Cardiac Surgery – Pubmed

CONCLUSIONS: At 10 years, TAVR with the SAPIEN 3 valve and surgery resulted in similar rates of mortality and aortic valve reintervention, and similar hemodynamics in intermediate-risk patients with symptomatic severe aortic stenosis. This analysis highlights challenges associated with extended long-term follow-up of clinical trials, including differential loss to follow-up and the competing risk of mortality in elderly populations. (PARTNER 2A Trial; NCT01314313; PARTNER 2 SAPIEN 3...

CONCLUSIONS: At the 10-year follow-up, TAVR in intermediate-risk patients with the SAPIEN XT prosthesis compared with surgery was associated with lower survival rates, with differences predominantly observed in the TA/TAo access cohort. TAVR with the XT valve was also associated with significantly higher rates of aortic valve reintervention. (PARTNER II Trial: Placement of AoRTic TraNscathetER Valves II - XT Intermediate and High Risk [PII A]; NCT01314313).

CONCLUSIONS: This 13-year nationwide overview highlights the growing uptake of TAVR in France, likely driven by clinical practice and procedural innovation rather than guidelines. Further analyses will compare efficacy and safety between TAVR and SAVR.

CONCLUSIONS: Findings from the PRIME-MR registry highlight substantial reductions in residual MR severity and complication rates over time in PMR patients undergoing M-TEER.

CONCLUSION: In this observational cohort, adjusted three-year mortality was not significantly different between PCI and CABG, with non-cardiac causes accounting for the largest proportion of deaths. Due to potential confounding by indication, these findings represent observational associations rather than clinical equivalence. Both remain vital revascularization strategies, with selection guided by individualized heart-team assessment.

CONCLUSIONS: After aortic valve surgery for IE, net survival was higher among female patients after accounting for baseline differences, and loss of life expectancy was considerable for both female and male patients, particularly in younger patients. Focus on early diagnosis, as well as optimized pre- and postoperative care, is essential in patients with IE.

CONCLUSIONS: Despite increasing post-Norwood ECMO use, survival outcomes remain poor. Identified risk factors may inform prospective risk stratification strategies, early identification of high-risk patients, and evidence-based decision-making regarding ECMO initiation, continuation, or withdrawal in this vulnerable population. Significant heterogeneity across studies precluded meta-analysis, highlighting the need for standardized reporting in future research.

CONCLUSION: INSPIRIS RESILIA aortic valve shows favorable 1-year safety profiles and stable hemodynamics in Chinese patients.

This prospective study compared the Marsh and Schnider pharmacokinetic models for propofol target-controlled infusion (TCI) during anesthetic induction in obese patients undergoing elective cardiac surgery. A total of 118 patients were randomly assigned to either the Marsh or Schnider group (n = 59 each). The primary outcome was the performance error (ΔC = measured minus predicted plasma concentration) during and after TCI. Secondary outcomes included hemodynamic pharmacokinetic-pharmacodynamic...

CONCLUSIONS: LAMT-PVR is a feasible and safe alternative to redo sternotomy for selected post-TOF patients. This approach provides direct access to the pulmonary artery with reduced surgical trauma and favorable early outcomes.

Background: The C-reactive protein-to-albumin ratio (CAR) has emerged as a composite biomarker reflecting both systemic inflammation and nutritional status. This study investigated the prognostic value of preoperative and postoperative CAR in predicting early mortality following coronary artery bypass grafting (CABG). Methods: This retrospective study included 273 patients who underwent isolated CABG. Patients were categorized as mortality (+) (Ex group, n = 41) and mortality (-) (Non-Ex group,...

CONCLUSIONS: This report expands the scope of bloodless medicine, offering a model for managing complex multi-organ transplants in patients with religious restrictions to blood products, with the patient continuing to exhibit excellent recovery approximately ten months post-transplant.

CONCLUSION: Our findings demonstrated comparable short-term outcomes between patients receiving simultaneous cardio-cerebrovascular revascularization and those undergoing isolated CABG. This simultaneous intervention represents a clinically meaningful advancement in managing systemic vasculopathy.

