{"title":"Established and Emerging Device Therapy in Heart Failure: Cardiac Contractility Modulation.","authors":"Justin Haloot, Mihail G Chelu","doi":"10.14503/THIJ-23-8184","DOIUrl":"10.14503/THIJ-23-8184","url":null,"abstract":"","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 6","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew W Segar, Alexander Marzec, Mehdi Razavi, Karen Mullins, Joanna E Molina-Razavi, Subhasis Chatterjee, Alexis E Shafii, Jennifer R Cozart, Marc R Moon, Abdi Rasekh, Mohammad Saeed
{"title":"Incidence, Risk Score Performance, and In-Hospital Outcomes of Postoperative Atrial Fibrillation After Cardiac Surgery.","authors":"Matthew W Segar, Alexander Marzec, Mehdi Razavi, Karen Mullins, Joanna E Molina-Razavi, Subhasis Chatterjee, Alexis E Shafii, Jennifer R Cozart, Marc R Moon, Abdi Rasekh, Mohammad Saeed","doi":"10.14503/THIJ-23-8221","DOIUrl":"10.14503/THIJ-23-8221","url":null,"abstract":"<p><strong>Background: </strong>Postoperative atrial fibrillation (POAF) frequently complicates cardiac surgery. Predicting POAF can guide interventions to prevent its onset. This study assessed the incidence, risk factors, and related adverse outcomes of POAF after cardiac surgery.</p><p><strong>Methods: </strong>A cohort of 1,606 patients undergoing cardiac surgery at a tertiary referral center was analyzed. Postoperative AF was defined based on the Society of Thoracic Surgeons' criteria: AF/atrial flutter after operating room exit that either lasted longer than 1 hour or required medical or procedural intervention. Risk factors for POAF were evaluated, and the performance of established risk scores (POAF, HATCH, COM-AF, CHA2DS2-VASc, and Society of Thoracic Surgeons risk scores) in predicting POAF was assessed using discrimination (area under the receiver operator characteristics curve) analysis. The association of POAF with secondary outcomes, including length of hospital stay, ventilator time, and discharge to rehabilitation facilities, was evaluated using adjusted linear and logistic regression models.</p><p><strong>Results: </strong>The incidence of POAF was 32.2% (n = 517). Patients who developed POAF were older, had traditional cardiovascular risk factors and higher Society of Thoracic Surgeons risk scores, and often underwent valve surgery. The POAF risk score demonstrated the highest area under the receiver operator characteristics curve (0.65), but risk scores generally underperformed. Postoperative AF was associated with extended hospital stays, longer ventilator use, and higher likelihood of discharge to rehabilitation facilities (odds ratio, 2.30; 95% CI, 1.73-3.08).</p><p><strong>Conclusion: </strong>This study observed a high incidence of POAF following cardiac surgery and its association with increased morbidity and resource utilization. Accurate POAF prediction remains elusive, emphasizing the need for better risk-prediction methods and tailored interventions to diminish the effect of POAF on patient outcomes.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Optimized Catheter System Demonstrates Utility for Endomyocardial Delivery of Cardiopoietic Stem Cells in Target Patients With Heart Failure.","authors":"Jozef Bartunek, Andre Terzic","doi":"10.14503/THIJ-23-8247","DOIUrl":"10.14503/THIJ-23-8247","url":null,"abstract":"","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50163319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"ST-Segment Elevation Myocardial Infarction and Bleeding Complications in JAK2-Negative Polycythemia.","authors":"Priscilla Duran Luciano, Vanessa Sabella-Jiménez","doi":"10.14503/THIJ-23-8148","DOIUrl":"10.14503/THIJ-23-8148","url":null,"abstract":"<p><p>Thrombotic and bleeding complications are major causes of morbidity and mortality in patients with polycythemia vera, who predominantly present with an alteration in the JAK2 gene. Because of their hypercoagulable state and risk of hemorrhage, patients with polycythemia vera who present with an acute myocardial infarction pose a challenge to physicians. This case report describes the presentation and treatment of a Hispanic patient with JAK2 V617F-negative primary polycythemia who developed cardiac arrest and ST-segment elevation myocardial infarction owing to complete occlusion of the left anterior descending artery as well as bleeding complications and postmyocardial pericarditis.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lekhya Raavi, Pankaj Garg, Mohammad Alomari, Mostafa Ali, Ishaq Wadiwala, Magdy M El-Sayed Ahmed
