Edelman JJ, Rogers T, Khan JM, Thourani VH
J. Thorac. Cardiovasc. Surg. 2018 Aug;
PMID: 30241767
Edelman JJ, Rogers T, Khan JM, Thourani VH
J. Thorac. Cardiovasc. Surg. 2018 Aug;
PMID: 30241767
Thourani VH, Edelman JJ, Satler LF, Weintraub WS
JACC Cardiovasc Interv 2018 Nov;11(21):2157-2159
PMID: 30343021
Filipe EC, Santos M, Hung J, Lee BSL, Yang N, Chan AHP, Ng MKC, Rnjak-Kovacina J, Wise SG
JACC Basic Transl Sci 2018 Feb;3(1):38-53
PMID: 30062193
Synthetic vascular grafts for small diameter revascularization are lacking. Clinically available conduits expanded polytetrafluorethylene and Dacron fail acutely due to thrombosis and in the longer term from neointimal hyperplasia. We report the bioengineering of a cell-free, silk-based vascular graft. In vitro we demonstrate strong, elastic silk conduits that support rapid endothelial cell attachment and spreading while simultaneously resisting blood clot and fibrin network formation. In vivo rat studies show complete graft patency at all time points, rapid endothelialization, and stabilization and contraction of neointimal hyperplasia. These studies show the potential of silk as an off-the-shelf small diameter vascular graft.
Vanags LZ, Tan JTM, Galougahi KK, Schaefer A, Wise SG, Murphy A, Ali ZA, Bursill CA
JACC Basic Transl Sci 2018 Apr;3(2):200-209
PMID: 30062205
Even the most advanced drug-eluting stents evoke unresolved issues, including chronic inflammation, late thrombosis, and neoatherosclerosis. This highlights the need for novel strategies that improve stent biocompatibility. Our studies show that apolipoprotein A-I (apoA-I) reduces in-stent restenosis and platelet activation, and enhances endothelialization. These findings have therapeutic implications for improving stent biocompatibility.
Zhao DF, Edelman JJ, Seco M, Bannon PG, Vallely MP
J. Am. Coll. Cardiol. 2018 Jul;72(3):345-347
PMID: 30012329
McBride KE, Solomon MJ, Young JM, Steffens D, Lambert TJ, Glozier N, Bannon PG
ANZ J Surg 2018 May;
PMID: 29756676
BACKGROUND: People with comorbid mental illness have poorer health status and disparate access to healthcare. Several studies internationally have reported mixed findings regarding the association between mental illness and surgical patient outcomes. This study examines the surgical outcomes in people with decompensated serious mental illness (SMI) within the setting of the Australian universal healthcare system.
METHODS: Retrospective cohort study involving elective overnight surgical patients aged 18 years and above who attended a large public tertiary referral hospital in Sydney, Australia, between 2010 and 2014. Patients were identified using ICD-10-AM diagnosis codes. Outcomes measure including in-hospital mortality, post-operative complications, morbidity, admission and time in intensive care, length and cost of hospitalization, discharge destination and 28-day re-admission rates were examined.
RESULTS: Of 23 343 surgical patient admissions, 451 (2%) patients had decompensated comorbid SMI with a subset of 47 (0.2%) having a specific psychotic illness. Patients with SMI comorbidity had significantly higher in-hospital mortality (2% versus 0%), post-operative complications (22% versus 8%), total comorbidity (7.6 versus 3.4 secondary codes), admissions (29% versus 9%) and time in intensive care (34.6 h versus 5.0 h), stay in hospital (12.2 days versus 4.6 days), admission costs ($24 162 versus $12 336), re-admission within 28 days (14% versus 10%) and discharges to another facility (11% versus 3%).
CONCLUSION: Patients with comorbid SMI had significantly worse surgical outcomes and incur much higher costs compared with the general surgical population. These results strongly highlight that specific perioperative interventions are needed to proactively improve the identification, management and outcomes for these disadvantaged patients.
Lu R, Mei J, Zhao D, Jiang Z, Xiao H, Wang M, Ma N
Interact Cardiovasc Thorac Surg 2018 03;26(3):402-406
PMID: 29136152
OBJECTIVES: The incidence of both solitary pulmonary nodules (SPN) and non-valvular atrial fibrillation (NVAF) has increased over the past decade. We performed concomitant video-assisted thoracoscopic surgery with modified epicardial radiofrequency ablation procedure for NVAF and SPN resection.
METHODS: Sixteen patients (7 men, mean age 62.6 ± 11.2 years) with SPN and NVAF underwent this procedure. Of these patients, 10 had paroxysmal atrial fibrillation and 6 persistent atrial fibrillation. A modified epicardial radiofrequency ablation combined with pulmonary vein isolation, circumferential left atrial ablation, ganglionic plexus ablation and left atrial appendage resection was performed for all patients. Left pulmonary surgery was carried out subsequently.
RESULTS: The mean procedure duration was 203.1 ± 15.6 (range 177-224) min. All patients successfully underwent this procedure with no conversion to sternotomy or pacemaker implantation. Of the 16 included patients, 13 received lobectomy and 3 received wedge resection. No severe complications occurred postoperatively. The mean length of hospital stay was 9.1 ± 1.4 (range 7-11) days with a mean follow-up period of 18.7 ± 6.7 (range 8-32) months. One patient had AF recurrence 6 months postoperatively. No pulmonary vein stenosis was detected at the 3rd postoperative month. There were no deaths or thromboembolic events during follow-up.
CONCLUSIONS: This concomitant therapy proved to be safe and yielded good clinical outcomes. Therefore, it deserves to be considered as a treatment for patients with SPN and NVAF.