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Moreover, a total of 90 patients (48.9%) had low cardiac output, 41 (22.3%) had acute myocardial infarction, and 33 (17.9%) had fulminant myocarditis. Eighty-six (48.04%) patients survived to hospital discharge, 36 (20.11%) had limb ischemia, and 42 (23.46%) had incision bleeding. Furthermore, the ECMO-assisted time was 114.23 ± 67.88 hours. There was no significant difference in age, sex, and Sequential Organ Failure Assessment score between the limb ischemia group and the non-limb ischemia group. Multivariate logistic regression analysis showed that peripheral artery disease (odds ratio, 27.12; 95% confidence interval, 5.614-130.96) was an independent risk factor of limb ischemia in patients with ECMO. Conclusion Limb ischemia is a common complication in patients with VA ECMO, and peripheral artery disease is an independent risk factor of limb ischemia in patients with VA ECMO via femoral artery catheterization.Background While the surgical correction of moderate aortic stenosis (AS) can be deferred with a watchful waiting according to the present guideline, the clinical outcomes for moderate AS with comorbidity have not extensively been studied. We aimed to explore the factors that would contribute to the outcomes of moderate AS with at least five years of follow-up duration. Methods Medical records review identified patients with moderate aortic valve (AV) stenosis from January 2008 and December 2012. Echocardiographic data were gathered, and the final 5-year clinical outcomes, defined as the composite of cardiovascular (CV) death, admission for heart failure (HF) aggravation, and AV replacement, were evaluated. Results Among 148 patients (mean age, 69.3 years; mean AV area, 1.24 cm2), 79 had adverse outcomes (16 CV deaths, 32 AV replacements, and 31 HF cases), during a mean follow-up of 5.6 years. The event group showed worse dyspnea of NYHA III-IV and a higher frequency of diabetes mellitus (DM). They had a higher frequency of moderate or moderate-to-severe functional mitral regurgitation (MR) and smaller AV area. In the multivariate analysis, DM (HR 2.29, 95% CI 1.03-5.10), moderate or moderate-to-severe MR (HR 4.84, 95% CI 1.66-10.07), and NYHA III-IV (HR 3.84, 95% CI 1.72-8.56) independently were associated with adverse outcomes. Conclusions The symptomatic patients with moderate AS had higher events than expected, and early intervention should be considered in case of concomitant MR and DM.Iatrogenic dissections of coronary artery and aorta is a rare and potentially fatal event, often following percutaneous coronary intervention (PCI). The prognosis of patients often depends on early accurate diagnosis and timely and effective treatment. There are no definite guidelines for the treatment of acute coronary artery dissection caused by PCI. AZD9668 in vitro Here, we report a 50-year-old patient with iatrogenic dissection of the right coronary artery and type A aortic dissection who underwent PCI for chest pain. We performed emergency surgery of right coronary artery ostium repair, aortic valvoplasty, ascending aorta replacement, and aortic arch descending stent implantation for the patient. The operation went smoothly, and the patient successfully was discharged two weeks after the operation.Background Out-of-center extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) implantation for the treatment of acute cardiorespiratory failure with subsequent transport to a tertiary care center has been introduced successfully into the medical practice. However, due to the very specific and resource intensive nature of this therapeutic concept, it seems important to generate algorithms for adequate patient selection. The aim of our study was to analyze the impact of patients' gender on early clinical outcome in this specific therapeutic scenario. Methods Ninety-seven consecutive patients treated by out-of-center ECMO/ECLS implantation and subsequent transport and treatment in our tertiary care cardiovascular center within the Hallesche Extracorporeal Life Support Program (HELP) retrospectively were analyzed, regarding the impact of patients' gender on early clinical outcome. Results Mechanical circulatory support successfully was weaned in two-thirds of the male patients. This result was achieved in only one-third of the female patients (59.4% in male vs. 33.3% in female, P = .0267). Overall survival significantly was higher in the male group (62.5% in male versus 30.3% in female, P = .0052). In uni- and multivariate logistic regression analysis, female gender was an independent predictor of in-hospital mortality (uni OR3.833, CI1.597-9.745, P = .0034; multi OR3.477, CI1.146-11.494, P = .0322). Worse outcome also was associated with following independent predictors, age, SOFA score, lactate and ventilation time pre-ECMO/ECLS implantation. Conclusion The current study demonstrates a worse early survival for women, following emergent out-of- center ECMO/ECLS implantation and subsequent transport and treatment in our tertiary care cardiovascular center. Gender should be included in patient selection algorithms while basic research approaches are needed to better understand the mechanisms underlying these gender- specific outcome disparities.Background The incidence of atherosclerotic cardiovascular diseases, which constitute an important disease group, is expected to rise with increasing life expectancy. The aim of this study was to investigate the predictive values of triglyceride/HDL cholesterol (TG/HDL-C) ratio and whole blood viscosity on possible severe carotid or peripheral arterial disease in patients who were admitted to our clinic and scheduled for coronary artery bypass graft (CABG) surgery. Methods This study retrospectively examined 299 patients who were admitted to our clinic and scheduled for CABG between August 1, 2015, and August 1, 2019. Patients with severe carotid or peripheral arterial disease were included in group 2; those in whom peripheral arterial disease and stenosis were not detected were included in group 1. Results Group 1 consisted of 255 patients, mean (± standard deviation) age 58.1 ± 8.9 years; the 44 patients in group 2 had a mean age of 64.1 ± 10.6 years (P = .018). The incidence of diabetes mellitus and tobacco use were significantly higher in group 2 (P less then .
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