Contemporary experience of mitral transcatheter edge-to-edge repair technology in patients with mitral annular calcification.

BACKGROUND: Mitral annular calcification (MAC) has been an exclusion for many of the earlier pivotal trials that were instrumental in gaining device approval and indications for mitral transcatheter edge-to-edge repair (M-TEER). AIMS: To evaluate the impact of MAC on the procedural durability and success of newer generation MitraClip® systems (G3 and G4 systems). METHODS: Data were collected from Northwell TEER registry. Patients that underwent M-TEER with third or fourth generation MitraClip device were included. Patients were divided into -MAC (none-mild) and +MAC (moderate-severe) groups. Procedural success was defined as ≤ grade 2 + mitral regurgitation (MR) postprocedure, and durability was defined as ≤ grade 2 + MR retention at 1 month and 1 year. Univariate analysis compared outcomes between groups. RESULTS: Of 260 M-TEER patients, 160 were -MAC and 100 were +MAC. Procedural success was comparable; however, there were three patients who required conversion to cardiac surgery during the index hospitalization in the +MAC group versus none in the -MAC group (though this was not statistically significant). At 1-month follow-up, there were no significant differences in MR severity. At 1-year follow-up, +MAC had higher moderate-severe MR (22.1% vs. 7.5%; p = 0.002) and higher mean transmitral gradients (5.3 vs. 4.0 mmHg; p = 0.001) with no differences in mortality, New York Heart Association functional class or ejection fraction. CONCLUSION: In selective patients with high burden of MAC, contemporary M-TEER is safe, and procedural success is similar to patients with none-mild MAC. However, a loss of procedural durability was seen in +MAC group at 1-year follow-up. Further studies with longer follow-ups are required to assess newer mTEER devices and their potential clinical implications in patients with a high burden of MAC.

Usefulness and Accuracy of Artificial Intelligence Chatbot Responses to Patient Questions for Neurosurgical Procedures.

BACKGROUND AND OBJECTIVES: The Internet has become a primary source of health information, leading patients to seek answers online before consulting health care providers. This study aims to evaluate the implementation of Chat Generative Pre-Trained Transformer (ChatGPT) in neurosurgery by assessing the accuracy and helpfulness of artificial intelligence (AI)-generated responses to common postsurgical questions. METHODS: A list of 60 commonly asked questions regarding neurosurgical procedures was developed. ChatGPT-3.0, ChatGPT-3.5, and ChatGPT-4.0 responses to these questions were recorded and graded by numerous practitioners for accuracy and helpfulness. The understandability and actionability of the answers were assessed using the Patient Education Materials Assessment Tool. Readability analysis was conducted using established scales. RESULTS: A total of 1080 responses were evaluated, equally divided among ChatGPT-3.0, 3.5, and 4.0, each contributing 360 responses. The mean helpfulness score across the 3 subsections was 3.511 ± 0.647 while the accuracy score was 4.165 ± 0.567. The Patient Education Materials Assessment Tool analysis revealed that the AI-generated responses had higher actionability scores than understandability. This indicates that the answers provided practical guidance and recommendations that patients could apply effectively. On the other hand, the mean Flesch Reading Ease score was 33.5, suggesting that the readability level of the responses was relatively complex. The Raygor Readability Estimate scores ranged within the graduate level, with an average score of the 15th grade. CONCLUSION: The artificial intelligence chatbot's responses, although factually accurate, were not rated highly beneficial, with only marginal differences in perceived helpfulness and accuracy between ChatGPT-3.0 and ChatGPT-3.5 versions. Despite this, the responses from ChatGPT-4.0 showed a notable improvement in understandability, indicating enhanced readability over earlier versions.

Patient and Caregiver Perception of Adenoidectomies: A Non-Real-World Social Media Analysis.

Objective: To survey the social media outlets Twitter and Instagram for public posts related to adenoidectomy surgery. This study aims to investigate the attitudes and perceptions of patients and caregivers on social media, through thematic content-analysis of social media posts regarding adenoidectomy. Study Design: Non-real world qualitative study. Setting: Twitter and Instagram social media platforms. Methods: Public posts uploaded between February, 2021 and February, 2023 using the hashtags "#adenoidectomy," and "#adenoidectomyrecovery" were searched. Posts were excluded if they were unrelated to adenoidectomy or were in a non-English language. Relevant posts were stratified demographically as patient or caregiver and pre- or postoperative, and categorized into relevant themes for analysis. Outcomes were measured as the total number of posts. Results: A total of 394 relevant posts were analyzed. A significance threshold of P < 0.05 was used. Patients posted significantly more posts regarding procedure pain (P = 0.002) and concern for appearance (P = 0.048) compared to caregivers. Caregivers posted significantly (P < 0.001) more posts regarding condition awareness and were significantly (P < 0.001) more likely to spread positivity in their posts compared to patients themselves. Posts made by female caregivers were more likely to reference fear, while those made by male caregivers were more likely to provide education (P = 0.002). Conclusion: Patients may worry about appearance and mental health while caregivers are more likely to spread information and positivity. Male and female caregivers may also use social media differently. A better understanding of patient and caregiver concerns may optimize physician interaction and involvement.