ABSTRACT Introduction: Systemic inflammatory response syndrome (SIRS) is related to increased circulating endothelial microparticles (EMP). Objective: The aim of this study was to compare the plasma concentration of EMP between patients undergoing aortic valve replacement with conventional bioprosthesis implantation and Perceval™ S (LivaNova) and to evaluate its impact on the inflammatory response in the short-term follow-up. Methods: This is a randomized clinical trial with 24 patients submitted to isolated aortic valve replacement divided into two groups: Perceval™ S (Group P) and conventional bioprostheses (Group C). Incidence of severe SIRS (three or more criteria) in the first 48 hours postoperatively, EMP release profile, interleukins (IL) 6 and 8, C-reactive protein, and procalcitonin were analyzed preand postoperatively at 24 hours and three months. Results: There were 24 patients (12 in each group), mean age was 69.92±5.17 years, 83.33% were female, the incidence of severe SIRS was 66.7% and 50% in groups C and P, respectively (P=0.68), and EMP showed a significant increase in the 24-hour postoperative period (P≤0.001) and subsequent decrease in the three-month postoperative period (P≤0.001), returning to baseline levels. For IL-6 and IL-8, there was a greater increase in group C at 24 hours postoperatively (P=.0.02 and P<0.001). Conclusion: The incidence of severe SIRS was similar in both groups, with significantly higher levels of IL-6 and IL-8, at the 24-hour postoperative period, in group C, however with higher levels of EMP in group P, and subsequent return to baseline levels at the three-month postoperative period in both groups. Introduction (SIRS EMP. . (EMP) Objective Perceval LivaNova (LivaNova shortterm short term followup. followup follow up. up follow-up Methods 2 Group P C. C) criteria 4 profile IL (IL 8 Creactive reactive protein months Results 12 (1 group, , group) 6992517 69 92 5 17 69.92±5.1 years 8333 83 33 83.33 female 667 66 7 66.7 50 P=0.68, P068 P=0.68 0 68 (P=0.68) 24hour hour P≤0.001 P0001 001 (P≤0.001 threemonth month P≤0.001, IL6 IL- IL8, IL8 IL-8 P=.0.02 P002 02 (P=.0.0 P<0.001. P<0.001 P<0.001) Conclusion (EMP 1 ( 699251 9 69.92±5. 833 3 83.3 66. P06 P=0.6 (P=0.68 P≤0.00 P000 00 (P≤0.00 P=.0.0 P00 (P=.0. P<0.00 69925 69.92±5 83. P0 P=0. (P=0.6 P≤0.0 (P≤0.0 P=.0. (P=.0 P<0.0 6992 69.92± P=0 (P=0. P≤0. (P≤0. P=.0 (P=. P<0. 699 69.92 P= (P=0 P≤0 (P≤0 P=. (P= P<0 69.9 P≤ (P≤ (P P< 69.

ABSTRACT Introduction: Extracorporeal membrane oxygenation (ECMO) is the first-line therapy for temporary mechanical circulatory support allowing cardiac and pulmonary recovery or as a bridge to further therapeutic alternatives. The aim of this study was to report clinical outcomes in adult patients with refractory cardiac failure after open-heart surgery undergoing ECMO in a single center with an ECMO unit in Chile. Methods: We retrospectively analyzed adults with refractory cardiac failure after open-heart surgery who required a venoarterial (VA) ECMO between 2016 and 2021. Results: Of 16 patients with VA ECMO, 60% were men (n=10), 90% had hypertension (n=14), 69% had < 30% of left ventricular ejection fraction (n=11), and the mean European System for Cardiac Operative Risk Evaluation II score was 12 ± 11%. ECMO support with central cannulation accounts for 81% (n=13), and an intra-aortic balloon pump was used in nine patients (56%). The mean time of support was 4.7 ± 2.6 days (1.5 - 12 days). ECMO weaning was achieved in 88% of patients, and in-hospital mortality was 44% (n=7) after discharge. The freedom from all-cause mortality at one year of follow-up of the entire cohort was 38% (n=6). Conclusion: VA ECMO is now a well-known life-saving therapeutic option, but mortality and morbidity remain high. Implementation of an ECMO program with educational training is mandatory in order to find the proper balance between patient benefits, ethical considerations, and public health financial input in South America. Introduction (ECMO firstline first line alternatives openheart open heart Chile Methods (VA 201 2021 Results 1 60 n=10, n10 n n=10 , 10 (n=10) 90 n=14, n14 n=14 14 (n=14) 69 30 n=11, n11 n=11 11 (n=11) 11% 81 n=13, n13 n=13 13 (n=13) intraaortic intra aortic 56%. 