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Do rapid deployment aortic valves improve outcomes compared with surgical aortic valve replacement?
A best evidence topic was written according to a structured protocol. The question addressed was ‘In patients requiring an aortic valve replacement, are rapid deployment aortic valve systems better than conventional aortic valve prostheses in terms of mortality, morbidity and/or valve function?’ A total of 508 papers were found using the reported search, of which 11 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. The rapid deployment valves (RDVs) ...
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Davies, R. A., Bandara, T. D., Perera, N. K., Orr, Y. Tags: Basic research vascular Adult Cardiac Source Type: research

eComment. Resident surgical training in mitral valve surgery
(Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Garcia-Villarreal, O. A. Tags: E-Comment Source Type: research

How safe is it to train residents to perform mitral valve surgery?
A best evidence topic was constructed according to a structured protocol. The enquiry: In [patients undergoing mitral valve surgery] are [postoperative morbidity and mortality outcomes] acceptable when patients are operated on by [residents]? Four hundred and twenty-three were identified from the search strategy. Six articles selected as best evidence were tabulated. All current published evidence, encompassing open and minimally invasive mitral valve repair in addition to mitral valve replacement, supports the involvement of trainees in mitral procedures. Although trainees may experience longer aortic cross-clamp and card...
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Gabriel, J., Göbölös, L., Miskolczi, S., Barlow, C. Tags: Transplantation - heart, Basic research vascular Adult Cardiac Source Type: research

Do we have to operate on moderate functional mitral regurgitation during aortic valve replacement for aortic stenosis?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was ‘Do we have to operate on moderate functional mitral regurgitation (FMR) during aortic valve replacement (AVR) for aortic stenosis (AS)?’ Altogether 325 papers were found using the reported search, of which 9 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. The current evidence obtained from these papers revealed that the significant p...
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Kowalowka, A. R., Onyszczuk, M., Wanha, W., Deja, M. A. Tags: Basic research vascular Adult Cardiac Source Type: research

Congestive kidney failure in cardiac surgery: the relationship between central venous pressure and acute kidney injury
Acute kidney injury (AKI) in cardiac surgery has traditionally been linked to reduced arterial perfusion. There is ongoing evidence that central venous pressure (CVP) has a pivotal role in precipitating acute renal dysfunction in cardiac medical and surgical settings. We can regard this AKI driven by systemic venous hypertension as ‘kidney congestive failure’. In the cardiac surgery population as a whole, when the CVP value reaches the threshold of 14 mmHg in postoperative period, the risk of AKI increases 2-fold with an odds ratio (OR) of 1.99, 95% confidence interval (95% CI) of 1.16–3.40. In cardiac su...
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Gambardella, I., Gaudino, M., Ronco, C., Lau, C., Ivascu, N., Girardi, L. N. Tags: Electrophysiology - arrhythmias, Minimally invasive surgery, History Adult Cardiac Source Type: research

Incidence, risk factors and prognosis of postoperative atrial arrhythmias after lung transplantation: a systematic review and meta-analysis
In conclusion, the significant risk factors for postoperative atrial arrhythmias were gender, age, history of atrial arrhythmias, vasopressor use, cystic fibrosis, interstitial lung disease, hypertension, coronary artery disease, hyperlipidaemia, cardiac index and left atrial size. Development of postoperative atrial arrhythmias has prognostic implications for length of stay and overall survival after lung transplantation. Prospective and randomized trials are needed to address these issues in the future. (Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Fan, J., Zhou, K., Li, S., Du, H., Che, G. Tags: Trachea and bronchi, History Thoracic Source Type: research

Minimally invasive mitral valve repair for functional mitral regurgitation in severe heart failure: MitraClip versus minimally invasive surgical approach
CONCLUSION Despite the significant baseline differences in accumulated expertise and risk profile between the surgical and the MitraClip groups, both minimally invasive techniques were associated with similar 30-day and long-term outcomes. (Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Ondrus, T., Bartunek, J., Vanderheyden, M., Stockman, B., Kotrc, M., Van Praet, F., Van Camp, G., Lecomte, P., Mo, Y., Penicka, M. Tags: Minimally invasive surgery, History, Transplantation - heart, Basic research vascular Adult Cardiac Source Type: research

