In RCTs comparing TAVR and SAVR in low-risk patients, early mortality and stroke were lower in TAVR, but did not differ at 1 year. There was no difference in mortality and stroke in intermediate-risk patients. The Multidisciplinary Heart Team must consider individual patient characteristics and preferences when recommending TAVR or SAVR. The decision must consider the long-term management of each patient’s aortic valve disease.Read More
Although there is a paucity of data regarding cardiac manifestations of malaria, an algorithm for appropriate use of diagnostic tools to assess cardiac involvement has been developed in this paper. Furthermore, it is important to note that typical antimalarial treatment regimens can have fatal cardiac side-effects.Read More
By reading this article you should be able to:
•Discuss why it may be beneficial to avoid allogeneic (donor) transfusion.
•List the benefits that intraoperative cell salvage (ICS) can provide.
•Identify when ICS usage is both appropriate and safe.
•Explain the complications of ICS.
•Describe areas of controversy relating to the use of ICS.
Leveraging computer vision approaches through interdisciplinary collaboration and advanced approaches to data acquisition, modeling, interpretation, and integration promises a powerful impact on patient safety, public health, and financial costs.Read More
CPB time, cross-clamp time and numbers of proximal saphenous graft and distal anastomosis showed a significant positive correlation with the postoperative lactate level. In the regression analysis, CPB time emerged as the only independent predictor of PHL (OR 1.04, CI 95% 1.01-1.07, P=0.011). There was no difference in postoperative blood lactate levels between SCT and DCT groups.Read More
This report introduces how such decision was made based on what supporting evidence and the diagnostic process leading to the initiation of surgical intervention. This report may help with decision-making process when confronted by blunt cardiac injury patients who need cardiac exploration.Read More
This work supports the possibility to detect real-time SNS activation, which could enable interventions to proactively mitigate errors. Additional studies on our large database of surgical cases are underway to confirm this observation.Read More
This review offers education on the correlation of microaggression and unconscious bias to health disparities, provides tools to address microaggressions as a bystander, and outlines processes for institutional improvement.Read More
Argatroban infusion rates and anticoagulation target ranges showed substantial variations. The rational for divergent dosing and monitoring approaches are discussed in this paper. Argatroban appears to be a potential alternative to UFH in patients requiring ECMO. To definitively establish its safety, efficacy and ideal dosing strategy, larger prospective studies on well-defined patient populations are warranted.Read More
We report the case of a 14.7 kg girl undergoing CPB with a pre-admission FXII concentration of <1% and aPTT >200 seconds. The child was transfused with fresh-frozen plasma to replenish FXII, allowing safe ACT monitoring of heparin anticoagulation throughout CPB.Read More
An increasing number of transplant programs use hearts donated after cardiac death. Here we consider the history of donation after cardiac death heart transplantation with the surrounding ethical controversies, outline the different surgical techniques that were developed and conclude with a look into the future.Read More
Previous evidence from similar patient populations proved that carefully selected patients with severe ARDS who did not benefit from conventional treatment might be successfully supported with Veno-Venous extracorporeal membrane oxygenation (V-V ECMO). We now share the case reports of COVID-19 patients with ECMO combined prone position strategies.Read More
The diagnosis and the treatment of this case, given the mid-term gestational age combined with an increased surgical risk due to the reintervention, required a particular effort by our team. A multidisciplinary approach to the management of this patient was the key to achieve a favorable outcome both for the mother and for the baby.Read More
Patients without clinical bleeding still required transfusion, with higher rates observed with VA- than VV-ECMO. Transfusion requirements dramatically increased when patients developed various bleeding complications and had a significant impact on 30-day mortality rate.Read More
Performing ANA significantly decreases the incidence of PD and ePOCD compared with “conventional” OPCAB with vein grafts, whereas CO2FF is inconsequential in this regard. These results, which probably reflect decreased delivery of embolic load to the brain in ANA, may have practical applicability in daily practice to improve clinical outcomes.Read More
The updated STAT metrics reflect contemporary practice and outcomes. New empirically based STAT 2020 Scores and Category designations are assigned to a larger set of procedure codes, while accounting for risk associated with multiple component operations. Updating STAT metrics based on contemporary outcomes facilitates accurate assessment of case mix.Read More
The prevalence of sexist and racial/ethnic microaggressions against female and racial/ethnic–minority surgeons and anesthesiologists was high and associated with physician burnout. This study provides a valuable response to the increasing call for evidence-based data on surgical workplace mistreatment.Read More
MiECC preserves clot quality throughout surgery acting in both key determinants of clot strength; fibrinogen and platelets. This is clinically translated into minimal postoperative bleeding and restricted use of blood products and coagulation factors.Read More
To conclude, the practice of temperature management is changing with the awareness of new research. Lower target temperatures are recommended for rewarming, ensuring a lower temperature gradient and a longer mean rewarming time.Read More
Roller pumps with silicone tubing but not PVC tubing may be used for running ECMO circuits. Silicone tubing may endure the roller pump shear forces for up to 1 week. Thus, repeated tubing repositioning may be a solution. Circuit heating and substantial limitations in flow detection should increase attention if clinical use in situations of crisis is considered.Read More