56 56% . (56%) 47 4 7 4. 26 2 6 2. 1.5 15 5 (1. days. days) 88 inhospital hospital 44 n=7 n7 (n=7 discharge allcause all cause followup follow up 38 n=6. n6 n=6 (n=6) Conclusion wellknown well known lifesaving life saving option high benefits considerations America 20 202 n1 n=1 (n=10 9 (n=14 3 (n=11 8 (n=13 (56% 1. (1 n= (n= (n=6 (n=1 (56 ( (n (5

ABSTRACT Introduction: According to recent data, thoracic aortic surgery has reduced morbidity and mortality including ascending aortic aneurysm treatment; however, women are at increased postoperative risk of adverse outcomes. Objective: Our aim was to evaluate early and late outcomes in male and female patients who underwent pre-emptive ascending aortic replacement (AAR). Methods: From January 2013 to September 2021, 91 patients (56 [61.5%] men and 35 [38.5%] women) underwent AAR for small (ranged from 5.0 to 5.5 cm) non-syndromic aneurysms. A propensity score-based adjustment of the groups was performed. We compared clinical outcomes between males and females. Results: Preoperative normalized aortic diameters were significantly larger in females (2.9 [2.7; 3.2] cm/m2) than in males (2.5 [2.3; 2.6] cm/m2, P<0.001), without differences in absolute values (51 [49; 53] mm vs. 52 [50; 53] mm, P=0.356). There were no significant differences in neurological, cardiac, pulmonary, and renal complications in both groups before and after matching. In-hospital mortality was 1 (1.8%) and 2 (5.7%) (P=0.307) in male and female patients in unmatched groups and 1 (2.9%) and 2 (5.7%) (P=0.553) in matched groups, respectively. Univariate logistic regression analysis revealed that the only risk factor for in-hospital mortality was age (odds ratio 1.117, 95% confidence interval 1.003-1.244; P=0.04). The overall survival rate was 83.5±0.06% in men and 94.3±0.04% in women at 36 months (P=0.404). Conclusion: Ascending aortic surgery for aneurysms ranged from 5.0 to 5.5 cm seems to have tolerable early and late outcomes in men and women. Introduction data treatment however Objective preemptive pre emptive AAR. . (AAR) Methods 201 2021 9 56 (5 61.5% 615 61 5 [61.5% 3 38.5% 385 38 [38.5% 50 0 5. 55 nonsyndromic non syndromic scorebased score based performed Results 2.9 29 (2. 2.7 27 7 [2.7 3.2 32 cm/m2 cmm2 cmm m2 m 2.5 25 2.3 23 [2.3 2.6 26 6 P<0.001, P0001 P P<0.001 , 001 P<0.001) 51 49 [49 53 vs [50 P=0.356. P0356 P=0.356 356 P=0.356) neurological cardiac pulmonary matching Inhospital In hospital 1.8% 18 8 (1.8% 5.7% 57 (5.7% P=0.307 P0307 307 (P=0.307 2.9% (2.9% P=0.553 P0553 553 (P=0.553 respectively inhospital odds 1117 117 1.117 95 1.0031.244 10031244 1.003 1.244 003 244 1.003-1.244 P=0.04. P004 P=0.04 04 P=0.04) 835006 83 06 83.5±0.06 943004 94 94.3±0.04 P=0.404. P0404 P=0.404 404 (P=0.404) Conclusion (AAR 20 202 ( 61.5 [61.5 38.5 [38.5 2. (2 [2. 3. cm/m P000 P<0.00 00 4 [4 [5 P035 P=0.35 1.8 (1.8 5.7 (5.7 P=0.30 P030 30 (P=0.30 P=0.55 P055 (P=0.55 111 11 1.11 0031 1.0031.24 1003124 1003 1.00 1244 1.24 24 1.003-1.24 P00 P=0.0 83500 83.5±0.0 94300 94.3±0.0 P040 P=0.40 40 (P=0.404 61. [61. 38. [38. [2 P<0.0 [ P03 P=0.3 1. (1. (5. (P=0.3 P=0.5 P05 (P=0.5 1.1 1.0031.2 100312 100 1.0 124 1.2 1.003-1.2 P0 P=0. 8350 83.5±0. 9430 94.3±0. P04 P=0.4 (P=0.40 [61 [38 P<0. (1 (P=0. 1.0031. 10031 10 12 1.003-1. P=0 835 83.5±0 943 94.3±0 (P=0.4 [6 [3 P<0 (P=0 1.0031 1.003-1 P= 83.5± 94.3± P< (P= 1.003- 83.5 94.3 (P 83. 94.

