Contact Isolation Precautions are Associated With Increased Complications and Failure to Rescue After Cardiac Surgery.

Introduction: Contact isolation (CI) refers to a set of practices intended to reduce the transmission of infectious organisms. Previous literature suggests that CI can have a negative effect on direct patient care by discouraging frequent patient-provider contact; however, it is unknown how CI affects the care of postoperative cardiac surgery patients. Our aim was to characterize the outcomes of patients in CI following cardiac surgery.

Does retrograde autologous priming during coronary artery bypass grafting reduce blood transfusions?

Objective: Coronary artery bypass grafting is associated with a significant risk of blood transfusion. The clinical efficacy of retrograde autologous priming, a potential blood conservation strategy, lacks consensus. We aim to evaluate the effect of retrograde autologous priming on transfusion requirements and clinical outcomes in patients undergoing coronary artery bypass grafting.

Early Tracheostomy in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation.

Background: Early tracheostomy (ET) can decrease length of stay and mortality. The benefits of ET in patients requiring venovenous (VV) extracorporeal membrane oxygenation (ECMO) remain contentious. We assessed the influence of ET on outcomes in patients requiring VV ECMO.

Predictors of Radial Artery Use in Coronary Bypass Grafting: A Multi-institutional Cohort Study.

Introduction: To explore trends and analyze clinical and angiographic predictors of radial utilization in patients undergoing isolated coronary artery bypass grafting (CABG).

Methods: We analyzed data from 17,352 patients undergoing isolated CABG (January 1, 2017, to December 31, 2022) in a regional Society of Thoracic Surgeons Adult Cardiac Surgery Database linked with the National Cardiovascular Data Registry CathPCI registry. Multivariable logistic regression assessed predictors of radial artery (RA) use.

Ideal Timing of Coronary Artery Bypass Grafting After Non-ST-Segment Elevation Myocardial Infarction.

Background: Patients with non-ST-segment elevation myocardial infarction (NSTEMI) benefit from revascularization, but guidelines are vague regarding optimal timing. This study aimed to identify the ideal timing of coronary artery bypass grafting (CABG) after NSTEMI.

Methods: Study investigators examined patients with NSTEMI who underwent isolated CABG within 30 days of cardiac catheterization between July 2011 and July 2023 in a multicenter regional collaborative.

Percutaneous coronary intervention during the shortage of iodinated contrast.

Objectives: A recent coronavirus-related factory shutdown led to a global shortage of iodinated contrast. The authors evaluated how the contrast shortage impacted percutaneous coronary interventions (PCI).

Methods: Using a statewide database incorporating CathPCI registry data from 19 hospitals, the authors evaluated 2 time periods: pre-shortage (May 1, 2021 - April 30, 2022) and during the shortage (May 1, 2022 - October 31, 2022).

Clinical Outcomes for Postinfarct Ventricular Septal Defect Repair in a Large State-Wide Surgical Registry.

Ventricular septal defect (VSD) is a life-threatening complication occurring after delayed presentation of acute myocardial infarction (AMI). We assessed clinical characteristics based on mortality following surgical repair of post-AMI VSD and evaluated trends of mortality, mechanical circulatory support (MCS) device use, and surgical approach. We included all patients who had surgical VSD repair following AMI who were included in a regional quality collaborative from May 2008 through January 2020.

Cannulation Configuration and Its Effects on Bridging to Lung Transplant: Analysis of the Extracorporeal Life Support Organization Registry.

Background: Donor stagnation and modification of lung allocation scores has resulted in a higher acuity of patient presentation before lung transplantation. Extracorporeal membrane oxygenation (ECMO) has been used as a bridge to lung transplant (BTT), although the effect of cannulation strategy on outcomes has not been well investigated. We analyzed contemporary data on ECMO BTT by using a large, international registry of patients.

Multi-institutional model to predict intensive care unit length of stay after cardiac surgery.

Objective: Intensive care unit length of stay (ICU LOS) accounts for a large percentage of inpatient cost after cardiac surgery. The Society of Thoracic Surgeons risk calculator predicts total LOS but does not discriminate between ICU and non-ICU time. We sought to develop a predictive model of prolonged ICU LOS.

Assessing the impact of socioeconomic distress on hospital readmissions after cardiac surgery.

Background: The impact of socioeconomic distress on readmission rates following cardiac surgery has not been studied. We hypothesized that patients living in distressed communities would have a higher 30-day readmission rate after cardiac surgery compared to those living in less distressed communities.

