Evaluating Patient Outcomes and Access to Care in Aortic Surgery Based on Ethnicity and Social Vulnerability.

We previously demonstrated the impact of ethnicity on aortic surgery, with underrepresentation and greater acuity in minority patients, raising concerns regarding access to care. The Centers for Disease Control and Prevention's social vulnerability index (SVI) measure is increasingly used to quantify patient socioeconomic and demographic factors. This study expands on our prior work by incorporating SVI and ethnicity to analyze patient presentation and outcomes in aortic arch surgery.

Cardiopulmonary bypass with deep hypothermic circulatory arrest results in organ-specific transcriptomic responses in pediatric swine.

The organ-level molecular response to cardiac surgery with cardiopulmonary bypass (CPB) remains inadequately understood and may be heterogeneous. Here, we measured organ-specific gene expression in a piglet model of CPB with deep hypothermic circulatory arrest (DHCA). Infant piglets underwent peripheral CPB with 75 min of DHCA and 6 h of critical care after separation from CPB.

Survival following liver transplantation: A population-based nested case-control study.

Background: Liver transplantation is the gold standard treatment for end-stage liver disease. This study evaluates post-transplantation survival compared with the general population by quantifying standardized mortality ratios in a nested case-control study.

Methods: Controls were noninstitutionalized United States inhabitants from the National Longitudinal Mortality Study.

Evaluation of veteran community care outcomes after coronary artery bypass grafting: a retrospective pilot cohort.

For Veterans who cannot be seen in a timely fashion or must travel long distances to be seen, the Veterans Health Administration (VHA) offers funded care in the community. The use of this program has rapidly increased; however, there have been no systematic evaluations of surgery specific metrics such as perioperative complications, mortality and timeliness of care. To evaluate this in cardiac surgery patients, we compared veterans undergoing coronary artery bypass grafting in the community to those remaining within the VHA.

Can Artificial Intelligence Improve the Readability of Patient Education Materials on Aortic Stenosis? A Pilot Study.

Introduction: The advent of generative artificial intelligence (AI) dialogue platforms and large language models (LLMs) may help facilitate ongoing efforts to improve health literacy. Additionally, recent studies have highlighted inadequate health literacy among patients with cardiac disease. The aim of the present study was to ascertain whether two freely available generative AI dialogue platforms could rewrite online aortic stenosis (AS) patient education materials (PEMs) to meet recommended reading skill levels for the public.

Association of cardiac preservation solution with short-term outcomes after heart transplantation.

Aims: There is wide variability in the practice of cardiac preservation for heart transplantation. Prior reports suggest that the type of solution may be linked with a reduced incidence of posttransplantation complications.

Methods: Adult (≥18 years old) heart recipients who underwent transplantation between 2015 and 2021 in the United States were examined.

Ventricular Remodeling Following Metabolic and Bariatric Surgery Decreases Need for Heart Transplantation: A Predictive Model.

Purpose: For patients with obesity and congestive heart failure (CHF) who require heart transplantation (HT), aggressive weight loss has been associated with ventricular remodeling, or subclinical alterations in left and right ventricular structure that affect systolic function. Many have suggested offering metabolic and bariatric surgery (MBS) for these patients. As such, we evaluated the role of MBS in HT for patients with obesity and CHF using predictive modelling techniques.

Kir1.1 and SUR1 are not implicated as subunits of an adenosine triphosphate-sensitive potassium channel involved in diazoxide cardioprotection.

Objective: The adenosine triphosphate-sensitive potassium channel opener diazoxide mimics ischemic preconditioning and is cardioprotective. Clarification of diazoxide's site and mechanism of action could lead to targeted pharmacologic therapies for patients undergoing cardiac surgery. Several mitochondrial candidate proteins have been investigated as potential adenosine triphosphate-sensitive potassium channel components.

Implementation of a Holistic Review Process of US Allopathic Medical Students Eliminates Non-Comparable Metrics and Bias in General Surgery Residency Interview Invitations.

Objective: Use of traditional scoring metrics for residency recruitment creates racial and gender bias. In addition, widespread use of pass/fail grading has led to noncomparable data. To adjust to these challenges, we developed a holistic review (HR) rubric for scoring residency applicants for interview selection.

Variability in Heart Yield From Donation After Brain Death Between Organ Procurement Organizations: An Opportunity for Improvement.

