Association Officers
(Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - March 1, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Contents
(Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - March 1, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Masthead (copyright and information page)
(Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - March 1, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Tension-free tracheobronchial anastomosis by auto-lung transplantation for right upper lobe lung cancer
A 56-year-old man presented with cervical swelling and back pain. He had been diagnosed with right upper lobe adenocarcinoma developing superior vena cava (SVC) syndrome two years prior. His tumor was invading the lower tracheal lateral wall and tracheobronchial angle (cT4N2M0). He was initially judged as inoperable and offered definitive chemo-radiotherapy (3 cycles cisplatin and vinorelbine with concurrent radiotherapy 66 Gy) followed by atezolizumab with no response. He was referred to us for potential salvage surgery. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 29, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Akihiro Ohsumi, Katsutaka Mineura, Masatsugu Hamaji, Hiroshi Date Tags: THORACIC – Case Report Source Type: research

Cardiac ERAS: A Guide to Team Building and Successful Implementation
Enhanced Recovery After Surgery (ERAS ®) is a bundled approach to perioperative care based upon the philosophy that patients do better when emotional and physiologic stresses are minimized during surgery. The goal of ERAS is to return patients to normal functional status as quickly as possible. Initially designed for patients having co lorectal surgery, ERAS programs have now been developed for nearly every surgical subspecialty. Multiple studies examining the effect of ERAS have demonstrated decreased postoperative complications, length of stay, costs, and increased patient and staff satisfaction. (Source: Seminars in...
Source: Seminars in Thoracic and Cardiovascular Surgery - February 28, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Rawn Salenger, Vicki Morton-Bailey, Michael Grant, Alexander Gregory, Judson B. Williams, Daniel T. Engelman Tags: ADULT – State of the Art Source Type: research

Commentary: Aorto-Ventricular Tunnel: More Than a Mere Tunnel!
Aorto-ventricular tunnel is a rare congenital anomaly and the multicenter study by Protopapas et al is both educative and timely.1 Despite the limitations often intrinsic to a study of such nature, the manuscript sheds light on many features of the disease and brings to the fore the issue of associated aortic valve disease as a key determinant of both short and long term outcomes. The study population included 42 patients from 15 centers over a period of 3 decades. It is interesting to note that the aorto-left ventricle tunnel group tended to present much earlier although the aorto-right ventricle tunnel group should also ...
Source: Seminars in Thoracic and Cardiovascular Surgery - February 27, 2020 Category: Cardiovascular & Thoracic Surgery Authors: T.K. Susheel Kumar, Christopher J. Knott-Craig Tags: CONGENITAL – Commentary Source Type: research

Extra-corporeal membrane oxygenation for neonatal respiratory support
To review our experience with Extra-Corporeal Membrane Oxygenation (ECMO) for respiratory support in neonates. From 1989 to 2018 2,114 patients underwent respiratory ECMO support, with 764(36%) neonates. Veno-Venous (V-V) cannulation was used in 428(56%) neonates and Veno-Arterial (V-A) in 336(44%). Historically V-V ECMO was our preferred modality, but due to lack of suitable cannula in the last 7 years V-A was used in 209/228(92%) neonates. Mean and IQR of ECMO duration was 117 hours (IQR 90 to 164 hours). (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 27, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Antonio F. Corno, Gail M. Faulkner, Chris Harvey Tags: CONGENITAL – Mechanical Circulatory Support Source Type: research

Commentary: pain management in thoracic surgery should extend into late follow-up
Despite it has been described since about forty years, cryoanalgesia has never known a true soaring in the thoracic surgery practice, and its employment has long remained confined to a minority of experienced practitioners. Lying among the limitations of the present investigation by Clemence and coworkers,1 the use of cryoablation on the basis of individual surgeon's experience is the expression of such larger feature. Other drawbacks of this paper comprise the pooled analysis of patients undergoing thoracotomy and thoraco-phreno-laparotomy, the latter incision being potentially associated with pain originating from areas ...
Source: Seminars in Thoracic and Cardiovascular Surgery - February 27, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Amedeo ANSELMI, Bertrand RICHARD DE LATOUR Tags: THORACIC – Commentary Source Type: research

