Dantrolene induces mitigation of myocardial ischemia-reperfusion injury by ryanodine receptor inhibition
The objective of the present study was to evaluate the in-vivo impact of dantrolene sodium on myocardial ischemia-reperfusion injury in swine models. An in vivo, experimental trial comparing 10 experimental animals which received dantrolene sodium with 9 control swine models was conducted. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 15, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Ilias Samiotis, Nikolaos A. Papakonstantinou, Panagiotis Dedeilias, Ioannis Vasileiadis, Apostolos Papalois, Spyridon Deftereos, Anastasia Kotanidou Tags: ADULT – Original Submission Source Type: research

The Residency Selection Process In The New World; Time For A Rethink
Central message The transition of the USMLE to a pass fail system provides a unique opportunity to reevaluate the residency selection process. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 12, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Edo K.S. Bedzra, Jo Ling Goh Tags: CONGENITAL – Young Surgeon's Note Source Type: research

Impact of Pre-Existing Mitral Regurgitation Following Left Ventricular Assist Device Implant
This study evaluates the effect of untreated pre-op SMR on outcomes following LVAD implant. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 11, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Garrett N. Coyan, Brian R. Pierce, Zachary J. Rhinehart, Kristen M. Ruppert, William Katz, Arman Kilic, Robert L. Kormos, Christopher M. Sciortino Tags: ADULT – Original Submission Source Type: research

Early Thromboprophylaxis Initiation is Associated with Reduced Fontan Thromboses in the Early Postoperative Period
Objective: Fontan circuit thrombosis is a significant cause of early postoperative morbidity and mortality. Thrombosis incidence and relationship to thromboprophylaxis choice and timing of initiation are not well established. We sought to evaluate the incidence of Fontan circuit thrombosis in the first 30 postoperative days and its relationship to thromboprophylaxis choice and timing. Methods: Patients undergoing Fontan surgery, 2006-2016, were reviewed. Fontan circuit thrombosis was defined by sonographic detection of intracardiac or deep venous thrombi. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 11, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Ashish A. Ankola, Brett R. Anderson, Tarif A. Choudhury, Ellis Rochelson, Rozelle Corda, Emile A. Bacha, Arthur J. Smerling Tags: CONGENITAL – Original Submission Source Type: research

Surgical strategies for pre- and minimally invasive lung adenocarcinoma 3.0: lessons learned from the optimal timing of surgical intervention
We discuss the optimal timing of surgery for lung cancer, and propose three surgical strategies for pre- and minimally invasive lung adenocarcinoma to avoid “overdiagnosis” and “overtreatment”. Benign disease should not be treated as malignancy, pre- and minimally invasive disease should not be treated as invasive disease, and indolent malignancy should not be treated as aggressive malignancy. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 11, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Yang Zhang, Zongwei Chen, Hong Hu, Haiquan Chen Tags: THORACIC – Expert Review Source Type: research

Systematic Review of Neoadjuvant Immunotherapy for Patients with Non-Small Cell Lung Cancer
There is a paucity of robust clinical evidence for the role of neoadjuvant immunotherapy in patients with resectable non-small cell lung cancer. The primary aim of the study was to identify the available data on the feasibility, safety and efficacy of neoadjuvant immunotherapy. A systematic review was conducted using electronic databases. Relevant studies were identified according to predefined selection criteria. Five relevant publications on four completed trials were identified. In most studies,>90% of patients were able to undergo surgery within the planned timeframe after neoadjuvant immunotherapy. (Source: Seminar...
Source: Seminars in Thoracic and Cardiovascular Surgery - January 11, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Christopher Cao, Allen Guo, Christopher Chen, Adam Chakos, Matthew Bott, Jeffrey Yang, Rob Zielinski, Franca Melfi Tags: THORACIC – Original Submission Source Type: research

Donor and Recipient Size Matching in Heart Transplantation with Predicted Heart and Lean Body Mass
Donor and recipient size matching during heart transplant can be assessed using weight or predicted heart mass (PHM) ratios. We developed sex-specific allomteric equations for PHM and predicted lean body mass (PLBM) using the United Kingdom Biobank (UKB) and evaluated their predictive value in the United Network of Organ Sharing (UNOS) database. Donor and recipient size matching was based on weight, PHM and PLBM ratios. PHM was calculated using the Multi-ethnic Study of Atherosclerosis and UKB equations. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 11, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Robert J.H. Miller, Kristofer Hedman, Myriam Amsallem, Zeynep Tulu, William Kent, Ali Fatehi, Brian Clarke, Paul Heidenreich, William Hiesinger, Kiran K. Khush, Jeffrey Teuteberg, Francois Haddad Tags: ADULT – Original Submission Source Type: research

