Journal and News Scan

Stroke after transcatheter aortic valve implantation (TAVI) is associated with considerably worse postinterventional outcomes. However, predictors of stroke and the long-term risk after TAVI remain unknown. In this study from the SwissTAVI registry, the authors aimed to investigate the short- and long-term incidence and predictors of stroke following TAVR. A total of 11,957 patients (mean age 81.8 ± 6.5 years, 48.0 percent female) who underwent TAVI between 2011 and 2021 were included in the analysis. History of a previous stroke (11.8 percent) and atrial fibrillation (32.3 percent) were common among the analyzed patients. The thirty-day incidence of stroke was 3.0 percent, with 69 percent of the strokes occurring within the first 48 hours after TAVI. The incidence of stroke was 4.3 percent at one year and 7.8 percent at five years. After adjusting for matched comparison with same age and sex general population, the risk of stroke was significantly higher in the TAVI population during the first two years after TAVI. In the first year, SSR is 7.26 (95 percent CI: 6.3-8.36) and 6.82 (95 percent CI: 5.97-7.79) for males and females, respectively. In the second year, SSR is 1.98 (95 percent CI: 1.47-2.67) and 1.48 (95 percent CI: 1.09-2.02) for males and females, respectively. The authors concluded that TAVI patients experienced a higher risk of stroke up to two years after TAVI and a comparable risk after that.

This cross-sectional analysis of data from the Accreditation Council for Graduate Medical Education and the Association of American Medical Colleges comparing cardiothoracic surgeon faculty demographics and salary between 2019 and 2021 indicates that women comprised 11.5 percent of the cardiothoracic workforce and earned, on average, $0.71 to $0.86 for every $1.00 earned by men. Ascending academic rank correlated with greater salary disparity. Between 2019 and 2021, women at associate professor, professor, and chief rank experienced a decrease in mean salary whereas men at the same rank experienced an increase in mean salary.

In this article, the author describes three patients who had undergone previous mitral and aortic valve replacement, experiencing cardiogenic shock due to valve dysfunction. The initial evaluation demonstrated that the patients were deemed inoperable based on risk score calculations. AV ECMO was employed to recover them from cardiogenic shock and severe acidosis. Successful redo surgical valve replacement was performed in all cases, and the results are presented, followed by a discussion and literature review. The paper concludes that AV ECMO might be beneficial for patients with these severe conditions, providing them with a chance for survival after undergoing valve replacement redo surgery.

The authors used machine learning techniques on twenty-year outcome data from 436 consecutive patients who underwent mitral valve repair over an eighteen-year period. The endpoints were actuarial survival and freedom from moderate or high mitral regurgitation (MR). Five machine learning models were used, and concordance indices (C-indices) were compared. The study shows that machine learning models were able to predict overall mortality and MR recurrence after mitral valve repair. The C-indices of machine learning models were higher than those of the Cox model. Further validation will be required.