Commentary: Has the time finally arrived for radiofrequency ablation to enter the game?
As surgeons, we like to operate. However, a subset of patients with non-small cell lung cancer (NSCLC) are medically-inoperable due to comorbid conditions. At most institutions, these patients are treated with definitive chemoradiation or stereotactic body radiotherapy (SBRT). For patients with localized disease, SBRT has been shown to be safe and effective for ablation of early-stage disease and oligometastatic tumors.1-3 Recent studies have suggested that lesions can be repeatedly treated with SBRT, particularly as the interval between treatments increases. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 27, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Christopher W. Seder Tags: THORACIC – Commentary Source Type: research

“Commentary: Aorto-Ventricular Tunnel: More than a mere tunnel!“
Aorto-ventricular tunnel is a rare congenital anomaly and the multicenter study by Protopapas et al is both educative and timely.1 Despite the limitations often intrinsic to a study of such nature, the manuscript sheds light on many features of the disease and brings to the fore the issue of associated aortic valve disease as a key determinant of both short and long term outcomes. The study population included 42 patients from 15 centers over a period of 3 decades. It is interesting to note that the Aorto-left ventricle tunnel group tended to present much earlier although the aorto-right ventricle tunnel group should also ...
Source: Seminars in Thoracic and Cardiovascular Surgery - February 27, 2020 Category: Cardiovascular & Thoracic Surgery Authors: T.K. Susheel Kumar, Christopher J. Knott-Craig Tags: CONGENITAL – Commentary Source Type: research

Commentary: How Should We Build The Wall? The Importance of Sternal Closure
Median sternotomy remains the most common cardiac surgical incision used to access the heart and great vessels. Although sternotomy allows safe and effective exposure of mediastinal structures, complications including chronic pain, sternal instability and non-union, surgical site infection and mediastinitis cause significant morbidity and mortality.1 In addition, sternal complications add to procedural costs and overall hospital length of stay. The importance of the sternotomy closure to a successful cardiac operation cannot be overstated. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 27, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Kevin Landolfo, Osama Haddad Tags: ADULT – Commentary Source Type: research

Commentary: Prevention of Systolic Anterior Motion after Mitral Repair in Hypertrophic Obstructive Cardiomyopathy: One Simple Stitch Fits All?
Left ventricular outflow tract (LVOT) obstruction due to systolic anterior motion (SAM) of the mitral valve (MV) is a frequent cause of disabling symptoms hypertrophic obstructive cardiomyopathy (HOCM).1 This phenomenon has a wide clinical spectrum with varying severity and can be associated, in severe cases, with hemodynamic instability due to LVOT obstruction and/or mitral regurgitation (MR).2 The following 3 main pathophysiological risk factors, or a combination thereof, can lead to SAM in patients with HOCM: (1) reduced coaptation-septum distance; (2) elongated anterior mitral leaflet (AML) and/or posterior mitral leaf...
Source: Seminars in Thoracic and Cardiovascular Surgery - February 27, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Thilo Noack, Michael A. Borger Tags: ADULT – Commentary Source Type: research

Commentary: Impact of Prosthesis Size and Prosthesis – Patient Mismatch on Outcomes in Younger Female Patients Undergoing Aortic Valve Replacement
The authors, Kaneko and colleagues, explored an unexpected concept of prosthesis – patient prosthesis (PPM) and valve size in a young female aortic valve replacement population.1 The study evaluated 451 female patients (age0.85 cm2/m2, moderate 0.65 – 0.85 cm2/m2, and severe (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 27, 2020 Category: Cardiovascular & Thoracic Surgery Authors: W.R. Eric Jamieson Tags: ADULT – Commentary Source Type: research

Commentary: Piecing together the puzzle of the aortic root
Critical to optimal management of the aortic root is a thorough understanding of its composition, geometry and dynamics. Its complexity is evident in that even today it's precise structure, function and even nomenclature is debated.1 One area of evolving knowledge is in the true degree of myocardial support of the root. Myocardial, rather than fibrous, support has implications on tension of the valvular sinuses as well as electrical activity and potential arrhythmogenicity. Reports on the precise histologic characterization of the aortic root thus far have produced variable conclusions on this support. (Source: Seminars in...
Source: Seminars in Thoracic and Cardiovascular Surgery - February 27, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Peter J. Altshuler, Pavan Atluri Tags: ADULT – Commentary Source Type: research