Thoracoscopic versus open surgery following neoadjuvant chemoradiation for clinical N2 lung cancer
We evaluated the feasibility of video-assisted thoracoscopic surgery (VATS) following neoadjuvant concurrent chemoradiotherapy (nCCRT) for N2 non-small cell lung cancer (NSCLC). (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 11, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Yeong Jeong Jeon, Yong Soo Choi, Jong Ho Cho, Hong Kwan Kim, Jhingook Kim, Jae Ill Zo, Young Mog Shim Tags: THORACIC – Original Submission Source Type: research

Optimizing Nicorandil for Spinal Cord Protection in a Murine Model of Complex Aortic Intervention
There are currently no clinically utilized pharmacological agents for the induction of metabolic tolerance to spinal cord ischemia-reperfusion injury in the setting of complex aortic intervention. Nicorandil, a nitric oxide donor and ATP-sensitive potassium (KATP) channel opener, has shown promise in neuroprotection. However, the optimized clinical application of the drug and its mechanism of neuroprotection remains unclear. We hypothesized that 3-days pretreatment would confer the most effective neuroprotection, mediated by mitochondrial KATP channel activation. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 11, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Yuki Ikeno, Christian V. Ghincea, Gavriel F. Roda, Linling Cheng, Muhammad Aftab, Xianzhong Meng, Michael J. Weyant, Joseph C. Cleveland, David A. Fullerton, T. Brett Reece Tags: ADULT – Original Submission Source Type: research

Cardiac Surgery Outcomes in an Epicenter of the COVID-19 Pandemic
As New York State quickly became the epicenter of the COVID-19 pandemic, innovative strategies to provide care for the COVID-19 negative patients with urgent or immediately life threatening cardiovascular conditions became imperative. To date, there has not been a focused analysis of patients undergoing cardiothoracic surgery in the United States during the COVID-19 pandemic. Therefore, we seek to summarize the selection, screening, exposure/conversion, and recovery of patients undergoing cardiac surgery during the peak of the COVID-19 pandemic. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 11, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Woodrow J. Farrington, N. Bryce Robinson, Mohamed Rahouma, Christopher Lau, Irbaz Hameed, Erin M. Iannacone, Natalia S. Ivascu, Stephanie L. Mick, Mario FL Gaudino, Leonard N. Girardi Tags: ADULT – Original Submission Source Type: research

Prediction of bleeding in paediatric cardiac surgery using clinical characteristics and prospective coagulation test results
Bleeding caused by coagulopathy is common in children undergoing cardiac surgery and causes adverse outcomes. Coagulation testing assists selection of treatments to stop bleeding but has an uncertain role for predicting bleeding. We aimed to evaluate how well prospective coagulation testing predicted excessive bleeding during and after cardiac surgery compared to prediction using clinical characteristics alone. A single centre, prospective cohort study in children having a range of cardiac surgery procedures with coagulation testing at anaesthetic induction and immediately after cardio-pulmonary bypass. (Source: Seminars i...
Source: Seminars in Thoracic and Cardiovascular Surgery - January 11, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Jessica M. Harris, Karen Sheehan, Chris A. Rogers, Tim Murphy, Massimo Caputo, Andrew D. Mumford Tags: CONGENITAL – Original Submission Source Type: research

Commentary: Re-exploration Versus Transfusion: The Choice is Clear
This study is particularly meaningful since it included only Society of Thoracic Surgery (STS) Major procedures, that is, coronary and valvular surgery, encompassing roughly 80% of the cases that adult cardiac surgeons perform. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 9, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Katherine Giuliano, Glenn J.R. Whitman Tags: ADULT – Commentary Source Type: research

Commentary: Total Arch Replacement with Frozen Elephant Trunk: One Stop Shop
In this article, Dr. Ho and colleagues from Prince of Wales Hospital in Hong Kong report their single center experience using total aortic arch replacement and frozen elephant trunk procedure (TAR FET) using the Thoraflex hybrid graft to treat complex aortic arch and proximal descending thoracic aortic pathology.1 The TAR FET procedure, popularized by Dr. Sun's and other groups, has emerged as a technique to address a wide range of thoracic aortic pathologies, including 1) acute Type A aortic dissection with pseudocoarctation or malperfusion; 2) distal aortic arch aneurysms; 3) chronic residual dissection; and 4) Type B di...
Source: Seminars in Thoracic and Cardiovascular Surgery - January 9, 2021 Category: Cardiovascular & Thoracic Surgery Authors: George J. Arnaoutakis, Ibrahim Sultan Tags: ADULT – Commentary Source Type: research

