Predictors of prolonged hospitalization in modified sternoplasty following postoperative mediastinitis.

Background And Aim: Deep sternal wound infection (DSWI) is a serious complication following cardiac surgery, and demands early intervention as any delay in diagnosis and management may lead to increased morbidity and mortality. DSWI is associated with increased length of hospitalization (LOH) and economic burden in this patient population. The aim of this study was to determine predictors for increased length of hospitalization in patients who underwent the Modified Sternoplasty technique for deep sternal wound infection following cardiac surgery.

Acute Kidney Injury Following Transcatheter Aortic Valve Implantation: Association with Contrast Media Dosage and Contrast Media Based Risk Predication Models.

The effect of contrast media (CM), delivered prior to- and during transcatheter aortic valve implantation (TAVI), on kidney function, following the procedure, is debatable. Consequently, the performance of CM-based, acute kidney injury (AKI) risk prediction models is also questionable. We retrospectively studied 210 patients that underwent TAVI.

High Mitral Annulus Calcium Score in Pre-Operative Chest Computerized Tomography and Adverse Outcomes in Mitral Valve Surgery.

Background: Severe mitral annulus calcification (MAC) is believed to bear high operative and post-operative risk during mitral valve replacement (MVR) surgery, including longer surgery time, post-surgical valvular leaks and increased rate of embolic phenomena. We hypothesized that quantification of mitral calcium in pre-operative chest computerized tomography (CCT), performed to assess aortic root before cross-clamping may help in risk assessment of adverse intraoperative and postoperative outcomes in patients undergoing MVR.

Methods: We included patients who underwent MVR between the years 2015 and 2018 at Poriya medical center.

Immediate Post-Procedural and Discharge Assessment of Mitral Valve Function Following Transcatheter Edge-to-Edge Mitral Valve Repair: Correlation and Association with Outcomes.

The correlation between residual mitral regurgitation (rMR) grade or mitral valve pressure gradient (MVPG), at transcatheter edge-to-edge mitral valve repair (TEEMr) completion and at discharge, is unknown. Furthermore, there is disagreement regarding rMR grade or MVPG from which prognosis diverts. We retrospectively studied 82 patients that underwent TEEMr.

Predictors of Mitral Regurgitation Severity Improvement in Patients With Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation.

Background: Mitral regurgitation (MR) is frequently associated with severe aortic stenosis (AS). Significant MR is associated with less favorable prognosis after transcatheter aortic valve implantation (TAVI), including higher early and late mortality rate. The severity of MR is improved in about half of patients undergoing TAVI.

Clinical and echocardiographic characteristics of patients with preserved versus mid-range ejection fraction.

A wide range of ejection fraction (EF) thresholds have been used to categorize patients with heart failure (HF) with "preserved" EF. Our goal was to characterize the clinical and echocardiographic differences among patients with cardiac structural/functional alterations and mid-range EF (mrEF) (EF 40-49%) compared to preserved EF (pEF) (EF ≥ 50%), irrespective of HF. Patients with an EF ≥ 40% and echocardiographic evidence of structural alterations (left atrial enlargement and/or left ventricular hypertrophy) and/or functional alterations (evidence of diastolic dysfunction) were retrospectively selected.

The association between carotid calcium on dental panoramic radiographs and coronary calcium score on chest computerized tomography.

Objectives: Coronary artery calcium measured by CT predicts future coronary events. Similarly, carotid artery calcium on dental panoramic radiographs has been associated with increased cardiovascular events. Pre-procedural assessment of candidates for valve replacement in our institution includes panoramic radiographs and chest tomography.

Veno-arterial extracorporeal membrane oxygenation for electrical injury induced cardiogenic shock support: a case report.

Background: High voltage electrical injury (HVEI) of more than 1000 V is a potentially devastating form of a multisystem injury associated with high morbidity and mortality. We present the first case of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a life saving device for treating a patient with severe cardiogenic shock after a high voltage electrical injury.

Case Presentation: A 26-year-old male sustained HVEI while working with a concrete mixer pump that came in contact with a high voltage cable of 10,000 V.

Safety and In-Hospital Outcomes of Transvenous Lead Extraction for Cardiac Implantable Device-Related Infections: Analysis of 13 Years of Inpatient Data in the United States.

Objectives: The aim of this study was to investigate the safety and in-hospital outcomes of transcutaneous lead extraction (TLE) associated with device-related infection (DRI) in the United States from 2003 to 2015.

Background: DRI remains the most serious complication and the most common indication for lead extraction in patients with cardiac implantable electronic devices. The rates of DRI and associated lead extraction have been growing in line with the increasing number of cardiac implantable electronic device implantations worldwide.

