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Cardiac

November 10, 2014
The effects of exercise, increasing pump speed, or both on invasive hemodynamics in centrifugal flow LVAD patients were analyzed in this small study.  Findings included:
November 9, 2014
The correlation between "field independence"--i.e., the ability to ignore distracting visual stimuli--and surgical skills was examined in this simulator model.  Resident participants, after undergoing field dependence testing, were asked to place curved needles in a mitral valve model at 10 premarked sites.
November 7, 2014
The Cardiothoracic Surgical Trials Network recently reported that a third of patients after mitral valve repair for ischemic MR developed at least moderate recurrent MR at 1 year following surgery.  This begs the question as to which patients with ischemic MR would benefit from repair vs. replacement.
November 7, 2014
A multicenter, randomized, controlled trail including 900 patients divided patients into those undergoing on-pump versus off-pump CABG.  Identical heparinization and heparin reversal protocols were followed.  At angiography at 6 months following CABG, graft patency was inferior after off-pump as compared to on-pump  revascularization.
November 6, 2014
This is a new “real-world” study comparing bleeding risk in Medicare patients treated with dabigatran (n=1302) and warfarin (n=8102) for newly diagnosed atrial fibrillation. The use of dabigatran was associated with a significantly higher risk of any, major, and gastrointestinal bleeding when compared with warfarin.
November 5, 2014
This video presents the options available when a patient has greater-than-mild aortic insufficiency at the time of LVAD placement, and demonstrates the performance of a Parks’ stitch.
November 5, 2014
Challenges of balancing reduced costs and improved quality were explored for congenital heart surgery linking clinical data from STS Congenital Heart Surgery Database patients to administrative data from the Pediatric Health Information Systems Database.  Excess costs associated with any complication were over $56,000, and this increased to more than
November 5, 2014
The authors explored the impact of wait time for AVR in patients with severe symptomatic aortic stenosis using a single institution database.  For patients who were recommended to undergo AVR, wait time mortality at 3 weeks was 1.2% for those scheduled for AVR and 6.9% for those who declined AVR.  Wait time mortality for pts undergoing AVR was 3.7% a
November 5, 2014
The authors explored readmission rates for heart failure after MV repair/replacement in the US Medicare population as a means for assessing quality.  The preop heart failure rate in this population was 61%.  Readmission rates were 25% at 30 days and 78% at 5 years; they were substantially higher for those with preop heart failure and were higher for
November 3, 2014
This case describes a 74-year-old woman whose routine coronary bypass graft surgery was complicated with the rare and potentially lethal aortic root and left main dissection. The authors show how disaster for this patient was averted using a simple surgical technique.

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