Commentary: Reexploration vs. Transfusion: the choice is clear.
This study is particularly meaningful since it included only STS Major procedures, i.e coronary and valvular surgery, encompassing roughly 80% of the cases that adult cardiac surgeons perform. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 9, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Katherine Giuliano, Glenn J.R. Whitman Tags: ADULT – Commentary Source Type: research

Social Media and Your Cancer Patient
In an increasingly connected world, healthcare is rapidly evolving to meet the needs of a growing patient population seeking information online. In the past few years, social media has erupted as a means of dissemination of health-related information between patients and healthcare providers alike. Patients online have access to communities and expert-opinion previously inaccessible. Cancer patients especially are empowered through online knowledge acquisition and interactions with support groups or advocacy groups. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - January 9, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Brendon M. Stiles, J. Nathan Mynard Tags: THORACIC – News and Views Source Type: research

National Institutes of Health R01 Grant Funding Is Associated with Enhanced Research Productivity and Career Advancement Among Academic Cardiothoracic Surgeons
National Institutes of Health (NIH) funding has declined among cardiothoracic surgeons. R01 grants are a well-known mechanism to support high-impact research, and we sought to clarify the association between NIH funding and academic achievement. We hypothesized that cardiothoracic surgeons who acquired R01 funding exhibit greater research output and faster career advancement. All cardiothoracic surgeons (n=992) working at accredited United States cardiothoracic surgery training hospitals in 2018 were included. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - December 24, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Simar S. Bajaj, Hanjay Wang, Kiah M. Williams, Joshua M. Pickering, Joseph C. Heiler, Keerthi Manjunatha, Christian T. O'Donnell, Mark Sanchez, Jack H. Boyd Tags: ADULT – Original Submission Source Type: research

Preoperative eccentric aortic regurgitation and outcomes following valve-sparing root replacement
This study compares outcomes in TAV patients with pre-operative AI>2+ based on jet centricity and cusp repair status. Review of a single institutional database identified 309 consecutive patients undergoing VSRR from 2005-2018. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - December 22, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Dale S. Deas, Xiaoying Lou, Bradley G. Leshnower, Zakaria Almuwaqqat, Jose N. Binongo, LaRonica McPherson, Edward P. Chen Tags: ADULT – Original Submission Source Type: research

A Minimal Opioid Postoperative Management Protocol in Congenital Cardiac Surgery: Safe and Effective
There is evidence that reducing opioid exposure in children undergoing cardiac surgery may enhance postoperative recovery. We aimed to describe a minimal opioid postoperative management protocol in children undergoing cardiac surgery and our early outcomes with this strategy. We reviewed the medical records of children (6 months –18 years) who underwent elective cardiac surgery through a median sternotomy with cardiopulmonary bypass at our institution between 2016 and 2018. All patients were managed postoperatively using a standardized protocol. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - December 14, 2020 Category: Cardiovascular & Thoracic Surgery Authors: William C. Frankel, Timothy M. Maul, Constantinos Chrysostomou, Peter D. Wearden, Adam W. Lowry, Kimberly N. Baker, Jennifer S. Nelson Tags: CONGENITAL – Original Submission Source Type: research

Cardiac Surgeons ’ Treatment Approaches for Infective Endocarditis Based on Patients’ Substance Use History
U.S. cardiac surgeons encounter complex decision-making when treating patients with injection drug use-associated infective endocarditis (IDU-IE). We evaluated surgeons ’ treatment approaches for IDU-IE compared to non-IDU-IE. This is an anonymous survey of U.S. cardiac surgeons who answered hypothetical infective endocarditis (IE) clinical scenarios that varied based on patient substance use history, addiction treatment, and history of IE. Treatment approaches w ere classified as operative vs non-operative. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - December 3, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Max Jordan Nguemeni Tiako, Reed Mszar, Cornell Brooks, Syed Usman Bin Mahmood, Makoto Mori, Arnar Geirsson, Melissa B. Weimer Tags: ADULT – Original Submission Source Type: research

