Impact of Inflammation After Cardiac Surgery on 30-Day Mortality and Machine Learning Risk Prediction.

Objectives: To investigate the impact of systemic inflammatory response syndrome (SIRS) on 30-day mortality following cardiac surgery and develop a machine learning model to predict SIRS.

Design: Retrospective cohort study.

Setting: Single tertiary care hospital.

Valvular and perivalvular thrombosis following self-expandable aortic valve replacement: analysis of 100 multi-detector computed tomography scans.

Aims: Subclinical thrombosis may represent an early stage of prosthesis structural disease. Most of the available evidence on the incidence, location, predictors, and consequences of thrombosis comes from studies that have employed balloon-expandable valves. We aimed to describe the different localisations of valvular and perivalvular thrombosis and analyse prosthesis-host multi-detector computed tomography predictors in the context of self-expandable prosthesis.

Post-implant transcatheter aortic prosthesis deformation: tricuspid versus bicuspid valve.

Objective: We sought to assess whether post-implant transcatheter aortic valve prosthesis multi detector computed characteristics differ between patients with native tricuspid and bicuspid aortic valve stenosis, as well as the effect on valve performance and clinical implications.

Methods: We analysed 100 consecutive post-implant multi detector computed tomography scans to assess self-expandable prosthesis non-uniform expansion at six pre-specified valvular levels, and other specific parameters, including valvular and perivalvular thrombosis at six months follow-up. Echocardiographic prosthesis performance and clinical outcome was also evaluated.

Mechanical heart valves between myths and new evidence: a systematic review and meta-analysis.

Aims: The use of mechanical valve prostheses in cardiac surgery remains a necessary and indicated intervention in a large number of patients. However, predicted results associated with their use, on which current guideline recommendations have been developed, are based on dated studies at risk of bias (e.g.

A narrative review on the evolution and impact of smart cannulas in minimally invasive procedures.

Background: This study aimed to explore the evolution and impact of smart cannulas in enhancing outcomes and expanding the scope of minimally invasive cardiac surgery.

Methods: In this study, a comprehensive review of the relevant literature was conducted, focusing on articles detailing the development, implementation, and outcomes associated with smart cannulas in cardiac surgery. PubMed, MEDLINE, and Google Scholar databases were searched until January 2024 using specific search terms related to smart cannulas and cardiac surgery.

Selective monitoring of superior and inferior vena cava drainage flows in bicaval cannulation: Potential clinical benefits of proximal junction placement on the CPB side.

In cardiac surgery, precision and efficiency are crucial, especially in managing venous drainage flows during complex procedures. This practical technique evaluates the benefits of placing the proximal junction on the cardiopulmonary bypass (CPB) side rather than on the surgical table in bicaval cannulation. Bicaval cannulation, involving both the superior vena cava (SVC) and inferior vena cava (IVC), ensures efficient venous return.

The State-of-the-Art of Infections and the Causal Link with Health Settings: A Systematic Review.

(1) Background. A definition of healthcare-associated infections is essential also for the attribution of the restorative burden to healthcare facilities in case of harm and for clinical risk management strategies. Regarding infections, there remains several issues on the ecosystem and pathogenesis.

The emerging role of minimally invasive extracorporeal circulation in totally endoscopic and robotic-assisted cardiac surgery procedures.

This review explores the potential benefits of combining totally endoscopic and robotic-assisted cardiac surgery with minimally invasive extracorporeal circulation (MiECC). Robotic techniques herald a new era of surgical precision, leveraging advanced instrumentation and enhanced visualization to navigate cardiac anatomy with unprecedented accuracy. Concurrently, MiECC systems provide tailored physiological support during cardiopulmonary bypass, meticulously managing perfusion parameters to safeguard vital organs' function.

Minimally invasive extracorporeal circulation versus conventional cardiopulmonary bypass in patients undergoing cardiac surgery (MiECS): Rationale and design of a multicentre randomised trial.

