TEMPORAL TRENDS IN PATIENT CHARACTERISTICS, MANAGEMENT, AND OUTCOMES AMONG PATIENTS ADMITTED FOR PRIMARY CARDIAC TUMORS: RESULTS FROM THE NATIONAL INPATIENT SAMPLE

OBJECTIVEAnalysis of temporal trends in patient populations and procedure types may provide important information regarding the evolution of hydrocephalus treatment. The purpose of this study was to use the Hydrocephalus Clinical Research Network’s Core Data Project to identify meaningful trends in patient characteristics and the surgical management of pediatric hydrocephalus over a 9-year period.METHODSThe Core Data Project prospectively collected patient and procedural data on the study cohort from 9 centers between 2008 and 2016. Logistic and Poisson regression were used to test for significant temporal trends in patient characteristics and new and revision hydrocephalus procedures.RESULTSThe authors analyzed 10,149 procedures in 5541 patients. New procedures for hydrocephalus (shunt or endoscopic third ventriculostomy [ETV]) decreased by 1.5%/year (95% CI −3.1%, +0.1%). During the study period, new shunt insertions decreased by 6.5%/year (95% CI −8.3%, −4.6%), whereas new ETV procedures increased by 12.5%/year (95% CI 9.3%, 15.7%). Revision procedures for hydrocephalus (shunt or ETV) decreased by 4.2%/year (95% CI −5.2%, −3.1%), driven largely by a decrease of 5.7%/year in shunt revisions (95% CI −6.8%, −4.6%). Concomitant with the observed increase in new ETV procedures was an increase in ETV revisions (13.4%/year, 95% CI 9.6%, 17.2%). Because revisions decreased at a faster rate than new procedures, the Revision Quotient (ratio of revisions to new procedures) for the Network decreased significantly over the study period (p = 0.0363). No temporal change was observed in the age or etiology characteristics of the cohort, although the proportion of patients with one or more complex chronic conditions significantly increased over time (p = 0.0007).CONCLUSIONSOver a relatively short period, important changes in hydrocephalus care have been observed. A significant temporal decrease in revision procedures amid the backdrop of a more modest change in new procedures appears to be the most notable finding and may be indicative of an improvement in the quality of surgical care for pediatric hydrocephalus. Further studies will be directed at elucidation of the possible drivers of the observed trends.

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Intracardiac EUS-B-Guided FNA for Diagnosing Cardiac Tumors

Respiration ◽

10.1159/000516504 ◽

2021 ◽

pp. 1-5

Author(s):

Haizea Alvarez Martinez ◽

Jolanda C. Kuijvenhoven ◽

Jouke T. Annema

Keyword(s):

Left Atrium ◽

Heart Surgery ◽

Open Heart Surgery ◽

Needle Aspiration ◽

Invasive Technique ◽

Cardiac Tumors ◽

Surgical Interventions ◽

Tumor Diagnostics ◽

Specific Tumor ◽

Primary Cardiac Tumors

Primary cardiac tumors are extremely rare. Obtaining a tissue diagnosis is difficult and commonly requires open-heart surgery with associated morbidity. Esophageal endoscopic ultrasound (EUS) and EUS with the EBUS scope (EUS-B) provide real-time sampling of centrally located lung tumors and mediastinal lymph nodes. They also provide an excellent view of the left atrium, since it is located adjacent to the esophagus. To date, left atrium tumor diagnostics by endosonography is poorly explored. We describe 2 exceptional diagnostic cases of left atrium tumors in which cardiac surgery was hazardous due to the clinical condition or previous surgical interventions. During EUS-B-guided fine-needle aspiration (FNA), the left atrial masses were successfully and safely sampled, revealing a Burkitt lymphoma and a synovial sarcoma. FNA including cell block analysis enabled specific tumor diagnosis and molecular subtyping. Our findings suggest that in selected cases, linear endosonography qualifies as a minimally invasive technique for intracardiac tumor diagnostics.

