A Prospective, Multicentre Randomised Controlled Study of Angiographic and Clinical Outcomes in Total Arterial Coronary Bypass Grafting: The TA Trial Protocol.

Background & Aim: Conventional coronary artery bypass grafting (CABG) procedures typically utilise the left internal mammary artery and supplementary saphenous vein grafts (SVGs) to re-establish adequate coronary blood flow to ischaemic territories. However, extensive observational studies have consistently demonstrated that SVGs are prone to accelerated atherosclerosis and progressive failure compared to arterial conduits. These limitations have heightened interest in total arterial revascularisation (TAR) as a potentially superior strategy.

Head-to-head comparison of V-A ECMO, Impella and ECPELLA in normal ovine hearts.

Temporary mechanical circulatory support (MCS), including veno-arterial extracorporeal membrane oxygenation (ECMO) and micro-axial pumps (Impella), is increasingly used in clinical practice for refractory circulatory failure. Complex physiological responses to each technique or their combination (ECPELLA) remain debated and are often specific to cardiovascular pathology. A paucity of data on physiological responses to MCS in normal subjects makes comprehensive understanding of such responses in variable disease states difficult, as well as during weaning MCS in recovering hearts.

Survival Outcomes After Multiple vs Single Arterial Grafting Among Patients With Reduced Ejection Fraction.

Importance: Multiarterial coronary bypass procedures offer improved clinical outcomes compared with single arterial grafting with supplementary saphenous vein grafts. However, the survival advantage of multiarterial grafting across varying levels of left ventricular impairment remains uncertain.

Objective: To compare long-term survival outcomes of patients undergoing multiple vs single arterial grafting, stratified by preoperative ejection fraction.

Predictors of successful weaning from veno-arterial extracorporeal membrane oxygenation (V-A ECMO): A systematic review and meta-analysis.

Background: Venoarterial extracorporeal membrane oxygenation (V-A ECMO) use to support patients in cardiac failure is increasing. Despite this increased use, predicting successful weaning from ECMO can be challenging, no uniform guidelines on weaning exist. Therefore, we completed a systematic review to evaluate prognostic factors that predict successful weaning from V-A ECMO.

Use of transoesophageal echocardiography in the pre-hospital setting to determine compression position in out of hospital cardiac arrest.

Background: A proportion of patients due to anatomical variation do not receive chest compressions over the left ventricle. Transoesophageal echocardiography (TOE) has the potential to impact survival rates by identifying the area of maximal compression (AMC), potentially improving forward flow and systemic perfusion in cardiac arrest. There is a paucity of data regarding the use of TOE during out of hospital cardiac arrest (OHCA) in the pre-hospital setting, with most data coming from studies performed in hospital.

Olfactory receptor coexpression and co-option in the dengue mosquito.

The olfactory sensory neurons of vinegar flies and mice tend to express a single ligand-specific receptor. While this 'one neuron-one receptor' motif has long been expected to apply broadly across insects, recent evidence suggests it may not extend to mosquitoes. We sequenced and analyzed the transcriptomes of 46,000 neurons from antennae of the dengue mosquito to resolve all olfactory, thermosensory, and hygrosensory neuron subtypes and identify the receptors expressed therein.

Multiple arterial vs. single arterial coronary artery bypass grafting: sex-related differences in outcomes.

Background And Aims: Uncertainty exists over whether multiple arterial grafting has a sex-related association with survival after coronary artery bypass grafting. This study aims to compare the long-term survival of using multiple arterial grafting vs. single arterial grafting in women and men undergoing coronary artery bypass grafting.

From a Position of Known Angiographic Perfect Patency: What Happens Next?

Background And Aim: The biological behaviour of coronary graft conduits over time may be considered by serial angiography.

Methods: A single institution retrospective cohort received mostly clinically indicated angiography between 1997 and 2020, following coronary bypass surgery. Only perfectly patent grafts (absence of any lumen irregularity) for each conduit type at the first postoperative angiogram were selected for a later comparison.

Sex differences in long-term survival after total arterial coronary artery bypass grafting.

Objectives: It is uncertain if the evidence on improved long-term survival of total arterial coronary artery bypass grafting applies to female patients. This study aims to compare the long-term survival outcomes of using total arterial revascularization (TAR) versus at least 1 saphenous vein graft separately for men and women.

Methods: This retrospective analysis of the Australian and New Zealand Society of Cardiac-Thoracic Surgical Database had administrative linkage to the National Death Index.

Hypocalcaemia upon arrival (HUA) in trauma patients who did and did not receive prehospital blood products: a systematic review and meta-analysis.

Purpose: Hypocalcaemia upon arrival (HUA) to hospital is associated with morbidity and mortality in the trauma patient. It has been hypothesised that there is an increased incidence of HUA in patients receiving prehospital transfusion as a result of citrated blood products. This research aimed to determine if there was a difference in arrival ionised calcium (iCa) levels in trauma patients who did and did not receive prehospital transfusion.

Survival Benefit of Multiple Arterial Revascularization With and Without Supplementary Saphenous Vein Graft.

Background: It is unknown if the presence of saphenous vein grafting (SVG) adversely affects late survival following coronary surgery with multiple arterial grafting (MAG) versus single arterial grafting.

