Apical Access Management in Transapical Transcatheter Mitral Valve Replacement.

Background: The role of the surgical technique and anatomy in transapical mitral valve replacement (TA-TMVR) are scarcely investigated.

Methods: Computed tomography scans, surgical reports and planning slides of 127 patients undergoing TA-TMVR with the Tendyne valve system at 15 centers, participating at a European observational study, were retrospectively analyzed and compared between patients with (cohort A) and without (cohort B) apical access complications (AAC).

Results: A total of 8 (6.

Outcomes of patients with mitral annular disjunction undergoing mitral valve repair†.

Objectives: Mitral annular disjunction (MAD) is an abnormal displacement of the posterior mitral leaflet into the left atrial wall, potentially leading to left ventricular dysfunction, malignant ventricular arrhythmias (VA) and sudden cardiac death. This study investigates the outcomes of patients with and without MAD undergoing mitral valve repair for valve prolapse (MVP).

Methods: The study retrospectively collected a single-center experience from 2021 to 2023 on 326 consecutive patients undergoing mitral valve repair for MVP.

Prediction Model for POstoperative atriaL fibrillAtion in caRdIac Surgery: The POLARIS Score.

: New-onset postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery, occurring approximately in one-third of the patients. This study considered all-comer patients who underwent cardiac surgery to build a predictive model for POAF. : A total of 3467 (Center 1) consecutive patients were used as a derivation cohort to build the model.

Central venus cannulation during cardiac surgery as a possible new additional risk factor for late post-operative atrial fibrillation insurgence.

Background: Postoperative atrial fibrillation (POAF) is the most frequent cardiac arrhythmia following cardiac operations. It has been associated with an increased risk of postoperative cerebrovascular complications, morbidity and mortality. The aim of this study is to evaluate if the type of venous cannulation to institute the cardiopulmonary bypass (CPB) during major cardiac surgery procedures can influence the rate of POAF and late FA onset.

Pancreatic Stone Protein in the Diagnosis of Sepsis in Children Admitted to High-Dependency Care: A Single-Center Prospective Cohort Study.

Objectives: Blood level of pancreatic stone protein (PSP) is a promising biomarker of sepsis both in adults and children. The aim of our study was to investigate the diagnostic accuracy of PSP in children with suspected sepsis and to compare diagnostic performance with other sepsis biomarkers approved for clinical use, that is, procalcitonin (PCT) and C-reactive protein (CRP).

Design: Prospective study.

Reliability of EuroSCORE II on Prediction of Thirty-Day Mortality and Long-Term Results in Patients Treated with Sutureless Valves.

EuroSCORE II (ES2) is a reliable tool for preoperative cardiac surgery mortality risk prediction; however, a patient's age, a surgical procedure's weight and the new devices available may cause its accuracy to drift. We sought to investigate ES2 performance related to the surgical risk and late mortality estimation in patients who underwent aortic valve replacement (AVR) with sutureless valves. : Between 2012 and 2021, a total of 1126 patients with isolated aortic stenosis who underwent surgical AVR by means of sutureless valves were retrospectively collected from six European centers.

Aging well in an aging society: physical health in older lesbian, gay, and bisexual adults.

Introduction: Older sexual minority people meet a double stigma in our society related to their sexual identity and chronological age. The present study explores how experiences of discrimination and prejudice, coming out, and personal resiliency influence physical health of older lesbian, gay, and bisexual (LGB) adults.

Methods: Respondents were recruited through online advertisements and an online-based survey.

Risk Score for Long-Term Survival and Major Adverse Cardiovascular and Cerebrovascular Events After Coronary Artery Bypass Grafting Surgery.

To develop risk scoring models predicting long-term survival and major adverse cardiovascular and cerebrovascular events (MACCEs), including myocardial infarction and stroke after coronary artery bypass grafting (CABG). All 4,821 consecutive patients who underwent isolated CABG at Lankenau between January 2005 and July 2021 were included. MACCE was defined as all-cause mortality + myocardial infarction + stroke.

Surgical options for atrial fibrillation treatment during concomitant cardiac procedures.

Current guidelines recommend concomitant surgical ablation (SA) of atrial fibrillation (AF) in the context of mitral valve disease. A variety of energy sources have been tested for SA to perform effective transmural lesions reliably. To date, only radiofrequency and cryothermy energies are considered viable options.

Hybrid strategies for stand-alone surgical ablation of atrial fibrillation.

Atrial fibrillation (AF) has been reported as a major cause of cardiac morbidity and mortality, and significantly reduces the quality of life in symptomatic patients. Current guidelines recommend antiarrhythmic drugs and catheter ablation (CA) as first-line therapy. Despite CA showed to be associated with lower incidence of peri-procedural complications, rhythm outcomes are far from optimal.

Racialized Migrant Transgender Women Engaged in Sex Work: Double Binds and Identifications with the Community.

