Orthotopic Heart Transplantation in a Patient With Hypertrophic Cardiomyopathy and Marfan Syndrome.

A 24-year-old man with Marfan syndrome and heart failure from hypertrophic cardiomyopathy was referred to our institution in cardiogenic shock for advanced therapies. He was supported by a femoral intra-aortic balloon pump, then bridged to orthotopic heart transplantation. This is a report of an orthotopic heart transplantation in a patient with both Marfan syndrome and heart failure from hypertrophic cardiomyopathy.

Pulmonary artery mass with PIK3CA mutation after orthotopic heart transplantation.

Background: Patients can develop de novo malignancies following orthotopic heart transplantation. However, vascular tumors are not commonly described in this population.

Case Presentation: We present a 69-year-old female with a history of orthotopic heart transplantation for chemotherapy-induced cardiomyopathy who developed an incidental pulmonary artery mass six years after her transplantation.

Impact of preoperative body mass index on long-term survival, quality of life, and functional outcomes after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: Results from the UK National Cohort.

Background: Previous studies have demonstrated the safety of pulmonary endarterectomy (PEA) across body mass index (BMI) strata. However, long-term survival and patient-reported outcome measures by BMI strata remain unknown. We examined the impact of preoperative BMI on long-term survival, QOL, and functional outcomes for patients undergoing PEA for chronic thromboembolic pulmonary hypertension (CTEPH).

Resection of Primary Mediastinal Liposarcoma Invading Right Ventricular Outflow Tract.

Liposarcomas, the most common soft tissue tumors, occur predominantly in the lower limbs and retroperitoneum. Primary mediastinal liposarcomas are rare and account for <1% of mediastinal masses. We report a case of a large primary mediastinal liposarcoma invading the right ventricular outflow tract, pulmonary artery, and aortic adventitia that was successfully resected.

Surgical Management of Retained Foreign Bodies During Percutaneous Coronary Interventions.

Retained coronary wires, stents, and catheters are rare complications of percutaneous coronary interventions. Descriptions of operative techniques for removal are scarce. We present a series of retained coronary material and various operative management techniques for removal.

Role of renal mass biopsy for diagnosis and management: Review of current trends and future directions.

The frequency of detection of renal masses has increased over recent decades, causing a concurrent increase in early intervention by surgery. Growing recognition that this approach was contributing to overtreatment led to the broader use of preoperative renal mass biopsy (RMB) by core biopsy and/or fine-needle aspiration. Because more options for management, such as active surveillance and personalized therapy, are becoming increasingly available, a diagnosis by RMB is becoming a valuable tool for risk stratification and clinical decision making.

Vancomycin-resistant Enterococcus outbreak in a pre- and post-cardiothoracic transplant population: Impact of discontinuing multidrug-resistant organism surveillance during the coronavirus disease 2019 pandemic.

Introduction: Many institutions suspended surveillance and contact precautions for multidrug-resistant organisms (MDROs) at the outset of the coronavirus disease 2019 (COVID-19) pandemic due to a lack of resources. Once our institution reinstated surveillance in September 2020, a vancomycin-resistant Enterococcus (VRE) faecium outbreak was detected in the cardiothoracic transplant units, a population in which we had not previously detected outbreaks.

Methods: An outbreak investigation was conducted using pulsed-field gel electrophoresis for strain typing and electronic medical record review to determine the clinical characteristics of involved patients.

Fate of moderate aortic regurgitation after cardiac surgery.

Objective: To determine the prevalence of concomitant aortic regurgitation (AR) in cardiac surgery and the outcomes of treatment options.

Methods: Between April 2004 and June 2018, 3289 patients underwent coronary artery bypass, mitral valve, or aortic aneurysm surgery without aortic stenosis. AR was graded none/trivial (score = 0), mild (score = 1+), or moderate (score = 2+).

Outcomes of 3-day discharge after elective cardiac surgery.

Background: Shorter length of stay (LOS) is a welcome consequence of optimized perioperative care. However, accelerated hospital discharge may have unintended consequences. Before implementing an institutional enhanced recovery after surgery protocol, we evaluated the safety of shorter LOS and compared outcomes of patients with shorter LOS (LOS ≤ 3 days) to those with longer LOS (LOS > 3 days).

The relationship of atrial fibrillation and tricuspid annular dilation to late tricuspid regurgitation in patients with degenerative mitral repair.

Objectives: Guidelines do not address preoperative atrial fibrillation when considering adding tricuspid annuloplasty to mitral surgery. Our purpose was to determine the occurrence of late tricuspid regurgitation in patients with less than moderate tricuspid regurgitation undergoing surgery for degenerative mitral regurgitation and the importance of atrial fibrillation and tricuspid annular dilation.

Methods: From 2004 to 2017, 1021 patients underwent surgery for degenerative mitral regurgitation; 869 (85%) had less than moderate tricuspid regurgitation, and 846 (97%) underwent repair.

The impact of intraoperative residual mild regurgitation after repair of degenerative mitral regurgitation.

Objectives: During degenerative mitral repair, surgeons must decide if further repair is warranted for residual mild mitral regurgitation. We examined the incidence of mild mitral regurgitation, late echocardiographic and clinical outcomes, and influence of surgical experience in decision making.

Methods: From April 2004 to June 2018, 1155 of 1195 patients with pure degenerative disease underwent repair (97% repair rate).

De novo atrial fibrillation after mitral valve surgery.

Objectives: We sought to determine the incidence and risk factors for de novo atrial fibrillation (>90 days after surgery) in patients without preoperative atrial fibrillation.

Methods: From 2004 to 2014, 2261 patients underwent mitral valve surgery; 1288 patients (57%) did not have a history of atrial fibrillation, and 930 patients had rhythm information more than 90 days after surgery. De novo atrial fibrillation and death probabilities were estimated using a semi-competing risks, multi-state model.

The Bethesda System for Reporting Cervical Cytology: A Historical Perspective.

The aims of The Bethesda System (TBS) were to provide effective communication from the laboratory to the clinical provider; facilitate cytologic-histologic correlation; facilitate research into the epidemiology, biology, and pathology of cervical disease; and provide reproducible and reliable data for national and international statistical analysis comparisons. Dr. Diane Solomon and colleagues' contribution to cervical cancer screening, diagnosis, and management began with the inception and dissemination of TBS for reporting cervical cytology in 1988, as detailed in the accompanying article [Solomon et al.