ABSTRACT Introduction: Atrial fibrillation is one of the common complications of mitral valve disease. Currently, in the absence of freezing equipment, it’s still impossible to fully conduct a minimally invasive Cox-maze IV procedure to treat atrial fibrillation. Methods: We analyzed the clinical data of 28 patients who underwent thoracoscopic minimally invasive mitral valve full maze surgery in our hospital from October 2021 to September 2022; 13 patients were male and 15 were female, three suffered from paroxysmal atrial fibrillation, and 25 suffered from permanent atrial fibrillation; average age was 61.88±8.30 years, and mean preoperative left atrial diameter was 47.12±8.34 mm. Isolation of left atrial posterior wall (box lesion) was completed in all patients by cut-and-sew technique and bipolar clamp ablation. Results: For these subjects, the median cardiopulmonary bypass time was 169 (109.75-202.75) minutes, aortic cross-clamping time was 106 (77.75-125.50) minutes, and ventilator assistance time was 6.5 (0-10) hours. Among them, eight subjects had the endotracheal tubes removed immediately after surgical operation. Three subjects were in the blanking period; two subjects still had atrial fibrillation at three months after operation, one of whom resumed sinus rhythm after electrical cardioversion therapy; and all the remaining 23 subjects had sinus rhythm. Conclusion: The minimally invasive cut-and-sew technique for electrical isolation of left pulmonary veins can improve sinus conversion rate of patients suffering from both mitral valve disease and atrial fibrillation. In selected subjects, it is safe and has good results in the short-term postoperative period. Introduction Currently equipment its s Coxmaze Cox Methods 2 202 2022 1 female 6188830 61 88 8 30 61.88±8.3 years 4712834 47 12 34 47.12±8.3 mm box lesion cutandsew cut sew ablation Results 16 109.75202.75 1097520275 109.75 202.75 109 75 (109.75-202.75 minutes crossclamping cross clamping 10 77.75125.50 777512550 77.75 125.50 77 125 50 (77.75-125.50 65 6 5 6. 010 0 (0-10 hours them operation period therapy Conclusion shortterm short term 20 618883 3 61.88±8. 471283 4 47.12±8. 75202 109.75202.7 109752027 10975 109.7 20275 202.7 7 (109.75-202.7 75125 77.75125.5 77751255 7775 77.7 12550 125.5 (77.75-125.5 01 (0-1 61888 61.88±8 47128 47.12±8 7520 109.75202. 10975202 1097 109. 2027 202. (109.75-202. 7512 77.75125. 7775125 777 77. 1255 125. (77.75-125. (0- 6188 61.88± 4712 47.12± 752 109.75202 1097520 (109.75-202 751 77.75125 777512 (77.75-125 (0 618 61.88 471 47.12 109.7520 109752 (109.75-20 77.7512 77751 (77.75-12 ( 61.8 47.1 109.752 (109.75-2 77.751 (77.75-1 61. 47. (109.75- (77.75- (109.75 (77.75 (109.7 (77.7 (109. (77. (109 (77 (10 (7 (1

ABSTRACT Objective: To define a reference chart comparing pressure drop vs. flow generated by a set of arterial cannulae currently utilized in cardiopulmonary bypass conditions in pediatric surgery. Methods: Cannulae from two manufacturers were selected considering their design and outer and inner diameters. Cannula performance was evaluated in terms of pressure drop vs. flow during simulated cardiopulmonary bypass conditions. The experimental circuits consisted of a Jostra HL-20 roller pump, a Quadrox-i pediatric oxygenator (Maquet Cardiopulmonary AG, Rastatt, Germany), and a custom pediatric tubing set. The circuit was primed with lactated Ringer’s solution only (first condition) and with human packed red blood cells added (second condition) to achieve a hematocrit of 30%. Cannula sizes 8 to 16 Fr were inserted into the cardiopulmonary bypass circuit with a “Y” connector. The flow was adjusted in 100 ml/min increments within typical flow ranges for each cannula. Pre-cannula and post-cannula pressures were measured to calculate the pressure drop. Results: Utilizing a pressure drop limit of 100 mmHg, our results suggest a recommended flow limit of 500, 900, 1400, 2600, and 3100 mL/min for Braile arterial cannulae sizes 8, 10, 12, 14, and 16 Fr, respectively. For Medtronic DLP arterial cannulae sizes 8, 10, 12, 14, and 16 Fr, the recommended flow limit is 600, 1100, 1700, 2700, and 3300 mL/min, respectively. Conclusion: This study reinforces discrepancies in pressure drop between cannulae of the same diameter supplied by different manufacturers and the importance of independent translational research to evaluate components’ performance. Objective vs surgery Methods diameters HL20 HL 20 HL-2 pump Quadroxi Quadrox i Maquet AG Rastatt Germany, Germany , Germany) Ringers Ringer s first condition second 30 30% 1 Y “Y connector 10 mlmin ml min cannula Precannula Pre postcannula post Results mmHg 500 900 1400 2600 310 mLmin mL 12 14 respectively 600 1100 1700 2700 330 Conclusion components HL2 2 HL- 3 50 90 140 260 31 60 110 170 270 33 5 9 26 6 11 17 27

