Ventricular Arrhythmias in Patients Undergoing Degenerative Mitral Repair: Prevalence and Impact on Survival.

Objective: Ventricular arrhythmias occur in a subset of patients with mitral valve prolapse. However, their impact on post-operative survival after degenerative mitral repair is unclear.

Methods: We compared long-term survival after degenerative mitral repair in patients presenting with and without arrhythmic mitral valve prolapse (defined by degenerative mitral regurgitation and ventricular arrhythmias) in a national insurance database.

Circulating Trimethylamine N-Oxide and Growth Rate of Abdominal Aortic Aneurysms and Surgical Risk.

Importance: Plasma levels of the gut microbiota-dependent metabolite trimethylamine N-oxide (TMAO) are associated with prevalent abdominal aortic aneurysms (AAA) in humans and fostering of AAA progression in animal models; therapeutic targeting of TMAO production blocks AAA progression and rupture in multiple mouse models. A blood biomarker that identifies individuals at risk for incident AAA development, accelerated AAA expansion, or recommendation for surgical AAA repair could be an asset for risk stratification.

Objective: To determine whether TMAO is associated with risk for AAA development, rapid AAA expansion, and risk for recommended surgical intervention.

Managing the side effects of sodium-glucose cotransporter-2 inhibitors.

Although sodium-glucose cotransporter-2 (SGLT2) inhibitors are widely used because of their exceptional cardiovascular and renal benefits, their side effects and corresponding management strategies have not been well characterized to date. The latest evidence suggests that class effects of SGLT2 inhibitors include volume depletion, genital fungal infections, and euglycemic diabetic ketoacidosis, while medication-specific side effects include urinary tract infections with dapagliflozin and potential increased risk of amputations with canagliflozin. Management strategies include close monitoring, adjusting medication dosages, and temporarily holding SGLT2 inhibitors when appropriate.

A Curious Case of Scimitar Syndrome That Defies Embryology.

Scimitar syndrome is a rare condition described by unique anatomic features that consist mainly of an abnormal connection of the right pulmonary veins to the inferior vena cava and right atrial junction, as well as an anomalous systemic arterial supply to the right lung. We present the case of a 60-year-old man with an atypical variant of scimitar syndrome that was embryologically perplexing and anatomically challenging to correct. We highlight key surgical and procedural considerations for a patient with scimitar syndrome presenting with this complex surgical anatomy.

Bariatric and Metabolic Surgery in the Adult Population: What a Primary Care Provider Needs to Know.

Obesity is a significant public health concern worldwide and a leading cause of preventable death and morbidity, but the management of this condition remains a challenge. Metabolic and bariatric surgery (MBS) is safe and currently has the most consistent and robust data among anti-obesity interventions for ameliorating obesity and its associated complications. Despite the benefits and safety of MBS, it is significantly underused.

Predictors of spontaneous pregnancy loss in single ventricle physiology.

Background: Pregnant patients with single ventricle (SV) physiology carry a high risk of spontaneous pregnancy loss (SPL), yet the clinical factors contributing to this risk are not well defined.

Methods: Single-centre retrospective study of pregnant patients with SV physiology seen in cardio-obstetrics clinic over the past 20 years with chart review of their obstetric history. Patients without a known pregnancy outcome were excluded.

Racial and ethnic representation in peripheral artery disease randomized clinical trials.

Clinical trial enrollment provides various benefits to study participants including early access to novel therapies that may potentially alter the trajectory of disease states. Trial sponsors benefit from enrolling demographically diverse trial participants enabling the trial outcomes to be generalizable to a larger proportion of the community at large. Despite these and other well-documented benefits, clinical trial enrollment for Black and Hispanic Americans as well as women continues to be low.

No difference in midterm outcomes and complication rate between retroperitoneal and transperitoneal open aortic aneurysm repair in females.

ObjectivesAbdominal Aortic Aneurysms (AAA) in females are less prevalent, have higher expansion rates and experience rupture at smaller diameters than in males. Studies have compared outcomes of the retroperitoneal (RP) and transperitoneal (TP) approach in open aortic aneurysm repair (OAR) with conflicting results. No study to date has compared the two approaches solely in females.

Effects of Sociodemographic Factors on Access to and Outcomes in Congenital Heart Disease in the United States.

Congenital heart defects (CHDs) are complex conditions affecting the heart and/or great vessels that are present at birth. These defects occur in approximately 9 in every 1000 live births. From diagnosis to intervention, care has dramatically improved over the last several decades.

Can perioperative electroencephalogram and adverse hemodynamic events predict neurodevelopmental outcomes in infants with congenital heart disease?

Objective: The study objective was to characterize preoperative and postoperative continuous electroencephalogram metrics and hemodynamic adverse events as predictors of neurodevelopment in congenital heart disease infants undergoing cardiac surgery.

Methods: From 2010 to 2021, 320 infants underwent congenital heart disease surgery at our institution, of whom 217 had perioperative continuous electroencephalogram monitoring and were included in our study. Neurodevelopment was assessed in 76 patients by the Bayley Scales of Infant and Toddler Development, 3rd edition, consisting of cognitive, communication, and motor scaled scores.

Determining the Minimum Clinically Important Difference for the European Hernia Society Quality of Life Instrument in Inguinal Hernia Repair Patients.

Background: Patient-reported outcomes in clinical research allow for a more comprehensive and meaningful assessment of interventions but are subjective and difficult to interpret. European Registry for Abdominal Wall Hernias-Quality of Life (EuraHS-QoL) is a tool designed to assess perioperative quality of life for patients undergoing inguinal hernia repair, one of the most performed operations worldwide. Defining the minimum clinically important difference (MCID) for EuraHS-QoL tool can help standardize its interpretation for research purposes and facilitate improved shared decision making in clinical settings.