Correction to: Suprasternal approach for insertion of Impella 5.5 into the proximal right subclavian artery.

[This corrects the article DOI: 10.1007/s12055-024-01699-5.].

Suprasternal approach for insertion of Impella 5.5 into the proximal right subclavian artery.

The Impella 5.5 (Abiomed) is a percutaneous, temporary left ventricular assist device (LVAD) that serves as an important method of treatment of acute cardiogenic shock refractory to medical management. The Impella 5.5 and 5.0 are commonly inserted through the right axillary artery; however, this may be limited by inadequate vessel diameter to accommodate the Impella and inadequate vessel quality. A central approach to Impella 5.5 incision has been described in the pediatric population, particularly via the innominate artery through a suprasternal and/or neck incision, with success. As an alternative to axillary Impella placement, we propose the usage of a limited suprasternal incision for Impella 5.5 insertion in the adult population, either through the proximal right subclavian artery or the distal innominate artery. This may offer multiple advantages, such as increased vessel diameter and quality of more proximal vessels, avoidance of partial sternotomy, avoidance of a second infraclavicular wound site if the patient progresses to require LVAD or transplant, avoidance of lymphatic and nerve injury through the axillary exposure, ease of manipulation for repositioning, and patient rehabilitation. Potential limitations include difficulty due to body habitus, potential risk of stroke with the innominate approach, and wound complications. A central approach is a reasonable alternative to axillary Impella placement in patients with inadequate axillary artery caliber, defined as less than 6-7 mm diameter, poor artery quality to accommodate anastomosis, and small body habitus, allowing for ease of exposure.

Review of Standardized Incidence Ratios (SIR) of non-lymphoid de novo malignancies after liver transplantation: Structured analysis of global differences.

INTRODUCTION: De Novo malignancy after liver transplantation (LTx) is the second most common cause of death in adult LTx recipients. The current report identifies differences in Standardized Incidence Ratios (SIR) for various non-lymphoid de novo malignancies by comparing and analyzing post LTx SIR for non-lymphoid de novo malignancies. MATERIAL AND METHODS: A thorough search of PubMed and Web of Science databases was conducted; 25 publications describing de novo malignancies post-LTx with SIR were identified. RESULTS: Overall SIR varied from 1.4 to 11.6 (median 2.4). Oropharyngeal/larynx (OPL), lung, colo-rectal, and kidney malignancies were more prevalent with higher SIR (median = 4.4, 1.9, 2.67, 2.5, respectively). Breast and prostate malignancies were also more prevalent with lower SIR (median = 0.9, 1.0, respectively). Pancreatic, central nervous system (CNS), melanoma, rare cancers and Kaposi's sarcoma were less prevalent (except in Italy and Sweden) but had much higher SIR (median = 2.6, 2.4, 2.02, 22.5 and 53.6, respectively). The overall higher SIR values are related to the age of the recipient, length of follow-up, the grouping of different organ systems, inclusion or exclusion of epidermal non-malacotic skin cancers, lymphoid malignancy, and occurrence of rare malignancies including Kaposi's sarcoma. CONCLUSION: OPL, lung, gastrointestinal, kidney, and bladder malignancies were more prevalent with higher SIR. Breast and prostate cancers were more prevalent with lower SIR. Pancreatic, CNS, melanoma, rare cancers and Kaposi's sarcoma were less prevalent with higher SIR. Age of the recipients, length of follow-up, and rare cancer types influence overall SIR values with some global differences.

Follicular dendritic cell sarcoma of the porta hepatis.

Follicular dendritic cell (FDC) sarcoma is a very rare neoplasm which commonly involves the lymph nodes and less commonly involves extranodal organs such as the liver. Most cases of FDC sarcoma are idiopathic, however some cases are associated with other disease states. Management of FDC sarcoma is primarily focused on surgical resection of the mass, and secondarily focused on radiotherapy, chemotherapy and/or biologic pharmacotherapy. We report the case of a patient who was found to have FDC sarcoma presenting as an obstructing mass of the porta hepatis, a manifestation which does not appear to be reported in the literature.

The use of CorMatrix extracellular matrix for aortic root enlargement.

This manuscript presents a published record of the use and efficacy of the extracellular matrix CorMatrix and why it may be superior to other materials used for aortic root enlargement. The potential benefits of an extracellular matrix are the natural ingrowth and development of native arterial cells and structure.

Transapical arterial cannulation for salvage cardiopulmonary bypass in transcatheter aortic valve replacement.

Hemodynamic instability during transcatheter aortic valve replacement procedures may require transient cardiopulmonary bypass for support. In patients with severe atherosclerosis, peripheral cannulation may not be possible. This method of direct left ventricle cannulation during transapical TAVR is a facile means to provide arterial inflow.

Role of macrophage receptor with collagenous structure in innate immune tolerance.

Macrophages play a key role in host defense against microbes, in part, through phagocytosis. Macrophage receptor with collagenous structure (MARCO) is a scavenger receptor on the cell surface of macrophages that mediates opsonin-independent phagocytosis. The goal of our study is to investigate the role of MARCO in LPS or lipotechoic acid-induced macrophage tolerance. Although it has been established that expression of MARCO and phagocytosis is increased in tolerant macrophages, the transcriptional regulation and biological role of MARCO in tolerant macrophages have not been investigated. In this study, we confirm that tolerized mouse bone marrow-derived macrophages (BMDM) selectively increase expression of MARCO (both transcript and cell surface receptor) and increase phagocytosis. We found that H3K4me3 dynamic modification of a promoter site of MARCO was increased in tolerized BMDM. Blocking methylation by treatment with 5-aza-2'-deoxycytidine resulted in reduced H3K4me3 binding in the promoter of MARCO, decreased expression of MARCO, and impaired phagocytosis in tolerized BMDM. However, 5-aza-2'-deoxycytidine had no effect on the inflammatory component of innate immune tolerance. In aggregate, we found that histone methylation was critical to MARCO expression and phagocytosis in tolerized macrophages, but did not affect the inflammatory component of innate immune tolerance.