Journal of cardiac surgery
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Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is utilized as a life-saving procedure and bridge to myocardial recovery for patients in refractory cardiogenic shock. Despite technical advancements, VA-ECMO retains high mortality. This study aims to identify the clinical predictors of in-hospital mortality after VA-ECMO to improve risk stratification for this tenuous patient population. ⋯ In a large study of recent VA-ECMO patients, in-hospital mortality remains significant, but acceptable given the severe pathology manifested in this population. Identification of pre-ECMO predictors of mortality helps stratify high-risk patients when deciding on ECMO placement, prolonged support, and prognosis.
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Both coronavirus disease (COVID-19) and cardiac surgery have a negative impact on pulmonary function. This study aimed to determine the postoperative respiratory outcomes of patients with COVID-19 who underwent cardiac surgery. ⋯ Although early respiratory outcomes of asymptomatic COVID-19 patients who underwent early cardiac surgery appeared to be satisfactory, compared to the propensity-scored matched non-COVID group, the postoperative outcomes were worse, especially in the ICU readmitted patients. We suggest postponing cardiac operations unless the patient requires emergency surgery.
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Surgical left atrial appendage occlusion or exclusion has been performed with various techniques, however, during the following years the left atrial appendage elimination often fails. We propose a novel, rapid surgery process of safely closing and obliterating the left atrial appendage by an intra-atrial sutureless closure. ⋯ While we have shown that this technique is feasible, a longer follow-up and a larger series of patients is necessary before this method can be accepted in routine clinical practice.
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Starting as a therapeutically option for high-risk surgical patients with degenerative aortic valve stenosis, the transcatheter aortic valve implantation method is probably going to become the method of choice for this pathology also in younger and low-risk patients. As bioprosthesis are prone to degeneration, requiring a redo procedure, whenever a valve in valve procedure is contraindicated, a surgical valve replacement will become necessary. We describe a simple surgical method for explantation of a Sapien XT prosthesis that was implanted 7 years previously in a calcified aortic valve.