Sternal wound complications are significant problems in cardiac surgery and cause challenges to surgeons as they are associated with high mortality, morbidity, and a tremendous load on the hospital budget. Risk factors and preventive measures against sternal wound infection need to be in focus. Classification of different types of sternotomy complications post cardiac surgery is important for specific categorization and management. Reviewing the literature, a variety of classifications was introduced to help understand the pathophysiology of these wounds and how best to manage them. Initial classifications were based on the postoperative period of the infectious process and risk factors. Recently, the anatomical description of sternal wound, including the depth and location, was shown to be more practical. There is a lack of evidence-based surgical consensus for the appropriate management strategy, including type of closure, choice of sternal coverage post sternectomy, whether primary, delayed and when to use reconstructive flaps.

Transcatheter tricuspid valve interventions have rapidly evolved over the last decade in response to the large, historically undertreated population with severe tricuspid regurgitation (TR). While most early experience focused on leaflet approximation and annuloplasty, orthotopic transcatheter tricuspid valve replacement (TTVR) has emerged as a transformative strategy that can achieve near-complete elimination of TR in anatomies that are suboptimal for repair. This narrative review summarizes the epidemiology and pathophysiology of severe TR, the rationale for valve replacement, contemporary TTVR devices and implantation concepts, available clinical evidence, and remaining challenges and future directions.

Heavily calcified coronary lesions present a significant challenge in percutaneous coronary intervention (PCI), often leading to complications such as stent underexpansion and malposition, which can negatively impact clinical outcomes. This retrospective study assesses the effectiveness of intravascular lithotripsy (IVL) in preparing calcified coronary lesions before stenting in native coronary lesions and in patients with in-stent restenosis (ISR). Data were collected from patients treated at King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, between January 2019 and January 2025. Patients with coronary lesions exhibiting ≥70% stenosis requiring IVL were included. The primary objectives of the study are to assess key clinical outcomes, including repeat revascularization, target lesion revascularization, stroke, and major adverse cardiovascular events (MACE) post-IVL. Given the increasing use of novel lesion preparation techniques, this study aims to clarify whether IVL in native coronary or ISR offers effective and safe outcomes, potentially influencing treatment decisions for patients with severely calcified coronary lesions. In our study, IVL was demonstrated to be a safe and effective modality for the management of heavily calcified coronary lesions. Among the 45 enrolled patients, successful reperfusion was achieved in all cases, with 100% (45/45) attaining final thrombolysis in myocardial infarction (TIMI) 3 flow. No in-hospital MACE (0%) was reported.

Fracture of acromion is uncommon because of its unique anatomical structure and location. Usually it heals by itself using conservative therapy intervention, and a subject’s shoulder can get back to its functional performance without surgical approach. However, rare cases may not recover due to pseudarthrosis taking place, surgical avoidance plus using noninvasive tools to manage acromion pseudarthrosis with the application of extracorporeal shockwave therapy at medium to high intensity is the author's motivation to report this condition. Likewise, to our knowledge, there is no published literature using extracorporeal shockwave therapy specific to acromion. A case of 36 old male, active, and alert had been referred to the physical therapy outpatient clinic for high density extracorporeal shockwave therapy to manage the acromion pseudarthrosis after going on range of motion and strengthening rehabilitation program for seven months. After having six sessions of extracorporeal shockwave therapy, the acromion nonunion fracture unified, with complete patient recovery. The pain was stopped. The range of motion became full, with the restoration of the shoulder's functional abilities.