ABSTRACT In this article, we present the case of a 47-year-old man who underwent Bentall-Bono procedure and frozen elephant trunk prosthesis implantation due to severe aortic regurgitation and aortic dilatation with a second-time endovascular stent-graft repair in descending aorta. Over eight years, a subacute graft infection by Propionibacterium acnes was developed, culminating in cardiogenic shock secondary to severe aortic regurgitation due to a complete aortic root dehiscence because of multiple aortic pseudoaneurysms. The patient underwent emergency surgery in which the replacement of the graft by a biological valve tube was performed accompanied by a complete debranching of the three supra-aortic vessels. article 47yearold yearold 47 year old BentallBono Bentall Bono secondtime second time stentgraft stent aorta years developed pseudoaneurysms supraaortic supra vessels 4

ABSTRACT Luis Tavares revolutionized cardiac surgery, always bringing the most modern instruments and equipment from his travels to England - surgical forceps, scissors, scalpels, etc. He always insisted that he was not just a thoracic surgeon, for his work extended over a wide field and created three important cardiac surgery centers which promoted a great development of cardiology. He carried out the first open heart surgery (atrial septal defect) employing extracorporeal circulation and closure of a ventricular septal defect with deep surface hypothermia of north and northeast Brazil. He promoted an intense scientific exchange program between Recife and England, resulting in significant advances in medicine, and participated directly in the creation of HEMOPE), leading to radical changes and improvements in blood therapy in the whole country. The PROCAPE, inaugurated in 2006, was the result of the cardiac center created by him in early 1970 at Hospital Oswaldo Cruz and can be considered the second largest public-university cardiology center in Brazil. He is thus widely regarded as an outstanding name in medicine in the 20th century and one of the fathers of modern cardiac surgery in Brazil. forceps scissors scalpels etc surgeon atrial Brazil HEMOPE, HEMOPE , HEMOPE) country PROCAPE 2006 197 publicuniversity public university th 200 19 20 1 2

ABSTRACT Introduction: Acute aortic dissection Stanford type A (AADA) is a surgical emergency associated with high morbidity and mortality. Although surgical management has improved, the optimal therapy is a matter of debate. Different surgical strategies have been proposed for patients under 60 years old. This paper evaluates the postoperative outcome and the need for secondary aortic operation after a limited surgical approach (proximal arch replacement) vs. extended arch repair. Methods: Between January 2000 and January 2018, 530 patients received surgical treatment for AADA at our hospital; 182 were under 60 years old and were enrolled in this study - Group A (n=68), limited arch repair (proximal arch replacement), and group B (n=114), extended arch repair (> proximal arch replacement). Results: More pericardial tamponade (P=0.005) and preoperative mechanical resuscitation (P=0.014) were seen in Group A. More need for renal replacement therapy (P=0.047) was seen in the full arch group. Mechanical ventilation time (P=0.022) and intensive care unit stay (P<0.001) were shorter in the limited repair group. Thirty-day mortality was comparable (P=0.117). New onset of postoperative stroke was comparable (Group A four patients [5.9%] vs. Group B 15 patients [13.2%]; P=0.120). Long-term follow-up did not differ significantly for secondary aortic surgery. Conclusion: Even though young patients received only limited arch repair, the outcome was comparable. Full-arch replacement was not beneficial in the long-time follow-up. A limited approach is justified in the cohort of young AADA patients. Exemptions, like known Marfan syndrome and the presence of an intimal tear in the arch, should be considered. Introduction (AADA improved debate 6 vs Methods 200 2018 53 hospital 