CORRIB Research Centre for Advanced Imaging and Core Laboratory’s Post

🫀 POAF after Aortic Valve Replacement — Insights from Long-Term Follow-Up POAF remains one of the most frequent complications after cardiac surgery, but its long-term implications are still debated. In this recent analysis of patients undergoing aortic valve replacement (AVR) with biological prostheses between 2005 and 2023, we explored how POAF relates to long-term recurrence and outcomes. 🔍 Key Findings: - Incidence of POAF: 22% - Risk factors for POAF: Postoperative renal insufficiency (p<0.001) and COPD (p=0.047) - Long-term recurrence: 20.4% of patients without prior AF developed it during follow-up 40.4% of those with POAF developed long-term AF → Hazard Ratio = 2.18 (1.33–3.56); p=0.002 - Independent predictors of long-term AF: Age, COPD, and POAF - Permanent AF and mortality: Trend toward higher long-term mortality [HR=1.4 (95% CI: 0.9–1.8); p=0.06] 📈 Conclusion: POAF is not just a transient postoperative event — it doubles the risk of developing permanent atrial fibrillation over time. Identifying and managing at-risk patients (especially those with COPD or renal insufficiency) could improve long-term outcomes after AVR. See more: https://shorturl.at/Mjuyv

I’m proud to share that our latest article, "Selective Appendectomy in Patients Undergoing Minimally Invasive Surgery for Endometriosis: A Retrospective Cohort Study," has just been published in the Journal of Clinical Medicine (JCM) MDPI! Endometriosis is a complex, chronic inflammatory disease that can often involve the bowel — including the appendix, where disease may mimic or coexist with chronic appendicitis. Yet, appendiceal involvement frequently goes undetected by visual inspection alone. In this study of 236 patients who underwent selective appendectomy during laparoscopic surgery for endometriosis, we found that: ✅ 91.5% had abnormal appendiceal pathology ✅ 14.4% had histologically confirmed appendiceal endometriosis ✅ 1.3% had neuroendocrine tumors (including one malignant) ✅ There were no intraoperative complications and favorable postoperative outcomes Our findings suggest that even when no visible implants are present, the appendix may contribute to symptoms in endometriosis patients. Selective appendectomy, when guided by intraoperative findings, can help ensure more comprehensive care while maintaining patient safety. 📄 Read the full article here: https://lnkd.in/dCajSAyS #Endometriosis #MinimallyInvasiveSurgery #Laparoscopy #RoboticSurgery #WomensHealth #Research #Surgery #Innovation #Appendectomy

Proud to share our latest work: “Ultrasound-detected postoperative diaphragmatic dysfunction and its association with pulmonary complications.” 👉 https://lnkd.in/dgP-Nms4 📊 Key message: Ultrasound-detected diaphragmatic dysfunction after surgery is linked to a threefold increase in pulmonary complications and a fivefold higher risk of pneumonia. This meta-analysis highlights the growing role of perioperative diaphragm ultrasound in identifying high-risk patients and guiding personalized respiratory care. #Anesthesia #CriticalCare #Ultrasound #Diaphragm #PerioperativeMedicine #Research #MetaAnalysis #TeamScience

Placement of a filter in the superior vena cava (SVC filter) is very rare compared to inferior vena cava filters (IVCFs), but it can be considered in highly selective cases Indications of Superior Vena Cava (SVC) Filter Placement According to available literature and society guidelines (SIR, ACCP, ESVS, and ACR): 1. Contraindication to anticoagulation • Patients with upper extremity DVT (UEDVT) involving the axillary/subclavian vein or more proximal thrombosis who cannot be anticoagulated (e.g., due to active bleeding, recent surgery, intracranial hemorrhage). 2. Failure of anticoagulation • Patients with recurrent pulmonary embolism (PE) despite adequate therapeutic anticoagulation from an upper extremity source. 3. Complication of anticoagulation • Severe bleeding related to anticoagulant therapy when continued treatment is unsafe. 4. High risk of embolization from UEDVT in selected situations: • Large free-floating thrombus in the SVC or innominate/axillary vein. • Patients with central venous catheters, pacemaker/ICD leads with associated extensive thrombosis and high risk of PE. Guideline & Reference Highlights • Society of Interventional Radiology (SIR) Guidelines 2020 • SVC filters may be considered in patients with upper extremity or central venous thrombosis at high risk of clinically significant pulmonary embolism when anticoagulation is contraindicated or ineffective. • Routine prophylactic use is not recommended. • American College of Chest Physicians (CHEST/ACCP 2021 VTE Guidelines) • Do not recommend routine filter use in upper extremity DVT. • Anticoagulation remains the mainstay; SVC filters only for absolute contraindication to anticoagulation with symptomatic PE or very high embolic risk. • European Society for Vascular Surgery (ESVS 2021 Venous Thrombosis Guidelines) • SVC filters are rarely indicated; can be considered if there is proximal UEDVT with contraindication to anticoagulation and high PE risk. • Emphasis on removal once indication has resolved. #VascularHealth #BloodClots #SVCCare #VascularAwareness #DrMuhammadNasir

