Background: Among patients undergoing cardiac surgery on cardiopulmonary bypass (CPB), post-operative complications are common, occurring in up to 67% of patients, and significantly impact long-term outcomes. We conducted a Phase 2 clinical trial of RBT-1, a pharmacologic preconditioning drug, to assess cytoprotective biomarkers and clinical outcomes. Herein, we report our final results. Methods: This randomized, [...]

Background: Acute kidney injury (AKI) following cardiac surgery occurs in 30% of cases with 1% requiring dialysis resulting in significant morbidity and mortality.  HMG-CoA Reductase Inhibitors (“statins”) have been postulated to be of benefit in this population, however results from existing clinical studies have been inconsistent. Since there is abundance of evidence showing that short-term [...]

Background: The 2014 ACC/AHA Perioperative Guidelines suggest using the Revised Cardiac Risk Index (RCRI), myocardial infarction or cardiac arrest (MICA), or American College of Surgeons (ACS)-NSQIP calculators for combined patient-surgical risk assessment. However, there is no published data comparing their performance. Methods: We retrospectively reviewed records of 663 patients seen in our preop clinic who [...]

Background: Patients undergoing cardiac surgery are at risk of anemia from blood loss, inflammation, and red blood cell lysis, necessitating blood product utilization and increasing the risk of post-operative complications. RBT-1 (a combination of stannic protoporfin and iron sucrose) is a novel preconditioning drug administered prior to surgery that upregulates anti-inflammatory, antioxidant, and iron scavenging [...]

Background: In 2014, the ACC/AHA released guidelines regarding indications for preoperative transthoracic echocardiogram (pre-op TTE) in patients undergoing noncardiac surgery. Studies indicate that the ordering of pre-op TTE in noncardiac surgery is not consistent with the ACC/AHA guidelines. Some studies suggest the pre-op TTE have a significant impact on management, while others have demonstrated low cardiac [...]

Background: Perioperative management of anticoagulant in mechanical valve patients is challenging, Current recommendations focus on management in patients undergoing elective surgery, while the data in patients hospitalized for emergency/urgency non-cardiac surgery is limited. We aimed to identify thromboembolic and bleeding events after anticoagulant interruption in patients with mechanical heart valves hospitalized for emergency/urgent non-cardiac surgery. [...]

Background: Current guidelines recommend continuing aspirin during elective non-cardiac surgery in 1) patients with prior percutaneous coronary intervention (PCI) if the bleeding risk allows and 2) patients without prior PCI if thrombotic risk outweighs bleeding risk. Comparing the risk of thrombosis and bleeding is frequently inexplicit, particularly in low and intermediate bleeding risk surgery. The [...]