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Temporal trends in utilization of transcatheter aortic valve implantation and patient characteristics – a nationwide cohort study

European Heart Journal ◽

10.1093/ehjci/ehaa946.2618 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J.E Strange ◽

C Sindet-Pedersen ◽

G Gislason ◽

C Torp-Pedersen ◽

E.L Fosboel ◽

...

Keyword(s):

Aortic Valve ◽

Transcatheter Aortic Valve Implantation ◽

Temporal Trends ◽

Patient Characteristics ◽

P Value ◽

Transcatheter Aortic Valve ◽

History Of ◽

Aortic Valve Implantation ◽

Valve Implantation ◽

First Time

Abstract Introduction In recent years, there has been a surge in the utilization of transcatheter aortic valve implantation (TAVI) for the treatment of severe symptomatic aortic stenosis. Randomized controlled trials have compared TAVI to surgical aortic valve replacement (SAVR) in patients at high-, intermediate-, and low perioperative risk. As TAVI continues to be utilized in patients with lower risk profiles, it is important to investigate the temporal trends in “real-world” patients undergoing TAVI. Purpose To investigate temporal trends in the utilization of TAVI and examine changes in patient characteristics of patients undergoing first-time TAVI. Methods Using complete Danish nationwide registries, we included all patients undergoing first-time TAVI between 2008 and 2017. To compare patient characteristics, the study population was stratified according to calendar year in the following groups: 2008–2009, 2010–2011, 2012–2013, 2014–2015, and 2016–2017. Results We identified 3,534 patients undergoing first-time TAVI. In 2008–2009, 180 patients underwent first-time TAVI compared with 1,417 patients in 2016–2017, resulting in a 687% increase in TAVI procedures performed. During the study period, the median age remained stable (2008–2009: Median age 82 year [25th–75th percentile: 78–85] vs. 2016–2017: Median age 81 years [25th–75th percentile: 76–85]; P-value: 0.06). The proportion of men undergoing first-time TAVI increased over the years (2008–2009: 49.4% vs 2016–2017: 54.9%; P-value for trend: <0.05), also the proportion with diabetes increased (2008–2009: 12.2% vs. 2016–2017: 19.3%; P-value for trend: <0.05). The proportion of patients with a history of stroke decreased over the years (2008–2009: 13.9% vs. 2016–2017: 12.1%; P-value for trend: <0.05). The same trend was seen in patients with a history of myocardial infarction (2008–2009: 24.4% vs. 2016–2017: 11.9%; P-value for trend: <0.05), ischaemic heart disease (2008–2009: 71.7% vs. 2016–2017: 29.4%; P-value for trend: <0.05), and heart failure (2008–2009: 45.6% vs. 2016–2017: 29.4%; P-value for trend: <0.05). Conclusions In this nationwide study, there was a marked increase in the utilization of TAVI in the years 2008–2017. Patients undergoing first-time TAVI had a decreasing comorbidity burden, while the age of the patients at first-time TAVI remained stable. Funding Acknowledgement Type of funding source: None

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CONCURRENT PRIMARY CARDIAC TUMORS IN A HIGH RISK PATIENT PRESENTING WITH TAMPONADE

CHEST Journal ◽

10.1016/j.chest.2020.08.118 ◽

2020 ◽

Vol 158 (4) ◽

pp. A93

Author(s):

Joseph Zackary ◽

Lauren Crowley ◽

Shawn Quinn ◽

Timothy Misselbeck

Keyword(s):

High Risk ◽

High Risk Patient ◽

Risk Patient ◽

Cardiac Tumors ◽

Primary Cardiac Tumors

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Temporal trends and patient characteristics associated with 30-day hospital readmission rates after a first acute myocardial infarction

The American Journal of Medicine ◽

10.1016/j.amjmed.2021.03.024 ◽

2021 ◽

Author(s):

Mayra Tisminetzky ◽

Jordy Mehawej ◽

Ruben Miozzo ◽

Jerry H. Gurwitz ◽

Joel M. Gore ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Hospital Readmission ◽

