We report an unusual case of a Starr-Edwards aortic valve malfunction with fatal dislodgment and embolization of its ball portion to the distal abdominal aorta, just above the bifurcation, leading to sudden death. This case is unusual in that it is, to date, the longest time elapsed between valve placement and ball dislodgment.
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Perioperative Tranexamic Acid Should Be Considered for Total Joint Arthroplasty Patients Receiving Apixaban for Thromboprophylaxis.
Arthroplast Today
December 2024
Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
Article Synopsis
- This study examines whether giving tranexamic acid (TXA) to total joint arthroplasty (TJA) patients receiving apixaban can lower the risk of postoperative bleeding without increasing thromboembolic events.
- Researchers analyzed data from over 118,000 TJA patients and found that those who received both apixaban and TXA had significantly lower rates of bleeding complications and transfusions compared to those who only received apixaban.
- The findings suggest that using TXA in conjunction with apixaban during surgery is beneficial for reducing bleeding risks without raising the chances of serious blood clots or heart problems, making it a recommended practice for surgeons.
Main versus segmental hepatic artery angioembolization in patients with traumatic liver injuries: A Western Trauma Association multicenter study.
Surgery
February 2025
Division of Trauma, Department of Surgery, Burns and Surgical Critical Care, University of California, Irvine, CA. Electronic address:
Introduction: Hepatic angioembolization is highly effective for hemorrhage control in hemodynamically stable patients with traumatic liver injuries and contrast extravasation. However, there is a paucity of data regarding the specific location of angioembolization within the hepatic arterial vasculature and its implications on patient outcomes.
Methods: A post-hoc analysis of a multicenter prospective observational study across 23 centers was performed.
Observation-first versus angioembolization-first approach in stable patients with blunt liver trauma: A WTA multicenter study.
J Trauma Acute Care Surg
November 2024
From the Division of Division of Trauma, Burns and Surgical Critical Care, Department of Surgery (P.D.N., J.N., N.A., A.G.), University of California, Irvine, Orange, California; Section of Surgical Sciences (J.M.S.), Vanderbilt University Medical Center, Nashville, TN; Department of Surgery, University of Colorado, Aurora, Colorado (M.C., H.C., R.M., S.U., C.C.B., C.V.); Department of Surgery (S.B., R.C.D.), UCSF-Fresno, Fresno, California; Division of Trauma and Acute Care Surgery (M.C.S.), Mount Carmel East; Trauma, Critical Care and Acute Care Surgery (A.L.), Grant Medical Center, Columbus, Ohio; Department of Surgery (M.S.F.), Lehigh Valley Health Network, Allentown, Pennsylvania; Departments of Emergency Medicine and Surgery, Program in Trauma (D.M.S.), R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland; Graduate Medical Education (M.S.T., H.M.G.V.), Methodist Dallas Medical Center, Dallas, Texas; Division of Trauma, Acute Care Surgery and Surgical Critical Care, Department of Surgery (C.J.M., T.J.M.), Spartanburg Regional Medical Center, Spartanburg, South Carolina; Department of Surgery (C.G.B.), University of Calgary, Calgary, Alberta, Canada; Division of Acute Care Surgery (K.M., G.M.), Loma Linda University Health, Loma Linda, California; Department of Surgery (D.J.H., H.A.), University of Maryland School of Medicine, Baltimore, Maryland; Department of Trauma and Acute Care Surgery (T.J.S., J.R.), UCHealth Memorial Hospital, Colorado Springs, Colorado; Department of General Surgery (M.B.), Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Division of Trauma, Acute Care Surgery and Surgical Critical Care (N.K., M.C.), Banner-University Medical Center Phoenix, Phoenix, Arizona; Division of Trauma and Critical Care, Department of Surgery (N.K.D., E.J.L.), Cedars-Sinai Medical Center, Los Angeles, California; Department of Surgery (T.E., J.W.), Cooper University Hospital, Camden, New Jersey; Department of Surgery and Perioperative Care (T.C.P.C., V.E.), Dell Medical School, University of Texas at Austin, Austin, Texas; Division of Trauma Acute Care Surgery, Department of Surgery (K.P., K.C.), Banner Thunderbird Medical Center, Glendale, Arizona; Division of Trauma and Surgical Critical Care, Department of Surgery (S.B.), Hackensack University Medical Center, Hackensack, New Jersey; Division of Trauma and Surgical Critical Care, Department of Surgery (F.S.E.), Rutgers New Jersey Medical School, Newark, New Jersey; Department of Trauma and Acute Care Surgery (W.D., C.P.), Medical Center of the Rockies, Loveland, Colorado; University of Wisconsin-Madison School of Medicine and Public Health (N.L.W.), Madison, Wisconsin; Department of Trauma (J.M.H., K.L.), Ascension Via Christi Saint Francis, Wichita, Kansas; Department of Surgery (G.S.), Miami Valley Hospital, Wright State University, Dayton, Ohio; Department of Surgery (K.S.), Prisma Health-Upstate, Greenville, South Carolina; and Department of Surgery (L.A.H.), Boulder Community Hospital, Boulder, Colorado.
Background: Prior studies evaluating observation versus angioembolization (AE) for blunt liver injuries (BLT) with contrast extravasation (CE) on computed tomography imaging have yielded inconsistent conclusions, primarily due to limitations in single-center and/or retrospective study design. Therefore, this multicenter study aims to compare an observation versus AE-first approach for BLT, hypothesizing decreased liver-related complications (LRCs) with observation.
Methods: We conducted a post hoc analysis of a multicenter, prospective observational study (2019-2021) across 23 centers.
Looking into the cholesterol crystal ball: is complement the answer?
Kidney Int
November 2024
Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Clinical Research, Center for Rare Diseases Aldo e Cele Daccò, Ranica, Bergamo, Italy.
Cholesterol crystal embolism (CCE) is a complication of atherosclerosis and can cause microvascular obstruction in multiple organs. Because the consequences may be fatal, and there is no specific treatment, it is crucial to understand the mechanisms and identify treatment strategies. In this issue, Zhao et al.
View Article and Find Full Text PDFCombined portal and hepatic vein embolisation in perihilar cholangiocarcinoma.
HPB (Oxford)
December 2024
Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229, HX, Maastricht, The Netherlands; GROW - School for Oncology and Reproduction, Maastricht University, Universiteitssingel 40, 6229, ER, Maastricht, The Netherlands; Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany. Electronic address:
Background: Major hepatectomy in perihilar cholangiocarcinoma (pCCA) patients with a small future liver remnant (FLR) risks posthepatectomy liver failure (PHLF). This study examines combined portal and hepatic vein embolisation (PVE/HVE) to increase preoperative FLR volume and potentially decrease PHLF rates.
Methods: In this retrospective, multicentre, observational study, data was collected from centres affiliated with the DRAGON Trials Collaborative and the EuroLVD registry.
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