Publications by authors named "Tulio Caldonazo"

Background:  Rapid and accurate diagnosis of infective endocarditis (IE) allows timely management of this life-threatening disease and improves outcome. The Duke criteria have traditionally been the clinical method for diagnosing IE. These criteria were reformulated at different timepoints.

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  • * It found that 269 patients (3.1%) had C. acnes endocarditis, primarily affecting younger individuals with native valves, while prosthetic valve cases were more frequent in older age groups.
  • * Although survival rates were better for native valve cases, the incidence of C. acnes endocarditis is concerning and requires specialized diagnostic methods, but surgical outcomes were generally acceptable.
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  • CCTA is a noninvasive method for diagnosing coronary artery disease (CAD) and may guide surgical decisions, particularly before valve surgery.
  • * A meta-analysis was conducted using data from 5 studies involving 6,654 patients to compare outcomes between patients receiving ICA and CCTA.
  • * The analysis found no significant differences in perioperative mortality or secondary outcomes like AKI, MI, or stroke, suggesting that CCTA is a safe alternative to ICA.
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  • Coronary artery disease (CAD) reduces life expectancy, especially in older adults, with myocardial infarctions being a leading cause of death in people over 70.
  • A study analyzed data from 4,045 elderly patients (>70 years) who underwent coronary artery bypass grafting (CABG) to assess its impact on long-term survival compared to the general age-matched population.
  • Results showed that CABG significantly lowers the risk of death in elderly patients, suggesting that the surgery effectively prolongs life by mitigating the risks associated with CAD, particularly after the first year post-surgery.
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Background: Transcatheter Aortic Valve Implantation (TAVI) and Surgical Aortic Valve Replacement (SAVR) have different levels of invasiveness which can result in different levels of functional status after the procedure.

Methods: We performed a systematic review and meta-analysis to detect studies showing direct comparison between TAVI and SAVR regarding postoperative functional status. The primary endpoint was the incidence of postoperative delirium (POD) after TAVI or SAVR, assessed using the Confusion Assessment Method (CAM).

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  • A study evaluated the effectiveness of a commercial sponge diffuser versus a custom-made cannula and no CO2 in preventing neurological events after aortic valve replacement surgery.
  • Three patient groups were compared based on their CO2 delivery method, with a focus on outcomes like stroke, dizziness, and mechanical ventilation duration.
  • Results showed that the sponge diffuser group had a significantly lower duration of mechanical ventilation, decreased 30-day mortality, and fewer neurological events compared to the other methods.
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Background: Liver dysfunction is a known risk factor in the cardiovascular field. It specifically increases perioperative risk in patients undergoing coronary bypass surgery. Since percutaneous coronary intervention (PCI) is the much less invasive procedure for the treatment of coronary artery disease, we aimed to assess the relationship of liver dysfunction with outcomes in patients undergoing PCI.

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This study aimed to conduct a systematic review and meta-analysis comparing video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT) in the context of pulmonary metastasectomy. Three databases were assessed. The primary outcome was overall survival.

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  • High-risk surgical patients often face poor outcomes due to acid-base disorders, specifically metabolic acidosis, which can be assessed using the delta anion gap to bicarbonate ratio.* -
  • This study aimed to evaluate the relationship between metabolic acidosis (MA) and complications in patients undergoing high-risk surgeries by categorizing them into three groups based on their delta AG/delta Bic values.* -
  • Results showed that out of 621 patients, a significant portion had acidosis, and those in the subgroup with no mixed disorders had a notably higher risk of 30-day mortality and cardiovascular complications.*
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Background: Aortic regurgitation (AR) is a known complication after left ventricular assist device (LVAD) implantation potentially leading to recurrent heart failure. Possible pathomechanisms include valvular pathologies and aortic root dilatation. We assessed aortic root dimensions in a group of consecutive LVAD patients who received HeartMate 3.

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The degree of both mitral (MR) and tricuspid valve regurgitation (TR) correlates with mortality. A vicious cycle has been proposed consisting of increasing regurgitation and decreasing ventricular function. Restoration of valve competence should break this vicious cycle and improve life expectancy.

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Recent randomized evidence has shown that low-dose colchicine lowers the risk of cardiovascular events in patients with chronic coronary artery disease. Colchicine has also been used in coronary artery bypass grafting (CABG), with individual studies suggesting protective effects for postoperative atrial fibrillation (POAF). We performed a meta-analysis of studies assessing the effect of colchicine on outcomes in CABG surgery.

