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Introduction: Aortic valve replacement with either mechanical or bioprosthetic valves is the gold standard treatment for severe aortic stenosis. Unfortunately, enhanced bleeding and hemodynamic decompensation thrombocytopenia is a frequent postoperative complication. The latter could be secondary to the shearing effect of mechanical prosthesis upon the blood flow that favors platelet aggregation or the presence of thrombogenic materials such as glutaraldehyde used to preserve bioprosthetic valves. Our aim was to discern which type of valve is associated with a more severe post-surgery thrombocytopenia so we compared postoperative platelet counts in patients treated with mechanical vs bioprosthetic valves. Material and Method: Two hundred and fifty patients with severe aortic stenosis underwent valve replacement surgery were included in the analysis. 126 patients received a mechanical (group A) and 124 patients received a biological (group B) prosthesis. A conventional surgical procedure with Extracorporeal Life Supports (ECLS) was performed in all. Patients' age, gender, cardiovascular risk factors, type and time length of antiaggregant treatment, size of the implanted valve, and perioperative events were recorded. Pre-surgery platelet count and daily post-surgery registers of platelets count for a 10-day period was documented. Results: Platelet count before surgery was within normal values in both groups. There was a significant decrease the first postsurgical day in both groups (127±48 vs 224±56 in group A, and 132±45 vs 229±54 in group B, p <0.001). Normal platelet count, was reached the fourth post-surgery day in group A patients compared to the eighth day of group B. The differences in platelet count between both groups, independently of the postsurgical day, were highly significant. Thrombocytopenia remained significantly lower and did not reach normal values (141) in the 10 days follow-up in patients that received the 19 mm prosthesis, whereas those receiving the 21 mm valves reached normal values (150) the eighth day. Conclusion : Thrombocytopenia in patients undergoing aortic valve replacement is secondary to the synergic effect of ECLS, aldehydes present on the preservation solution of prosthesis, and the shear flow induced by the prosthesis diameter. The implant of small diameter prosthesis prolongs thrombocytopenia. [ABSTRACT FROM AUTHOR]

Uterine neoplasm metastases to heart is infrequent, especially from uterine cancer, although it is possible because leiomyosarcoma is very invasive. We present a case of a 33 years old woman with 9 months evolution of this neoplasm. By cardiac and brain symptomatology, this patient was diagnosed with cardiac and brain tumors in imaging studies. The patient underwent tumors resection by cardiac surgery and stereotaxic procedure and subsequent chemo and radiotherapy, without neurological and cardiac symptoms in her evolution. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic and inflammatory disorders are widely described in COVID-19 disease by SARS-CoV-2, especially in advanced gravity stages, nevertheless, the increase in inflammatory and tissue damage biomarkers could identify patients with higher mortality risk since early disease stages. Material and Method: A retrospective Cohort study was performed to evaluate the progression pattern and mortality risk of proinflammatory (Ferritin and IL- 6) and damage tissue biomarkers seric levels (LDH, CPK, CPK-MB and TnIc) since the beginning of the disease to end outcome considered, in this study, as death or recovery. Results: We evaluated 120 patients with mean age 51±10 years. The CAT study showed in all patients bilateral polished glass lung lesions. The inflammatory and seric tissue injured biomarkers were significantly higher since the beginning of the hospitalization in patients who died compared with patients that survived (p = 0.01). The myocardial injury biomarkers (CPK-MB and TnIc) were significantly higher in severe gravity stages of deceased patients compared to patients who survived (p = 0.001 and 0.003 respectively) with a global mortality of 38.3% (n = 48). The mortality risk was extremely elevated (RR> 10) when inflammatory and tissue injury biomarkers showed seric levels 2 folds above normal values, showing survival of < 60% after tenth day since the beginning disease. Conclusion: Since the beginning of COVID-19 disease by SARS CoV2 virus, patients show serum elevation in ferritin, LDH and CPK. This seric values were associated with higher mortality risk, when elevated 2 folds above normal values. [ABSTRACT FROM AUTHOR]

Introduction: The physiological process of sternum surgical fracture consolidation in patients undergoing cardiac surgery could be prolonged by the invasion of gram-positive saprophytic bacteria which perpetuates the local inflammatory process despite the standardized aseptic and antiseptic measures in cardiac surgery. In this regard, the topical application of Vancomycin can exert a positive effect and prevent the perpetuation of the local inflammatory process by the elimination of these bacteria which in turn reduces bone consolidation time. The purpose of the current study was to determine the effect of topical Vancomycin on sternum surgical fracture consolidation in patients undergoing to openheart surgery. Materials and Methods: Patients who underwent open heart surgery were assigned into groups receiving the topical application of bone wax or Vancomycin mass in the spongy tissue exposed by surgical sternotomy, prior to sternal closure. The bone consolidation processes were assessed by two expert radiologists with simple chest computed tomography (CT) in the postoperative period (4, 8, and 12 weeks). Results: The study was conducted on 55 patients in Vancomycin (n=33) and bone wax group (n=19). The computerized axial tomography (CAT) scan revealed a higher number of patients with early bone consolidation (Medullar and bone continuity, and callus bone) in Vancomycin group, as compared to bone wax group (p values between 0.004-0.02 at 4 weeks and 0.01-0.06 at 8 weeks). However, no difference was observed at 12 weeks (P=0.09-0.11). Moreover, The magnitude effect of topical Vancomycin was high (>90%) at 3, 8, and 12 weeks of follow up, compared to the patients who received bone wax (<90%). Conclusion: The topical Vancomycin application had a positive effect on sternal surgical fracture and promotes an early bone consolidation in patients undergoing open-heart surgery. [ABSTRACT FROM AUTHOR]