Multivessel arterial revascularization via left anterior thoracotomy
To present the technique and to evaluate the outcomes of the multivessel minimally invasive coronary revascularization through the left anterior thoracotomy. From July 2017 to March 2019 in 229 consecutive patients with isolated multivessel coronary artery disease we performed complete coronary revascularization through the left anterior minithoracotomy (6-8 cm skin incision). In 47 of them we performed multiarterial revascularization using left internal mammary artery (LIMA) and T-shunt with left radial artery or right internal mammary artery (RIMA). (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 27, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Oleksandr Babliak, Volodymyr Demianenko, Yevhenii Melnyk, Katerina Revenko, Dmytro Babliak, Oleksii Stohov, Liliya Pidgayna Tags: ADULT – Original Submission Source Type: research

Commentary: Arterial Switch Operation When Perfection Is Not the Finish Line But the Beginning of the Journey
The journey of treatment of transposition of the great arteries from the surgical perspective has probably reached the final round and the Fraser et al1 article clearly describes the achievement of such goal. It has to be acknowledged that this goal may be hard to replicate in developing countries2 despite several steps forward has been done as reported by Schidlow et al. in their multicenter study.3 Fraser et al reported the result of a 23-year experience with the arterial switch operation for transposition of the great arteries of different forms at the Texas Children's Hospital. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 24, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Alessandra Dozio, Mauro Lo Rito Tags: CONGENITAL – Commentary Source Type: research

Commentary: “Arterial Switch operation when perfection is not the finish line but the beginning of the journey.”
The journey of treatment of transposition of the great arteries from the surgical perspective has probably reached the final round and the Fraser et al.1 article clearly describes the achievement of such goal. It has to be acknowledged that this goal may be hard to replicate in developing countries2 despite several steps forward has been done as reported by Schidlow et al. in their multicenter study3. Fraser et al. reported the result of a 23-year experience with the arterial switch operation for transposition of the great arteries of different forms at the Texas Children's Hospital1. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 24, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Alessandra Dozio, Mauro Lo Rito Tags: CONGENITAL – Commentary Source Type: research

A New Graft for Total Arch Replacement with Frozen Elephant Trunk in Type A Dissection
In this study, we propose a novel Sutureless Integrated Stented graft (SIS graft), greatly simplifying the distal aortic anastomosis and reducing the DHCA time in the setting of total arch replacment with frozen elephant tunk for type A aortic dissection. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 24, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Jinlin Wu, Juntao Qiu, Jiawei Qiu, Lu Dai, Mingxing Ma, Liang Zhang, Cuntao Yu Tags: ADULT - Surgical Technique Source Type: research

The Strongest Risk Factor for Operative Mortality in Acute Type A Aortic Dissection is Acidosis: Validation of Risk Model
Multiple risk factors for operative mortality in the setting of acute type A aortic dissection (ATAAD) have been described. Recently, the combination of severe acidosis and malperfusion was found to significantly impact operative mortality following surgery for ATAAD and a treatment algorithm was proposed. The purpose of this study is to validate these findings in our institution. A retrospective chart review was performed for patients who underwent ATAAD repair between Feb 1997 and Jan 2018. Preoperative nadir pH, bicarbonate, base deficit, organ malperfusion, and other relevant parameters were collected. (Source: Seminar...
Source: Seminars in Thoracic and Cardiovascular Surgery - February 24, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Chin Siang Ong, Lucy Nam, Pooja Yesantharao, Jie Dong, Joseph K. Canner, Roald J. Teuben, Xun Zhou, Allen Young, Alejandro Suarez Pierre, Michael K. Pasque, Jennifer S. Lawton Tags: ADULT – Original Submission Source Type: research

