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Background: Significant tricuspid regurgitation (TR) is a predictor of right heart failure (RHF) and increased mortality following left ventricular assist device (LVAD) implantation, however the benefit of tricuspid valve surgery (TVS) at the time of LVAD implantation remains unclear. This study compares early and late mortality and RHF outcomes in patients with significant TR undergoing LVAD implantation with and without concomitant TVS. Methods: A systematic search of four electronic databases was conducted for studies comparing patients with moderate or severe TR undergoing LVAD implantation with or without concomitant TVS. Meta‐analysis was performed for primary outcomes of early and late mortality and RHF. Secondary outcomes included rate of stroke, renal failure, hospital and ICU length of stay. An overall survival curve was constructed using aggregated, reconstructed individual patient data from Kaplan–Meier (KM) curves. Results: Nine studies included 575 patients that underwent isolated LVAD and 308 patients whom received concomitant TVS. Both groups had similar rates of severe TR (46.5% vs. 45.6%). There was no significant difference seen in risk of early mortality (RR 0.90; 95% CI, 0.57–1.42; p = 0.64; I2 = 0%) or early RHF (RR 0.82; 95% CI, 0.66–1.19; p = 0.41; I2 = 57) and late outcomes remained comparable between both groups. The aggregated KM curve showed isolated LVAD to be associated with overall increased survival (HR 1.42; 95% CI, 1.05–1.93; p = 0.023). Conclusions: Undergoing concomitant TVS did not display increased benefit in terms of early or late mortality and RHF in patients with preoperative significant TR. Further data to evaluate the benefit of concomitant TVS stratified by TR severity or by other predictors of RHF will be beneficial. [ABSTRACT FROM AUTHOR]

Numerous studies have documented that experts exhibit more efficient gaze patterns than those of less experienced individuals. In visual search tasks, experts use fewer, longer fixations to fixate for relatively longer on salient regions of the visual field while less experienced observers spend more time examining nonsalient regions. This study investigates whether changes in gaze patterns reflect learning by students in a medical gross anatomy course. Students were asked to examine photographs of dissections similar to those they experienced in class and to identify the tagged structure in each image. We postulated that, compared to naive behavior (behavior at baseline and when examining unfamiliar content) students would examine familiar content for longer and would direct proportionally more fixation time on cognitively salient regions of the images while using fewer, longer duration fixations. Our students examined familiar images for significantly longer than they did at baseline (P?

Background: BiVACOR is a novel total artificial heart (TAH) utilizing a single centrifugal magnetically levitated rotor with the ability to modulate pulsatile flow. The device has been successfully tested in a bovine model. We undertook a multicenter anatomical and virtual fitting study of the BiVACOR in patients undergoing heart transplantation. Methods: 10 patients were recruited across two heart transplant centers. A sterilized 1:1 titanium model of the device was inserted into the patient's chest post heart explant, prior to implantation of the donor heart. Measurements were recorded in situ. The device was then removed. Following this, retrospective 3D reconstructions were created from computed tomography chest scans to simulate a virtual fitting. Results: Mean age was 53 years (range 38–67). Mean BMI was 28 (range 20–37). Heart failure etiology was varied—with ischemic cardiomyopathy being the most common. Mean spine‐to‐sternum distance at the tenth thoracic vertebrae (T10) was 14 cm (range 11–18). Mean aorta to aortic Port distance was 0.2 cm (range 0–0.5). Mean pulmonary artery to pulmonary artery port distance was 4.2 cm (range 1–7). The device fitted suitably in all patients without gross distortion to the geometry between native vessel/chamber and port. Conclusions: This study described the anatomical and virtual fitting of the BiVACOR TAH. The device fit well within the chest cavities of all 10 patients, who represented a variety of body morphologies and heart failure etiology. [ABSTRACT FROM AUTHOR]