Seoul St.Mary's Hospital’s Post

Can atrial fibrillation patients avoid lifelong anticoagulation after surgical closure of the left atrial appendage?   This urgent question will be answered soon! We are exited to announce the launch of the ATLAAC trial (Anticoagulant Therapy after Left Atrial Appendage Closure) at Aarhus University Hospital today! Initiated and led by Professor Lars Riber and PhD student Kristina Gosvig from Odense University Hospital's Department of Cardiothoracic Surgery, this pivotal non-inferiority RCT aims to assess the safety of discontinuing oral anticoagulation in atrial fibrillation (AFib) patients following sufficient surgical closure of the left atrial appendage. Inceasing evidence suggests that thrombus formation in the left atrial appendage increases stroke risk in Afib patients. A recent RCT has shown that surgical closure of the left atrial appendage along with oral anticoagulation can significantly reduce the risk of thromboembolic events in these patients (Whitlock 2021). However, a trial without oral anticoagulation is pending. Hence, current guidelines recommend long-term oral anticoagulation for most AFib patients, despite its substantial bleeding and management challenges, to reduce the risk of ischemic stroke. The primary outcome of the ATLAAC trial is a composite endpoint, focusing on cerebrovascular events and systemic embolisms, with additional measures including mortality and major hemorrhage. We look forward to join forces with other Danish Heart Centers to learn more about preventing stroke in AFib patients. The results of ATLAAC are expected to make a big difference for our patients. For more information, check out the comment below.

The NOVACC trial, a multicentre, randomized, double-blind study, evaluates vasopressin against norepinephrine for patients at renal risk during cardiac surgery with cardiopulmonary bypass. Targeting the reduction of cardiac surgery-associated acute kidney injury (CS-AKI) #AcuteKidneyInjury #AtrialFibrillation #Cardiopulmonarybypass #Norepinephrine #Vasopressin

The NOVACC trial, a multicentre, randomized, double-blind study, evaluates vasopressin against norepinephrine for patients at renal risk during cardiac surgery with cardiopulmonary bypass. Targeting the reduction of cardiac surgery-associated acute kidney injury (CS-AKI) #AcuteKidneyInjury #AtrialFibrillation #Cardiopulmonarybypass #Norepinephrine #Vasopressin

I’m thrilled to share our recently published study, "Complex Aortic Valve Repair in Congenital Patients: Clinical Feedback", in Frontiers in Pediatrics. This work delves into the outcomes and techniques of complex aortic valve repair in pediatric and young adult populations with congenital heart disease, providing valuable insights for the field of pediatric cardiac surgery. Key findings include: ✅ A high postoperative survival rate of 96.4% with a mean follow-up of 35 months. ✅ An 85.7% freedom from reoperation rate (at a 3 years of follow-up), showcasing the durability of the procedures. ✅ Statistically significant improvements in aortic stenosis and regurgitation. This study highlights the viability of complex aortic valve repair as a preferred first-line procedure, emphasizing its potential to enhance quality of life and reduce long-term complications for patients. It also underscores the importance of tailoring techniques, such as bicuspidization and annuloplasty, to the unique anatomical challenges in congenital cases. I welcome your thoughts on these findings and look forward to further collaborations that push the boundaries of congenital cardiac care. Check out the full study here: https://lnkd.in/dKtjCgnt Hospices Civils de Lyon - HCL Nathan Mewton Guillaume CARO HENAINE ROLAND Matteo Pozzi Marie-Anne BARBIER

Our Care@Home team was fortunate enough to participate in this study alongside our Medical Director Dr. Lidia Vognar and Dr. Joanna Abi Chebl. Extending care coordination for GSV selected patients beyond hospital walls with in home visits by Dr. Abi Chebl and Care@Home RN resulted in 2 less days spent in hospital, 7.3% discharged to SNF and 72% had higher rate of independence at discharge. What this study does not mention and should not be overlooked is the power of these physicians and nurses to connect with patients as if they were caring for their own parents. Nicely done Dr. Ponnandai Somasundar and team! "Shorter Hospital Stays: With the GSV program in effect, patients’ average length of stay was significantly shorter (4.4 days) than the group treated before the implementation of GSV (6.5 days). Patients More Likely to Be Discharged Home: Only 7.3% of patients in the intervention group were newly discharged to a care institution rather than their primary residence, compared to 24.1% in the control group. Reduced Loss of Independence: GSV program implementation was associated with 72% lower odds of increased care needs at discharge, indicating higher levels of independence." Jennifer Landi BSN, RN, HIHC-CSp, WCC