Pathologic characteristics of 119 archived specimens showing the phenotypic features of hypoplastic left heart syndrome
To assess the phenotypic variations found amongst hearts diagnosed at autopsy with hypoplastic left heart syndrome, with attention to implications related to this syndrome as an acquired disease of fetal life, rather than being the consequence of abnormal embryogenesis. We assessed 119 specimens, from two archives, diagnosed initially as representing hypoplastic left heart syndrome. Among the 119 specimens, the majority of which had been entered into the archives prior to the availability of surgical treatment for the syndrome, 36 (30%) had the combination of mitral and aortic atresia, 26 (22%) had mitral and aortic stenos...
Source: Seminars in Thoracic and Cardiovascular Surgery - February 21, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Elizabeth H. Stephens, Dipankar Gupta, Mark Bleiweis, Carl L. Backer, Robert H. Anderson, Diane E. Spicer Tags: CONGENITAL – Original Submission Source Type: research

Commentary: One-Stage Norwood Reconstruction with Aortic Uncrossing: A Tailored Approach to a Rare Problem
The article by Alsoufi and colleagues1 shrewdly describes the steps taken in navigating a rare and complex case and clearly explains the reasoning behind their approach in combining two operations into one. Aortic uncrossing was first described by Planch é and Lacour-Gayet2 and is the procedure of choice for managing circumflex aorta in patients with biventricular hearts. However, this finding in combination with single ventricle defects is extremely rare. Multiple surgical approaches could be considered for a rare condition such as circumflex aort a and single ventricle. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 19, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Karthik Thangappan, Awais Ashfaq, Farhan Zafar Tags: CONGENITAL – Commentary Source Type: research

Commentary: TEE in TOF surgery: Looking for the pearls
How much importance should the cardiac surgeon place on the dynamic, intraoperative transesophageal echo (TEE) information in executing an excellent operation? Perhaps this seems almost a silly question. After all, no one would question the importance of TEE in assessing adequacy of a mitral valve repair or left ventricular outflow tract resection or aortic valve repair. So, why are the completely intuitive findings in the current paper, e.g., that obvious residual right ventricular outflow tract obstruction (RVOTO) in the acute, intraoperative TEE after tetralogy of Fallot repair (TOF), important enough to add to the surg...
Source: Seminars in Thoracic and Cardiovascular Surgery - February 19, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Charles D. Fraser Tags: CONGENITAL – Commentary Source Type: research

Identification of Risk Factors for Early Fontan Failure
Despite improvements in operative and perioperative care, the risk of significant morbidity and mortality for children undergoing Fontan procedures persists. Previous investigations have identified peri-Fontan characteristics that may predict early adverse events. The purpose of this study was to identify characteristics from throughout a patient's lifespan, including all perioperative stages, that might predict early Fontan failure — defined as death, Fontan takedown, or listing for cardiac transplantation before hospital discharge or within 30 postoperative days. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 19, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Ellis Rochelson, Marc E. Richmond, Damien J. LaPar, Alejandro Torres, Brett R. Anderson Tags: CONGENITAL – Original Submission Source Type: research

Commentary: No Child Left Behind: Toddler evaluations correlate with school age evaluations but still plan early intervention for all
Meaningful improvements in surgical approaches and medical management have led to increased survival rates for children born with single ventricle heart disease; but with improved early survival, morbidities have become more evident. Neurodevelopmental and behavioral impairments are among the most concerning morbidities for these children. There is a broad range of potential impairments, and while all children with complex congenital heart disease are at risk for developmental impairments, it is generally agreed that children with single ventricle heart diseases are at highest risk; the causes are multifactorial, including...
Source: Seminars in Thoracic and Cardiovascular Surgery - February 14, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Caren S. Goldberg Tags: CONGENITAL – Commentary Source Type: research

Discussions in Cardiothoracic Treatment and Care: The Contemporary Management of Acute Type A Aortic Dissection
DR. CHEN: My named is Edward Chen and I am a cardiac surgeon at Emory University. Today at 2019 AATS we are here to talk about the contemporary management of acute type A aortic dissection. I am joined by a distinguished panel of surgeons who are leading experts in the treatment of this complex disease process. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 13, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Edward Chen, Thomas Gleason, Bo Yang, Joseph Coselli, Malakh Shrestha Tags: ADULT – Discussions in Cardiothoracic Treatment and Care Source Type: research