In 2024, the total number of heart transplants in the United States reached a record of 4,636, an 81.5% increase since 2013. Of these, 4,146 occurred in adults while 490 occurred in pediatric recipients (93.5% and 19.2% increases, respectively, since 2013). This growth has been insufficient to meet the demand, as the number of adult patients awaiting transplant has always far exceeded the number of transplants performed. This is compounded by increasing numbers of new listings, although new...

CONCLUSIONS: Public insurance and insurance instability are associated with worse heart transplantation outcomes, while gaining private insurance was associated with improved outcomes, highlighting disparities in posttransplant care.

CONCLUSIONS: Fontan-related lymphatic complications develop in 1 out of 4 patients by 20 years of age, and they are associated with older age, renal dysfunction, thromboembolism, and arrhythmia. Patients with LC have higher rates of transplantation and death. Our findings indicate that elevated central venous pressure, rather than systolic cardiac or atrioventricular valve function, is associated with these complications.

The usefulness of several noninvasive assessments for evaluating liver fibrosis has been reported in Fontan-associated liver disease (FALD). However, no studies have reported on the usefulness of Mac-2 binding protein glycosylation isomer (M2BPGi) in FALD. Here, we investigated the usefulness of M2BPGi in identifying advanced FALD. This retrospective study included patients diagnosed with FALD. Based on the clinical signs of portal hypertension, we defined advanced FALD as a varices, ascites,...

Coronary artery obstruction is a potential life-threatening complication of transcatheter aortic valve replacement (TAVR) in all settings including native, valve-in-valve, and redo-TAVR. Risk of obstruction can be identified on preprocedural computed tomography. BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction) effectively prevents TAVR-induced coronary obstruction. Perceived technical complexity, limited availability of...

CONCLUSIONS: Development efficiency is an independent and clinically meaningful determinant of survival after CABG in Brazil. Higher income-independent HDI performance is associated with substantial absolute mortality reductions, driven predominantly by direct system-level pathways rather than changes in urgency profile. Strengthening health-system efficiency and perioperative capacity may therefore yield meaningful gains in cardiac surgical outcomes.

CONCLUSIONS: In patients undergoing ViV TAVR, intentional leaflet modification is associated with a significantly reduced incidence of HALT, suggesting a protective association with subclinical leaflet thrombosis. These results support a potentially hemodynamic benefit of leaflet modification beyond coronary obstruction prevention.

Leaflet modification is a necessary element in the armamentarium of the structural interventionalist and will remain an area of active investment in the future. Although leaflet splitting is proven, there are limitations in certain extreme cases. Although intraleaflet techniques are emerging and potentially have more broad applicability, there remain safety concerns with these techniques. The proposed systematic algorithms on aortic and mitral leaflet modification procedures can serve as a guide...

CONCLUSIONS: BASILICA is technically feasible for both stented and stentless valves. However, stentless valves had a higher rate of partial CAO after BASILICA and TAVR and may therefore require additional or alternative coronary artery protection measures in selected patients.

CONCLUSIONS: A CT-based algorithm stratifies patients into 3 CO risk categories, though the decision for CP in clinical practice seems to incorporate additional clinical and procedural variables. Although CP reduces CO risk, its efficacy is limited in patients with very small VTCV, which can be predicted preprocedurally via CT. (Leipzig TAVR Registry; NCT05015452).

CONCLUSIONS: BASILICA and BA-BASILICA create similar sized vertical splays in the leaflet neoskirt, whereas UNICORN generates larger FSAs but only when intraleaflet deployment is feasible. The design, alignment, and implantation depth of the second TAV may influence the FSA after leaflet modification.

CONCLUSIONS: Leaflet splay following LM for redo-TAVR is highly dependent on THV type and constraint, implantation of the second THV, laceration pattern, and the nature of index THV degeneration.

CONCLUSIONS: The authors propose a systematic, imaging-guided approach to leaflet modification in redo-TAVR. Further studies are ongoing to evaluate and validate its feasibility and effectiveness.

CONCLUSIONS: Commissural changes in smaller S3UR valves and thinner leaflets drive differences in hydrodynamics, leaflet motion, tensile strength, and leaflet splay after leaflet modification. This warrants further study.

