Injecting a ventricular tachycardia into the heart-Α unique case report.

INTRODUCTION: A 52-year-old woman presented with a complex ventricular arrhythmia in an intraoperative context, during kyphoplasty for an osteoporotic fracture of a lumbar vertebra. The subject showed no indications of a previous cardiovascular condition. METHODS AND RESULTS: Causes of arrhythmias associated with the procedure were excluded. Due to her positive family history for dilated cardiomyopathy, upcoming thoughts were made for unmasking a previous asymptomatic cardiomyopathy. Nevertheless, an intracardiac cement embolism was diagnosed and, finally, the patient underwent an open-heart surgery with successful removal of the cardiac cement. Νo new arrhythmia recorded during follow up. CONCLUSION: To the best of our knowledge, this is the first reported case of ventricular arrhythmogenic presentation of a cardiac cement embolus after a KP procedure.

Machine learning and artificial intelligence in cardiac transplantation: A systematic review.

BACKGROUND: This review aims to systematically evaluate the currently available evidence investigating the use of artificial intelligence (AI) and machine learning (ML) in the field of cardiac transplantation. Furthermore, based on the challenges identified we aim to provide a series of recommendations and a knowledge base for future research in the field of ML and heart transplantation. METHODS: A systematic database search was conducted of original articles that explored the use of ML and/or AI in heart transplantation in EMBASE, MEDLINE, Cochrane database, and Google Scholar, from inception to November 2021. RESULTS: Our search yielded 237 articles, of which 13 studies were included in this review, featuring 463 850 patients. Three main areas of application were identified: (1) ML for predictive modeling of heart transplantation mortality outcomes; (2) ML in graft failure outcomes; (3) ML to aid imaging in heart transplantation. The results of the included studies suggest that AI and ML are more accurate in predicting graft failure and mortality than traditional scoring systems and conventional regression analysis. Major predictors of graft failure and mortality identified in ML models were: length of hospital stay, immunosuppressive regimen, recipient's age, congenital heart disease, and organ ischemia time. Other potential benefits include analyzing initial lab investigations and imaging, assisting a patient with medication adherence, and creating positive behavioral changes to minimize further cardiovascular risk. CONCLUSION: ML demonstrated promising applications for improving heart transplantation outcomes and patient-centered care, nevertheless, there remain important limitations relating to implementing AI into everyday surgical practices.

Coronary artery disease following mediastinal irradiation.

Mediastinal irradiation is a known cause of late onset cardiac complications including coronary artery disease. We describe a 58-year-old female patient, without any of the traditional coronary risk factors, who presented with inferior infarction 23 years after radiotherapy for Hodgkin's lymphoma of the mediastinum. Coronary angiography demonstrated severe ostial stenoses of both coronary arteries. The patient underwent coronary artery bypass grafting and is doing well 10 months later. The therapeutic value of mediastinal irradiation is unquestionable. However, it may be associated with late complications from the irradiated tissues, including the heart. Long-term follow up of cancer survivors who have received mediastinal irradiation should therefore include annual cardiac ultrasound examinations, as well as functional testing for the detection of myocardial ischaemia.

Surgical treatment for aneurysm at the origin of an aberrant right subclavian artery.

Atherosclerotic aneurysms at the origin of an aberrant right subclavian artery (ARSA) are extremely rare entities of congenital origin. We report a case of a 62-year-old man who presented with dyspnea and upper chest pain. The CT scan and digital subtraction angiography revealed a 7-cm aneurysm of an ARSA arising from Kommerell's diverticulum. Deep hypothermic circulatory arrest was instituted and a transaortic approach was used for closure of the origin of the aneurysm with a prosthetic patch. A Dacron graft was interposed between the right subclavian artery and the ascending aorta and the aneurysmal sac was resected. The patient had an uneventful recovery.