Huge thrombus formation in the left ventricle during bilateral CentriMag ventricular assist device with successful bridging to heart transplantation: a case report and review of the literature.

Owing to shortage of donor hearts, the ventricular assist device is used as a bridging therapy to heart transplantation. However, thrombus formation is a critical complication during ventricular assist device circulatory support that might result in ischemic infarction of end organs. Here, we report a patient diagnosed with decompensated dilated cardiomyopathy and cardiogenic shock who underwent emergent extracorporeal life support, and subsequent temporary bilateral ventricular assistance with the CentriMag device (Levitronix LLC, Waltham, MA). Daily transthoracic echocardiography did not detect any thrombus formation, and no stroke event occurred during biventricular support. During eventual orthotopic heart transplantation, transesophageal echocardiography detected a huge thrombus in the left ventricle. We removed the biventricular assist device, excised the recipient heart, cleaned up the thrombus, and then implanted the donor heart successfully. No stroke or transient neurological deficit was noted during or after the transplantation. The patient was discharged 14 days after transplantation. No major adverse cardiovascular event was noted during 2 years of outpatient follow-up.

Risk Factors of Mortality and Long-Term Survival in Burn Patients With/Without Extracorporeal Membrane Oxygenation: A 16 Year Real-World Study.

Burn patients face cardiopulmonary failure risks, with recent observational studies suggesting promising outcomes for extracorporeal membrane oxygenation (ECMO). However, the effectiveness and long-term survival remain unclear. Our study aims to assess mortality risk factors and long-term survival in burn patients with and without ECMO. This study used Taiwan's National Health Insurance Research Database and designed a case-control with onefold propensity score matching across variables including sex, age, total body surface area (TBSA) burned, and index date. We analyzed mortality and survival risk factors in each stratified group with/without ECMO. Finally, we analyze the mortality according to ECMO and TBSA burned, and the cause of death and long-term survival. From 2000 to 2015, 4,556 burn patients with ECMO compared to an equivalent number without ECMO. Primary mortality include male, age >65, TBSA ≥30%, escharotomy, hemodialysis, and bacteremia. The ECMO group showed lower survival across all stratified risk factors, with the primary cause of death being burn-related issues, followed by respiratory and heart failure. The overall mortality rate was 54.41% with ECMO and 40.94% without ECMO (p < 0.001). Additionally, long-term survival is lower in the group with ECMO. This research provides a valuable real-world gross report about ECMO efficacy and long-term survival among burn patients with/without ECMO.

Hypothyroidism Is Correlated with Ventilator Complications and Longer Hospital Days after Coronary Artery Bypass Grafting Surgery in a Relatively Young Population: A Nationwide, Population-Based Study.

Background: Some research indicated that hypothyroidism has huge adverse effects for the metabolic, cardiovascular, respiratory, and immune systems. However, there is no confirmed conclusion for the effect of cardiovascular surgery. This cohort study aims to investigate the prognosis of hypothyroidism patient at the age under 65-year-old after coronary artery bypass grafting (CABG) surgery. Method: From the National Health Insurance Research Database of Taiwan, 1586 patients with hypothyroidism who underwent elective CABG surgery were selected, along with 6334 patients who underwent surgery in a ratio of 1:4 sex-, age- and index year-matched controls, who were out of hypothyroidism. We used Cox proportional hazard analysis to compare the rate of 30-day, 5-year mortality, post-operative atrial fibrillation, respiratory complication during an average of 10-year follow-up. Result: Post-CABG patients had more hospital days, which was associated with hypothyroidism, male, DM and higher CCI_R (p < 0.001). Post-CABG patients had more inpatient respiratory complications, which was associated with hypothyroidism (p = 0.041), DM and CCI_R (p < 0.001, p = 0.046), and there was no difference in 1-year respiratory complication, tracheostomy in the same hospital course and within 1 year, repeated PCI, Af, CVVH, cerebral infarction, 30-day and 5-year mortality rate. Conclusions: Hypothyroidism correlates to post-CABG ventilator-related complications and pneumonia, and prolonged hospital days, but no effect on 30-day, 5-year mortality, post-operative atrial fibrillation and cerebral infarction rate. Thyroid function survey might include routinely preoperative survey for CABG outcome prognosis.

Solar Power Can Substantially Prolong Maximum Achievable Airtime of Quadcopter Drones.

Sunlight energy is potentially excellent for small drones, which can often operate during daylight hours and fly high enough to avoid cloud blockade. However, the best solar cells provide limited power, compared to conventional power sources, making their use for aerial vehicles difficult to realize, especially in rotorcraft where significant lift ordinarily generated by a wing is already sacrificed for the ability to hover. In recent years, advances in materials (use of carbon-fiber components, improvement in specific solar cells and motors) have finally brought solar rotorcraft within reach. Here, the application is explored through a concise mathematical model of solar rotorcraft based on the limits of solar power generation and motor power consumption. Multiple solar quadcopters based on this model with majority solar power are described. One of them has achieved an outdoor airtime over 3 hours, 48 times longer than it can last on just battery alone with the solar cells carried as dead weight and representing a significant prolongation of drone operation. Solar-power fluctuations during long flight and their interaction with power requirements are experimentally characterized. The general conclusion is that solar cells have reached high enough efficiencies and can outperform batteries under the right conditions for quadcopters.

Traumatic retropharyngeal hematoma: case report.

Traumatic retropharyngeal hematoma is a rare but potentially life-threatening condition that requires an early diagnosis. Isolated retropharyngeal hematoma without an associated cervical fracture is a relatively rare condition. The treatment of retropharyngeal hematoma is conservative in most cases, with close observation. The indications for surgical evacuation of hematomas are large size, difficult with mechanical ventilation and failure to improve with medical therapy. We present the case of a 50-year-old man with retropharyngeal hematoma with a compromised airway due to minor contusion of the neck, which required surgical intervention. The patient underwent emergent surgical debridement and tracheostomy. Postoperative course was uneventful. The patient was discharged 9 days later. Early surgical intervention can reduce the hospital stay, resulting in a rapid convalescence.