Evaluating the Impact of Pneumonia Prevention Recommendations After Cardiac Surgery.

Background: Pneumonia is the most prevalent healthcare-associated infection after coronary artery bypass grafting (CABG), but the relative effectiveness of strategies to reduce its incidence remains unclear. We evaluated the relationship between healthcare-associated infection recommendations and risk of pneumonia after CABG.

Methods: Pneumonia prevention practice recommendations were developed based on literature review and analysis of semistructured interviews with key health care personnel across centers with low (<5.

The Effect of Acute Pulmonary Hypertension on Tricuspid Annular Height, Strain, and Curvature in Sheep.

The tricuspid annulus shows significant alterations in patients with functional tricuspid regurgitation-tricuspid valve dysfunction that is secondary to other diseases such as pulmonary hypertension. Early changes in annular shape and dynamics may provide an understanding of disease mechanisms and could predict disease progression. To gain a mechanistic insight into these early changes we perform a spatially-resolved analysis of the effect of acute pulmonary hypertension on the tricuspid annulus in sheep.

Engineering Analysis of Tricuspid Annular Dynamics in the Beating Ovine Heart.

Functional tricuspid regurgitation is a significant source of morbidity and mortality in the US. Furthermore, treatment of functional tricuspid regurgitation is suboptimal with significant recurrence rates, which may, at least in part, be due to our limited knowledge of the relationship between valvular shape and function. Here we study the dynamics of the healthy in vivo ovine tricuspid annulus to improve our understanding of normal annular deformations throughout the cardiac cycle.

The effect of acute mechanical left ventricular unloading on ovine tricuspid annular size and geometry.

Objectives: Left ventricular assist device (LVAD) implantation may alter right ventricular shape and function and lead to tricuspid regurgitation. This in turn has been reported to be a determinant of right ventricular (RV) failure after LVAD implantation, but the effect of mechanical left ventricular (LV) unloading on the tricuspid annulus is unknown. The aim of the study was to provide insight into the effect of LVAD support on tricuspid annular geometry and dynamics that may help to optimize LV unloading with the least deleterious effect on the right-sided geometry.

The effect of pulmonary hypertension on ovine tricuspid annular dynamics.

Objectives: Pulmonary hypertension (PHT) is associated with tricuspid annular dilatation, but the effect of acute increase of pulmonary pressure on three-dimensional (3D) tricuspid annular dynamics and shape is unknown. Better understanding of tricuspid annular dynamics may lead to improved and more durable surgical reparative techniques.

Methods: In nine open-chest anaesthetized sheep nine sonomicrometry crystals were implanted on the right ventricle while on cardiopulmonary bypass.

Reversal of severe heart failure with a continuous-flow left ventricular assist device and pharmacological therapy: a prospective study.

Background: We have previously shown that a specific combination of drug therapy and left ventricular assist device unloading results in significant myocardial recovery, sufficient to allow pump removal, in two thirds of patients with dilated cardiomyopathy receiving a Heartmate I pulsatile device. However, this protocol has not been used with nonpulsatile devices.

Methods And Results: We report the results of a prospective study of 20 patients who received a combination of angiotensin-converting enzymes, β-blockers, angiotensin II inhibitors, and aldosterone antagonists followed by the β₂-agonist clenbuterol and were regularly tested (echocardiograms, exercise tests, catheterizations) with the pump at low speed.