Predictors of Length-of-Stay Among Transcatheter Aortic Valve Replacement Patients Using a Supervised Machine Learning Algorithm.

Background: Length of stay following transcatheter aortic valve replacement (TAVR) continues to improve, but significant gaps remain in predicting the length of stay following TAVR.

Objectives: This study aimed to develop a novel machine learning (ML) algorithm that would facilitate the understanding of the predictors of early and late hospital discharge in patients who have undergone TAVR.

Methods: Using the Biome data set, 9,172 outpatient TAVR procedures were analyzed from 21 centers between 2017 and 2021 across the United States.

A capsular myofibroblastic niche maintains hematopoietic stem cells in the spleen.

The spleen is a key site for extramedullary hematopoiesis that hosts a rare population of functional hematopoietic stem cells (HSCs). While the microenvironment that supports extramedullary hematopoiesis response has gained interest, a niche for splenic HSCs at steady-state remains undescribed. Here, we have uncovered a red-pulp-specific, myofibroblastic niche that supports murine splenic HSCs within a ≈ 200-μm-wide capsular zone.

The hematopoietic stem cell expansion niche in fetal liver: Current state of the art and the way forward.

Hematopoietic development goes through a number of embryonic sites that host hematopoietic progenitor and stem cells with function required at specific developmental stages. Among embryonic sites, the fetal liver (FL) hosts definitive hematopoietic stem cells (HSCs) capable of engrafting adult hematopoietic system and supports their rapid expansion. Hence, this site provides an excellent model to understand the cellular and molecular components of the machinery involved in HSC-proliferative events, leading to their overall expansion.

Coronary steal syndrome caused by a large saphenous venous graft aneurysm with a fistula communicating to the right atrium managed by transcatheter closure.

A 71-year-old man with history of coronary artery disease status post coronary artery bypass grafting (CABG) in 1999 (left internal mammary artery-left anterior descending, saphenous venous graft [SVG]-diagonal, and SVG-right coronary artery [RCA], ascending aorta aneurysm [4.8 cm], infrarenal aorta aortic aneurysm status post endovascular aortic repair, heart failure with reduced ejection fraction of 25% status post cardiac resynchronization therapy-defibrillator) presented with decompensated heart failure. He was in monomorphic ventricular tachycardia; he was cardioverted and started on amiodarone and lidocaine.

Thrombectomy using AlphaVac for left atrial thrombus causing mechanical mitral valve obstruction and cardiogenic shock.

We present a 73-year-old female with history of rheumatic heart disease status post-mechanical mitral valve on warfarin, valvular atrial fibrillation, and alpha thalassemia who was admitted to an outside hospital with anterior ST-segment myocardial infarction. Coronary angiogram showed occluded left anterior descending artery (LAD) with acute thrombus status post-thrombectomy and balloon angioplasty.

Splenic flexure cancer: is right extended hemicolectomy better than left hemicolectomy?

Introduction: There is no consensus on the optimal surgery for splenic flexure cancers.

Methods: Review of a prospectively maintained database of patients with splenic flexure cancer undergoing either a right extended hemicolectomy or left hemicolectomy at a tertiary care cancer hospital from 14.5.

Prospective Randomized Control Trial to Compare the Role of Injection Cerebrolysin for 10 Days Duration Against Placebo in Operated Cases of Degenerative Cervical Myelopathy.

Study Design: Prospective randomized control trial.

Objective: To analyze outcomes following the injection of cerebrolysin in surgically treated patients with degenerative cervical myelopathy (DCM).

Summary Of Background Data: Previous research has concluded that superior functional outcomes are achieved with the use of cerebrolysin in surgically treated patients of DCM for 21 days.

Unilateral facet cyst at the atlantoaxial joint leading to cervical myelopathy: A case report and review of literature.

Background: Spinal synovial cysts are rare in the cervical spine where they may cause myeloradiculopathy. Contrast MR studies help differentiate these from other lesions. The optimal treatment is often surgical removal.

Long-term operative outcome of giant calcified thoracic disc herniation - A retrospective analysis of 24 patients.

Background: Thoracic disc herniations (TDHs) are rare (0.15-4%) and often cause significant myelopathy (70-95%). They are defined as "Giant" if they occupy >40% of the spinal canal.

