipients between January 1990 and August 2007.

Strategies for left ventricular assist device insertion after the Dor procedure.

Insertion of the inflow cannula of an implantable left ventricular assist device (LVAD) is a surgical challenge in patients who have previously undergone a Dor ventriculoplasty procedure. We report a 54-year-old man who had successful LVAD insertion 18 months after a Dor procedure. We also describe the strategy of LVAD insertion in such patients.

Off-pump transapical mitral valve replacement.

Objective: Percutaneous valve replacement was recently introduced, and reports of early clinical experience have already been published. To date, this technique is limited to the replacement of pulmonary and aortic valves in a strictly selected group of patients. The aim of this study was to analyse a self-expanding valved stent for minimally invasive replacement of the mitral valve in animals.

The impact of the lung allocation scoring system at the single national Veterans Affairs Hospital lung transplantation program.

Objective: The lung allocation score (LAS) has changed the distribution of donor lungs for transplantation. This study was undertaken to evaluate the impact of the LAS on a unique patient population undergoing lung transplantation (LTX) at the single national Veterans Affairs (VA) LT center.

Methods: One hundred and ten consecutive VA patients underwent LTX between 1994 and 2007.

To explant or not to explant: an invasive and noninvasive monitoring protocol to determine the need of continued ventricular assist device support.

Predictors of myocardial recovery after ventricular assist device (VAD) implantation are not well defined. The authors report their current VAD weaning protocol. Between 2003 and 2006, 38 patients received VAD implants.

Multidisciplinary approach decreases length of stay and reduces cost for ventricular assist device therapy.

High implantation costs and long postoperative length of stay (LOS) in debilitated patients complicate ventricular assist device (VAD) therapy. Between July 2000 and February 2005, 30 patients received a VAD at our institution. Of those, 20 patients were successfully discharged from the hospital with VADs.

Redo lung transplantation for acute and chronic lung allograft failure: long-term follow-up in a single center.

Objective: This study was undertaken to evaluate outcomes of redo lung transplantation (LT) for acute and chronic graft failure.

Methods: Between 1988 and 2007, 388 LT procedures were performed on 369 patients. From those, 17 (4.