Robert B. Hawkins

Premature Bioprosthetic Aortic Valve Degeneration Associated with Allergy to Galactose-Alpha-1,3-Galactose.

We present the cases of two patients with bioprosthetic aortic valves who developed an allergy to alpha‐gal. Each had premature degeneration of their bioprosthesis and demonstrated rapidly increasing transvalvular gradients after development of their allergy. Each underwent successful replacement with a mechanical aortic valve within 1–2 years of symptom onset. doi: 10.1111/jocs.12764 (J Card Surg 2016;31:446–448)

Coronary artery bypass grafting bundled payment proposal will have significant financial impact on hospitals

Objectives The Centers for Medicare and Medicaid Services plans to institute a 5‐year trial of bundled payments for coronary artery bypass grafting through 90 days after discharge. To investigate the impact, we reviewed actual inpatient costs for patients undergoing bypass surgery relative to the target price. Methods A total of 13,276 Medicare patients with estimated cost data underwent isolated coronary artery bypass grafting from 2008 to 2015 in 18 hospitals over 8 Medicare‐defined regions within the Commonwealth of Virginia. Actual 2015 inpatient costs were compared with estimated target prices for each year of the pilot, based on the previous 3 years and stratified by Diagnosis‐Related Group. Results The mean 2015 cost per patient was

Contemporary outcomes in reoperative mitral valve surgery

50,394 with high variation (range,

Cost of individual complications following coronary artery bypass grafting

27,862‐

Clinical significance of failure to lose weight 10 years after roux-en-y gastric bypass

74,169). On average, hospitals would receive a refund of

Minimally invasive mitral valve surgery is associated with excellent resource utilization, cost, and outcomes

17,682 in year 1, but then owe Medicare increasing amounts up to

Preoperative anemia versus blood transfusion: Which is the culprit for worse outcomes in cardiac surgery?

367,985 in year 5. If 2015 were the final year of the pilot, 13 of the 18 hospitals (72%) would have owed Medicare for cost overruns averaging

Revisiting successful transplantation with marginal lungs: Fourteen years later, a new era of extended criteria

614,270 (range,

Benefit of feeding tube placement for refractory malnutrition after bariatric surgery

67,404‐

Postoperative atrial fibrillation is associated with increased morbidity and resource utilization after left ventricular assist device placement

2,102,292). Costs were below the target price at 5 of 18 hospitals, and the Centers for Medicare and Medicaid Services would have paid them an extra