Bariatric surgery in obese patients with end-stage heart failure with ventricular assist devices

This is the raw data captured for a systematic review and individual participant data (IPD) meta-analysis evaluating the trends in body mass indices of obese patients with end-stage heart failure (ESHF) with ventricular assist devices (VADs) after undergoing bariatric surgery (BS).A systematic search was performed in ClinicalTrials.gov, Cochrane, Embase and PubMed on November 23rd, 2019. Additional searches were conducted in Google Scholar, websites of the most important journals for ESHF and BS, which also contained the proceedings of the most relevant scientific meetings in such specialties:-The Journal of Heart and Lung Transplantation-Journal of Cardiac Failure, Obesity Surgery-Surgery for Obesity and Related Diseases-Journals of following groups (journal families): --Journal of the American College of Cardiology--Circulation--European Heart JournalThese searches were performed at different before April 20th, 2020. Multiple official indexing terms and additional relevant terms for VADs and BS were used.Studies were selected if they reported IPD for the postoperative BMI of VAD patients after undergoing BS. Only patients with VAD support at the time of BS were included in the study. References selection, and data extraction were performed independently and in parallel by two investigators. In cases of disagreements, consensus was attempted through discussion, but if that was not achieved, a third investigator helped to solve the tie by simple majority. This database contains the most relevant variables from an ESHF and BS stand point.More details about data description and analyses can be found in the meta-analysis and data publication related to this project.THIS DATASET IS ARCHIVED AT DANS/EASY, BUT NOT ACCESSIBLE HERE. TO VIEW A LIST OF FILES AND ACCESS THE FILES IN THIS DATASET CLICK ON THE DOI-LINK ABOV

Laparoscopic sleeve gastrectomy in obese patients with ventricular assist devices

We identified the patients with end-stage heart failure and ventricular assist devices (VADs) who underwent bariatric surgery at Ochsner Medical Center, the only center with a VAD program in the State of Louisiana, USA. Every patient underwent a comprehensive preoperative evaluation that included psychological, metabolic, nutritional, and cardiovascular assessments. All patients were over the age of 18 years and underwent laparoscopic sleeve gastrectomy (LSG) between 2016 and January 2020. All patients were on chronic antiplatelet and anticoagulation therapy with warfarin and aspirin. Both medications were held at the time of admission and heparin infusion was started until the midnight prior to LSG. If the INR was > 1.5 the evening prior to the surgery, the patient received fresh frozen plasma and then, the INR was remeasured in the morning prior to surgery, which was performed when the INR was ≤ 1.5. Provided that the patient developed no bleeding complication, heparin was started at 200 U/hr eight hours after LSG, increased to 400 U/hr during the postoperative day one. The following day, heparin was titrated to a goal thromboplastin time of 35-45 sec with addition of aspirin. On postoperative day three, the goal thromboplastin time was increased to 45-54 sec and warfarin was restarted at a dose of 1 mg. This dataset (database: LSG in patients with VADs) includes baseline, periprocedural, and outcome data, which are described in one of the attached documents (description of variables)

Characteristics and Outcomes of Pulmonary Angioplasty With or Without Stenting for Sarcoidosis-Associated Pulmonary Hypertension: Systematic Review and Individual Participant Data Meta-Analysis

Background: Pulmonary angioplasty has been performed in patients with sarcoidosis-associated pulmonary hypertension (SAPH) but most evidence comes from case reports and small case series. Overall outcomes remain unclear. We conducted an individual participant data (IPD) meta-analysis of baseline, procedural, and outcome data of pulmonary angioplasty in patients with SAPH. Methods: We performed searches and systematically reviewed references from PubMed, Embase, Cochrane, ClinicalTrials.gov, and grey literature. We included IPD of patients who underwent pulmonary angioplasty for SAPH. Those without definitive diagnosis of sarcoidosis or with other causes of pulmonary vascular stenosis or compression were excluded. Results: Of 1293 screened references, 7 were included. IPD was obtained for 17 patients (median age 60 (55-65) years; 82.4% female); most of whom were Scadding stages III or IV and had NYHA FC III or IV. All patients with documented changes in 6-minute-walk distance (6MWD) had a significant improvement that ranged from 12.6 to 102.4% (P < 0.01). There were no deaths during a median follow-up of 6 (3-18) months. Conclusions: Pulmonary angioplasty with or without stenting of focal stenosis or compressions of pulmonary vessels may lead to significant improvement in 6MWD in patients with SAPH. However, this study had a small sample and some methodological limitations, such as analysis mostly of case reports and series. Randomized controlled clinical trials and/or large multicenter registry studies are needed to provide higher evidence in this topic

One-Year Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement for Stenotic Bicuspid versus Tricuspid Aortic Valves: A Meta-Analysis and Meta-Regression

Objective. To assess 1-year mortality after transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic stenosis (AS). Background. Clinical trials have proven the beneficial effect of TAVR on mortality in patients with tricuspid AS. Individuals with bicuspid AS were excluded from these trials. Methods. A meta-analysis using literature search from the Cochrane, PubMed, ClinicalTrials, SCOPUS, and EMBASE databases was conducted to determine the effect of TAVR on 1-year mortality in patients with bicuspid AS. Short-term outcomes that could potentially impact one-year mortality were analyzed. Results. After evaluating 380 potential articles, 5 observational studies were selected. A total of 3890 patients treated with TAVR were included: 721 had bicuspid and 3,169 had tricuspid AS. No statistically significant difference between the baseline characteristics of the two groups of patients was seen outside of mean aortic gradient. Our primary endpoint of one-year all-cause mortality revealed 85 deaths in 719 patients (11.82%) with bicuspid AS compared to 467 deaths in 3100 patients (15.06%) with tricuspid AS, with no difference between both groups [relative risk (RR) 1.03; 95% CI 0.70-1.51]. Patients with bicuspid AS were associated with a decrease in device success (RR 0.62; 95% CI 0.45-0.84) and an increase in moderate-to-severe prosthetic valve regurgitation (RR 1.55; 95% CI 1.07-2.22) after TAVR compared to patients with tricuspid AS. The effect of meta-regression coefficients on one-year all-cause mortality was not statistically significant for any patient baseline characteristics. Conclusion. When comparing TAVR procedure in tricuspid AS versus bicuspid AS, there was no difference noted in one-year all-cause mortality

LISTERIOSIS AND AIDS - CASE-REPORT AND LITERATURE-REVIEW

Listeriosis is a not uncommon infection in humans, usually associated with immunodeficient states and with newborns. However, relatively few cases have been reported in HIV-infected patients. This scarcity of reported cases has aroused interest in the association of listerosis and AIDS. In this paper we present a case of meningitis and septicemia caused by Listeria monocytogenes in a female patient with AIDS. A review of recent medical literature indicates that association of listeriosis and AIDS may be more common than it seems. Recent research in host-parasite interaction in listerial infection suggests an important role for tumor necrosis factor (TNF) and for integralin, a bacterial protein, in modulating listerial disease in AIDS patients. Inadequate diagnosis may be in part responsible for the scarcity of reports.34547547