Revisiting Equity in Healthcare Spending: Variation in Reimbursement for Aortic Procedures from the Perspective of Medicare Payments.

Objective: Medicare insures over 65 million Americans and is a primary driver of private insurance reimbursement rates. However, public data shows Medicare reimbursement for comparatively complex procedures such as aortic aneurysm repair is disproportionate. Medicare reimbursement rates are multifactorial and highly localized, yet little is known about nationwide trends.

Association Between Cardiothoracic Fellows and Clinical and Financial Outcomes in Coronary Surgery.

Introduction: Mounting financial pressures on academic institutions highlight the need to understand the effect on outcomes from trainee involvement in cardiac surgery. The purpose of this study is to examine the association between cardiothoracic fellows and clinical and financial outcomes in coronary artery bypass grafting (CABG).

Methods: Data for all patients from 2017 to 2022 at a single institution who underwent nonemergent, isolated, open CABG were included in the study, with patients grouped by whether there was fellow operative participation.

Perioperative extra corporeal membrane oxygenation in neonates with transposition of the great arteries: 15 years of experience.

Background: Extracorporeal membrane oxygenation (ECMO) can act as a bridge to recovery in both pre-and postoperative patients with transposition of the great arteries (TGA). However, literature on its use in these patients is scarce.

Methods: Retrospective single-centre cohort study encompassing all TGA patients who received ECMO between January 2009 and March 2024.

Ascending aortic replacement versus aortic root replacement in patients with type A aortic dissection involving the aortic root.

Background: Extensive surgical resection of the thoracic aorta in patients with type A aortic dissection (TAAD) is thought to reduce the risk of late aortic wall degeneration and the need for repeat aortic operations.

Objectives: We evaluated the early and late outcomes after aortic root replacement and supracoronary ascending aortic replacement in patients with TAAD involving the aortic root.

Design: Retrospective, multicenter cohort study.

Preoperative Hematocrit Is Not Associated With Stroke After Surgery for Acute Type A Aortic Dissection.

Objective: To determine the impact of hematocrit on adverse neurologic events after acute type A aortic dissection (ATAAD) repair under deep hypothermic circulatory arrest.

Design: Retrospective study of consecutive aortic surgeries from 2010 to 2021.

Setting: Single institution.

Low socioeconomic status adversely affects outcomes after coronary artery bypass grafting.

Objectives: Although socioeconomic status (SES) is believed to affect patient outcomes after coronary artery bypass grafting (CABG), readmission data are sparse. In a national cohort, we analyzed the influence of SES on readmission, resource utilization, and mortality after CABG.

Methods: We queried the Nationwide Readmissions Database to identify patients who underwent isolated CABG from January 2016 through December 2018.

Glucagon-Like Peptide-1 Receptor Agonists in Patients With Durable Left Ventricular Assist Devices.

Background: GLP-1 RAs improve cardiometabolic outcomes in obese, diabetic, and heart failure patients. Data on the safety and efficacy of GLP-1 RA in advanced heart failure with durable LVAD is limited.

Objectives: To assess the safety and efficacy of GLP-1 RA in durable LVAD patients.

Non-Canonical TERT Activity Initiates Osteogenesis in Calcific Aortic Valve Disease.

Background: Calcific aortic valve disease is the pathological remodeling of valve leaflets. The initial steps in valve leaflet osteogenic reprogramming are not fully understood. As TERT (telomerase reverse transcriptase) overexpression primes mesenchymal stem cells to differentiate into osteoblasts, we investigated whether TERT contributes to the osteogenic reprogramming of valve interstitial cells.

Case Report: pericardial and sternal wound infection following orthotopic heart transplantation.

, a genus of soil and vegetation-based fungi, is a rare cause of infections in immunocompromised individuals, including transplant recipients. In this case, we describe successful treatment of mediastinitis in the recipient of an orthotopic heart transplant. Treatment included multiple courses of combination antibiotic and antifungal therapy several surgical debridements, continuous mediastinal irrigation with antifungal agents, and staged closure with an omental flap.

Direct-acting oral anticoagulant removal by intraoperative hemoadsorption in CABG and/or single valve surgery: interim analysis of the International Safe and Timely Antithrombotic Removal (STAR) registry.

Objective: Patients on direct-acting oral anticoagulants (DOACs) are at high risk of perioperative bleeding complications. Intraoperative hemoadsorption is a novel strategy to reduce perioperative bleeding in patients on DOACs undergoing non-deferable cardiac surgery. The international STAR-registry reports real-world clinical outcomes associated with this application.

Transitioning from the safety of the womb to the outside world for neonates with life-threatening cardiovascular conditions: The IMmediate Postpartum Access to Cardiac Therapy (IMPACT) Procedure.