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The demographic shift towards an aging population necessitates a reevaluation of surgical interventions like coronary artery bypass grafting (CABG) in octogenarians. This study aims to elucidate the outcomes of CABG in octogenarians with heart failure and reduced ejection fraction (HFrEF), a group traditionally considered at high risk for such procedures. Conducted across four academic hospitals in Germany from 2017 to 2023, this retrospective multicenter study assessed 100 patients (50 octogenarians ≥80 years and 50 non-octogenarians <80 years) with HFrEF undergoing isolated CABG.

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There is debate on the best treatment for significant stenoses of the left main (LM) coronary artery. The available evidence is based on four randomized trials, which were either performed specifically to assess patients with LM disease (EXCEL, NOBLE, PRECOMBAT) or had a significant fraction of patients with this disease pattern (SYNTAX). A meta-analysis revealed no difference in periprocedural and 5-year mortality but demonstrated a significant reduction of spontaneous myocardial infarction (MI) with CABG.

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Background: Antithrombotic therapy (ATT) in patients with infective endocarditis (IE) is challenging.

Objectives: The authors evaluated the impact of anticoagulant and antiplatelet therapy on clinical endpoints in IE patients.

Methods: We performed a systematic review and meta-analysis comparing IE patients with prior and/or ongoing use of ATT vs those without any ATT during IE course.

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Self-expanding valves (SEV) and balloon-expandable valves (BEV) for transcatheter aortic valve implantation (TAVI) have their own features. There is a growing interest in long-term outcomes with the adoption of lifetime management in younger patients. To evaluate late outcomes in TAVI with SEV versus BEV, we performed a study-level meta-analysis of reconstructed time-to-event data published by May 31, 2023.

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Background: Complete removal of cardiac implantable electronic devices (CIEDs) is recommended in patients with CIED infections, including both systemic and localized pocket infection. The aim of the study was to provide an up-to-date and comprehensive assessment of evidence relating to the effect of complete CIED extraction in patients with a CIED infection.

Methods: We performed a systematic review and meta-analysis of studies reporting short- and mid-term outcomes in patients who had a device infection or infective endocarditis (IE) and underwent complete removal of the cardiac device (generator and leads) compared to those who received conservative therapy (no removal, partial removal, local antibiotic infiltration or isolated antibiotic therapy).

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Background: Postoperative bleeding requiring re-exploration is a serious complication that occurs in 2.8-4.6% of patients undergoing cardiac surgery.

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Introduction: Lipoprotein(a) (Lp[a]) is a variant of low-density lipoprotein (LDL) and has been associated with increased risk of vascular inflammation and thrombosis. Coronary artery bypass grafting (CABG) has been associated with local inflammation of the myocardium. It is plausible, therefore, that patients with elevated baseline Lp(a) may be prone to unfavorable clinical outcomes following CABG.

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Objectives: The association between obesity and graft failure after coronary artery bypass grafting has not been previously investigated.

Methods: We pooled individual patient data from randomized clinical trials with systematic postoperative coronary imaging to evaluate the association between obesity and graft failure at the individual graft and patient levels. Penalized cubic regression splines and mixed-effects multivariable logistic regression models were performed.

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Background:  This study aimed to assess the influence of the model of end-stage liver disease without International Normalized Ratio (INR) (MELD-XI) score on outcomes after elective coronary artery bypass surgery (CABG) without (Off-Pump) or with (On-Pump) cardiopulmonary bypass.

Methods:  We calculated MELD-XI (5.11 × ln serum bilirubin + 11.

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Objectives:  Mechanisms of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) differ as CABG provides surgical collateralization and may prolong life by preventing future myocardial infarctions (MIs). However, evidence for CABG in patients with chronic total occlusion (CTO) has not been fully elucidated and the impact of PCI is discussed controversially.

Methods:  We performed a meta-analysis of studies comparing outcomes in patients with/without multivessel disease undergoing CABG or PCI for CTO.

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We reviewed the cardiac surgical literature for 2023. PubMed displayed almost 34,000 hits for the search term "cardiac surgery AND 2023." We used a PRISMA approach for a results-oriented summary.

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