ChristianaCare's latest innovation in non-surgical valve procedures brings two new minimally invasive procedures to repair or replace tricuspid valves to #Delaware for the first time. ChristianaCare’s Center for Heart & Vascular Health is among the first in the nation to offer these advanced procedures, which can restore valve function and improve quality of life while eliminating the need for open-heart surgery. https://hubs.ly/Q03LKDvc0 #ChooseDelaware #NetDE

Postoperative respiratory and cardiac complications remain a major challenge in thoracic surgery using one-lung ventilation. In a new Thorax randomized controlled trial (Prevention HARP-2), patients scheduled for surgeries requiring one-lung ventilation (e.g. lobectomy, oesophagectomy) were randomized to high-dose simvastatin (80 mg) or placebo starting days before surgery and continuing postoperatively. The primary composite endpoint included acute respiratory distress syndrome, postoperative pulmonary complications, myocardial infarction or ischemia within the first 7 postoperative days. The trial was stopped early for futility: 42.5% in the simvastatin arm vs 38.2% in placebo met the primary endpoint (OR 1.19, 95% CI 0.68–2.08, p = 0.54). Secondary outcomes and safety profiles were similar between groups. This rigorous trial did not show a reduction in cardiopulmonary complications with perioperative simvastatin in one-lung ventilation surgeries. Its findings argue against routine use of simvastatin for this indication. Source: https://lnkd.in/eeN7P9ux Published Date: July 09, 2025 👉 Comment BIOHACK if you want more science and health news like this! #BiohackYourself #HealthNews #ScienceNews #ResearchUpdates #Biohack Disclaimer: This content is for educational and entertainment purposes only and is not a substitute for medical advice. Always consult a healthcare professional. Full disclaimer: https://lnkd.in/eJE9Rsty 🧠 We explore all angles — ancient wisdom, modern science, and everything in between. No allegiance to Big Pharma or Big Natural. 🔍 We cite studies, but encourage you to read them, question funding, and review the methods. Stay curious. 📚 Not all journals are equal. Peer-reviewed ≠ perfect. Check the source, think critically, and decide for yourself. ⚠️ One study isn’t the full story. Science evolves. We’re here to inform, not to tell you what to believe.

Management of fistulas in the upper gastrointestinal tract can be challenging In the review by Matteo M. V et al (https://lnkd.in/d6WP9eDg) we find some relevant ad updated points 1. Definition and relevance • Upper GI fistulas are abnormal communications between epithelial surfaces leading to leakage of gastrointestinal contents. • They are rare but serious conditions, often associated with high morbidity and mortality. 2. Etiology • Can result from inflammatory diseases, malignancy, radiation, or iatrogenic causes (e.g., post-surgical or endoscopic complications). • Often occur after anastomotic dehiscence or bariatric surgery. 3. Diagnostic approach • Requires high suspicion due to atypical presentation. • Diagnosis relies on endoscopic and radiologic imaging to assess tract anatomy, location, size, and associated collections. 4. Management principles • No standardized guidelines exist; management is individualized. • A multidisciplinary approach (endoscopists, surgeons, radiologists, nutritionists) is crucial. • Conservative management is possible in selected cases (especially small, recent fistulas). 5. Endoscopic treatments • Over-the-scope clips (OTSC) – effective for small defects. • Stents – suitable for longer or tubular fistulas, allowing internal drainage. • Endoscopic suturing – used for moderate defects or persistent leaks. • Endoluminal vacuum therapy (EVT) – effective in large or infected fistulas, promoting granulation and closure. • Combination therapies are increasingly used for complex cases. 6. Prognosis and future directions • Success depends on size, chronicity, and local inflammation. • Early diagnosis and minimally invasive endoscopic management can often avoid surgery. • Need for prospective studies and standardized protocols to optimize outcomes. #endoscopy #safeendoscopy #operativeendoscopy

