The Annals of thoracic surgery
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Multicenter Study
Outcomes of Patients Receiving Temporary Circulatory Support Before Durable Ventricular Assist Device.
Temporary circulatory support (TCS) is used to stabilize patients in critical cardiogenic shock and bridge patients to a durable ventricular assist device (VAD). Whether TCS confers increased risk at the time of VAD implant is unknown. ⋯ Temporary circulatory support restores hemodynamics and reverses end-organ dysfunction. Nevertheless, these patients have high residual risk with postoperative morbidity and mortality that parallels profile 1 patients without TCS. Caution is suggested in downgrading risk for TCS patients with improved hemodynamic stability.
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This case represents the first report of complete elimination of systolic anterior motion by beating-heart implantation of artificial chordae tendineae on a prolapsing and redundant posterior leaflet.
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Observational Study
PaO2/FiO2 Deterioration During Stable Extracorporeal Membrane Oxygenation Associates With Protracted Recovery and Increased Mortality in Severe Acute Respiratory Distress Syndrome.
During extracorporeal membrane oxygenation (ECMO), arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2; PF ratio reflects native and artificial lung blood oxygenation). In this study we analyzed PF ratio during ECMO support and its association with clinical outcome. ⋯ In severe acute respiratory distress syndrome, PF ratio deterioration during stable ECMO associates with protracted recovery and increased mortality, not accounted for by patient baseline characteristics, acute respiratory distress syndrome severity, or pre-ECMO management.
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The Freedom Solo (FS) bovine pericardial valve (Sorin Group, Milan, Italy) is a stentless bioprosthesis that was introduced in 2004 and approved by the United States Food and Drug Administration in 2014. No long-term follow-up series are available to date. We report the multicenter experience of 4 European institutions that began implanting FS extensively from its introduction, providing the largest series with long-term follow-up. ⋯ The FS valve provided excellent long-term durability and hemodynamic performance in this large, multicenter European experience. Moreover, the FS, given the low rate of SVD, along with a simple implantability, proved to be a reliable bioprosthesis in the aortic position as a valid alternative to stented bioprostheses.