CONCLUSION: The machine-learning model based on incorporating perioperative hemodynamics (pulmonary artery systolic pressure, mean arterial pressure, central venous pressure) accurately predict stage 2-3 acute kidney injury postorthotopic heart transplantation, thereby optimizing hemodynamic management and improving outcomes.

CONCLUSIONS: Controlled hypothermia may be a viable alternative to current DCD preservation methods, eliminating ethical concerns of thoracoabdominal normothermic regional perfusion and reducing logistical complexity and costs associated with direct procurement and reperfusion. These findings provide a foundation for a potential shift in DCD heart preservation practices, offering a more effective and cost-efficient approach to expand the donor pool and improve transplantation outcomes.

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are recommended for multiple populations-type 2 diabetes (T2D), chronic kidney disease, and heart failure-but their role after heart transplant (HTX) remains unclear. We searched PubMed, Cochrane, and Embase for studies of HTX recipients with T2D comparing outcomes in SGLT2i users vs. non-users. Outcomes of interest were all-cause mortality, urinary tract infection (UTI), and estimated glomerular filtration rate (eGFR) change from baseline. Odds...

CONCLUSION: We showed a successful surgical treatment of aortic prosthesis endocarditis with involvement of the IVFB. We were able to perform a radical resection of the infected tissue, reconstruct and replaced all sacrificed tissue with biological tissue and preserved the native mitral valve in a modified hemi-UFO procedure.

CONCLUSION: AMI Patients undergoing CABG within 48 h are at an increased risk for neurological injuries. In particular, patients with generalized atherosclerosis and those that underwent CPR pre-operatively, seem to represent a vulnerable subgroup. Further studies have to clarify whether individualized peri-operative actions may reduce the stroke rates in this setting.

CONCLUSION: Home-based rehabilitation using Vivifrail proved to be feasible for frail older adults during postoperative recovery. Clinically meaningful improvements were observed in physical performance during the first 6 weeks of the programme. Future research should confirm this trend and consider Vivifrail for patients who cannot access specialized rehabilitation centres.

Drug-coated balloon (DCB) therapy promotes beneficial vascular remodeling after percutaneous coronary intervention. However, its mechanisms remain elusive. Given paclitaxel's neurotoxicity, the effects of paclitaxel (PTX)-DCB treatment on periarterial innervation are unknown. This study assessed the impact of PTX-DCB on periarterial innervation in porcine coronary arteries. Coronary arteries from twelve pigs were treated with balloon catheters across four groups: (1) uncoated balloon (POBA), (2)...

Venous grafts remain the most used conduits in coronary artery bypass grafting (CABG) but are highly susceptible to early failure due to ischemia-reperfusion injury, intimal hyperplasia, and accelerated atherosclerosis. Specialized preservation solutions such as DuraGraft and TiProtec aim to protect endothelial integrity during intraoperative storage; however, their long-term effects on venous graft adaptation remain unclear. In this study, saline, DuraGraft, and TiProtec were compared in a rat...

We aimed to establish a rat TR model to further investigate the mechanisms of right heart remodeling and organ damage induced by TR. Intervention group rats (n = 6) underwent coronary stent system implantation via transjugular approach. The control group (n = 6) underwent the same procedure, except for coronary stent implantation. All rats survived at 8 weeks follow-up postoperatively. TR occurred immediately after the implantation of coronary stent in the intervention group. The right...

CONCLUSION: This study defines macrophage heterogeneity during acute cardiac allograft rejection and identifies an IFN-driven AIM2 axis in M1-like macrophages as a mechanism amplifying T cell-mediated rejection. Targeting AIM2 attenuates macrophage costimulatory activation, weakens naïve T-cell priming, and mitigates acute rejection while improving graft survival in mice, supporting AIM2 inhibition as a potential adjunct strategy in heart transplantation.

Partial heart transplantation has emerged as a novel, innovative solution to the problem of valvular cardiac disease in children, allowing the transplantation of living donor tissue that retains cellular viability and growth potential. Since the first pediatric partial heart transplant was performed at Duke University in 2022, the procedure has continued to grow and develop, with excellent clinical outcomes. This review examines the clinical history of partial heart transplantation; clinical...