18 n=68, n68 n n=68 , 68 (n=68) replacement, n=114, n114 n=114 114 (n=114) > ( replacement. . Results P=0.005 P0005 P 0 005 (P=0.005 P=0.014 P0014 014 (P=0.014 P=0.047 P0047 047 (P=0.047 P=0.022 P0022 022 (P=0.022 P<0.001 P0001 001 (P<0.001 Thirtyday Thirty day P=0.117. P0117 P=0.117 117 (P=0.117) 5.9% 59 5 9 [5.9% 1 13.2% 132 13 2 [13.2%] P=0.120. P0120 P=0.120 120 P=0.120) Longterm Long term followup follow up surgery Conclusion Fullarch Full longtime long followup. up. Exemptions considered 20 201 n6 n=6 (n=68 n11 n=11 11 (n=114 P=0.00 P000 00 (P=0.00 P=0.01 P001 01 (P=0.01 P=0.04 P004 04 (P=0.04 P=0.02 P002 02 (P=0.02 P<0.00 (P<0.00 P011 P=0.11 (P=0.117 5.9 [5.9 13.2 [13.2% P012 P=0.12 12 n= (n=6 n1 n=1 (n=11 P=0.0 P00 (P=0.0 P<0.0 (P<0.0 P01 P=0.1 (P=0.11 5. [5. 13. [13.2 (n= (n=1 P=0. P0 (P=0. P<0. (P<0. (P=0.1 [5 [13. (n P=0 (P=0 P<0 (P<0 [ [13 P= (P= P< (P< [1 (P

ABSTRACT Introduction: There is no consensus on the impact of coronary artery disease in patients undergoing transcatheter aortic valve implantation. Therefore, the objective of this study was, in a single-center setting, to evaluate the five-year outcome of transcatheter aortic valve implantation patients with or without coronary artery disease. Methods: All transcatheter aortic valve implantation patients between 2009 and 2019 were included and grouped according to the presence or absence of coronary artery disease. The primary endpoint, five-year all-cause mortality, was evaluated using Cox regression adjusted for age, sex, procedure years, and comorbidities. Comorbidities interacting with coronary artery disease were evaluated with interaction tests. In-hospital complications was the secondary endpoint. Results: In total, 176 patients had aortic stenosis and concomitant coronary artery disease, while 170 patients had aortic stenosis only. Mean follow-up was 2.2±1.6 years. There was no difference in the adjusted five-year all-cause mortality between transcatheter aortic valve implantation patients with and without coronary artery disease (hazard ratio 1.00, 95% confidence interval 0.59-1.70, P=0.99). In coronary artery disease patients, impaired renal function, peripheral arterial disease, or ejection fraction < 50% showed a significant interaction effect with higher five-year all-cause mortality. No significant differences in complications between the groups were found. Conclusion: Five-year mortality did not differ between transcatheter aortic valve implantation patients with or without coronary artery disease. However, in patients with coronary artery disease and impaired renal function, peripheral arterial disease, or ejection fraction < 50%, we found significantly higher five-year all-cause mortality. Introduction Therefore singlecenter single center setting fiveyear five year Methods 200 201 endpoint allcause all cause age sex years comorbidities tests Inhospital hospital Results total 17 only followup follow up 2216 2 1 6 2.2±1. hazard 100 00 1.00 95 0.591.70, 059170 0.59 1.70, 0 59 70 0.59-1.70 P=0.99. P099 P P=0.99 . 99 P=0.99) function 50 Conclusion Fiveyear Five However 20 221 2.2±1 10 1.0 9 591 0.591.70 05917 059 0.5 1.70 5 7 0.59-1.7 P09 P=0.9 22 2.2± 1. 0.591.7 0591 05 0. 1.7 0.59-1. P0 P=0. 2.2 0.591. 0.59-1 P=0 2. 0.591 0.59- P=

ABSTRACT Introduction: The impact of mitral regurgitation (MR) on valve-in-valve transcatheter aortic valve implantation (VIV-TAVI) in patients with failed bioprostheses remains unclear. The purpose of this study was to assess the prognostic impact of residual moderate MR following VIV-TAVI. Methods: We retrospectively analyzed 127 patients who underwent VIV-TAVI between March 2010 and November 2021. At least moderate MR was observed in 51.2% of patients before the procedure, and MR improved in 42.1% of all patients. Patients with postoperative severe MR, previous mitral valve intervention, and patients who died before postoperative echocardiography were excluded from further analyses. The remaining 114 subjects were divided into two groups according to the degree of postprocedural MR: none-mild MR (73.7%) or moderate MR (26.3%). Propensity score matching yielded 23 pairs for final comparison. Results: No significant differences were found between groups before and after matching in early results. In the matched cohort, survival probabilities at one, three, and five years were 95.7% vs. 87.0%, 85.0% vs. 64.5%, and 85.0% vs. 29.0% in the none-mild MR