Commentary: To Bleed or to Breathe? Never a Time to Die
After lung cancer resections, a postoperative venous thromboembolism (VTE) increases the perioperative mortality rate nearly 8-fold.1 Chemoprophylaxis with unfractionated or low molecular weight heparin is routine for thoracic patients and internationally recognized as an intervention to reduce postoperative VTE in cancer patients.2 It is within the standard of care for surgeons to forego the preoperative heparin and use intermittent pneumatic compression devices alone for patients undergoing resections if deemed at high risk for bleeding. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 13, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Virginia R. Litle Tags: THORACIC – Commentary Source Type: research

Commentary: The Great Divide
There is mounting evidence that social determinants of health, such as education, socioeconomic status, race and ethnicity, sex and gender, age, geographic location, English language proficiency, housing, access to healthy food, and exposure to neighborhood violence, have marked influence on several health-related outcomes. 1, 2 In the current issue of Seminars in Thoracic and Cardiovascular Surgery, Asokan and colleagues 3 present the experience of an inner-city hospital delivering care to esophageal cancer patients. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 13, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Africa F. Wallace, Benny Weksler Tags: THORACIC – Commentary Source Type: research

Commentary: “To Bleed or to Breathe? Never a Time to Die”
After lung cancer resections a postoperative venous thromboembolism (VTE) increases the perioperative mortality rate nearly eight-fold.1 Chemoprophylaxis with unfractionated or low molecular weight heparin is routine for thoracic patients and internationally recognized as an intervention to reduce postoperative VTE in cancer patients.2 It is within the standard of care for surgeons to forego the preoperative heparin and use intermittent pneumatic compression devices alone for patients undergoing resections if deemed at high risk for bleeding. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 13, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Virginia R. Litle Tags: THORACIC – Commentary Source Type: research

Commentary: One and Done
Sterno-clavicular joint infections are a difficult problem for both the patient and the surgeon. For the patient the infection and surgical extirpation are very painful. With conventional therapy of excision followed by granulating wound care was slow. The surgeon and the patient are bound together for the long period of debridement, granulation and healing. The surgeon is not happy and the patient is not happy. Being that this is an uncommon problem, the nonthoracic community may not be familiar with the disease. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 13, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Fred Weber Tags: THORACIC – Commentary Source Type: research

Strategies to Minimise Need for Prosthetic Aortic Valve Replacement in Congenital Aortic Stenosis – Value of the Ross Procedure
To examine the role and outcomes of all interventions for aortic stenosis in children, with focus on freedom from reintervention and the aim to minimise prosthetic aortic valve replacement (pAVR) during childhood. Retrospective analysis of 194 consecutive children who underwent any aortic valve intervention for a biventricular repair strategy at a single institution between 1995-2017. Data were obtained from hospital records and follow-up was 100% complete. Over a 22-year period, 194 children underwent total 313 aortic valve procedures: Primary interventions were surgical valvotomy (SV)/surgical repair (SR) in 94 (48.5%), ...
Source: Seminars in Thoracic and Cardiovascular Surgery - February 13, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Yaroslav Ivanov, Nigel E. Drury, John Stickley, Phil Botha, Natasha E. Khan, Timothy J. Jones, William J. Brawn, David J. Barron Tags: CONGENITAL – Original Submission Source Type: research

The Contemporary Management of Acute Type A Aortic Dissection
Dr Chen: My name is Edward Chen and I am a cardiac surgeon at Emory University. Today at 2019 AATS, we are here to talk about the contemporary management of acute type A aortic dissection. I am joined by a distinguished panel of surgeons who are leading experts in the treatment of this complex disease process. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 12, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Edward Chen, Thomas Gleason, Bo Yang, Joseph Coselli, Malakh Shrestha Tags: ADULT – Discussions in Cardiothoracic Treatment and Care Source Type: research

Discussion
Gabriele Di Luozzo, MD (New York, NY): (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 11, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Gabriele Di Luozzo Tags: THORACIC – Discussion Source Type: research

