Predictors of 1- and 12-month mortality in bifurcation coronary intervention: a contemporary perspective.

Bifurcation-PCI is performed frequently, although without extensive evidence to back up a definitive solution for its complexity. We set out to identify factors associated with 1- and 12-month mortality after bifurcation-PCI between 2017 and 2021 in our tertiary center in Wales, UK. Of 732 bifurcation PCI cases (mean age 69; 25% female), 67% were in ACS, 42% were left main PCI and 25.

Use of aortic wall patches as leaflet replacement material during aortic valve repair.

Objectives: Aortic valve repair can be limited by inadequate leaflet tissue for proper coaptation. Various kinds of pericardium have been used for cusp augmentation, but most have failed because of tissue degeneration. A more durable leaflet substitute is needed.

Comparison of Outcomes and Discharge Location After Transcatheter vs. Surgical Aortic Valve Replacement With Prior Coronary Artery Bypass Grafting.

Background: Published trials have shown that transcatheter aortic valve replacement (TAVR) is a safe alternative to surgical aortic valve replacement (SAVR) after prior coronary artery bypass grafting (CABG). However, differences in morbidity and discharge location between the 2 procedures are less thoroughly characterized.

Methods: From January 1, 2006 to January 7, 2020, 1059 patients with severe aortic stenosis after CABG underwent either SAVR (n = 315/30%), transfemoral TAVR (TF-TAVR) (n = 575/54%), or alternative access TAVR (n = 169/16%) at a single, tertiary care, academic institution.

Outcomes after resection of primary cardiac sarcoma.

Objective: To evaluate the outcomes of surgical resection of malignant primary cardiovascular tumors.

Methods: From 1983 to 2018, 32 patients underwent surgical resection of malignant primary cardiovascular sarcoma at Cleveland Clinic. Mean age was 48 ± 15 years, and 19 (59%) were women.

Predicting Gastrostomy Tube Placement After Intracerebral Hemorrhage: External Validation of the GRAVo Score.

Background: Dysphagia is a common consequence of intracerebral hemorrhages (ICH). It can lead to enduring impairments of dietary intake and the requirement for feeding via percutaneous gastrostomy (PEG) tubes. However, variabilities in the course of swallowing recovery after ICH make it difficult to anticipate the need for PEG placement in an individual patient.

A comparative study of the efficacy of Glidescope versus Macintosh direct laryngoscopy for intubation in pediatric patients undergoing cardiac surgery.

Background: The Glidescope is a novel, portable, reusable video laryngoscope that has provided superior laryngeal visualization to facilitate tracheal intubation, especially in the management of difficult airways. In this study, we aimed to compare the efficacy of the Glidescope (video-laryngoscope) against the Macintosh direct laryngoscope.

Methods: Fifty patients were randomly selected via simple randomization using computer-generated random numbers, and sorted into two groups of 25 patients: the Glidescope group and the Macintosh group.

A Comparative Evaluation of Marginal Accuracy of Co-Cr Metal Copings Fabricated Using Traditional Casting Techniques and Metal Laser Sintering.

Aims And Objectives: The aim and objective of the study were to determine the amount of marginal discrepancy produced by cobalt-chromium (Co-Cr) copings fabricated using two different fabrication methods, i.e., traditional casting and direct metal laser-sintering (DMLS), and compare the values obtained between each fabrication technique and to evaluate if the fabrication technique can produce prosthesis that is within the standards of clinical acceptance of marginal discrepancy.

Case Report: Ramipril and microscopic colitis; a necessary tool of cardiologists can rarely be devastating for patients.

Angiotensin converting enzyme inhibitors could lead to severe diarrhoea related to microscopic colitis. Few of such cases have been reported before and this serious problem, from a widely used class of drugs in hypertension and heart failure, needs to be more recognised. We describe the case of collagenous colitis related to ramipril use in the following case report.

A Vexing Recurrent Pericardial Effusion Without Underlying Pathology - Subsequent Diagnosis Of Lymphoma Proves A Rare First Presentation.

An elderly man had recurrent admissions with large symptomatic pericardial effusions. Initial computed tomography (CT) of thorax, abdomen and pelvis and pericardial fluid analysis did not reveal underlying cause. On subsequent presentation, pericardial window was formed but repeat pericardial fluid analysis and biopsy failed to give a diagnosis again.

Ischemic Stroke and Intracranial Hemorrhages During Impella Cardiac Support.

Impella is a percutaneously placed, ventricular assist device for short-term cardiac support. We aimed to study acute neurologic complications during short-term cardiac support with Impella. We reviewed prospectively collected data of 79 consecutive persons implanted with Impella at a single tertiary center.

Early Outcomes for In Situ Pericardial Roll Repair for Distant Anomalous Pulmonary Venous Return.

Background: Repair of anomalous pulmonary venous return (APVR) when veins are remote from the left atrium (LA) is challenging and may eventuate in a higher prevalence of pulmonary vein stenosis, superior vena cava stenosis, or intracardiac baffle obstruction. We describe our experience in 6 patients with a technique, using both anterior and posterior in situ pericardial roll repairs, which reduces these complications.