PRESS RELEASE | The American College of Surgeons published a news article on how the Geriatric Surgery Verification program decreased hospital stays and improved independence in #OlderAdults undergoing major abdominal procedures. The ACS GSV Program is designed to address the five domains included in the new #AgeFriendly Hospital measure. Learn more: https://ow.ly/wvfM50UuqBQ

Our Care@Home team was fortunate enough to participate in this study alongside our Medical Director Dr. Lidia Vognar and Dr. Joanna Abi Chebl. Extending care coordination for GSV selected patients beyond hospital walls with in home visits by Dr. Abi Chebl and Care@Home RN resulted in 2 less days spent in hospital, 7.3% discharged to SNF and 72% had higher rate of independence at discharge. What this study does not mention and should not be overlooked is the power of these physicians and nurses to connect with patients as if they were caring for their own parents. Nicely done Dr. Ponnandai Somasundar and team! "Shorter Hospital Stays: With the GSV program in effect, patients’ average length of stay was significantly shorter (4.4 days) than the group treated before the implementation of GSV (6.5 days). Patients More Likely to Be Discharged Home: Only 7.3% of patients in the intervention group were newly discharged to a care institution rather than their primary residence, compared to 24.1% in the control group. Reduced Loss of Independence: GSV program implementation was associated with 72% lower odds of increased care needs at discharge, indicating higher levels of independence." Jennifer Landi BSN, RN, HIHC-CSp, WCC

NHS patients to access world-leading laser beam surgery to prevent epileptic seizures The NHS is to roll out a “game-changing” new laser beam therapy next month to help reduce seizures for patients with epilepsy. The cutting-edge fibre optic laser therapy, known as Laser Interstitial Thermal Therapy (LITT), targets the part of the brain causing seizures without the need for invasive surgery. The treatment will now be rolled out for eligible patients across England from June, being offered at King’s College Hospital in London and The Walton Centre in Liverpool as specialist national hubs. The treatment involves drilling a tiny hole to allow a 1.5mm-wide probe with a fibre optic laser at the tip to be inserted into the skull. This reaches and destroys the epilepsy-causing brain tissue from the inside by heating it. Using an MRI scanner, the clinical team navigate through the brain avoiding blood vessels and other critical structures. They also monitor the temperature of the surrounding areas to make sure healthy brain tissue does not overheat. The wound heals quickly, meaning patients can go home the next day (within 24-48 hours) with minimal risk of infection or other side effects and can usually return to work and other activities within a week. It is estimated that up to 50 patients in England each year whose epilepsy cannot be controlled by standard anti-seizure drugs will be eligible for LITT. https://lnkd.in/eg3u7sPQ

A recent clinical trial published in The Lancet Gastroenterology & Hepatology demonstrates that hypovolemic phlebotomy, involving the removal and subsequent reinfusion of 10% of a patient's blood before major liver surgery, can reduce the need for transfusions by half. Conducted across four Canadian hospitals, the trial involved 446 patients and showed that only 7.6% of those undergoing hypovolemic phlebotomy required transfusions, compared to 16.1% with standard care. This approach not only reduces blood loss but also offers a cost-effective solution, potentially transforming standard practices in liver surgeries worldwide.

Vagus nerve stimulation (#VNS) has been clinically effective and cost-efficient in managing epilepsy. This recent study covers the surgical complications that still may arise in VNS surgery.    606 VNS procedures were analyzed, including primary implantation, generator replacement, lead revision, and system removal. The most common complications included transient hoarseness and surgical site infection. Surgical site infection was common across different surgery types but particularly prominent in primary implantation and complete removal cases. Hoarseness and vocal cord paresis varied in persistence but were notable across primary implantation, complete revision, and complete removal surgeries.   The study highlighted that while VNS is relatively safe, the type of VNS surgery influences the complication rate and type. Primary implantation and complete removal surgeries exhibited a higher rate and variety of complications, underscoring the need for careful consideration in the planning and execution of VNS procedures. They say that future research should involve larger sample sizes, and further studies are recommended to optimize treatment and confirm these findings.  In our experience, leveraging machine learning for predictive analytics in VNS procedures can greatly reduce the risk of complications. By analyzing historical surgical data, #ML models can help identify patterns and risk factors associated with specific complications. This insight allows for personalized surgical planning, minimizing potential risks, and improving patient outcomes. How do predictive models tailor surgical approaches across different neurostimulation therapies, and what can VNS learn from them? #predictiveanalytics #neurostimulation https://lnkd.in/dtvHS3_b