phosphorus-31-magnetic-resonance-spectroscopy-for-serial-measurements

Phosphorus-31 Magnetic Resonance Spectroscopy for Serial Measurements of Cardiac Energetics During Temperature-Controlled Heart Preservation

Reliable organ preservation is critical to increasing donor availability and improving transplant outcomes. While static storage remains the standard for ...

Johns Hopkins University School of Medicine

Failure to rescue (FTR) is mortality after at least 1 postoperative complication. We investigated the impact of nighttime intensivist staffing and FTR after cardiac surgery.

Impact of Nighttime Cardiovascular Intensive Care Unit Staffing on Failure to Rescue and Revenue.

Coronary ostial obstruction after redo sternotomy and aortic root replacement: Case report.

A 4-h preservation time threshold for cardiac allografts is the current standard in heart transplantation, but novel technologies are proposed to decrease the morbidity associated with prolonged allograft storage. This study examined adult heart transplant recipients from 2000-2015 and 2020-2023 in the United States, stratified into an early (2000-2015) and modern era (2020-2023), then into standard (≤ 4 h) and prolonged (≥ 5 h) preservation time groups within each era. This study reinforced the 4-h threshold in the early era, where prolonged preservation significantly increased one-year mortality (HR 1.60, 95% CI 1.36-1.90). However, this association was no longer significant in the modern era (HR 1.14, 95% CI 0.85-1.50). A sub-analysis showed that using machine perfusion devices for allograft storage was not associated with one-year mortality (HR 1.15, 95% CI 0.79-1.70). Spline analysis demonstrated possible inflection points between 4 and 5 h and 8-9 h in the modern era, and further analysis found that 5-8 h of preservation did not increase one-year mortality (HR 1.09, 95% CI 0.80-1.47) relative to the ≤ 4 h group. In conclusion, the association between cardiac allograft preservation duration and morbidity has decreased in the modern era. Today, a 4-h preservation duration threshold may be too restrictive.

Understanding preservation time thresholds in the modern era of heart transplantation.

To investigate the impact of body mass index (BMI) on neurologic outcomes in venoarterial extracorporeal membrane oxygenation (VA-ECMO) DESIGN: Retrospective observational study SETTING: Single center PARTICIPANTS: Adults INTERVENTIONS: VA-ECMO MEASUREMENTS AND MAIN RESULTS: Obese (BMI≥30 kg/m²) and nonobese (BMI<30 kg/m²) patient groups were compared. The primary outcome was neurologic outcomes at discharge, with "good" (modified Rankin Scale [mRS] score 0-3) and "poor" (mRS score 4-6). Secondary outcomes were acute brain injury (ABI) and mortality. Multivariable Cox regression was used to investigate risk factors for poor neurologic outcomes, adjusting for demographics, comorbidities, pre-ECMO PaO, pericannulation PaCO change, lactate, central cannulation, and ABI. Spline regression was performed to assess the relationship between BMI and neurologic outcomes. The Kaplan-Meier estimator was used to evaluate 90-day survival. Among 214 patients (median age 58 years, 63% male), 104 were obese (median BMI, 35.4; interquartile range [IQR], 32.2-39.9), and 110 were nonobese (median BMI, 25; IQR, 23.2-27.5). Obese patients had higher rates of poor neurologic outcomes (91% vs 69%; p < 0.001) and ABI (50% vs 36%; p = 0.04). The Cox model identified associations of obesity (adjusted hazard ratio [aHR], 1.63, 95% confidence interval [CI], 1.15-2.31; p = 0.006) and ABI (aHR, 1.41; 95% CI, 1.01-1.96; p = 0.04) were associated with increased hazards of poor neurologic outcomes. Spline regression showed a fairly linear relationship between BMI and poor neurologic outcomes. Kaplan-Meier analysis suggested that the obese patients had a lower 90-day survival probability (p < 0.0001, log-rank test).

Impact of Obesity on Neurologic Outcomes in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation.

[This corrects the article DOI: 10.1016/j.xjtc.2024.09.005.].

Corrigendum to Coronary ostial obstruction after redo sternotomy and aortic root replacement: Case report [JTCVS Techniques, Volume 28, 2024, Pages 39-40].

Cardiac hemangiomas are rare, benign primary tumors that can be locally invasive and cause symptoms. The current recommendation is a complete R0 resection, which may require coronary artery reconstruction. We present a patient with progressive dyspnea who was found to have a large cardiac hemangioma encasing the left anterior descending artery and compressing the left ventricle. To achieve an R0 resection, the mass was removed en bloc with the left anterior descending artery, and the artery was reconstructed using a saphenous vein interposition graft. This case demonstrates the importance of an R0 resection for cardiac hemangioma, which may need nontraditional revascularization techniques.

Article	Year
Impact of Nighttime Cardiovascular Intensive Care Unit Staffing on Failure to Rescue and Revenue. The Annals of thoracic surgery\| PubMed ID: 39481824	2025
Coronary ostial obstruction after redo sternotomy and aortic root replacement: Case report. JTCVS techniques\| PubMed ID: 39669318	2024
Understanding preservation time thresholds in the modern era of heart transplantation. Scientific reports\| PubMed ID: 40240451	2025
Impact of Obesity on Neurologic Outcomes in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation. Journal of cardiothoracic and vascular anesthesia\| PubMed ID: 40518336	2025
Corrigendum to Coronary ostial obstruction after redo sternotomy and aortic root replacement: Case report [JTCVS Techniques, Volume 28, 2024, Pages 39-40]. JTCVS techniques\| PubMed ID: 40814667	2025
Cardiac Hemangioma: Getting to the Heart of the Matter. The Annals of thoracic surgery\| PubMed ID: 41223917	2026
Turning ideas into action: A framework for cardiothoracic trainees and surgeons to launch translational clinical trials. JTCVS open\| PubMed ID: 41466798	2025

Jessica B. Briscoe

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