group vs. moderate MR-group, respectively (log-rank P=0.035). Among survivors, patients with moderate MR had worse functional status according to New York Heart Association (NYHA) class at follow-up (P=0.006). Conclusion: MR is common in patients with failed aortic bioprostheses, and improvement in MR-status was observed in over 40% of patients following VIV-TAVI. Residual moderate MR after VIV-TAVI is not associated with worse early outcomes, however, it was associated with increased mortality at five years of follow-up and worse NYHA class among survivors. Introduction (MR valveinvalve VIVTAVI VIV TAVI (VIV-TAVI unclear VIVTAVI. TAVI. Methods 12 201 2021 512 51 2 51.2 procedure 421 42 1 42.1 intervention analyses 11 nonemild none mild 73.7% 737 73 7 (73.7% 26.3%. 263 26.3% . 26 3 (26.3%) comparison Results results cohort one three 957 95 95.7 vs 870 87 0 87.0% 850 85 85.0 645 64 5 64.5% 290 29 29.0 MRgroup, MRgroup group, MR-group logrank log rank P=0.035. P0035 P P=0.035 035 P=0.035) survivors (NYHA followup follow up P=0.006. P0006 P=0.006 006 (P=0.006) Conclusion MRstatus 40 outcomes however 20 202 51. 4 42. 73.7 (73.7 26.3 (26.3% 9 95. 8 87.0 85. 6 64.5 29. P003 P=0.03 03 P000 P=0.00 00 (P=0.006 73. (73. 26. (26.3 87. 64. P00 P=0.0 (P=0.00 (73 (26. P0 P=0. (P=0.0 (7 (26 P=0 (P=0. ( (2 P= (P=0 (P= (P

ABSTRACT Introduction: With the introduction of minimally invasive cardiac surgery, more commonly cases of lung herniation are starting to appear. Acquired lung hernias are classified as postoperative, traumatic, pathologic, and spontaneous. Up to 83% of lung hernias are intercostal. Herein, we describe patients presenting with intercostal lung hernias following minimally invasive cardiac surgery at a single center in Medellín, Colombia. Methods: We conducted a retrospective search of all patients presenting with intercostal lung hernias secondary to minimally invasive cardiac surgery at our clinic in Medellín since the beginning of our program, from 2010 to 2022. Mini-sternotomies were excluded from our study. We reviewed the incision type and other possible factors leading to intercostal lung hernia development. We also describe the approach taken for these patients. Results: From 2010 up until 2022, 803 adult patients underwent minimally invasive cardiac surgeries through a mini-thoracotomy. At the time of data retrieval, nine patients presented with intercostal lung hernias at the previous incision site. Five hernias (55%) were from right 2nd intercostal parasternal mini-thoracotomies for aortic valve surgeries. Four hernias (45%) were from right 4th intercostal lateral mini-thoracotomies for mitral valve surgeries. Our preferred repair technique is a video-assisted thoracoscopic mesh approach. Conclusion: Minimally invasive cardiac surgical approaches are becoming more routine. Proper wound closure is critical in preventing lung hernias. Additionally, timely diagnosis and opportune hernia surgery using video-assisted thoracoscopic mesh repair can prevent further complications. Introduction appear postoperative traumatic pathologic spontaneous 83 Herein Colombia Methods program 201 2022 Ministernotomies Mini sternotomies study development Results 80 minithoracotomy. minithoracotomy mini thoracotomy. thoracotomy mini-thoracotomy retrieval site 55% 55 (55% nd minithoracotomies thoracotomies 45% 45 (45% th videoassisted video assisted Conclusion routine Additionally complications 8 20 202 5 (55 4 (45 2 (5 (4 (

ABSTRACT Introduction: The effect of pump flow type on perfusion in coronary surgery using cardiopulmonary bypass (CPB) is discussed. We aimed to evaluate the effect of pump flow type on cognitive functions with neurocognitive function tests. Methods: One hundred patients who underwent isolated coronary artery bypass surgery between November 2020 and July 2021 were divided into two equa groups. Groups were formed according to pump flow type pulsatile (Group 1) and non-pulsatile (Group 2). Clock drawing test (CDT) and standardized mini mental test (SMMT) were performed on the patients in both groups in the preoperative period, on the 1st preoperative day, and on the day before discharge. Neurocognitive effects were compared with all follow-up parameters. Results: There was no difference between the groups in terms of demographic data and in terms of neurocognitive tests performed before the operation. SMMT on postoperative day 1 (Group I: 27.64 ± 1.05; Group II: 24.44 ± 1.64; P=0.001) and CDT (Group I: 5.4 ± 0.54; Group II: 4 .66 ± 0.52; P=0.001), and SMMT on the day before discharge (Group I: 27.92 ± 1.16; Group II: 24.66 ± 1.22; P=0.001) and CDT (Group I: 5 It was calculated as .66 ± 0.48; Group II: 5.44 ± 0.5; P=0.001). The duration of intensive care and hospitalization were higher in the non-pulsatile group. Conclusion: We think that the type of pump flow used in coronary artery bypass surgery using CPB is effective in terms of neurocognitive functions and that pulsatile flow makes positive contributions to this issue. Introduction (CPB discussed Methods 202 nonpulsatile non 2. 