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Babesiosis is an emerging infection most commonly acquired from a tick bite. We describe three hospitalized patients with fever attributable to babesiosis after a splenectomy. Splenectomy was done because of splenic enlargement due to unsuspected babesia infection in one patient and because of splenic perforation due to babesiosis in a second patient. The third patient underwent splenectomy for trauma and acquired babesiosis postoperatively from a blood transfusion. Our cases demonstrate the need to be vigilant for babesiosis in patients undergoing splenectomy.

Background:We tested the hypothesis that sodium-hydrogen exchange inhibition attenuates ventricular dysfunction after ischemia-reperfusion injury in the intact porcine heart.Methods: Twelve pigs (weight, 30-45 kg) were evenly divided into 2 groups. Baseline ventricular function studies were based on echocardiography, conductance, aortic flow, and left ventricular pressure. Animals were given vehicle (control) or benzamide-N-(aminoiminomethl)-4-(4-[2-furanylcarbonyl]-1-piperazinyl)-3-(methylsulfonyl)methanesulfonate (BIIB 513; 3 mg/kg administered intravenously). Ten minutes later, hearts were subjected to 75 seconds of ventricular fibrillation. After reperfusion for 40 minutes, function studies were repeated. Hearts were arrested and excised. Postmortem data included passive pressure-volume curves and myocardial water content.Results: Preload recruitable stroke work was significantly decreased from baseline after ischemia and reperfusion in the control group (27.7 Ϯ 2.5 vs 48.0 Ϯ 5.6 mm Hg [Ϯ SEM], P ϭ .001) but not in the BIIB 513 group (43.0 Ϯ 5.8 vs 45.5 Ϯ 4.1 mm Hg, P ϭ not significant). In vivo diastolic and postmortem passive left ventricular compliance were reduced after ischemia and reperfusion for control animals but remained unchanged for animals receiving BIIB 513. Time required to recover baseline blood pressure after ventricular fibrillation was significantly longer for control animals (159 Ϯ 15 vs 88 Ϯ 14 seconds [Ϯ SEM], P ϭ .008). Myocardial water content (78.97% Ϯ 0.94% vs 77.86% Ϯ 0.46% [Ϯ SEM]) and normalized left ventricular mass (137.24 Ϯ 6.17 vs 128.41 Ϯ 1.96 g [Ϯ SEM]) were insignificantly increased in control animals.Conclusions: Sodium-hydrogen exchange inhibition attenuates ventricular dysfunction after 75 seconds of ventricular fibrillation and 40 minutes of reperfusion. This family of agents might prove useful in patients with severe left ventricular dysfunction undergoing ventricular fibrillation for implantable cardioverter defibrillator testing. I mplantable cardioverter-defibrillators (ICDs) are effective treatment for refractory malignant arrhythmias, decreasing the incidence of sudden arrhythmic death to 1% to 2% per year. [1][2][3] Insertion requires induction of ventricular fibrillation (VF) to measure defibrillation thresholds (DFTs). ICD recipients often have markedly decreased ventricular function caused by cardiomyopathy, infarct-related scars, or left ventricular (LV) aneurysms. 1 Although perioperative mortality for routine ICD insertion is low (0.5%-From the Departments of Surgery, a Pediatrics, b and Biostatistics,

Objectives To highlight short‐ and long‐term clinical outcomes of the Intuity TM rapid deployment prosthesis for surgical aortic valve replacement. Methods We reviewed on PubMed/MEDLINE, Embase, SciELO, LILACS, CCTR/CENTRAL, and Google Scholar for clinical trials, retrospective clinical studies, meta‐analysis, and gray literature. Results Fourty‐five clinical studies with 12.714 patients were included in the analysis. Thirty‐day mortality ranged from 3.8% for Intuity and 3.9% for transcatheter aortic valve replacement (TAVR). The incidence of paravalvular leak (PVL) (Intuity 0% and TAVR 2.17%), permanent pacemaker implantation (Intuity 11.11% and TAVR 12.5%), stroke (Intuity 2.2% and TAVR 2.6%), myocardial infarction (MI) (Intuity 0% and TAVR 1%), were all higher in the TAVR group. Compared to other sutured bioprosthesis (SB), mortality ranged from 0% to 3.9% for Intuity and 0%−6.9% for SB. Long‐term cardiac mortality ranged from 0.9% to 1.55% for Intuity and 1.4%−3.3% for the Perceval valve. The incidence of PVL (Intuity 0.24%−0.7% and Perceval 0%−1%), endocarditis (Intuity 0.2%−0.7% and Perceval 1.6%−6.6%), stroke (Intuity 0.36%−1.4% and Perceval 0%−0.8%), MI (Intuity 0.07%−0.26%), and SVD (Intuity 0.12%−0.7% and Perceval 0%) were comparable. Compared to standard full sternotomy (SFS), minimally invasive surgery (MINV) mortality ranged from 0% to 4.3% for MINV and 0%−2.1% for SFS. Hospital costs outcomes ranged from $37,187−$44,368 for the Intuity, $69,389 for TAVR, and $13,543 for SB. Intuity short‐term mortality ranged between 0.9% and 12.4% while long‐term mortality ranged between 2.6% and 20%. Conclusions This manuscript provides a 360° overview of the current rapid deployments, sutureless, and TAVR prosthesis.