Methods: Six patients underwent in situ pericardial roll repair of APVR at Cleveland Clinic between 2018 and 2019.

Devices for ex vivo heart and lung perfusion.

Introduction: The number of organs available for heart and lung transplantation is far short of the number that is needed to meet demand. Perfusion and ventilation of donor organs after procurement has led to exciting advances in the field of cardiothoracic transplantation. The clinical implications of this technology allows for techniques to evaluate the quality of an organ, active rehabilitation of organs after procurement and prior to implantation, and increased time between organ procurement and implantation.

Inoperable patients with acute type A dissection: are they candidates for endovascular repair?

Objectives: The objectives are to (i) report characteristics and outcomes of patients with inoperable acute type A aortic dissection, (ii) describe proximal aortic morphology and (iii) identify potential for endovascular treatment of the entry tear.

Methods: Fifty-three (7.7%) of 686 patients with acute type A dissection between 2005 and 2015 were deemed inoperable.

Bone Mesenchymal Stem Cells with Growth Factors Successfully Treat Nonunions and Delayed Unions.

Background: While the gold standard of treatment of nonunion is open autologous bone grafting, studies have shown that injecting bone marrow aspirate concentrates (BMAC) is effective in treating tibial nonunions with fracture gaps less than 5 mm.

Questions/purposes: We aim to demonstrate that combining BMAC with osteoinductive agents can effectively treat delayed or nonunion regardless of fracture gap size, nonunion site, or osteoinductive agent used.

Methods: In this non-randomized retrospective-prospective cohort study, 49 patients with tibial nonunion met the inclusion criteria and underwent BMAC injection with demineralized bone matrix (DBM) and/or recombinant human bone morphogenic protein-2 (rhBMP-2).

Second primary lung cancers: smokers versus nonsmokers after resection of stage I lung adenocarcinoma.

Background: Smokers have a higher risk of developing non-small cell lung cancer (NSCLC) than never-smokers, but the relative risk of developing second primary lung cancer (SPLC) is unclear. Determining the risk of SPLC in smokers versus never-smokers after treatment of an initial cancer may help guide recommendations for long-term surveillance.

Methods: Patients who underwent resection for stage I adenocarcinoma were identified from a prospectively maintained institutional database.

A natural vanishing act: the enzyme-catalyzed degradation of carbon nanomaterials.

Over the past three decades, revolutionary research in nanotechnology by the scientific, medical, and engineering communities has yielded a treasure trove of discoveries with diverse applications that promise to benefit humanity. With their unique electronic and mechanical properties, carbon nanomaterials (CNMs) represent a prime example of the promise of nanotechnology with applications in areas that include electronics, fuel cells, composites, and nanomedicine. Because of toxicological issues associated with CNMs, however, their full commercial potential may not be achieved.

Brain evolution triggers increased diversification of electric fishes.

Communication can contribute to the evolution of biodiversity by promoting speciation and reinforcing reproductive isolation between existing species. The evolution of species-specific signals depends on the ability of individuals to detect signal variation, which in turn relies on the capability of the brain to process signal information. Here, we show that evolutionary change in a region of the brain devoted to the analysis of communication signals in mormyrid electric fishes improved detection of subtle signal variation and resulted in enhanced rates of signal evolution and species diversification.

Transferable graphene oxide films with tunable microstructures.

This report describes methods to produce large-area films of graphene oxide from aqueous suspensions using electrophoretic deposition. By selecting the appropriate suspension pH and deposition voltage, films of the negatively charged graphene oxide sheets can be produced with either a smooth "rug" microstructure on the anode or a porous "brick" microstructure on the cathode. Cathodic deposition occurs in the low pH suspension with the application of a relatively high voltage, which facilitates a gradual change in the colloids' charge from negative to positive as they adsorb protons released by the electrolysis of water.

Sacrificial layer electrophoretic deposition of free-standing multilayered nanoparticle films.

Sacrificial layer electrophoretic deposition (SLED) is a technique to assemble nanoparticles that yields free-standing, multilayered nanoparticle films with macroscopic lateral dimensions after the sacrificial layer is dissolved.

Controlled electrophoretic deposition of uniquely nanostructured star polymer films.

The controlled electrophoretic deposition of polystyrene/divinylbenzene (PS/DVB) star polymer films from a colloidal suspension is reported. Liquid suspensions, containing the PS/DVB star polymer, were prepared by injecting a dichloromethane (DCM) solution of the star polymer into a stratified liquid combination of hexane and DCM. A variety of hexane/DCM volume ratios were examined to identify the optimal solution conditions for electrophoretic deposition; thin films were produced from both unmixed and well-mixed hexane/DCM suspensions.

The effect of polygamous marital structure on behavioral, emotional, and academic adjustment in children: a comprehensive review of the literature.

Polygamy represents expanded family structures that are based on marriages involving a husband with 2 or more wives. Interestingly, polygamy is legally and widely practiced in 850 societies across the globe. In the last 2 decades, polygamy has been the focus of a significant growth in public, political, and academic awareness.