Revisiting the PARTNER 3 trial: are 5-year hemodynamic findings enough to settle the debate in low-risk aortic stenosis?

This review revisits the 5-year echocardiographic findings from the PARTNER 3 trial, which assessed valve performance in low-surgical-risk patients undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). While TAVR demonstrated early hemodynamic advantages, including more favourable right ventricular-pulmonary artery coupling and lower valvulo-arterial impedance, these benefits did not consistently translate into superior long-term outcomes. Emerging data from companion publications highlight a potential late mortality in the TAVR group, despite comparable early results.

Outcomes of reoperative aortic valve surgery: data from a national registry over 23 years.

Objective: Over the past two decades, early mortality following re-operative aortic valve surgery has declined significantly; however, it remains higher than that observed after primary isolated valve replacement. We sought to examine temporal trends and identify independent predictors of adverse outcomes in patients undergoing re-operative aortic valve surgery.

Method: The study included all patients undergoing re-operative aortic valve replacement (AVR) in the United Kingdom between January-1996 and March-2019 including those with multiple previous operations and those undergoing additional procedures.

Cardiac Surgery During and After the Pandemic: A Retrospective Analysis of UK Trends and Outcomes.

Objectives: The full extent of the COVID-19 pandemic's impact during different phases of the pandemic and the recovery of cardiac surgical services in the United Kingdom have not been comprehensively assessed. This study aims to evaluate these disruptions' impact and immediate recovery on delivering adult cardiac surgical care in the United Kingdom.

Methods: The periods investigated were divided into pre-lockdown, first lockdown, first relaxation, second lockdown, second relaxation, third lockdown, and post-lockdown (recovery).

Selective antegrade cerebral perfusion as a neuroprotective strategy for aortic arch repair with congenital heart disease.

IntroductionSelective antegrade cerebral perfusion (SACP), combined with continuous cardiopulmonary bypass (CPB), has become a widely accepted alternative to deep hypothermic circulatory arrest (DHCA). This technique ensures a continuous supply of oxygenated blood to the brain during aortic arch surgery, minimizing the risk of ischemic injury and improving neurological outcomes.MethodsRetrospective data of all 36 patients undergoing aortic arch repair with selective antegrade cerebral perfusion between September 2020 to June 2024 was collected from hospital medical records.

FFR-guided PCI in multivessel disease: a close match, or an underpowered verdict on CABG?

In this review, we critically examine the 5-year outcomes of the Fractional Flow Reserve-Guided Percutaneous Coronary Intervention and Coronary Artery Bypass Graft Surgery in Patients With Multivessel Coronary Artery Disease (FAME 3) trial. While the composite outcome of death, stroke, or myocardial infarction showed no significant difference between the two strategies at 5 years, percutaneous coronary intervention was associated with higher rates of myocardial infarction and repeat revascularization. Coronary artery bypass graft surgery demonstrated greater benefit in patients with more complex coronary lesions.

Socioeconomic deprivation is associated with worse in-hospital survival after isolated coronary artery bypass grafting in the UK.

Objectives: Previous studies have identified a correlation between socioeconomic deprivation and poorer outcomes following cardiac surgery in the USA, where healthcare is predominantly delivered through private system. However, the influence of socioeconomic deprivation in countries with universal healthcare systems, such as the UK, has been less extensively investigated. Therefore, we used the index of multiple deprivation (IMD) to evaluate the impact of socioeconomic status on early clinical outcomes following coronary artery bypass grafting (CABG) in the UK.

Hospital readmission after heart valve surgery in the United Kingdom.

Objective: To evaluate hospital readmission rates in the United Kingdom within the first 12 months following heart valve surgery.

Methods: All patients who underwent heart valve surgery between January 2013 and April 2023 were included in the study. Readmission to any National Health Service hospital within 12 months after discharge was captured.

Reoperative surgery for early- and late-onset prosthetic valve endocarditis: temporal trends and outcomes.

Objectives: Prosthetic valve endocarditis (PVE) remains a serious complication following aortic valve replacement, with varying outcomes based on timing of presentation. This study investigated the relationship between timing of reoperation and outcomes in PVE patients using a nationwide database, while examining temporal trends and identifying mortality risk factors.

Methods: We analysed 406 patients who underwent reoperative surgery for PVE between 1996 and 2019 across the United Kingdom using the National Institute of Cardiovascular Outcomes Research database.

Integrated transcriptomic and regulatory RNA profiling reflects complex pathophysiology and uncovers a conserved gene signature in end stage heart failure.

Background: Heart failure (HF) is a complex syndrome. Despite availability of multiple treatment options, the mortality remains high and the quality of life poor. Better understanding of the underlying pathophysiological processes can lead to development of novel therapies.

Leveraging ECG images for predicting ejection fraction using machine learning algorithms.

