Use of percutaneous ventricular assist device as bridge to high risk combined heart valve surgery.

peer reviewe

Utilisation d'assistance ventriculaire percutanée avant une procédure chirurgicale de double remplacement valvulaire à haut risque

peer reviewe

Giant vegetation of the tricuspid valve in a healthy patient without risk factors for right-sided endocarditis.

peer reviewedWe present the case of a middle-aged man who developed infective endocarditis of the tricuspid valve caused by methicillin-sensitive Staphylococcus aureus and associated with very large vegetation (∼5 cm). Besides the quite unusual size of the vegetation, this report highlights that severe right-sided endocarditis can occur in the absence of classical risk factors (intravenous drug abuse, presence of a cardiac implantable electronic device or other intravascular devices, and underlying right-sided cardiac anomaly) and that some cases of severe tricuspid endocarditis can be successfully treated by partial excision and patch repair

Stem cells in the adult rat spinal cord: plasticity after injury and treadmill training exercise

ABSTRACT Ependymal cells located around the central canal of the adult spinal cord are considered as a source of neural stem cells (NSCs) and represent an interesting pool of endogenous stem cells for repair strategies. Physical exercise is known to increase ependymal cell proliferation, while improving functional recovery. In this work, we further characterized those endogenous NSCs within the normal and injured adult rat spinal cord and investigated the effects of treadmill training using immunohistochemical and behavioural studies. In uninjured untrained rats, Sox-2, a NSC marker, was detected in all ependymal cells of the central canal, and also scattered throughout the parenchyma of the spinal cord. Within the lesion, Sox-2 expression increased transiently, while the number of nestin-positive ependymal cells increased with a concomitant enhancement of proliferation, as indicated by the mitotic markers Ki67 and BrdU. Exercise, which improved functional recovery and autonomous micturition, maintained nestin expression in both injured and uninjured spinal cords, with a positive correlation between locomotor recovery and the number of nestin-positive cells

Development and Validation of a Prediction Score for Low-Cardiac-Output Syndrome After Adult Cardiac Surgery.

peer reviewed[en] OBJECTIVES: The authors aimed to develop a simple prediction score to help identify patients at high risk of low-cardiac-output syndrome after adult cardiac surgery. DESIGN: A single-center, retrospective, observational study. SETTING: At a tertiary hospital. PARTICIPANTS: Adult patients who underwent on-pump cardiac surgery between April 2016 and March 2021. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: Among the 2,806 patients retained for final analyses, 355 (12.7%) developed low-cardiac-output syndrome. Using a stepwise backward variable selection procedure applied to a multivariate logistic regression, a prediction model, including 8 risk factors, could be identified-preoperative left ventricular ejection fraction, glomerular filtration rate <60 mL/min according to the Cockcroft formula or preoperative dialysis, combined surgery, nonelective surgery, mitral valve surgery for mitral valve regurgitation, history of extracardiac arteriopathy, preoperative hemoglobin <13 g/dL, and New York Heart Association functional class III or IV. A clinical prediction score was derived from the regression coefficients. The model had a good discriminative ability, with an area under the receiver operating characteristics curve of 0.8 (95% CI: 077-0.84). Using a threshold value of 5, the score had a 68% sensitivity, 79% specificity, a positive-predictive value of 33%, and a negative-predictive value of 94%. These results were validated on a validation sample using the bootstrap resampling technique. CONCLUSIONS: The authors developed a clinical score to facilitate the prediction of low- cardiac-output syndrome after adult cardiac surgery. This could help tailor patient management by contributing to the early identification of those at high risk of postoperative low cardiac output

Effect of hydroxy ethyl starch (HES) 130/0.4 on renal function and mortality one year after adult cardiac surgery : A single center retrospective study

peer reviewedHydroxyethyl starch (HES) adversely affect short-term survival and renal function of intensive care unit and possibly of surgical patients. We retrospectively investigated whether using HES as a pump prime and for intraoperative fluid therapy is associated with mortality and end-stage renal failure one year after adult cardiac surgery. Multivariable logistic regression was used to adjust for imbalanced characteristics between the two study groups. The primary outcome, a composite of end-stage renal failure or mortality during the first postoperative year was observed in 9.7% of patients who received HES and in 6.2% of patients treated with crystalloids only (Adjusted OR 1.05; 95%CI, 0.5-2; P = 0.9). These results suggest that using HES or balanced crystalloids as a pump prime and for intraoperative fluid therapy results in similar one-year outcomes but must be considered as preliminary given the limited statistical power of the study

Intraoperative recruitment does not affect postoperative restrictive pulmonary syndrome and hypoxaemia after laparoscopic gastric by-pass in morbidly obese patients: A randomised controlled study

peer reviewed[No abstract available

On-table Extubation After Minimally Invasive Cardiac Surgery: A Retrospective Observational Pilot Study

peer reviewe