Journal and News Scan

Arfaee et al. present the first proof of concept of a soft robotic total artificial hybrid heart (Hybrid Heart) designed to overcome the limitations of current total artificial hearts (TAHs). This device integrates soft pneumatic actuation with a tissue-engineerable, heparin-functionalized supramolecular inner lining, aiming to improve biocompatibility and hemocompatibility while mimicking physiological pulsatile flow. In vitro, the Hybrid Heart achieved a cardiac output of 5.7 L/min with preload sensitivity and laminar flow patterns. Acute goat implantation demonstrated full cardiac support for 50 minutes, with a mean aortic pressure of 49 mmHg and a stroke volume of approximately 35 mL. Wire-based contraction mechanics allow ventricular output balancing, and a wireless transcutaneous energy transfer (TET) concept was explored to eliminate percutaneous drivelines. While currently limited to short-term function and pneumatic actuation, this platform represents a new generation of biomimetic TAHs that could ultimately serve as destination therapy for end-stage heart failure. 

This study on patients undergoing open valve surgeries revelated that Cor-Knot fasteners reduced surgery times compared to manual tying in aortic valve replacements and valve surgeries with coronary artery bypass grafting (CABG). However, the Cor-Knot group showed higher residual valvular regurgitation in mitral valve procedures, and freedom from valve reintervention was lower in aortic valve replacements. Further research is needed to validate these findings, especially in complex cases.  

In this retrospective study, the authors analyzed outcomes in 245 patients with left-sided infective endocarditis (IE) and noninfected cardiac implantable electronic devices (CIEDs) who underwent cardiac surgery, using data from the CAMPAIGN Registry, which included 4,917 patients operated on between 1994 and 2018. Two groups were compared: those who underwent CIED extraction (100 patients, 40.8 percent) and those who did not (145 patients, 59.1 percent). After propensity score matching, 74 pairs were analyzed, revealing the 30-day mortality was 13.5 percent in the extraction group vs 20.3 percent in the nonextraction group (p=0.23). Patients who underwent device extraction had significantly longer ICU stays (median of 8 vs. 4 days; p=0.003) and hospital stays (median of 24 vs. 17 days; p<0.001). Estimated eight-year survival was similar between groups, with 31.5 percent for the extraction group and 28.6 percent for the nonextraction group (subdistribution hazard ratio 0.8; 95 percent CI 0.5–1.2; p=0.26). Recurrent IE rates were also comparable, with six-month rates of 3.5 percent extraction vs. 4.7 percent for nonextraction, and eight-year rates of 5.4 percent vs. 11.3 percent (subdistribution hazard ratio 0.43; 95 percent CI 0.1–1.7; p=0.24). Overall, CIED extraction in these patients did not lead to improved survival or lower rates of IE recurrence, though it was associated with longer ICU and hospital stays. 

The U.S. healthcare system faces significant challenges, including staff shortages and reimbursement cuts, impacting physician compensation and leading to a decline in independent practices. In 2024, average physician compensation increased by 3.7 percent, with greater disparities noted between genders and between adult and pediatric specialists. These findings, based on extensive survey data, aim to help physicians navigate their careers and advocate for improved conditions and patient care.