The health effects of housing instability and its association with congestive heart failure.

Housing instability is a critical social determinant of health (SDOH). Prior studies of homelessness and congestive heart failure (CHF) have looked primarily at the association between socioeconomic status and hospitalization. The association between housing instability and the development of CHF has not been fully investigated.

Inadequate Anti-Factor Xa Levels With Daily 40-mg Enoxaparin After Cardiac Surgery.

Background: Cardiac surgery patients are at increased risk for venous thromboembolism (VTE). Prevention is the most critical strategy to reduce VTE-associated morbidity and death. However, there is a lack of data on the optimal approach to VTE prophylaxis in this population of high-risk patients.

Serum Lidocaine Levels in Adult Patients Undergoing Cardiac Surgery With del Nido Cardioplegia.

Background: Lidocaine in del Nido cardioplegia solution prolongs the refractory period of cardiomyocytes, yielding a longer arrest per dose. Serum lidocaine concentrations >8 mg/L are associated with seizure and cardiotoxicity. We evaluated serum lidocaine concentrations in patients receiving del Nido solution during cardiac surgery.

Predictors of Postoperative Morphine Milligram Equivalents in Cardiac Surgery.

Objectives: Given both the short- and long-term deleterious effects of opioids, there has been an increased focused on reducing the use of postoperative opioid analgesia. As patients undergoing cardiac surgery often require high levels opioids postoperatively, understanding risk factors for increased postoperative opioid use may be helpful for the development of patient-specific opioid-sparing pain regimens for this patient population.

Design: A retrospective analysis of data from our electronic medical records and the Society of Thoracic Surgeon's database.

Use of Bioimpedance Spectroscopy for Postoperative Fluid Management in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass.

Objective: To assess whether bioimpedance spectroscopy analysis (BIA) can be used as a tool to guide postoperative fluid management in patients undergoing cardiac surgery.

Design: An observational study.

Setting: A single tertiary hospital.

Factor Eight Inhibitor Bypassing Activity as First-line Therapy for Coagulopathy in Cardiac Surgery.

Objectives: To compare the outcomes of factor eight inhibitor bypassing activity (FEIBA) versus fresh frozen plasma (FFP) as the primary treatment for postoperative coagulopathy in patients undergoing cardiac surgery.

Design: A retrospective, propensity-matched study.

Setting: A single, tertiary hospital.

Low respiratory quotient correlates with high mortality in patients undergoing mechanical ventilation.

Objective: Oxygen consumption (VO), carbon dioxide generation (VCO), and respiratory quotient (RQ), which is the ratio of VO to VCO, are critical indicators of human metabolism. To seek a link between the patient's metabolism and pathophysiology of critical illness, we investigated the correlation of these values with mortality in critical care patients.

Methods: This was a prospective, observational study conducted at a suburban, quaternary care teaching hospital.

Impact of Limited Enhanced Recovery Pathway for Cardiac Surgery: A Single-Institution Experience.

Objectives: Enhanced recovery pathway (ERP) refers to extensive multidisciplinary, evidence-based pathways used to facilitate recovery after surgery. The authors assessed the impact that limited ERP protocols had on outcomes in patients undergoing cardiac surgery at their institution.

Design: A retrospective cohort study.

Continuous and repeat metabolic measurements compared between post-cardiothoracic surgery and critical care patients.

Objective: Using a system, which accuracy is equivalent to the gold standard Douglas Bag (DB) technique for measuring oxygen consumption (VO), carbon dioxide generation (VCO), and respiratory quotient (RQ), we aimed to continuously measure these metabolic indicators and compare the values between post-cardiothoracic surgery and critical care patients.

Methods: This was a prospective, observational study conducted at a suburban, quaternary care teaching hospital. Age 18 years or older patients who underwent mechanical ventilation were enrolled.

Endovascular Repair of Thoracoabdominal Aortic Aneurysm: A Brief Review.

Thoracoabdominal aortic aneurysms (TAAAs) are complex and if untreated have high mortality and morbidity rates. Open surgical repair is the historical treatment approach; however, postoperative complications remain high with spinal cord ischemia notably one of the more serious and common complications. The avoidance of thoracotomy or laparotomy with the advent of endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR) have decreased the morbidity and mortality with TAAA repair, especially in patients with significant comorbidities such as a history of aortic surgery, underlying cardiac disease, and chronic obstructive pulmonary disease.

Simultaneous Heart-Kidney Transplant-Does Hospital Experience With Heart Transplant or Kidney Transplant Have a Greater Impact on Patient Outcomes?

High institutional transplant volume is associated with improved outcomes in isolated heart and kidney transplant. The aim of this study was to assess trends and outcomes of simultaneous heart-kidney transplant (SHKT) nationally, as well as the impact of institutional heart and kidney transplant volume on survival. All adult patients who underwent SHKT between 2005-2019 were identified using the United Network for Organ Sharing (UNOS) database.

Suction-based catheter retrieval of right ventricular clot-in-transit.

Right ventricular clot-in-transit (CIT) is a rare finding in venous thromboembolic disease and carries a high mortality rate. Its optimal treatments have yet to be established in the literature. Here we describe the usage of a suction-based catheter, the INARI FlowTriever® system (INARI Medical Inc.