Coronary artery disease is the most common type of heart disease. Revascularization with coronary artery bypass grafting can improve survival in patients with severe coronary artery disease and reduced left ventricular ejection fraction. The Impella 5.5 (Abiomed) with SmartAssist intravascular microaxial blood pump can provide safe and effective perioperative support in patients with severely reduced left ventricular ejection fraction of less than 20%. However, no research has been conducted on...

CONCLUSION: This audit provides the first concrete evidence of widespread potential inequity in access to AHF therapies across the UK and Ireland. These findings have important implications for national healthcare planning, including workforce development and allocation of public health resources. Further work is required to investigate barriers to referral, enhance clinician awareness and optimise care pathways for patients in need of both life-prolonging and supportive therapies.

CONCLUSION: In this large multicentre cohort of adults with MFS, cardiac surgery was common, and redo sternotomy occurred frequently among operated patients. These findings provide a contemporary description of the long-term need for cardiac surgery in adults with MFS managed at tertiary referral centres.

Nurse practitioners are essential members of the multidisciplinary team managing heart transplant candidates and recipients, a patient population with highly specialized, complex care needs. Nurse practitioners contribute to successful patient outcomes by delivering expert care, facilitating smooth transitions, and maintaining continuity of care throughout the patient's journey. This continuum of care progresses from pretransplant evaluation and optimization, to the vulnerable perioperative and...

Heart transplantation offers life-saving therapy for patients with end-stage heart disease, but outcomes depend on precise management of immune risk and immunosuppression. The transplanted heart is a potent antigenic stimulus that can trigger immune pathways, leading to rejection and graft dysfunction if not adequately controlled. Intensive care unit nurses and advanced practice registered nurses need a working knowledge of transplant immunology because daily decisions about rejection...

Evidence suggests that both tranexamic acid (TXA) and ulinastatin (ULI) possess anti-inflammatory and blood-conserving properties. This study aimed to determine whether combining TXA and ULI yields additional benefits for patients undergoing cardiac surgery compared with the use of either medicine alone. This systematic review was conducted through comprehensive searches of PubMed, the Cochrane Library, EMBASE, CBM, CNKI, and WANFANG Data from their inception to December 2024 to identify all...

Transcatheter aortic valve implantation (TAVI) has become the preferred treatment for severe aortic stenosis. Nonetheless, interplay between aortic valve disease, transcatheter valve implantation, and the coronary arteries is frequent and clinically relevant. Coronary intervention in the context of TAVI encompasses distinct but interrelated scenarios, including the management of concomitant coronary artery disease and the prevention or treatment of coronary artery obstruction. These aspects...

CONCLUSIONS: Redo-TAVI with a balloon-expandable SAPIEN 3 THV platform is a safe and effective reintervention strategy across diverse failed THV types, when guided by the Heart Team, standardised procedural planning, and comprehensive imaging.

CONCLUSIONS: Diaphragm atrophy is a significant and early complication in pediatric cardiac surgery patients. While atrophy alone did not predict weaning outcomes in this cohort, a higher dTF was independently associated with extubation success, suggesting that dTF may serve as a functional marker of weaning readiness in this population.

Background: Access to cardiac surgery remains severely limited in many low- and middle-income countries, where care is often delivered through short-term missions or overseas referrals. Papua New Guinea (PNG) is undergoing a transition towards sustainable national cardiac surgical capacity. Methods: We conducted a mixed-methods evaluation of a March 2026 Singapore-PNG cardiac surgery mission at Port Moresby General Hospital. Quantitative data were collected using Likert-scale surveys assessing...

CONCLUSIONS: Select biomarkers of kidney tubule dysfunction, but not injury, are associated with future risk of AKI after CABG surgery. Biomarkers measured years before surgery may predict post-CABG surgery AKI.

Valvular heart disease (VHD) affects millions worldwide and remains a major cause of morbidity and mortality, placing a substantial and growing burden on healthcare systems. Over the past two decades, transcatheter therapies have emerged to meet this challenge, transforming the management of aortic, mitral, and tricuspid valve disease. Initially developed for inoperable or high-risk surgical patients, procedures such as transcatheter aortic valve implantation (TAVI) and mitral transcatheter...