Determinants of late outcomes in women undergoing mitral repair of myxomatous degeneration
CONCLUSIONS In this large series, women with degenerative mitral valve disease presented with echocardiographic markers suggestive of more advanced disease at the time of surgery. Although there was no difference in early or late survival between groups, women were more likely to develop recurrent MR ≥2+ over the course of follow-up. Earlier surgical referral of women may, therefore, be advised. (Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Chan, V., Chen, L., Elmistekawy, E., Ruel, M., Mesana, T. G. Tags: Basic research vascular Adult Cardiac Source Type: research

Aortic cross-clamping phase of cardiopulmonary bypass is related to decreased microvascular reactivity after short-term ischaemia of the thenar muscle both under intravenous and volatile anaesthesia: a randomized trial
CONCLUSIONS This study demonstrated that the aortic cross-clamping phase of CPB cardiac surgery is associated with lower values of tissue saturation and a decreased rate of saturation recovery under both propofol and sevoflurane anaesthesia. Aortic cross-clamp release is followed by accelerated tissue desaturation during VOT. Propofol anaesthesia for CPB cardiac surgery results in greater reduction of nadir tissue saturation during the ischaemic phase of VOT in comparison to that of sevoflurane. TRIAL REGISTRATION NUMBER NCT02593448 (Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Biedrzycka, A., Kowalik, M., Pawlaczyk, R., Jagielak, D., Swietlik, D., Szymanowicz, W., Lango, R. Tags: Anesthesia, History, Myocardial protection Adult Cardiac Source Type: research

eReply. Diagnostic intricacies and fortuitous treatment approaches for carbapenem-resistant Klebsiella pneumoniae
(Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Giacobbe, D. R., Salsano, A., Marchese, A., Santini, F. Tags: eReply Source Type: research

eComment. Diagnostic intricacies and fortuitous treatment approaches for carbapenem-resistant Klebsiella pneumoniae
(Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Mestrovic, T., Bedenic, B. Tags: E-Comment Source Type: research

Risk factors for infections due to carbapenem-resistant Klebsiella pneumoniae after open heart surgery
CONCLUSIONS In our cohort, CR-Kp colonization was an important predictor of CR-Kp infection after open heart surgery. CR-Kp infection after surgery significantly affected survival. Preventing colonization is conceivably the most effective current strategy to reduce the impact of CR-Kp. (Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Salsano, A., Giacobbe, D. R., Sportelli, E., Olivieri, G. M., Brega, C., Di Biase, C., Coppo, E., Marchese, A., Del Bono, V., Viscoli, C., Santini, F. Tags: Electrophysiology - arrhythmias, History Adult Cardiac Source Type: research

A clinical score to predict acute kidney injury after cardiac surgery in a Southeast-Asian population
CONCLUSIONS In conclusion, the risk model is valid in predicting AKI post-cardiac surgery and can be used for the early diagnosis and treatment of AKI. (Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Nah, C. W., Ti, L. K., Liu, W., Ng, R. R. G., Shen, L., Chew, S. T. H. Tags: Anesthesia, History, Peripheral vascular Adult Cardiac Source Type: research

Does the surgeon's experience have an impact on outcome after total arterial revascularization with composite T-grafts? A risk factor analysis
CONCLUSIONS Total arterial revascularization with composite T-grafts can be performed safely by surgeons with different surgical experience. Despite differences in surgical performance parameters (e.g. operation times, blood transfusions), complication rates were extremely low, irrespective of the surgeon's operative experience. Surgeons can be introduced to these procedures in an early phase of training. (Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Umminger, J., Reitz, M., Rojas, S. V., Stiefel, P., Shrestha, M., Haverich, A., Ismail, I., Martens, A. Tags: Education, Molecular biology Adult Cardiac Source Type: research

eComment. How can we be sure?
(Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - October 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Hurdus, B. P. Tags: E-Comment Source Type: research