CRT-146 Follow-up Results And Health-related Quality-of-life After Implantation Of Left Ventricular Passive Containment Device For Heart Failure And Dilated Cardiomyopathy

Se refiere al protagonismo de los medios en problemas de corrupción gubernamental y la desgastada credibilidad de los medios ante el público y la ciudadanía. Otro artículo ilustra los cambios de actitud latentes en medios nuevos y tradicionales. En la agenda política latinoamericana la reforma de las comunicaciones es prioritaria. La evolución de los medios en tan crucial para la sociedad que ningún sector afectado puede ser excluido de la gestión de reforma. Un módulo especial se dedica a la divulgación científica y tecnológica en América Latina y a la formación de periodistas especializados. Dos artículos más exploran algunos algunos aspectos de la contradictoria crisis que afecta al cine latinoamericano

[Ross procedure in a patient with mitro-aortic endocarditis]

Infective endocarditis (IE) affecting the heart valves is burdened by a high risk of mortality and complications. In the aortic valve IE, when valve replacement is essential, there is evidence of good results with the use of pulmonary autographs (Ross procedure), but the application of this technique remains limited due to its poor dissemination. We present a complex case of mitro-aortic IE treated with the Ross procedure associated with removal of vegetation from the mitral valve in a 28-year-old patient undergoing hemodialytic treatment, already undergoing cardiac surgery through sternotomy in the past

Mid-term results of endoscopic mitral valve repair and insights in surgical techniques for isolated posterior prolapse

Abstract Background The adoption of minimally invasive techniques to perform mitral valve repair surgery is increasing. This is enhanced by the compelling evidence of satisfactory short-term results and lower major morbidity. We analyzed mid-term follow-up results of our experience, and further compared two techniques: isolated leaflet resection and neochord implantation for posterior leaflet prolapse. Methods Data for all consecutive endoscopic mitral valve repairs via video-assisted right anterior mini-thoracotomy were analyzed between December 2012 and September 2021. The early and mid-term follow-up results were ascertained. The main outcome was the incidence of mortality and the recurrence of significant mitral regurgitation during follow-up which were summarized by the Kaplan-Meier estimator and compared between treatment arms using the stratified log-rank test. Secondary outcomes were the early-postoperative results including 30-days mortality and the occurrence of major complications. Results A total of 309 patients were included. Along with ring annuloplasty, 136 (44.4%) patients received posterior leaflet resection (122 isolated) whereas 97 (31.1%) underwent posterior leaflet chords implantation (88 isolated). Forty-nine patients had annuloplasty alone. In-hospital mortality was 1.0%. Mean follow-up was 28.8 ± 22.0 months (maximum 8.3 years). Kaplan–Meier survival rate at 5 years was 97.3 ± 1.0%, mitral regurgitation ( $$\ge$$ 3+) or valve reoperation free-survival at 5 years was estimated as 94.5 ± 2.3%. Subgroup time-to-event analysis for the indexed outcomes showed no statistical significance between the techniques. Conclusions Endoscopic mitral valve repair is safe and associated with excellent short- and mid-term outcomes. No differences were found between leaflet resection and gore-tex chords implantation for posterior leaflet prolapse

Prevalence and Clinical Impact of Systemic Inflammatory Reaction After Cardiac Surgery

Objectives: Cardiac surgery induces a systemic inflammatory reaction that has been associated with postoperative mortality and morbidity. Many studies have characterized this reaction through laboratory biomarkers while clinical studies generally are lacking. This study aimed to assess the incidence of postoperative systemic inflammation after cardiac surgery, and the association of postoperative systemic inflammation with preoperative patients’ characteristics and postoperative outcomes. Design: Retrospective analysis of prospectively collected data. Analysis of the overall population and of propensity-matched subgroups. Setting: Cardiac surgery intensive care unit. Patients: Adult patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) between June 2016 and June 2017. Interventions: Mixed cardiac surgery operations on CPB. Measurements and Main Results: During the study period, 502 patients underwent cardiac surgery with CPB. One hundred forty-two patients (28.3%) fulfilled SIRS criteria at 24 hours. After performing a multivariate analysis to adjust for the procedure type and preoperative systemic inflammatory reaction syndrome (SIRS) parameters, the occurrence of SIRS was associated inversely with age and extracardiac arteriopathy, and it was associated positively with preoperative white blood cell count. Vasopressors were used more frequently in SIRS patients who further experienced longer mechanical ventilation time and length of stay in the intensive care unit (ICU). The incidence of a composite outcome including death, transient ischemic attack/stroke, renal replacement therapy, bleeding, postoperative intra-aortic balloon pump insertion, and a length of stay in ICU >96 hours was more frequent in SIRS-positive patients. There was no difference between overall and matched subgroups for in-hospital mortality. Conclusion: In this retrospective study, the clinical signs of SIRS were detected in a substantial percentage of patients who underwent cardiac surgery. The postoperative SIRS criteria were associated with a more complicated postoperative course and higher postoperative morbidity