Increasing the number of available hearts for transplantation is the best strategy to decrease waitlist mortality. This study examines organ procurement organizations (OPOs) and their role in the transplantation network to determine whether variability in performance exists across them. Adult deceased donors who met the criteria for brain death between 2010 and 2020 (inclusive) in the United States were examined.

Conditional Survival in Lung Transplantation: An Organ Procurement and Transplantation Network Database Analysis.

Lung transplantation survival estimates are traditionally reported as fixed 1-, 5-, and 10-year mortality rates. Alternatively, this study aims to demonstrate how conditional survival models can provide useful prognostic information tailored to the time a recipient has already survived from the date of transplantation. Recipient data was obtained from the Organ Procurement and Transplantation Network database.

Sounding the Alarm: What Clinicians Need to Know about Physical, Emotional, and Cognitive Recovery After Venoarterial Extracorporeal Membrane Oxygenation.

Objective: We summarize the existing data on the occurrence of physical, emotional, and cognitive dysfunction associated with postintensive care syndrome (PICS) in adult survivors of venoarterial extracorporeal membrane oxygenation (VA-ECMO).

Data Sources: MEDLINE, Cochrane Library, EMBASE, Web of Science, and CINAHL databases were searched.

Study Selection: Peer-reviewed studies of adults receiving VA-ECMO for any reason with at least one measure of health-related quality of life outcomes or PICS at long-term follow-up of at least 6 months were included.

Cardiac Surgeons Highlight the Need for Innovation Stewardship: Noteworthy in 2022.

Modern cardiac surgery has rapidly evolved to treat complex cardiovascular disease. This past year boasted noteworthy advances in xenotransplantation, prosthetic cardiac valves, and endovascular thoracic aortic repair. Newer devices often offer incremental design changes while demanding significant cost increases that leave surgeons to decide if the benefit to patients justifies the increased cost.

Quality and readability of online patient information on the left ventricular assist device.

Background: As patients seek online health information to supplement their medical decision-making, the aim of this study is to assess the quality and readability of internet information on the left ventricular assist device (LVAD).

Methods: Three online search engines (Google, Bing, and Yahoo) were searched for "LVAD" and "Left ventricular assist device." Included websites were classified as academic, foundation/advocacy, hospital-affiliated, commercial, or unspecified.

Cardioprotective mechanisms of mitochondria-targeted S-nitrosating agent and adenosine triphosphate-sensitive potassium channel opener are mutually exclusive.

Background: Myocytes exposed to stress exhibit significant swelling and reduced contractility. These consequences are ameliorated by adenosine triphosphate-sensitive potassium (K) channel opener diazoxide (DZX) via an unknown mechanism. K channel openers also provide cardioprotection in multiple animal models.

Heart transplantation outcomes in arrhythmogenic right ventricular cardiomyopathy: a contemporary national analysis.

Aims: Heart failure is an increasingly recognized later stage manifestation of arrhythmogenic right ventricular cardiomyopathy (ARVC) that can require heart transplantation (HT) to appropriately treat. We aimed to study contemporary ARVC HT outcomes in a national registry.

Methods And Results: The United Network for Organ Sharing registry was queried for HT recipients from 1/1994 through 2/2020.

Measuring the effect of the COVID-19 pandemic on solid organ transplantation.

Background: The COVID-19 pandemic has uniquely affected the United States. We hypothesize that transplantation would be uniquely affected.

Methods: In this population-based cohort study, adult transplantation data were examined as time series data.

Posttransplant Long-Term Outcomes for Patients with Ventricular Assist Devices on the Heart Transplant Waitlist.

Ventricular assist devices (LVADs) are commonly used in end-stage heart failure for mechanical circulatory support as a bridge to heart transplantation. However, LVADs' long-term effects on posttransplant survival are unknown. We sought to compare long-term mortality after transplantation for patients with and without LVADs.

Patient-Specific Biomechanics in Marfan Ascending Thoracic Aortic Aneurysms.

Background: Guidelines for sinus of Valsalva (SOV)-thoracic aortic aneurysms in Marfan syndrome recommend size-based criteria for elective surgical repair. Biomechanics may provide a better prediction of dissection risk than diameter. Our aim was to determine magnitudes of wall stress in the aortic root of Marfan patients using finite element analyses.

High rates of de novo malignancy compromise post-heart transplantation survival.

Background: Transplant patients are known to have increased risk of developing de novo malignancies (DNMs). As post-transplant survival increases, DNM represents an obstacle to further improving survival. We sought to examine the incidence, types, and risk factors for post-transplant DNM.