Methods: Patients undergoing isolated coronary artery bypass grafting (CABG) between 2016 and 2023 within a regional collaborative were identified.

Machine Learning on 50,000 Manuscripts Shows Increased Clinical Research by Academic Cardiac Surgeons.

Introduction: Academic cardiac surgeons are productive researchers and innovators. We sought to perform a comprehensive machine learning (ML)-based characterization of cardiac surgery research over the past 40 y to identify trends in research pursuits.

Methods: US-based academic websites were queried for surgeon profiles.

Does Timing Matter? The Effect of Intensive Care Unit Arrival Timing on Elective Cardiac Surgery.

Background: Due to staffing changes at scheduled intervals and decreases in essential staff in the evenings, late intensive care unit (ICU) arrivals may be at risk for suboptimal outcomes. Utilizing a regional collaborative, we sought to determine the effect of ICU arrival timing on outcomes in elective isolated coronary artery bypass.

Methods: Adults undergoing elective, isolated coronary artery bypass from 17 hospitals between 2013 and 2023 were identified.

Cardiac Surgical Unit-Advanced Life Support-certified centers are associated with improved failure to rescue after cardiac arrest: A propensity score-matched analysis.

Objective: The impact of Cardiac Surgical Unit-Advanced Life Support (CSU-ALS) training on failure to rescue after cardiac arrest (FTR-CA) is unknown. We hypothesized that institutional CSU-ALS certification would be associated with lower FTR-CA.

Methods: Patients undergoing Society of Thoracic Surgeons index operations from 2020 to 2023 from a regional collaborative were analyzed.

Prophylactic left atrial appendage ligation during coronary artery bypass grafting: A propensity score-matched analysis.

Objective: The study objective was to evaluate short-term outcomes and statewide practice patterns of prophylactic left atrial appendage ligation in patients undergoing coronary artery bypass grafting without preoperative atrial fibrillation.

Methods: Adult patients who underwent on-pump coronary artery bypass grafting (2017-2023) within a regional collaborative were identified. Patients with a history of atrial fibrillation, previous cardiac surgery, or nondevice-based left atrial appendage ligation were excluded.

Operating Room Extubation for Patients Undergoing Cardiac Surgery: A National Society of Thoracic Surgeons Database Analysis.

Background: The utility of operating room extubation (ORE) after cardiac surgery over fast-track extubation (FTE) within 6 hours remains contested. We hypothesized ORE would be associated with equivalent rates of morbidity and mortality, relative to FTE.

Methods: Patients undergoing nonemergent cardiac surgery were identified in The Society of Thoracic Surgeons Adult Cardiac Surgery Database between July 2017 and December 2022.

Mitral valve repair in a regional quality collaborative: Respect or resect?

Objective: Mitral valve repair is the gold standard for treatment of mitral regurgitation, but the optimal technique remains debated. By using a regional collaborative, we sought to determine the change in repair technique over time.

Methods: We identified all patients undergoing isolated mitral valve repair from 2012 to 2022 for degenerative mitral disease.

Transient receptor potential vanilloid 4 channel inhibition attenuates lung ischemia-reperfusion injury in a porcine lung transplant model.

Objective: Transient receptor potential vanilloid 4 (TRPV4) is a nonselective cation channel important in many physiological and pathophysiological processes, including pulmonary disease. Using a murine model, we previously demonstrated that TRPV4 mediates lung ischemia-reperfusion injury, the major cause of primary graft dysfunction after transplant. The current study tests the hypothesis that treatment with a TRPV4 inhibitor will attenuate lung ischemia-reperfusion injury in a clinically relevant porcine lung transplant model.

Trends in the Use of Recombinant Activated Factor VII and Prothrombin Complex Concentrate in Heart Transplant Patients in Virginia.

Objectives: To explore trends in intraoperative procoagulant factor concentrate use in patients undergoing heart transplantation (HTx) in Virginia. Secondarily, to evaluate their association with postoperative thrombosis.

Design: Patients who underwent HTx were identified using a statewide database.

Delirium is associated with failure to rescue after cardiac surgery.

Objective: Postoperative delirium after cardiac surgery is associated with long-term cognitive decline and mortality. We investigated whether increased ICU Confusion Assessment Method scores were associated with greater 30-day mortality and failure to rescue after cardiac surgery.

Methods: We studied 4030 patients who underwent a Society of Thoracic Surgeons index operation at the University of Virginia Health System from 2011 to 2021.