Long-segment fixation versus short-segment fixation with instrumentation of index vertebra for thoracolumbar fractures.

Background: We assessed and analyzed the clinical, perioperative, functional, and radiological outcomes of long- versus short-segment (SS) fixation of thoracolumbar spine fractures that included the index vertebra.

Methods: We retrospectively evaluated 119 patients with thoracolumbar spine fractures (i.e.

Comparative Analysis of Long-Term Outcome of Anterior Reconstruction in Thoracic Tuberculosis by Direct Anterior Approach versus Posterior Approach.

Study Design: Retrospective study.

Aim: To retrospectively evaluate and compare the long-term outcome of anterior vertebral body reconstruction in tuberculosis (TB) of the dorsal spine by direct anterior-versus-posterior approach.

Materials And Methods: A total of 127 patients operated by posterior approach, 118 by anterior for TB-thoracic spine with at least 1-year follow-up were included and retrospectively analyzed.

Aortic Rupture in Transcatheter Aortic Valve Replacement.

This case demonstrates a rare but catastrophic complication of transcatheter aortic valve replacement (TAVR). In an era where TAVR is now indicated in low-risk patients, serious complication rates are less frequent. It exemplifies the importance of preparedness for vascular injury, with readiness for vascular covered stenting and potential bail-out strategies.

Computed tomography guided sizing for transcatheter pulmonary valve replacement.

Objective: To evaluate the predictive value of Computed Tomography Angiography (CTA) measurements of the RVOT for transcatheter valve sizing.

Background: Transcatheter pulmonary valve replacement (TPVR) provides an alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction. We studied 18 patients who underwent catheterization for potential TPVR to determine whether CT imaging can be used to accurately predict implant size.

Conduction System Abnormalities After Transcatheter Aortic Valve Replacement: Mechanism, Prediction, and Management.

Conduction disturbances following TAVR are a common occurrence given the proximity of the various conduction system tissues, including the AV node, His-bundle, and bundle branches to the left ventricular outflow tract and aortic root. Impairment of these conduction system abnormalities may necessitate permanent pacemaker implantation, which increases morbidity and mortality, as well as length of stay, for the patient. The incidence, mechanisms, and predictors of conduction abnormalities and treatment options are discussed in this up-to-date review of the topic.

Fractional Flow Reserve and Intravascular Ultrasound of Coronary Artery Lesions Beyond the Left Main: A Review of Literature.

Determining the severity of intermediate coronary artery lesions is a clinical dilemma. Physiologic assessment of these lesions can establish the presence of ischemia to justify percutaneous coronary intervention (PCI). Approximately 50% of patients undergo PCI without any noninvasive, cardiac, function testing to assess for myocardial ischemia.

Routine Angiographic Follow-Up After Coronary Artery Disease Revascularization: Is Seeing Believing?

Purpose Of The Review: Coronary artery disease is a major cause of mortality and morbidity in the world, and PCI and CABG account for over a million procedures performed annually in the USA. The goal of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is to achieve complete revascularization (CR) if at all possible. However, restenosis and stent thrombosis (ST) remain the Achilles heel of contemporary PCI with restenosis rates between 10 and 30% with bare metal stents to 5-15% after drug-eluting stents and ST rates of around 0.

Cocaine-related subcutaneous emphysema, pneumorrhachis and pneumomediastinum: a rare clinical finding.

A young man presented with several days of dyspnoea and delirium due to cocaine use which was confirmed by urine drug screening. Imaging studies confirmed the diagnosis of subcutaneous emphysema, pneumorrhachis and pneumomediastinum. He was managed successfully with conservative therapy.

Double right coronary artery and its clinical significance: Review of the literature.

Double right coronary artery is a very rare anomaly that is usually discovered incidentally during conventional coronary angiography. Double right coronary artery may have clinical implications in symptomatic patients requiring percutaneous coronary intervention and may be associated with other congenital abnormalities, myocardial ischemia and ventricular fibrillation in the absence of atherosclerosis. Here the reported cases in the literature are reviewed and a case of double right coronary artery with ischemia in inferior left ventricular wall is presented.