The Role of CT Angiography in Lower Limb Arteries: CT Angiography (CTA) of the lower limb with contrast is one of the most powerful diagnostic tools in vascular imaging. It provides high-resolution images of the arteries, helping physicians detect: Peripheral arterial disease (PAD) Arterial stenosis or occlusions Aneurysms Post-operative vascular complications ✨ Why it matters? Early and accurate diagnosis through CTA allows doctors to plan effective treatment—whether it’s medical management, angioplasty, or surgery—ultimately improving patient outcomes and reducing the risk of limb-threatening complications. ⚠️ Renal Function Check Since CTA requires a relatively large amount of contrast, it is essential to check the patient’s renal function (Creatinine level) before the scan. This ensures patient safety and reduces the risk of contrast-induced nephropathy. As a Radiographer, my role is to ensure patient preparation, check renal function results, administer contrast correctly, and deliver high-quality images for precise diagnosis. CTA of the lower limb is not just a scan—it’s a lifeline for patients at risk of vascular disease. #Radiography #CTA #Angio #MedicalImaging #Radiology #PatientCare #LowerLimb #VascularImaging #Healthcare #ContrastSafety

At our recent annual conference, Dr. Vincent Larouche discussed aggressive acromegaly and the challenges it presents endocrinologists and patients. While there is no consensus definition of aggressive acromegaly, the term is generally used for cases where the tumour: - is invasive (e.g., into the cavernous sinus); - has specific pathology markers; - is resistant to first-line therapies; - grows rapidly; or - has multiple local recurrences Anywhere from 4.5% to 31% of acromegaly cases are considered aggressive, and it’s often found in younger patients. Surgery is generally recommended as the first line of treatment, even if it’s not possible to remove the full tumour. Reducing the volume can help patients respond better to medical therapy later on. Radiation may also be recommended, but as a last resort. Newer medications are leading to more success in controlling IGF-1 levels in aggressive cases, but the ultimate aim is early diagnosis, so the tumour has less time to grow and surgery is more likely to be successful. #AcroCon #Acromegaly #Gigantism #RareDisease #Pituitary

💡 Gastric Bypass: Evolution and Long-Term Impact 📖 Authors: Joel Brockmeyer, Elisabeth M. Coffin Since Mason & Ito first used Roux-en-Y gastric bypass in 1966, it has become a gold standard for achieving durable weight loss and improving obesity-related comorbidities. 🔹 Technique Evolution: Extended Roux and biliopancreatic limbs, optimized Roux limb path, and adoption of minimally invasive approaches have made the procedure safer with faster recovery. 🔹 Long-Term Outcomes: Studies show most patients maintain significant weight loss for up to 20 years. 🔹 Comorbidity Improvement: Significant resolution of diabetes, hypertension, dyslipidemia, and other obesity-related conditions. 🔹 Safety: Complication rates have decreased but require continued expert monitoring. 🔗Gastric bypass: evolution toward mini-invasive techniques and long-term results 💬 Takeaway: Gastric bypass isn’t just a weight-loss surgery—it’s a long-term solution for overall health improvement. 💡 Mini-invasive Surgery welcomes submissions in related areas. Submit before the end of 2025 to enjoy special publication discounts! Irene Liu OAE Publishing Inc. TROGSS - The Robotic Global Surgical Society SurgeOn by Surgery Unified IRCAD China Michele Manara Karim Ataya,MD,FRCS(Eng) Bruno Dillemans Enrique F. Elli MD FACS Neil Floch M.D., F.A.C.S. Richard Zhu, MD FACS FASMBS FICS DABS-FPMBS DABOM Wael Arba Jihène El Kafsi Emanuel Shapera MD FACS Ricard Corcelles Joseph Derienne Abraham Krikhely, MD, FACS, FASMBS