Temporal Trends ◽

Patient Characteristics ◽

Day Hospital ◽

Readmission Rates ◽

Hospital Readmission Rates

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Practical characteristics of the patients with primary cardiac tumors

Journal of Cardiac Surgery ◽

10.1111/jocs.16039 ◽

2021 ◽

Author(s):

Teruhiko Imamura

Keyword(s):

Cardiac Tumors ◽

Primary Cardiac Tumors

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Left Atrial Myxoma Hypervascularized from the Right Coronary Artery: An Interesting Cath Lab Finding

Case Reports in Cardiology ◽

10.1155/2016/4865439 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Marcos Danillo Peixoto Oliveira ◽

Adriano Ossuna Tamazato ◽

Fernando Roberto de Fazzio ◽

Luiz J. Kajita ◽

Expedito E. Ribeiro ◽

...

Keyword(s):

Coronary Artery ◽

Right Coronary Artery ◽

Left Atrial ◽

Rare Case ◽

Vascular Supply ◽

Atrial Myxoma ◽

Cardiac Tumors ◽

Left Atrial Myxoma ◽

The Right ◽

Primary Cardiac Tumors

Primary cardiac tumors are rare and approximately half of them are atrial myxomas. They rarely remain asymptomatic, especially if large. The imaging of a myxoma by contrast dye during coronary angiography is an infrequent sign, which clarifies the vascular supply of the tumor. We report herein an interesting and rare case of a left atrial myxoma hypervascularized from the right coronary artery.

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Two Decades of Contemporary Surgery of Primary Cardiac Tumors

The Surgery Journal ◽

10.1055/s-0038-1673333 ◽

2018 ◽

Vol 04 (04) ◽

pp. e176-e181

Author(s):

Khalil Jawad ◽

Tamer Owais ◽

Stefan Feder ◽

Sven Lehmann ◽

Martin Misfeld ◽

...

Keyword(s):

Artery Bypass ◽

Golden Rule ◽

Tumor Location ◽

Cardiac Tumors ◽

Complete Excision ◽

Presenting Symptoms ◽

Single Center Experience ◽

Cardiac Procedures ◽

Primary Cardiac Tumors

Objective The decision to operate cardiac tumors is an issue of balancing surgical outcome and survival with quality of life (QOL). We report our single-center experience in managing primary cardiac tumors between 1994 and 2014. Methods and Results In this study, 269 patients were subjected to our standardized operative protocols, preoperative preparations, postoperative follow-up, and consents of participation. Demographic and preoperative/intraoperative/postoperative variables were collected with focus on long-term follow-up and survival. A total of 72,000 cardiac procedures were performed within 20 years at our institution. Two hundred sixty-nine patients were diagnosed with primary cardiac tumors (0.37%), with a male:female ratio of 1:1.68, mean age of 57.4 ± 19.5 years, and body mass index of 25.49 ± 6.5. The most presenting symptoms were dyspnea (n = 94), arrhythmias (n = 53), embolic event (n = 36), and chest pain (n = 29), and 33 patients were accidentally discovered. Isolated tumor excision and concomitant ablation were performed on 181 patients, while the rest needed additional procedures such as coronary artery bypass grafting (n = 27) or valve surgery (n = 61). Focus on pathology, tumor location was done reporting the commonest pathology such as myxoma (n = 177) and fibroelastoma (n = 56). The frequent site was the left atrium (n = 162). Our primary results showed incidence of bleeding in 9 patients (3.3%), arrhythmias in 76 patients (28.25%), and mortality in 49 patients (18.2%). Five patients (1.8%) showed recurrence and 220 patients (81.8%) showed complaint-free survival. Conclusion Complete excision of primary cardiac tumors is the golden rule in management as it improves survival and decreases morbidity expected from the progressing tumors process. The progression of minimally invasive techniques improves QOL and should be performed whenever possible.

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