Coronary arterial abnormalities in hypoplastic left heart syndrome: Pathologic characteristics of archived specimens
Palliation of patients with hypoplastic left heart syndrome remains challenging. Although coronary ischemia can be catastrophic, the prevalence and pathologies of anomalies of the coronary arteries remains unknown. We reviewed 119 specimens with the features of hypoplastic left heart syndrome, focusing our attention on the aortic root and the coronary arteries. We found 36 (30%) specimens with the combination of mitral and aortic atresia, 26 (22%) with mitral and aortic stenosis, and 57 (48%) with mitral stenosis combined with aortic atresia. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 11, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Elizabeth H. Stephens, Dipankar Gupta, Mark Bleiweis, Carl L. Backer, Robert H. Anderson, Diane E. Spicer Tags: CONGENITAL – Original Submission Source Type: research

Combined Valve Operations in the Aortic and Mitral Positions With or Without Added Tricuspid Valve Repair
In this study, we aimed to investigate the potential added value of performing a tricuspid valve repair concomitantly in patients requiring double valve surgery of the aortic and mitral valves. We reviewed 223 cases of multi-valve surgery from 2011 to 2016. In this single-institution series, 190 underwent double valve surgery (DVS) in aortic and mitral positions and 33 had triple valve surgery (TVS) in aortic, mitral, and tricuspid positions. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 11, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Thais Faggion Vinholo, Makoto Mori, Syed Usman Bin Mahmood, Clancy W. Mullan, Gabe Weininger, Sameh Yousef, Arnar Geirsson Tags: ADULT – Original Submission Source Type: research

Commentary: Remote Ischemic Preconditioning —Too Good to Be True?
In the late 1980s, in animal models of myocardial ischemia-reperfusion injury, short periods of temporary coronary occlusion led to decreased myocardial infarction size with subsequent coronary occlusion, a phenomenon termed ischemic preconditioning.1 Mitigation of ischemia-reperfusion injury was also noted when the infarcted area was in a different coronary distribution which had not been subjected to initial ischemia, an effect termed remote ischemic preconditioning (RIPC).2 Preconditioning was observed both when applied immediately prior to an ischemic insult (acute) or many hours before (delayed). (Source: Seminars in ...
Source: Seminars in Thoracic and Cardiovascular Surgery - February 10, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Samuel Davila, Robert DB. Jaquiss Tags: CONGENITAL – Commentary Source Type: research

Discussion
Matthew J. Bott, MD (New York, NY) (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 10, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Matthew J. Bott Tags: THORACIC – Discussion Source Type: research

Endobronchial ultrasound-guided radiofrequency ablation of lung tumors and mediastinal lymph nodes: a preclinical study in animal lung tumor and mediastinal adenopathy models
In this study, we evaluated a prototype bipolar RFA device applicator that can be deployed from a standard endobronchial ultrasound (EBUS) bronchoscope to determine feasibility and histopathological analysis in animal models. Rabbit lung cancers were created by transbronchial injection of VX2 rabbit cancer cells. Once the tumors were developed, they were ablated transpleurally, under EBUS guidance using the prototype RFA device. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 10, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Yamato Motooka, Kosuke Fujino, Alexander Gregor, Nicholas Bernards, Harley Chan, Terunaga Inage, Hideki Ujiie, Tatsuya Kato, Tomonari Kinoshita, Tsukasa Ishiwata, Makoto Suzuki, Kazuhiro Yasufuku Tags: THORACIC - Original Submission Source Type: research

“Commentary: Remote Ischemic Preconditioning - Too Good to Be True?”
In the late 1980s, in animal models of myocardial ischemia-reperfusion injury (IRI), short periods of temporary coronary occlusion led to decreased myocardial infarction size with subsequent coronary occlusion, a phenomenon termed ischemic preconditioning.1 Mitigation of IRI was also noted when the infarcted area was in a different coronary distribution which had not been subjected to initial ischemia, an effect termed remote ischemic preconditioning (RIPC).2 Preconditioning was observed both when applied immediately prior to an ischemic insult (acute) or many hours before (delayed). (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 10, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Samuel Davila, R.D.B. Jaquiss Tags: CONGENITAL – Commentary Source Type: research