Short- and Mid-Term Outcomes of Complex and High-Risk Versus Standard Percutaneous Coronary Interventions in Patients Undergoing Transcatheter Aortic Valve Replacement.

The prevalence of coronary artery disease (CAD) in patients undergoing TAVR varies and is associated with increased morbidity and mortality. We evaluated the outcomes of complex and high-risk percutaneous coronary interventions (CHIP-PCIs) and TAVR compared with standard PCI and TAVR. Between January 2014 and March 2021, a total of 276 consecutive patients with severe aortic stenosis (AS) who underwent TAVR and PCI at 3 centers within Northwell Health were retrospectively reviewed.

Factor eight inhibitor bypassing activity for refractory bleeding in coronary artery bypass grafting: A propensity-matched analysis.

Background: Perioperative bleeding and transfusion have been associated with major morbidity and mortality after cardiac surgery. As concerns remain regarding potential graft thrombosis following administration of a prothrombin factor concentrate, the use of factor eight inhibitor bypassing activity (FEIBA) in managing refractory postoperative bleeding has never been evaluated in patients undergoing isolated coronary artery bypass grafting (CABG).

Objectives: We aimed to examine the safety of FEIBA in patients undergoing isolated CABG, with respect to 30-day mortality, perioperative outcomes, and thrombotic complications.

Use of TIMP-2 and IGFBP-7 for prediction of postoperative acute kidney injury after cardiac surgery.

Background: The following cell cycle arrest urinary biomarkers, tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP-7), have been used for early detection of acute kidney injury (AKI) in critically ill patients. The purpose of this study is to validate the use of these urinary biomarkers in patients undergoing open heart surgery.

Materials And Methods: In a single-center prospective observational study, urine samples were collected in 108 consecutive patients who underwent open heart surgery immediately after separation from cardiopulmonary bypass and on postoperative day 1, and were sent for the biomarker [TIMP-2]*[IGFBP7] analysis.

Survival and readmission among patients with advanced cardiomyopathy undergoing transcatheter edge-to-edge mitral valve repair: Are we applying COAPT findings too broadly?

Objective: Transcathether edge-to-edge mitral valve repair (TEER) has been shown to be an effective treatment for secondary mitral regurgitation (MR). However, the outcomes of TEER in patients with severe cardiomyopathy is less clear. The objective of this study is to determine the outcomes of such patients who underwent TEER at our institution.

An Automation System Equivalent to the Douglas Bag Technique Enables Continuous and Repeat Metabolic Measurements in Patients Undergoing Mechanical Ventilation.

Purpose: To develop a system that is equivalent to the gold standard Douglas Bag (DB) technique for measuring oxygen consumption (V̇o), carbon dioxide generation (V̇co), and respiratory quotient (RQ) and to validate its use in clinical settings.

Methods: This was a prospective, observational study conducted at a suburban, quaternary care teaching hospital. Healthy volunteers and patients 18 years or older who received mechanical ventilation were enrolled.

Age, sex, and contemporary outcomes in surgical repair of type A aortic dissection: Insights from the National Inpatient Sample.

Objective: Acute type A aortic dissection (ATAAD) is a surgical emergency with significant morbidity and mortality, as well as significant center-level variation in outcomes. Our study aims to leverage a nationally representative database to assess contemporary in-hospital outcomes in surgical repair of ATAAD, as well as the association of age and sex with outcomes.

Methods: The National Inpatient Sample was queried to identify hospital discharge records of patients aged ≥18 years who underwent urgent surgical repair of ATAAD between 2017 and 2018.

Patient Satisfaction Scores After Cardiac Surgery: Should They Be Risk-Adjusted?

The Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) is a survey tool that quantifies patient satisfaction after hospitalization. We sought to interrogate our HCAHPS results in order to identify any association between preoperative health, type of operation, and postoperative outcomes, with patient satisfaction after cardiac surgery. Of 12,572 patients who underwent cardiac surgery between December 2012 and December 2019, 2587 patients (20.

Impact of age on outcomes after transcatheter aortic valve implantation.

Aims: Usage of transcatheter aortic valve implantation (TAVI) for treatment of severe aortic stenosis is increasing across age groups. However, literature on age-specific TAVI outcomes is lacking. The purpose of this study is to assess the risks of procedural complications, mortality, and readmission in patients undergoing TAVI across different age groups.

Contemporary national utilization of extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest.

Objective: The utilization of extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (ECPR) has demonstrated promising evidence for the management of out-of-hospital cardiac arrest (OHCA). We aim to describe contemporary utilization and predictors of survival of patients receiving ECPR for OHCA.

Methods: The National Inpatient Sample (NIS) was queried to identify hospital discharge records of patients aged ≥18 years who underwent ECPR from 2012 to 2017.

Racial and socioeconomic disparities in urgent transcatheter mitral valve repair: A National Inpatient Sample analysis.

Background: Cardiac interventions performed urgently are known to be associated with poor outcomes compared with electively performed procedures. Transcatheter edge-to-edge mitral valve repair (TMVr) has developed as a reasonable alternative to mitral valve surgery in certain patient populations. We aimed to leverage a national database to identify predictors of urgent versus elective TMVr, as well as the association between urgency and outcomes.