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Mashup Score: 2
Mitral and tricuspid valvular disease have been managed surgically; however, multiple transcatheter technologies have diversified the therapeutic arsenal and expanded the number of patients eligible for treatment. These new technologies and active trials currently being performed at The Texas Heart Institute will be highlighted.Transcatheter edge-to-edge repair (TEER) with MitraClip (Abbott Structural Heart) plays an important role in the management of degenerative and functional mitral regurgitation (MR). Despite its success, the limitations of MitraClip include challenging anatomy that may not be amenable to TEER, the common need for multiple devices, risk of device-related mitral stenosis, and a not-trivial rate of residual MR.1 Delivered via a 22F sheath, the PASCAL device (Edwards Lifesciences) offers several improvements.2 Its 3-catheter system (including a guide, steerable, and implantation catheter) offers easy maneuverability in 3 independent planes. It has a spacer that fills
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Mashup Score: 0The Past, Present, and Future of Complex Aortic Intervention - 9 month(s) ago
Albert Einstein once said, “The distinction between the past, present and future is only a stubbornly persistent illusion.”So much of what is done with complex aortic surgical interventions is a direct outgrowth of what has been done, what is being done, and what is intended to be accomplished.The first successful aortic aneurysm repair was performed by Dr Charles Dubost in 1951; he replaced an infrarenal abdominal aorta aneurysm using a cadaver homograft harvested weeks earlier.1 This surgery culminated substantial efforts to repair damaged aortas using various techniques, including wiring the aorta with materials to induce thrombosis; proximal ligation of aortic aneurysms using metal tape, sutures, and autogenous tissue; and wrapping the aorta with cellophane and other materials. Dr Dubost’s success was made possible by pioneering vascular surgeons, including Dr Alexis Carrel (1873–1944),2 Dr Rudolph Matas (1860–1957),3 and Dr Oscar Creech (1916–1967),4 and contributed to further inn
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Mashup Score: 3
When selecting conduits for coronary artery bypass, long-term patency, survival benefit, and patient factors such as coronary atherosclerotic burden and comorbid conditions are the primary influences on surgical decision-making (Fig. 1). Previous studies have shown that multiple arterial conduits offer a survival benefit,1 but the observational design of this work makes the findings subject to patient selection bias. The Arterial Revascularization Trial was a prospective, randomized trial comparing bilateral internal thoracic arteries (ITAs) with single ITA conduits plus either a vein or radial artery (RA) conduit.2 The study did not demonstrate the survival benefit that observational studies have shown. With a crossover rate of 14% and 21.8% of patients in the single-ITA group receiving RA grafts, the findings are far from conclusive. In a post hoc, as-treated analysis, a survival benefit was seen with 2 arterial grafts—left ITA (LITA) plus right IT or RA—compared with a single arteri
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Mashup Score: 0Leveraging Innovation to Mitigate Risk During Heart Surgery - 9 month(s) ago
Innovation is not necessarily about the “next big thing” according to Mehta.1 Instead, innovation can occur by combining existing technologies, developing small ideas that compound, or evolving to address problems that have arisen from previous innovations that yielded unpredictable consequences. Innovation in the field of cardiovascular surgery is no different. As the field becomes progressively less invasive through innovation, patients who require open cardiac surgery are increasingly complex and carry increased risk. Patients with ischemic cardiomyopathy at high risk for morbidity often require surgical revascularization and valve interventions; however, risk factors such as diminished ejection fraction, redo operation, and multiple comorbidities compound perioperative morbidity and operative mortality. This report will define high-risk cardiac surgery and discuss how surgeons can leverage innovation to mitigate risk.The Surgical Treatment for Ischemic Heart Failure (STICH) trial r
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Mashup Score: 3The James T. Willerson, MD, Editor's Choice Award - 9 month(s) ago
In 2021, The Texas Heart Institute Board of Trustees created the James T. Willerson, MD, Editor’s Choice Award to honor his standards for excellence in research and scientific publishing. That year, 3 groups of authors whose articles were published in The Texas Heart Institute Journal received an award.Going forward, 2 primary authors will be recognized annually for their work on a Clinical Investigation, Laboratory Investigation, or Systematic Review that has been published in The Journal. Each author, one of whom will be an early-career professional, will receive a certificate and $5,000.Authors can now apply for the Editor’s Choice award when they submit their eligible original research papers to The Journal (Application Details). Winners of the 2023 awards will be recognized during a live ceremony from the Denton A. Cooley Auditorium in early 2024. The ceremony will be livestreamed to accommodate out of town recipients and their guests.Dr Willerson was an exemplary clinician who pl
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Mashup Score: 4End-of-Life Issues in Patients With Left Ventricular Assist Devices - 9 month(s) ago
Left ventricular assist devices (LVAD) can be used as either short-term (ie, bridge) or long-term (ie, destination) therapies. In the latter instance, discussion with the patient about end of life with an LVAD is necessary. Important issues at end of life for these patients range from aggressive symptom management to quality-of-life and ethical dilemmas. Multiple members of the multidisciplinary…
Source: Allen PressCategories: Cardiology News and Journals, Latest HeadlinesTweet
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Mashup Score: 0Evidence and Practicality of Real-Time Ultrasound-Guided Procedures in the Intensive Care Unit: A New Skill Set for the Intensivist - 9 month(s) ago
Over the past few decades, ultrasonography has become an increasingly popular method of imaging in various clinical settings, from rapid assessment of patients who are critically ill to real-time visualization of invasive procedures. This increasing utility of ultrasonography can be largely contributed to its ability to visualize blood vessels and organs with little to no risk for the patient,…
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Mashup Score: 0The James T. Willerson, MD, Editor's Choice Award - 9 month(s) ago
In 2021, The Texas Heart Institute Board of Trustees created the James T. Willerson, MD, Editor’s Choice Award to honor his standards for excellence in research and scientific publishing. That year, 3 groups of authors whose articles were published in The Texas Heart Institute Journal received an award.Going forward, 2 primary authors will be recognized annually for their work on a Clinical…
Source: Allen PressCategories: Cardiology News and Journals, Latest HeadlinesTweet
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Mashup Score: 0In Memoriam: Michael R. Nihill, MBBS (1936–2023) - 9 month(s) ago
On February 10, 2023, Dr Michael Nihill passed away peacefully at the age of 87 years. Those who were lucky enough to know him knew he was truly one of a kind.Born in 1936 in Haberfield, Australia, Dr Nihill completed his medical degree, internship, and pediatric residency in Sydney and then traveled to London, England, to work as a postgraduate student in internal medicine. Reflecting on this…
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Mashup Score: 0Pivotal Changes at The Texas Heart Institute Journal: Open Access, Creative Commons Licenses, and Article Processing Charges - 9 month(s) ago
During the last decade, advancements in the scientific publication industry led to strategic business improvements at The Texas Heart Institute Journal, beginning with online-only publication in 2014. Seven years later, we began continuous publication, a model that enables articles to be published within 6 weeks of acceptance.As governance of the industry and best practices continue to evolve,…
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