Early Outcomes of Heart Transplantation Using Donation After Circulatory Death Donors in the United States.

Background: Limited donor availability and evolution in procurement techniques have renewed interest in heart transplantation (HT) with donation after circulatory death (DCD). The aim of this study is to evaluate outcomes of HT using DCD in the United States.

Methods: The United Network for Organ Sharing registry was used to identify adult HT recipients from 2019 to 2021.

Less invasive durable management of postoperative ventricular tachycardia storm after LVAD insertion.

Background: Ventricular tachycardia (VT) can be a challenging problem in patients following durable left ventricular device (LVAD) implantation, and can lead to significant morbidity and mortality. Both the etiology and management of VT in this population can also vary substantially.

Case Presentation: We herein report a case of a patient with preoperative VT who developed a drug resistant VT storm postoperatively that was ultimately controlled durably with a bedside stellate ganglion block.

National Surgical Quality Improvement Program Adverse Events Combined With Clavien-Dindo Scores Can Direct Quality Improvement Processes in Surgical Patients.

Objective: The burden of postoperative adverse events (AE) weighs immediately on the patient as unanticipated stress and on the healthcare system as unreimbursed cost. Applying the Clavien-Dindo (C-D) system of AE gradation as a surrogate of cost, we analyzed 4 years' data from a single-state National Surgical Quality Improvement Program (NSQIP) collaboration, hypothesizing that trends of AE were consistent over time and that more frequently performed cases would be associated with less and more minor AE.

Methods: The NSQIP defined AEs, consisting of 21 listed postoperative occurrences, which were analyzed using deidentified 30-day postoperative data for 2015 to 2018.

Reoperative Surgery After Minimally Invasive Ivor Lewis Esophagectomy.

Objective: The aim of this study is to identify factors influencing reoperations following minimally invasive Ivor Lewis esophagectomy and associated mortality and hospital costs.

Materials And Methods: Between 2013 and 2018, 125 patients were retrospectively analyzed. Outcomes included reoperations, mortality, and hospital costs.

Pericardial release for early LVAD malalignment a less invasive approach.

In a previously well-functioning LVAD, pericardial release via thoracotomy may improve inflow angle and correct malpositioning to ultimately restore LVAD function and patient hemodynamics. To prevent this, we recommend that implantations include a longitudinal pericardiotomy and anchoring sutures.

Aortic Valve Leaflet Disruption: A Severe Complication of Impella 5.5.

A 73-year-old male with a history of severe coronary artery disease and prior coronary artery bypass grafting (CABG) presented with chest pain and elevated troponins. His workup revealed an ejection fraction of 15%, severe native coronary disease, as well as stenosis of his bypass grafts. He underwent a high-risk redo CABG with an Impella 5.

Protek Duo Rapid Deployment cannulation utilized to bridge to durable heartware left ventricular assist device.

A 43-year-old gentleman was transferred for management of acute on chronic cardiogenic shock (left ventricular ejection fraction < 10%). Upon arrival, we inserted a left axillary intra-aortic balloon pump for hemodynamic support. He underwent an emergent left and right-heart catheterization which showed patent stents and coronaries, in the setting of severely elevated pulmonary artery and pulmonary capillary wedge pressure.