2 . 2) (CDT (SMMT period st followup follow up parameters Results operation I 2764 27 64 27.6 1.05 105 05 II 2444 24 44 24.4 1.64 164 P=0.001 P0001 P 0 001 54 5. 0.54 054 66 .6 0.52 052 52 P=0.001, , 2792 92 27.9 1.16 116 16 2466 24.6 1.22 122 22 0.48 048 48 544 0.5 P=0.001. group Conclusion issue 20 276 6 27. 1.0 10 244 24. 1.6 P=0.00 P000 00 279 9 1.1 11 246 1.2 12 0.4 04 0. 1. P=0.0 P00 P=0. P0 P=0 P=

ABSTRACT Introduction: The aim of this study was to identify perioperative risk factors of laryngeal symptoms and to develop an implementable risk prediction model for Chinese hospitalized patients undergoing coronary artery bypass grafting (CABG). Methods: A total of 1476 Chinese CABG patients admitted to Wuhan Asian Heart Hospital from January 2020 to June 2022 were included and then divided into a modeling cohort and a verification cohort. Univariate analysis was used to identify laryngeal symptoms risk factors, and multivariate logistic regression was applied to construct a prediction model for laryngeal symptoms after CABG. Discrimination and calibration of this model were validated based on the area under the receiver operating characteristic (ROC) curve and the Hosmer-Lemeshow (H-L) test, respectively. Results: The incidence of laryngeal symptoms in patients who underwent CABG was 6.48%. Four independent risk factors were included in the model, and the established aryngeal complications risk calculation formula was Logit (P) = −4.525 + 0.824 × female + 2.09 × body mass index < 18.5 Kg/m2 + 0.793 × transesophageal echocardiogram + 1.218 × intensive care unit intubation time. For laryngeal symptoms, the area under the ROC curve was 0.769 in the derivation cohort (95% confidence interval [CI]: 0.698-0.840) and 0.811 in the validation cohort (95% CI: 0.742-0.879). According to the H-L test, the P-values in the modeling group and the verification group were 0.659 and 0.838, respectively. Conclusion: The prediction model developed in this study can be used to identify high-risk patients for laryngealsymptoms undergoing CABG, and help clinicians implement the follow-up treatment. Introduction . (CABG) Methods 147 202 (ROC HosmerLemeshow Hosmer Lemeshow HL H L (H-L test respectively Results 648 6 48 6.48% P (P 4525 4 525 −4.52 0824 0 824 0.82 209 2 09 2.0 185 18 5 18. Kgm2 Kgm Kg m2 m Kg/m 0793 793 0.79 1218 1 218 1.21 time 0769 769 0.76 95% 95 (95 CI [CI] 0.6980.840 06980840 0.698 0.840 698 840 0.698-0.840 0811 811 0.81 0.7420.879. 07420879 0.742 0.879 742 879 0.742-0.879) Pvalues values 0659 659 0.65 0838 838 0.838 Conclusion highrisk high followup follow up treatment (CABG 14 20 64 6.48 452 52 −4.5 082 82 0.8 2. 079 79 0.7 121 21 1.2 076 76 9 (9 [CI 6980 0.6980.84 0698084 0698 0.69 0840 0.84 69 84 0.698-0.84 081 81 7420 0.7420.879 0742087 0742 0.74 0879 0.87 74 87 0.742-0.879 065 65 0.6 083 83 0.83 6.4 45 −4. 08 8 0. 07 7 12 1. ( 0.6980.8 069808 069 084 0.698-0.8 0.7420.87 074208 074 087 0.742-0.87 06 6. −4 0.6980. 06980 0.698-0. 0.7420.8 07420 0.742-0.8 − 0.6980 0.698-0 0.7420. 0.742-0. 0.698- 0.7420 0.742-0 0.742-

ABSTRACT Introduction: Heart transplantation is the gold standard for advanced heart failure treatment. This study examines the survival rates and risk factors for early mortality in adult heart transplant recipients at a Brazilian center. Methods: This retrospective cohort study involved 255 adult heart transplant patients from a single center in Brazil. Data were collected from medical records and databases including three defined periods (2012-2015, 2016-2019, and 2020-2022). Statistical analysis employed Kaplan-Meier survival curves, Cox proportional hazards analysis for 30-day mortality risk factors, and Log-rank tests. Results: The recipients were mostly male (74.9%), and the mean age was 46.6 years. Main causes