Introduction: The capability to accurately predict the ejection fraction (EF) from an electrocardiogram (ECG) holds significant and valuable clinical implications. Various algorithms based on ECG images are currently being evaluated, with most methods requiring raw signal data from ECG devices. In this study, our objective was to train and validate a neural network on a readily available ECG trace image graph to determine the presence or absence of left ventricular dysfunction (LVD).

Cresp: transforming the landscape of chemotherapy-induced anemia - a comprehensive retrospective real-world analysis in 523 Indian patients.

Introduction: Anemia, a frequently encountered issue among cancer patients undergoing chemotherapy, is regrettably underappreciated despite its prevalence and profound impact on their well-being. Chemotherapy-induced anemia (CIA) diminishes the quality of life, causing fatigue, breathlessness, and a decline in the performance status. However, correcting anemia can lead to notable improvements in these parameters.

Long-term clinical outcomes in patients between the age of 50-70 years receiving biological versus mechanical aortic valve prostheses.

Objectives: The last 2 decades have seen an incremental use of biological over mechanical prostheses. However, while short-term clinical outcomes are largely equivalent, there is still controversy about long-term outcomes.

Methods: All patients between the ages of 50 and 70 years undergoing elective/urgent isolated aortic valve replacement at our institute between 1996 and 2023 were included.

Invasive vs conservative management in elderly patients with NSTEMI- insights from the SENIOR-RITA trial.

The SENIOR-RITA trial randomized 1,518 elderly Non-ST-segment elevation myocardial infarction (NSTEMI) patients to invasive or conservative strategies. The primary composite outcome of cardiovascular death or nonfatal Myocardial Infarction (MI) occurred in 25.6% of the invasive group versus 26.

A Study on Radiation Level at the Treatment Plane Due to Induced Activity in Linear Accelerator Head.

Background: The induced activity is produced in the target, monitor chamber, flattening filter (FF), collimating jaws, etc., when a high-energy photon beam is utilized for radiation therapy. This may result in add-on exposure to radiation professionals.

Bicuspid Aortic Valve dilemma: TAVI or SAVR? Insights from the NOTION-2 trial.

The Nordic Aortic Valve Intervention-2 (NOTION-2) trial is the first randomized controlled trial to compare transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement (SAVR) in low-risk patients, specifically focusing on relatively younger patients and those with bicuspid valves. It randomized 370 patients (mean age 71 years) to assess outcomes at 1 year. Results indicated a higher composite primary endpoint rate for TAVI (10.

Gender disparities in cardiothoracic surgery: a comparative study in India.

Background: This study aimed to examine the prevalence of gender bias in the field of cardiothoracic vascular surgery in India and compared women surgeons and trainees in India and abroad.

Methods: This was a comparative, cross-sectional analytical study using an online questionnaire. The survey included questions about demographics, career choice, training, academic and leadership opportunities, and the impact of choosing cardiothoracic-vascular surgery as a career on personal life.

Technologies for retrospective radiation dosimetry.

Radiation dosimetry is an important task for assessing the biological damages created in human being due to ionising radiation exposure. Ionising radiation being invisible and beyond the perception of human natural sensors, the dosimetry equipments/systems are the utmost requirement for its measurement. Retrospective measurement of radiation doses is a challenging task as conventional radiation dosemeters are not available at the exposure site.

Impact of distension pressure on saphenous vein endothelial injury in coronary artery bypass grafting.

Introduction: Long saphenous vein grafts (LSVGs) are pivotal conduits in coronary artery bypass grafting (CABG), yet concerns persist regarding early failure and long-term patency. Endothelial damage, a potent initiator of graft failure, necessitates exploration of factors contributing to endothelial injury during LSVG preparation.

Methods: A prospective, single-center study was conducted, assessing the impact of unregulated distension pressure on LSVG endothelium during CABG.

Pre-operative anaemia-does it influence post-operative outcomes after isolated coronary artery bypass grafting?

Introduction: Preoperative anaemia is prevalent in a number of patients undergoing coronary artery bypass grafting. Studies provide conflicting results due to several reasons including variation in the threshold of haematocrit used to define anaemia. We aimed to assess the independent effect of preoperative anaemia on outcomes in patients undergoing off pump coronary artery bypass grafting (OPCAB).

Performance Drift in Machine Learning Models for Cardiac Surgery Risk Prediction: Retrospective Analysis.

Background: The Society of Thoracic Surgeons and European System for Cardiac Operative Risk Evaluation (EuroSCORE) II risk scores are the most commonly used risk prediction models for in-hospital mortality after adult cardiac surgery. However, they are prone to miscalibration over time and poor generalization across data sets; thus, their use remains controversial. Despite increased interest, a gap in understanding the effect of data set drift on the performance of machine learning (ML) over time remains a barrier to its wider use in clinical practice.