Discussion
Joseph Lamelas, MD (Houston, TX) (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 10, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Joseph Lamelas Source Type: research

Surgical Management of Aorto-Ventricular Tunnel. A Multicenter Study
This study reviews our collective 30-year experience with the surgical treatment of AoVT. Data was submitted by 15 participating centers on 42 patients who underwent correction of AoVT between 1987 and 2018. Of these, 36 had AoLVT, and six AoRVT. The tunnel originated above the right coronary sinus in 28 (77.8%) patients. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 10, 2020 Category: Cardiovascular & Thoracic Surgery Authors: E.M. Protopapas, R.H. Anderson, C.L. Backer, J. Fragata, N. Hakim, V.L. Vida, G.E. Sarris, the European Congenital Heart Surgeons Association-World Society for Pediatric and Congenital Heart Surgery (ECHSA-WSPCHS) Study Group, D.J. Barron, H. Berggren, M. Tags: CONGENITAL – Original Submission Source Type: research

Percutaneous Deactivation of Left Ventricular Assist Devices
Left ventricular assist device (LVAD) deactivation may be considered in cases of left ventricular recovery, pump thrombosis, infection, and end-of-life palliation. Surgical pump explantation remains the principal method, but percutaneous deactivation presents a safe and effective alternative. We have developed a formal program for percutaneous LVAD deactivation within our advanced heart failure program including patient selection criteria, pre-procedure testing, a procedural algorithm, and a post-procedure care plan. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 10, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Arif Albulushi, Andrew M. Goldsweig, Douglas Stoller, Jeffrey W. Delaney, John Um, Brian Lowes, Ronald Zolty Tags: ADULT – Original Submission Source Type: research

Discussion
Jonathan M. Chen, MD (Philadelphia, PA) (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - February 10, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Jonathan M. Chen Tags: CONGENITAL – Discussion Source Type: research

Mitral Valve Surgery in Neonates, Infants, and Children: Surgical Approach, Outcomes, and Predictors
The surgical treatment of mitral disease in pediatrics is challenging. Managing diversity in patient anatomy, growth, and the need for long-term anticoagulation requires trade-offs between imperfect solutions. We sought to assess our approach to pediatric mitral valve surgery and identify predictors associated with mortality and recurrent mitral disease. The medical records, echocardiograms, and operative reports of all patients who underwent surgical intervention on the mitral valve from January 2000 to April 2016 were reviewed. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 20, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Erin Isaacson, Camille Lucjak, William K. Johnson, Ziyan Yin, Tao Wang, Lisa Rein, Ronald K. Woods, James S. Tweddell, Viktor Hraska, Michael E. Mitchell Tags: CONGENITAL – Original Submission Source Type: research

Minimally invasive endoscopic aortic valve replacement: operative results
To describe our endoscopic aortic valve replacement (E-AVR) technique and to evaluate its early results regardless of the type of prosthetic valve implanted and the patients ’ characteristics. From July 2013 to September 2018, 125 patients (76 males, mean age 68.8±10.9 years, mean EuroScore II 1.51±1.39) underwent isolated E-AVR due to a severe stenosis in 99 cases and insufficiency in 26 cases. The surgical access was a 3-4 cm working port in the second right inter costal space with no-rib spreading and three additional 5 mm mini-ports for the introduction of a 30-degree thoracoscope, the Chitwood clam...
Source: Seminars in Thoracic and Cardiovascular Surgery - January 20, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Giovanni Domenico Cresce, Massimo Sella, Tommaso Hinna Danesi, Alessandro Favaro, Loris Salvador Tags: ADULT – Original Submission Source Type: research