Racialized migrant transgender women engaged in sex work represent an understudied population. They face unique challenges resulting from their multiple marginalized identities, such as racialized transmisogyny. Since marginalized communities play a vital role in mitigating systemic stigma, it is essential to expand the literature on the community of this population.

A multi-dimensional study of organisational boundaries and silos in the healthcare sector.

The aim of this study is to understand how healthcare practitioners experience organisational boundaries and silos in day-to-day operations. Based on a multi-dimensional scale of organisational boundaries, the study examines how organisational demarcation lines enable and constrain daily work tasks in the healthcare sector. The study is based on a quantitative and qualitative analysis of survey responses from 895 healthcare practitioners in Denmark.

Del Nido cardioplegia in adult cardiac surgery: Clinical outcomes in a single center all-comer study.

Introduction: The use of Del Nido Cardioplegia (DNC) has been extended in the latest years from pediatrics to adult cardiac surgery with encouraging results. We sought to investigate clinical and biochemical outcomes in adult patients who underwent cardiac surgery with different degrees of complexity who received DNC for myocardial protection.

Methods: Data on one-thousand patients were retrospectively collected from 2020 to 2022.

Left Atrium Volume Reduction Procedure Concomitant With Cox-Maze Ablation in Patients Undergoing Mitral Valve Surgery: A Meta-Analysis of Clinical and Rhythm Outcomes.

Background: The management of an enlarged left atrium (LA) in mitral valve (MV) disease with atrial fibrillation (AF) is still being debated. It has been postulated that a reduction in LA size may improve patient outcomes. This meta-analysis aimed to assess rhythm and clinical outcomes of combined surgical AF treatment with or without LA volume reduction (LAVR) in patients undergoing MV surgery.

Mitral valve surgery in acute infective endocarditis: long-term outcomes of mitral valve repair versus replacement.

Aims: Timing and surgical strategies in acute infective endocarditis are still questionable. We sought to investigate clinical outcomes of patients undergoing mitral valve repair (MVR) compared with mitral valve replacement [mitral valve prosthesis (MVP)] for acute infective endocarditis.

Methods: From 2004 to 2019, 109 consecutive patients with acute mitral valve infective endocarditis were retrospectively investigated.

Sutureless and Rapid Deployment vs. Transcatheter Valves for Aortic Stenosis in Low-Risk Patients: Mid-Term Results.

Background: Recent trials showed that TAVI is neither inferior nor superior to surgical aortic valve replacement. The aim of this study was to evaluate the outcomes of Sutureless and Rapid Deployment Valves (SuRD-AVR) when compared to TAVI in low surgical risk patients with isolated aortic stenosis.

Methods: Data from five European Centers were retrospectively collected.

Frozen elephant trunk technique for aortic arch surgery: the Bordeaux University Hospital experience with Thoraflex hybrid prosthesis.

Background: Aortic arch surgery still represents a challenge, and the frozen elephant trunk (FET) allows a one-step surgery for complex aortic diseases. The aim of the study was to analyze the results of patients undergoing FET procedure for aortic arch surgery at Bordeaux University Hospital.

Methods: Patients undergoing FET procedure for multisegmented aortic arch pathologies were analyzed in this single-center retrospective study.

Cerebral Perfusion and Neuromonitoring during Complex Aortic Arch Surgery: A Narrative Review.

Complex ascending and aortic arch surgery requires the implementation of different cerebral protection strategies to avoid or limit the probability of intraoperative brain damage during circulatory arrest. The etiology of the damage is multifactorial, involving cerebral embolism, hypoperfusion, hypoxia and inflammatory response. These protective strategies include the use of deep or moderate hypothermia to reduce the cerebral oxygen consumption, allowing the toleration of a variable period of absence of cerebral blood flow, and the use of different cerebral perfusion techniques, both anterograde and retrograde, on top of hypothermia, to avoid any period of intraoperative brain ischemia.

Thoracoscopic Surgical Ablation of Lone Atrial Fibrillation: Long-term Outcomes at 7 Years.

Background: Antiarrhythmic drugs and transcatheter ablation in atrial fibrillation (AF) provide suboptimal rhythm control with a not negligible rate of failure in paroxysmal AF (PAF) and nonparoxysmal AF (n-PAF) at midterm and long-term follow-up. This study evaluated the safety profile and long-term efficacy of thoracoscopic ablation in patients with lone AF.

Methods: A consecutive 153 patients with lone AF were prospectively enrolled and underwent thoracoscopic surgical ablation.

Coronary artery disease and TAVI: Current evidence on a recurrent issue.

Coronary artery disease (CAD) is a frequent finding in patients with aortic stenosis (AS). Concomitant coronary artery bypass and aortic valve replacement is considered the gold standard treatment in surgical candidates. However, limited evidence is available regarding the role of coronary revascularization in patients undergoing transcatheter aortic valve implantation (TAVI).