The IMmediate Postpartum Access to Cardiac Therapy (IMPACT) procedure is a multidisciplinary, collaborative, highly coordinated clinical service in which a planned delivery and intensive neonatal care are offered for conditions where there is a high likelihood of postnatal instability. This process includes prenatal consultation with the parent(s), involving each service engaged with the delivery, postnatal resuscitation, and procedural care. A Cesarean section delivery is planned in an operating room with immediate access to a multifunctional procedural suite where the neonate can undergo rapid cardiac evaluation and initiation of interventional treatments which can have a positive, life-saving impact.

Serious mental illness prolongs hospital admission following lung cancer resection.

Background: Serious mental illness (SMI) is associated with increased complications and worse outcomes in a variety of surgical diseases, however, SMI as a risk factor in thoracic surgery patients is incompletely understood. We aimed to investigate if comorbid SMI would impact mortality and morbidity following lung cancer resection.

Methods: We identified 615 patients from the Society of Thoracic Surgery (STS) database at the University of North Carolina - Chapel Hill (January 2013-June 2021) who underwent lung cancer resection for non-small cell lung cancer (NSCLC).

Prognostic value of ground-glass opacity on computed tomography for patients with pathological stage IA3 lung adenocarcinoma: a multicenter retrospective cohort study.

Background: Ground-glass opacity (GGO) on computed tomography (CT) has been suggested as a potential prognostic factor in lung adenocarcinoma (LUAD), but its significance in patients with pathological stage IA3 LUAD, particularly in relation to micropapillary (MIP) status, remains unclear. This study addresses the clinical need to stratify patients based on GGO and MIP status to optimize prognosis prediction and follow-up strategies.

Methods: A multicenter retrospective study was conducted on 411 patients with pathological stage IA3 LUAD, enrolled between July 2012 and July 2020.

Laparoscopic repair of Bochdalek hernia with intrathoracic kidney and concomitant redo-redo incisional hernia.

Bochdalek hernias (BHs), though rare, are the most common congenital diaphragmatic hernias. Their coexistence with an ectopic intrathoracic kidney (IK), found in 0.25% of cases, is even rarer.

The 2024 American Association for Thoracic Surgery expert consensus document: Current standards in donor lung procurement and preservation.

Background: Donor lung procurement and preservation is critical for lung transplantation success. Unfortunately, the large variability in techniques impacts organ utilization rates and transplantation outcomes. Compounding this variation, recent developments in cold static preservation and new technological advances with machine perfusion have increased the complexity of the procedure.

Incidence of hospital-acquired infections due to carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa in critically ill patients in Italy: a multicentre prospective cohort study.

Background: Carbapenem-Resistant Gram-Negative Bacteria, including Carbapenem-Resistant Enterobacterales (CRE) and Carbapenem-Resistant Pseudomonas aeruginosa (CRPA), are common causes of infections in intensive care units (ICUs) in Italy.

Objective: This prospective observational study evaluated the epidemiology, management, microbiological characterization, and outcomes of hospital-acquired CRE or CRPA infections treated in selected ICUs in Italy.

Methods: The study included patients with hospital-acquired infections due to CRE and CRPA treated in 20 ICUs from June 2021 to February 2023.

Rationale and Design of the HERZCHECK trial: Detection of Early Heart Failure Using Telemedicine and CMR in Structurally Weak Regions (NCT05122793).

Background And Aims: Heart failure (HF) is an imminent global health problem. Yet established screening algorithms for asymptomatic pre-HF, allowing for early and effective preventive interventions, are largely lacking. The HERZCHECK trial, conducted in structurally underserved rural regions of North-Eastern Germany, aims to close this gap by evaluating the feasibility, diagnostic efficacy, and cost-effectiveness of a fully mobile, telemedically-supervised screening approach, combining cardiac magnetic resonance imaging (CMR) and laboratory testing as central elements.

From Zone -1 to Zone 3: Feasibility and Safety of Complex Endovascular Aortic Repairs in Type A Aortic Dissection.

Objective: Over 30% of patients presenting with acute type A aortic dissection (ATAAD) are considered high - risk or inoperable. This study aims to investigate the early and mid-term outcomes of complex endovascular aortic repair of aortic root, ascending aorta, and aortic arch among patients with ATAAD.

Methods: From January 2018 to January 2023, 29 patients who were considered high risk for open operation underwent endovascular aortic repair.

Disparities in 180-day Infection Rates Following Coronary Artery Bypass Grafting and Aortic Valve Replacement.

Objective: To compare sex and racial differences in 180-day infection rates after coronary artery bypass grafting (CABG) and aortic valve replacement (AVR).

Methods: A Statewide Society of Thoracic Surgeons Adult Cardiac Surgery Database was linked to Medicare claims data to identify 8,887 beneficiaries undergoing CABG and AVR (surgical or transcatheter) between 2017 and 2021. The primary outcome was the incidence of 180-day infection.