of heart failure were idiopathic dilated cardiomyopathy (33.9%), Chagas cardiomyopathy (18%), and ischemic cardiomyopathy (14.3%). The study revealed an overall survival of 68.1% at one year, 58% at five years, and 40.8% at 10 years after heart transplantation. Survivalimproved significantly over time, combining the most recent periods (2016 to 2022) it was 73.2% in the first year and 63% in five years. The main risk factors for 30-day mortality were longer time on cardiopulmonary bypass, the initial period of transplants (2012 to 2015), older age of the donor, and nutritional status of the donor (overweight or obese). The main causes of death within 30 days post-transplant were infection and primary graft dysfunction. Conclusion: The survival analysis by period demonstrated that the increased surgical volume, coupled with the team’s experience and modifications to the immunosuppression protocol, contributed to the improved early and mid-term outcomes. Introduction treatment Methods 25 Brazil 20122015, 20122015 2012 2015, 2015 (2012-2015 20162019, 20162019 2016 2019, 2019 2016-2019 20202022. 20202022 2020 2022 . 2020-2022) KaplanMeier Kaplan Meier curves 30day day Logrank Log rank tests Results 74.9%, 749 74.9% , 74 9 (74.9%) 466 46 6 46. 33.9%, 339 33.9% 33 (33.9%) 18%, 18 18% (18%) 14.3%. 143 14.3% 14 3 (14.3%) 681 68 1 68.1 58 408 40 8 40.8 (201 732 73 2 73.2 63 bypass 2015) overweight obese. obese obese) posttransplant post dysfunction Conclusion volume teams team s protocol midterm mid term outcomes 2012201 201 (2012-201 2016201 2016-201 2020202 202 2020-2022 74.9 7 (74.9% 4 33.9 (33.9% (18% 14.3 (14.3% 68. 5 40. (20 73. 201220 20 (2012-20 201620 2016-20 202020 2020-202 74. (74.9 33. (33.9 (18 14. (14.3 (2 20122 (2012-2 20162 2016-2 20202 2020-20 (74. (33. (1 (14. ( (2012- 2016- 2020-2 (74 (33 (14 2020- (7 (3

ABSTRACT Introduction: The operating room is no longer the ideal place for early surgica training of cardiothoracic surgery residents, forcing the search for simulation-based learning options. The study’s aim was the construction and surgicaltraining of coronary anastomosis in a portable, low-cost, homemade simulator. Methods: This is an observational, analytical, and multicenter study. The simulator was built with common materials and was evaluated with the Objective Structured Assessment ofTechnical Skills (or OSATS) Modified. All junior and senior residents from nine national cardiothoracic surgery centers were considered for 90 days. Operative skill acquisition and time in the creation of side-to-side (S-T-S), end-to-side (E-T-S), and end-to-end (E-T-E) coronary anastomoses were evaluated. All sessions were recorded and evaluated by a single senior cardiothoracic surgeon during two time periods. Results: One hundred and forty residents were assessed in 270 sessions. In junior residents, a significant improvement in final scores was identified in S-T-S (use of Castroviejo needle holder, needle angles, and needle transfer) (P<0.05). In seniors, a significant improvement was identified in S-T-S (graft orientation, appropriate spacing, use of forceps, angles, and needle transfer) anastomoses (P<0.05). A significant improvement in the final anastomosis time of senior residents over junior residents was identified in S-T-S (8.11 vs. 11.22 minutes), E-T-S (7.93 vs. 10.10 minutes), and E-T-E (6.56 vs. 9.68 minutes) (P=0.039). Conclusion: Our portable and low-cost coronary anastomosis simulator is effective in improving operative skills in cardiothoracic surgery residents; therefore, skills acquired through simulation-based training transfer have a positive impact on the surgical environment. Introduction simulationbased simulation based options studys study s lowcost, lowcost low cost, cost Methods observational analytical or OSATS Modified 9 days sidetoside side to STS, STS S T , (S-T-S) endtoside end ETS, ETS E (E-T-S) endtoend ETE (E-T-E periods Results 27 holder angles P<0.05. P005 P P<0.05 . 0 05 (P<0.05) seniors graft orientation spacing forceps 8.11 811 8 11 (8.1 vs 1122 22 11.2 minutes, minutes 7.93 793 7 93 (7.9 1010 10 10.1 6.56 656 6 56 (6.5 968 68 9.6 P=0.039. P0039 P=0.039 039 (P=0.039) Conclusion therefore environment (S-T-S (E-T-S 2 P00 P<0.0 (P<0.05 8.1 81 1 (8. 112 11. 7.9 79 (7. 101 10. 6.5 65 5 (6. 96 9. P003 P=0.03 03 (P=0.039 P0 P<0. (P<0.0 8. (8 7. (7 6. (6 P=0.0 (P=0.03 P<0 (P<0. ( P=0. (P=0.0 P< (P<0 P=0 (P=0. (P< P= (P=0 (P (P=