Methods And Results: A retrospective, observational, multicenter cohort study from 2001 to 2020 was conducted using the Australian and New Zealand Society of Cardiac and Thoracic Surgeons Database linked to the National Death Index. Patients undergoing primary isolated coronary artery bypass grafting with ≥2 grafts were included, and exclusions were patients aged <18 years, reoperations, concomitant or previous cardiac surgery, and the absence of arterial grafting.

Expert consensus on training and accreditation for extracorporeal cardiopulmonary resuscitation an international, multidisciplinary modified Delphi Study.

Background: A multidisciplinary group of stakeholders were used to identify: (1) the core competencies of a training program required to perform in-hospital ECPR initiation (2) additional competencies required to perform pre-hospital ECPR initiation and; (3) the optimal training method and maintenance protocol for delivering an ECPR program.

Methods: A modified Delphi process was undertaken utilising two web based survey rounds and one virtual meeting. Experts rated the importance of different aspects of ECPR training, competency and governance on a 9-point Likert scale.

Retrograde Cerebral Perfusion May Decrease Stroke Risk During Elective Aortic Arch Surgery.

Objective: Controversy remains regarding the optimal neuroprotection strategy for elective hemiarch replacement (HEMI). This study sought to compare outcomes in patients who underwent HEMI utilizing the 2 most common contemporary methods of cerebral protection.

Methods: The ARCH international aortic database was queried, and 782 patients undergoing elective HEMI with circulatory arrest from 2007 to 2012 were identified.

Oxygenation during the apnoeic phase preceding intubation in adults in prehospital, emergency department, intensive care and operating theatre environments.

Background: Apnoeic oxygenation is the delivery of oxygen during the apnoeic phase preceding intubation. It is used to prevent respiratory complications of endotracheal intubation that have the potential to lead to significant adverse events including dysrhythmia, haemodynamic decompensation, hypoxic brain injury and death. Oxygen delivered by nasal cannulae during the apnoeic phase of intubation (apnoeic oxygenation) may serve as a non-invasive adjunct to endotracheal intubation to decrease the incidence of hypoxaemia, morbidity and mortality.

Chromosome-level reference genomes of two imperiled desert fishes: spikedace (Meda fulgida) and loach minnow (Tiaroga cobitis).

North American minnows (Cypriniformes: Leuciscidae) comprise a diverse taxonomic group, but many members, particularly those inhabiting deserts, face elevated extinction risks. Despite conservation concerns, leuciscids remain under sampled for reference assemblies relative to other groups of freshwater fishes. Here, we present 2 chromosome-scale reference genome assemblies spikedace (Meda fulgida) and loach minnow (Tiaroga cobitis) using PacBio, Illumina and Omni-C technologies.

del Nido versus blood cardioplegia in adult cardiac surgery: a meta-analysis.

Aims: Initially developed for myocardial protection in immature cardiomyocytes, del Nido cardioplegia has been increasingly used over the past decade in adult patients. Our aim is to analyse the results from randomized controlled trials and observational studies comparing early mortality and postoperative troponin release in patients who underwent cardiac surgery using del Nido solution and blood cardioplegia.

Methods: A literature search was performed through three online databases between January 2010 and August 2022.

ECPR Survivor Estimates: A Simulation-Based Approach to Comparing ECPR Delivery Strategies.

The number of out-of-hospital cardiac arrest (OHCA) patients who may benefit from prehospital extracorporeal cardiopulmonary resuscitation (ECPR) is yet to be elucidated. Patient eligibility is determined both by case characteristics and physical proximity to an ECPR service. We applied accessibility principles to historical cardiac arrest data, to identify the number of patients who would have been eligible for prehospital ECPR in Sydney, Australia, and the potential survival benefit had prehospital ECPR been available.

Survival of multiple arterial grafting in diabetic populations: a 20-year national experience.

Objectives: Diabetics may have diminished survival after coronary artery bypass grafting even with multiple arterial revascularization. We compared multi-arterial versus single-arterial grafting (SAG) survival in diabetic and non-diabetic patients undergoing primary isolated bypass surgery.

Methods: This is a retrospective analysis of the Australian and New Zealand Society of Cardiac-Thoracic Surgical Database from June 2001 to January 2020.

Quantification of changes in lung aeration associated with physiotherapy using lung ultrasound in mechanically ventilated patients: a prospective cohort study.

Background: Lung ultrasound (LUS) is a novel and emerging tool for physiotherapists in ICU and may provide a way of monitoring lung aeration change in response to respiratory physiotherapy treatment during a patient's ICU stay.

Objective: To measure change in the LUS score associated with a respiratory physiotherapy treatment; to determine whether change in LUS score correlates with other physiological measures.

Design And Setting: A single-centre prospective cohort study was undertaken in a tertiary teaching hospital in Sydney, Australia.

Prehospital Extracorporeal Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis.

Objectives: To evaluate the available published evidence of the effects of extracorporeal cardiopulmonary resuscitation (ECPR) in the prehospital setting on clinical outcomes in patients with out-of-hospital cardiac arrest.

Design: A systematic review and meta-analysis designed according to the Preferred Reporting Items for Systematic Reviews an Meta-Analyses guidelines.

Setting: In the prehospital setting.