Introduction: The ultimate answer to the question whether minimal invasive extracorporeal circulation (MiECC) represents the optimal perfusion technique in contemporary clinical practice remains elusive. The present study is a real-world study that focuses on specific perfusion-related clinical outcomes after cardiac surgery that could potentially be favourably affected by MiECC and thereby influence the future clinical practice.

Methods: The MiECS study is an international, multi-centre, two-arm randomized controlled trial.

Advancements in Donation after Circulatory Death Heart Procurement and Preservation: A Comprehensive Review of Recent Innovations.

Introduction: The persistent shortage of donor hearts for transplantation has prompted exploration into Donation after Circulatory Death (DCD) as a promising avenue for organ procurement. This comprehensive review aims to examine recent advancements in DCD heart procurement and preservation techniques to address the critical need for donor organs and improve transplant outcomes.

Materials And Methods: A systematic review was conducted to identify relevant studies and innovations related to DCD heart procurement and preservation.

Health Technology Assessment of Cardiopulmonary Bypass Circuit with and without Phosphorylcholine Coating: A Retrospective Study on Safety and Efficiency in Cardiac Surgery.

Background: Phosphorylcholine has emerged as a potential adjunctive agent in cardiopulmonary bypass (CPB) circuits. Phosphorylcholine serves as a coating for the CPB circuit, potentially enhancing biocompatibility and reducing thrombotic events. However, its impact on specific patient populations and procedural outcomes remains underexplored.

Evolocumab Treatment in Dyslipidemic Patients Undergoing Coronary Artery Bypass Grafting: One-Year Safety and Efficacy Results.

The inhibition of PCSK9 lowered LDL cholesterol levels, reducing the risk of cardiovascular events. However, the effect on patients who have undergone surgical myocardial revascularization has not yet been evaluated. From January 2017 to December 2022, 180 dyslipidemic patients who underwent coronary artery bypass were included in the study.

Hemadsorption to Contain Postoperative Cell-Free Hemoglobin and Haptoglobin Preservation for Extended Cardiopulmonary Bypass Time in Cardiac Surgery for Acute Kidney Injuries Prevention.

Introduction: Prevention of acute kidney injury during cardiopulmonary bypass (CPB) is still a challenge and has been the object of numerous studies. The incidence of acute kidney injury in the context of CPB is related to a multifactorial etiology. The role of hemadsorption in relation to cell-free hemoglobin and haptoglobin preservation is not well defined in the literature on CPB during cardiac surgery procedures.

Single suture-mediated closure system after transfemoral transcatheter aortic valve implantation: A single-center real-world experience.

Background: Despite the use of two crossed Perclose ProGlide™ (Abbott Vascular Devices) is the most widespread technique to close the main arterial access in transfemoral transcatheter aortic valve implantation (TF-TAVI), the safest and most effective strategy still remains much debated.

Aims: The aim of the present study was to evaluate the performance of a single Perclose ProGlide suture-mediated closure device to obtain femoral hemostasis after sheathless implantation of self-expanding transcatheter heart valves through their 14 F-equivalent fix delivery systems.

Methods: This prospective observational study included 439 patients undergoing TF-TAVI at the "Montevergine" Clinic of Mercogliano, Italy.

Develop of endocavitary suction device for MiECC on minimally invasive mitral valve surgery.

The minimally invasive extracorporeal circulation (MiECC) system was developed to minimize the contact of blood with air and foreign surfaces during conventional cardiopulmonary bypass (CPB). It is also aimed to reduce the inflammatory response by further increasing the biocompatibility of the components that make up the MiECC circuits. The Minithoracotomy (MTH) approach for mitral valve disease remains associated with prolonged operative times, but it is beneficial in terms of reduced postoperative complications (renal failure, atrial fibrillation, blood transfusion, wound infection), length of stay in intensive care unit (ICU) and in hospitalization, with finally a reduction in global cost.