Mitral Valve Surgery in Neonates, Infants and Children: Surgical Approach, Outcomes, & Predictors
The surgical treatment of mitral disease in pediatrics is challenging. Managing diversity in patient anatomy, growth, and the need for long term anticoagulation require tradeoffs between imperfect solutions. We sought to assess our approach to pediatric mitral valve surgery and identify predictors associated with mortality and recurrent mitral disease. The medical records, echocardiograms, and operative reports of all patients who underwent surgical intervention on the mitral valve from January 2000 through April 2016 were reviewed. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 20, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Erin Isaacson, Camille Lucjak, William K. Johnson, Ziyan Yin, Tao Wang, Lisa Rein, Ronald K. Woods, James S. Tweddell, Viktor Hraska, Michael E. Mitchell Tags: CONGENITAL – Original Submission Source Type: research

Cryoablation of Intercostal Nerves Decreased Narcotic Usage After Thoracic or Thoracoabdominal Aortic Aneurysm Repair
To improve surgical pain control through cryoablation of intercostal nerves and reduce narcotic usage in patients undergoing open thoracic or thoracoabdominal aortic aneurysm (TAA or TAAA) repair. From 2012-2018, 117 patients underwent open repair of TAA or TAAA. Of those patients, 25(21%) received cryoablation (2016-2018) of their intercostal nerves and 92(79%) did not (2012-2018). The primary outcome was pain scores and narcotic usage from extubation day 1 to 10 or the day of discharge. The median age (57 years), demographics, and preoperative comorbidities were not significantly different between the two groups. (Source...
Source: Seminars in Thoracic and Cardiovascular Surgery - January 20, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Jeffrey Clemence, Aroosa Malik, Linda Farhat, Xiaoting Wu, Karen M. Kim, Himanshu Patel, Bo Yang Tags: THORACIC – Original Submission Source Type: research

Twenty-Three-Year Experience With the Arterial Switch Operation: Expectations and Long-Term Outcomes
We aimed to describe the short- and long-term outcomes of patients after an arterial switch operation (ASO) at a single institution during a 23-year period. A retrospective chart review of all patients (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 17, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Charles D. Fraser, Martin A. Chacon-Portillo, Andrew Well, Rodrigo Zea-Vera, Ziyad Binsalamah, Iki Adachi, Carlos M. Mery, Jeffrey S. Heinle Tags: CONGENITAL – Original Submission Source Type: research

Perioperative and Long-Term Morbidity and Mortality for Elderly Patients Undergoing Thoracic Aortic Surgery
The impact of age on outcome in elective thoracic aortic surgery is not well characterized. We aim to evaluate age-related differences in short- and long-term outcomes in elderly patients undergoing elective thoracic aortic surgery. From 2004 to 2018, 786 patients underwent elective thoracic aortic surgery at a single center and were divided into 2 groups; (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 17, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Ming Hao Guo, Diem Tran, Aryan Ahmadvand, Thais Coutinho, David Glineur, Talal Al-Atassi, Munir Boodhwani Tags: ADULT – Original Submission Source Type: research

Surgical repair of peripheral pulmonary artery stenosis in patients without williams or alagille syndromes
Peripheral pulmonary artery stenosis (PPAS) is a relatively rare form of congenital heart disease typically associated with genetic syndromes, such as Williams or Alagille syndromes. However, some patients present with severe stenosis without associated syndromes. The purpose of the study was to review our surgical experience in such patients. This was a retrospective review of 30 patients who underwent surgical repair for peripheral pulmonary artery stenosis. Concomitant anatomical diagnoses in 20 patients (67%) included: supravalvar aortic stenosis (n=8), tetralogy of Fallot (n=4), d-transposition of the great arteries (...
Source: Seminars in Thoracic and Cardiovascular Surgery - January 17, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Elisabeth Martin, Richard D. Mainwaring, R. Thomas Collins, Kirstie L. MacMillen, Frank L. Hanley Tags: CONGENITAL – Original Submission Source Type: research

Twenty-Three Year Experience with the Arterial Switch Operation: Expectations and Long-Term Outcomes
We aimed to describe the short and long-term outcomes of patients after an arterial switch operation (ASO) at a single institution during a 23-year period. A retrospective chart review of all patients (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 17, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Charles D. Fraser, Martin A. Chacon-Portillo, Andrew Well, Rodrigo Zea-Vera, Ziyad Binsalamah, Iki Adachi, Carlos M. Mery, Jeffrey S. Heinle Tags: CONGENITAL – Original Submission Source Type: research