{"title":"Patent Foramen Ovale-Related Hypoxemia After Bilateral Lung Transplant.","authors":"Lekhya Raavi, Pankaj Garg, Mohammad Alomari, Mostafa Ali, Ishaq Wadiwala, Magdy M El-Sayed Ahmed","doi":"10.14503/THIJ-23-8229","DOIUrl":"10.14503/THIJ-23-8229","url":null,"abstract":"<p><p>A 64-year-old man with interstitial pulmonary fibrosis and a small patent foramen ovale with right-to-left shunting underwent bilateral lung transplant without closure of the patent foramen ovale. Postoperatively, the patient remained persistently hypoxemic with partial response to high-flow oxygen. Investigations revealed the presence of a large patent foramen ovale with right-to-left shunting on echocardiography and a shunt fraction of 21% on cardiac catheterization. Two months after the lung transplantation, primary surgical repair of the patent foramen ovale was performed with immediate improvement in oxygenation. Three years postoperatively, the patient remained oxygen independent.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Orlando R Suero, Sri Kartik Valluri, Mario H Farias-Kovac, Leo Simpson, Gabriel Loor, Diana M Guerra, Jose L Diaz-Gomez, Subhasis Chatterjee
{"title":"Recovery of Lung Function After 149 Days on Extracorporeal Membrane Oxygenation for COVID-19.","authors":"Orlando R Suero, Sri Kartik Valluri, Mario H Farias-Kovac, Leo Simpson, Gabriel Loor, Diana M Guerra, Jose L Diaz-Gomez, Subhasis Chatterjee","doi":"10.14503/THIJ-23-8132","DOIUrl":"10.14503/THIJ-23-8132","url":null,"abstract":"<p><p>This report highlights survival and the patient's perspective after prolonged venovenous extracorporeal membrane oxygenation (ECMO) for COVID-19-related respiratory failure. A 36-year-old man with COVID-19 presented with fever, anosmia, and hypoxia. After respiratory deterioration necessitating intubation and lung-protective ventilation, he was referred for ECMO. After 3 days of conventional venovenous ECMO, he required multiple creative cannulation configurations. Adequate sedation and recurrent bradycardia were persistent challenges. After 149 consecutive days of ECMO, he recovered native lung function and was weaned from mechanical ventilation. This represents the longest-duration ECMO support in a survivor of COVID-19 yet reported. Necessary strategies included unconventional cannulation and flexible anticoagulation.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Milos Matkovic, Nemanja Aleksic, Ilija Bilbija, Ana Antic, Jelena Milin Lazovic, Marko Cubrilo, Aleksandar Milojevic, Igor Zivkovic, Svetozar Putnik
{"title":"Clinical Impact of Patient-Prosthesis Mismatch After Aortic Valve Replacement With a Mechanical or Biological Prosthesis.","authors":"Milos Matkovic, Nemanja Aleksic, Ilija Bilbija, Ana Antic, Jelena Milin Lazovic, Marko Cubrilo, Aleksandar Milojevic, Igor Zivkovic, Svetozar Putnik","doi":"10.14503/THIJ-22-8048","DOIUrl":"10.14503/THIJ-22-8048","url":null,"abstract":"<p><strong>Background: </strong>Patient-prosthesis mismatch (PPM) may impair functional capacity and survival after aortic valve replacement. This study aimed to investigate the impact of PPM on long-term survival and quality of life after mechanical and biological aortic valve replacement.</p><p><strong>Methods: </strong>This study included 595 consecutive patients who had undergone isolated aortic valve replacement. Patients were divided into 2 groups according to prosthesis type. The baseline and operative characteristics, survival rates, complications, and quality of life of the groups with and without PPM were compared for up to 6 years. The PPM calculation was performed using the effective orifice area value provided by the manufacturer divided by the patient's body surface area.</p><p><strong>Results: </strong>The moderate to severe PPM rates were 69.8% and 3.7% after biological and mechanical prosthesis implantation, respectively. Mean survival for patients in the biological group who had PPM was statistically significantly shorter (50.2 months [95% CI, 45.2-55.3]) than for patients in the biological group without PPM (60.1 months [95% CI, 55.7-64.4]; P = .04). In the mechanical prosthesis group, there was no difference in mean survival between the subgroup with PPM (66.6 months [95% CI, 58.3-74.9]) and the subgroup without PPM (64.9 months [95% CI, 62.6-67.2]; P = .50). A quality-of-life questionnaire's scores did not differ between the groups.</p><p><strong>Conclusion: </strong>Mismatch is common after biological valve implantation and statistically significantly affects long-term survival and quality of life. If the risk of PPM after implantation of a biological prosthesis is suspected, adopting strategies to avoid PPM at the time of surgery is warranted.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inflammatory Pathways and Their Implications in Heart Failure With Preserved Ejection Fraction.","authors":"Matthew W Segar, Stephanie A Coulter","doi":"10.14503/THIJ-23-8223","DOIUrl":"10.14503/THIJ-23-8223","url":null,"abstract":"","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Science Is a Self-Correcting Discipline: Revisiting the Biological Potential of Adult Cardiac Progenitors.","authors":"Daniele Torella, Eleonora Cianflone","doi":"10.14503/THIJ-23-8241","DOIUrl":"10.14503/THIJ-23-8241","url":null,"abstract":"","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}