Long-Term Outcomes of Veteran Patients After Transcatheter Aortic Valve Replacement.

Background: Transcatheter aortic valve replacement (TAVR) has become a mainstay treatment for severe aortic stenosis and is increasingly used for veterans, producing excellent short-term outcomes. There is a paucity of long-term outcome data after TAVR in the veteran population.

Methods: We examined consecutive patients who underwent TAVR at a single Veterans Affairs medical center through 2019.

C-reactive protein and procalcitonin after congenital heart surgery utilizing cardiopulmonary bypass: When should we be worried?

Introduction: To assess the efficacy of C-reactive protein (CRP) and procalcitonin (PCT) at identifying infection in children after congenital heart surgery (CHS) with cardiopulmonary bypass (CPB).

Materials And Methods: Systematic review of the literature was conducted to identify studies with data regarding CRP and/or PCT after CHS with CPB. The primary variables identified to be characterized were CRP and PCT at different timepoints.

The Military Injuries: Understanding Post-Traumatic Epilepsy Study: Understanding Relationships among Lifetime Traumatic Brain Injury History, Epilepsy, and Quality of Life.

Understanding risk for epilepsy among persons who sustain a mild (mTBI) traumatic brain injury (TBI) is crucial for effective intervention and prevention. However, mTBI is frequently undocumented or poorly documented in health records. Further, health records are non-continuous, such as when persons move through health systems (e.

Resident and circulating memory T cells persist for years in melanoma patients with durable responses to immunotherapy.

While T-cell responses to cancer immunotherapy have been avidly studied, long-lived memory has been poorly characterized. In a cohort of metastatic melanoma survivors with exceptional responses to immunotherapy, we probed memory CD8 T-cell responses across tissues, and across several years. Single-cell RNA sequencing revealed three subsets of resident memory T (T) cells shared between tumors and distant vitiligo-affected skin.

Outcomes of Rescue Endovascular Treatment of Emergent Large Vessel Occlusion in Patients With Underlying Intracranial Atherosclerosis: Insights From STAR.

Background Some emergent large vessel occlusions (ELVOs) are refractory to reperfusion because of underlying intracranial atherosclerosis (ICAS), often requiring rescue therapy (RT) with balloon angioplasty, stenting, or both. In this study, we investigate the safety, efficacy, and long-term outcomes of RT in the setting of mechanical thrombectomy for ICAS-related ELVO. Methods and Results We queried the databases of 10 thrombectomy-capable centers in North America and Europe included in STAR (Stroke Thrombectomy and Aneurysm Registry).

Coronary artery bypass grafting after acute ST-elevation myocardial infarction.

Objectives: The study objectives were to describe the trends and outcomes of isolated coronary artery bypass grafting after ST-elevation myocardial infarction using a nationwide database.

Methods: We queried the 2002-2016 National Inpatient Sample database for hospitalized patients with ST-elevation myocardial infarction who underwent isolated coronary artery bypass grafting. We report temporal trends, predictors, and outcomes of coronary artery bypass grafting in the early (2002-2010) and recent (2011-2016) cohorts.

Outcomes of Acute Myocardial Infarction in Patients with Familial Hypercholesteremia.

Background: There is a paucity of contemporary data regarding the outcomes of acute myocardial infarction among patients with familial hypercholesteremia.

Methods: We queried the Nationwide Readmissions Database (2016-2018) for hospitalizations with acute myocardial infarction. Multivariable regression analysis was used to compare in-hospital outcomes and 30-day readmissions among patients with and without familial hypercholesteremia.

Long-Term Outcomes Comparing Medical Therapy versus Revascularization for Spontaneous Coronary Artery Dissection.

The ideal management of spontaneous coronary artery dissection (SCAD) has yet to be clearly defined. We conducted a comprehensive search of Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, Scopus, and Web of Science from database inception from 1966 through September 2020 for all original studies (randomized controlled trials and observational studies) that evaluated patients with SCAD. Study groups were defined by allocation to medical therapy (medical therapy) versus invasive therapy (invasive therapy) (ie, percutaneous coronary intervention or coronary artery bypass grafting).

Management of degenerative spondylolisthesis: development of appropriate use criteria.

Background Context: Outcomes of treatment in care of patients with spinal disorders are directly related to patient selection and treatment indications. However, for many disorders, there is absence of consensus for precise indications. With the increasing emphasis on quality and value in spine care, it is essential that treatment recommendations and decisions are optimized.

Trends and Outcomes of Elective Thoracic Aortic Repair and Acute Thoracic Aortic Syndromes in the United States.

Background: There is a paucity of data on the contemporary outcomes and trends of elective thoracic aortic aneurysm repair and aneurysm-associated acute aortic syndrome.

Methods: We queried the National Inpatient Sample (NIS) database years 2012-2016 to identify hospitalizations for elective thoracic aortic aneurysm repair and aneurysm-associated acute aortic syndrome. The main study outcome was in-hospital mortality.

Unilateral Corporal Cavernosum Partial Thrombosis: A Challenging Presentation and Management.