Dental screening prior to valve interventions: Should we prepare transcatheter aortic valve replacement candidates for "surgery"?

Background: 40% of cases of infective endocarditis (IE) are likely caused by oral bacteria. IE prevalence after transcatheter aortic valve replacement (TAVR) is comparable to IE following surgical prosthetic valve replacement (SVR). Current guidelines recommend pre-operative dental screening for SVR, without specific recommendations regarding TAVR.

The impact of left ventricular ejection fraction on heart failure patients with pulmonary hypertension.

Background: The most common cause of pulmonary hypertension (PH) in developed countries is left heart disease (LHD, group 2 PH). The development of PH in heart failure (HF) patients is indicative of worse outcomes.

Objective: The aim of this study was to evaluate the long term outcomes of HF patients with PH in a national long-term registry.

Multilayer Myocardial Mechanics in Genotype-Positive Left Ventricular Hypertrophy-Negative Patients With Hypertrophic Cardiomyopathy.

It is unknown whether the presence of a sarcomeric mutation alone is sufficient to result in abnormal myocardial force generation, or whether additional changes in myocardial architecture (hypertrophy, disarray, and fibrosis) are required to impair systolic function. Speckle tracking echocardiography allows quantification of global strain/strain rates, twist, and dyssynchrony. In the present study we sought to further elucidate early abnormalities of myocardial mechanics in sarcomeric mutation carriers without evidence of clinical disease.

The risk for a first acute coronary syndrome in patients treated with different types of antidepressants: A population based nested case-control study.

Background: Tricyclic antidepressants (TCAs) are still used in 30% of anxiety/depression cases and have been related to increased cardiovascular risk. Newer serotonin/norepinephrine reuptake inhibitors (SSRI/SNRI) safety remains conflicting. Our aim was to assess the risk of a first acute coronary syndrome (ACS) in patients treated by various types of antidepressants.

Natriuretic peptides system in the pulmonary tissue of rats with heart failure: potential involvement in lung edema and inflammation.

Congestive heart failure (CHF) often leads to progressive cardiac hypertrophy and salt/water retention as evident by peripheral and lung edema. Although the pathogenesis of CHF remains largely unclarified, it is widely accepted that neurohormonal changes and inflammatory processes are profoundly involved in structural and functional deterioration of vital organs including, heart, kidney and lungs. Corin, a cardiac serine protease, is responsible for converting pro-ANP and pro-BNP to biologically active natriuretic peptides (NPs).

Clinical and echocardiographic characteristics of patients in sinus rhythm, normal left ventricular function, and indeterminate diastolic function.

Background: Diastolic dysfunction (DDFx) is the major underlying mechanism of heart failure with preserved left ventricular ejection fraction (EF). Yet, the echocardiographic diagnosis of DDFx in patients in sinus rhythm is challenging and up to 25% of studies have discrepant measures making assessment of DDFx indeterminate. We aimed to describe the clinical and echocardiographic characteristics of patients with indeterminate diastolic function compared to patients with definite normal and abnormal diastolic function.

Left atrial and ventricular systolic and diastolic myocardial mechanics in patients with end-stage renal disease.

Background: Diastolic cardiac dysfunction is an important complication of end-stage renal disease (ESRD), but quantification remains a challenge. Given that diastolic dysfunction is reflected in both left atrial (LA) and ventricular (LV) function, we aimed to identify abnormalities in LV and LA volume and function using measures of myocardial mechanics.

Methods: We retrospectively studied 53 incident ESRD patients (46±16 y/o 44% male) and compared them to 85 normal controls.

Comparison of echocardiographic parameters between pre-clinical and clinical advanced diastolic dysfunction patients.

Background: The diagnosis of heart failure (HF) with preserved ejection fraction requires evidence of grade 2 or 3 (advanced) diastolic dysfunction (ADD), but many patients with ADD do not have clinical HF manifestations, hence termed pre-clinical diastolic dysfunction (PDD). The prevalence and characteristics of PDD in comparison to overt HF disease (clinical-ADD) are still debated.

Methods: We retrospectively analyzed 373 patients with LVEF≥45% and ADD in our echo-lab database.

Takotsubo cardiomyopathy caused by epinephrine-treated bee sting anaphylaxis: a case report.

Introduction: Stress-induced cardiomyopathy (Takotsubo) after bee stings in patients who have received catecholamines is rare. Endogenous as well as exogenous administration of catecholamines is thought to trigger stress-induced cardiomyopathy.

Case Presentation: A 37-year-old healthy white woman was stung by an unknown Hymenoptera that resulted in an anaphylactic reaction.