A 29-year-old African American male presented to our emergency department with a 5-day history of perineal pain and tender swelling of the left perineal body with no evidence of trauma. Physical examination revealed a firm left proximal corpus cavernosum body. Laboratory tests were within normal limits.

Self-employment and cardiovascular risk in the US general population.

Background: Studies on self-employment and cardiovascular risk are very limited. We examined the relationship between self-employment and cardiovascular risk among the general population in the United States from 1999 to 2016.

Methods: Using the National Health and Nutrition Examination Survey (NHANES), we identified all patients with hypertension (HTN), hyperlipidemia (HLD), diabetes mellitus (DM), stroke, heart failure (HF), and coronary artery disease (CAD) between 1999 and 2016.

Disparities in Cardiovascular Disease Outcomes Among Pregnant and Post-Partum Women.

Background The incidence of cardiovascular disease among pregnant women is rising in the United States. Data on racial disparities for the major cardiovascular events during pregnancy are limited. Methods and Results Pregnant and post-partum women hospitalized from January 2007 to December 2017 were identified from the Nationwide Inpatient Sample.

Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Prior Mediastinal Radiation.

Objectives: This study sought to evaluate the trends and outcomes of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) among patients with prior mediastinal radiation from a national database.

Background: There is a paucity of data about the temporal trends and outcomes of TAVR versus SAVR in patients with prior mediastinal radiation.

Methods: The National Inpatient Sample database years 2012 to 2017 was queried for hospitalizations of patients with prior mediastinal radiation who underwent isolated AVR.

Factors associated with deep venous thrombosis in patients infected with coronavirus disease 2019: a meta-analysis.

Coronavirus disease 2019 (COVID-19) has affected more than 6 million patients worldwide. Deep venous thrombosis (DVT) has been increasingly recognized complication in these patients and is associated with increased morbidity and mortality. However, the factors associated with development of DVT in patients with COVID-19 have not been elucidated due to the novelty of the virus.

Primary Prevention Trial Designs Using Coronary Imaging: A National Heart, Lung, and Blood Institute Workshop.

Coronary artery calcium (CAC) is considered a useful test for enhancing risk assessment in the primary prevention setting. Clinical trials are under consideration. The National Heart, Lung, and Blood Institute convened a multidisciplinary working group on August 26 to 27, 2019, in Bethesda, Maryland, to review available evidence and consider the appropriateness of conducting further research on coronary artery calcium (CAC) testing, or other coronary imaging studies, as a way of informing decisions for primary preventive treatments for cardiovascular disease.

Updates in Spontaneous Coronary Artery Dissection.

Purpose Of Review: To review the epidemiology, pathogenesis, diagnosis using emerging imaging modalities, management strategy, and prevention of recurrent spontaneous coronary artery dissection (SCAD) and provide a more extensive review of the current data.

Recent Findings: SCAD generally affects women without conventional cardiovascular risk factors. Diagnosis and management of SCAD are challenging due to heterogeneity, undefined mechanisms, differing phenotypes, and a lack of strong clinical evidence.

Outcomes of Reoperative Coronary Artery Bypass Graft Surgery in the United States.

Background There is a paucity of data on the trends and outcomes of reoperative coronary artery bypass graft (CABG) surgery during the current decade in the United States. Methods and Results We queried the National Inpatient Sample database (2002-2016) for all hospitalizations with isolated CABG procedure. We reported the temporal trends and outcomes of reoperative CABG versus primary CABG procedures.

Effects of inhaled nitric oxide on haemodynamics and gas exchange in children after having undergone cardiac surgery utilising cardiopulmonary bypass.

Introduction: For CHD patients undergoing corrective surgery utilising cardiopulmonary bypass, post-operative inhaled nitric oxide has been administered to alleviate pulmonary hypertension. We performed a systematic review and meta-analyses to determine the effect of inhaled nitric oxide on haemodynamics, gas exchange, and hospitalisation characteristics in children immediately after cardiopulmonary bypass.

Materials And Methods: A systematic review of the literature was performed to identify full-text manuscripts in English.

Temporal Trends and Outcomes of Transcatheter Mitral Valve Repair and Surgical Mitral Valve Intervention.

Background: There is a paucity of data regarding the contemporary changes in the uptake and outcomes of transcatheter mitral valve repair (TMVR) and surgical mitral valve repair/replacement (SMVR).

Methods: We queried the NIS database (2012-2016) to identify hospitalizations for TMVR and SMVR. We reported the temporal trends for uptake of TMVR and SMVR and their in-hospital outcomes.

Racial Disparities in the Utilization and Outcomes of Transcatheter Mitral Valve Repair: Insights From a National Database.

Background: There is paucity of data on racial disparities in the utilization and outcomes of transcatheter mitral valve repair (TMVR).

Methods: We queried the National inpatient Sample database (2012-2016) for TMVR hospitalizations among Caucasian and African American patients. We conducted a propensity score matching analysis to compare outcomes of Caucasians versus African Americans.