Primary Arterial Switch Operation for Late Presentation Of Transposition Of The Great Arteries With Intact Ventricular Septum
Transposition of the great arteries (TGA) with intact ventricular septum (IVS) are subject to neonatal arterial switch operation (ASO) to avoid deconditioning of the left ventricle (LV). Often an early repair is not feasible in developing countries where late referral is frequent. We aim to explore ASO outcomes in late TGA-IVS and compare 'unfavorable candidates' (LV myocardial mass (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 26, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Mauro Lo Rito, Irene Raso, Antonio Saracino, Domenica Paola Basile, Alessandro Varrica, Matteo Reali, Mario Carminati, Alessandro Frigiola, Alessandro Giamberti Tags: CONGENITAL – Original Submission Source Type: research

There is no “I” in “TEAM,” Unless You Don't Play as Much
Off-pump coronary artery grafting (OPCABG) remains a viable option for surgical revascularization in certain patient groups. However, emergent conversion from off- to on-pump coronary artery bypass grafting (CABG) has been associated with worse outcomes.1 The impact of surgeon experience has been studied and has demonstrated reduced conversion rates with more experience.2 In addition, several studies have shown an association of improved outcomes for CABG in high-volume centers.3,4 However, the interplay between hospital- and surgeon- volume on OPCABG conversion rates to on-pump CABG has not been extensively studied. (Sour...
Source: Seminars in Thoracic and Cardiovascular Surgery - November 25, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Sagar Damle, Vinod H. Thourani Tags: ADULT – Commentary Source Type: research

Effect of Renin-angiotensin System Inhibitors on Acute Kidney Injury among Patients undergoing Cardiac Surgery: A Review and Meta-analysis
Acute kidney injury (AKI) is a frequent complication of cardiac surgery, which can lead to higher mortality and long-term renal function impairment. The effect of perioperative renin-angiotensin system inhibitors (RASi) therapy on AKI incidence in patients undergoing cardiac surgery remains controversial. We reviewed related studies in PubMed, Scopus, and Cochrane Library from inception to February 2020. Two randomized controlled trials (RCTs) and 21 cohort studies were included in the meta-analysis, involving 76,321 participants. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 25, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Han Zhou, Jingui Xie, Zhichao Zheng, Oon Cheong Ooi, Haidong Luo Tags: ADULT – Expert Review Source Type: research

Postoperative improvement of brain maturation in infants with congenital heart disease
We examined brain maturation in infants undergoing neonatal cardiopulmonary bypass surgery or hybrid procedure for hypoplastic left heart syndrome compared to controls. This is a prospective cohort study on term-born infants with congenital heart disease with cerebral MRI pre- and postoperatively. Healthy infants served as controls. Brain maturation was measured using a semi-quantitative scoring system. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 25, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Selma J. Hottinger, Rabia Liamlahi, Maria Feldmann, Walter Knirsch, Beatrice Latal, Cornelia F. Hagmann, for the Heart and Brain Research Group Tags: CONGENITAL – Original Submission Source Type: research

Comparison of cryomaze with cut-and-sew maze concomitant with mitral valve surgery: a randomized noninferiority trial
In this trial, we sought to evaluate the efficacy and safety of the addition of the Maze performed by cryoablation (CryoMaze) to the mitral valve surgeries. The trial is a randomized, single-center trial to determine whether CryoMaze was noninferior to cut-and-sew Maze procedure (CSM) in patients with persistent or longstanding persistent atrial fibrillation (AF), with a 15% margin to establish non-inferiority. The primary endpoint was freedom from AF off anti-arrhythmic drugs (AADs) at 12 months. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 24, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Jinsong Han, Huishan Wang, Zengwei Wang, Zongtao Yin, Jian Zhang, Yan Jin, Hongguang Han Tags: ADULT – Original Submission Source Type: research

Aortic Regurgitation Index Ratio Is a Strong Predictor of 1-Year Mortality After Transcatheter Aortic Valve Implantation Using Self-Expanding Devices
Grading paravalvular leak (PVL) at the time of transcatheter aortic valve implantation (TAVI) deployment is challenging. Per-procedural invasive hemodynamic measurements could serve to optimize PVL grading and predict outcome after TAVI. The aim of this study was to compare hemodynamic measures of paravalvular leak and their prognostic relevance in self-expanding TAVI devices. Between December 2008 and December 2017 consecutive patients treated for severe symptomatic aortic valve stenosis with self-expanding devices were prospectively studied. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 23, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Marleen van Wely, Kees van der Wulp, Max Rooijakkers, Priya Vart, Wim Morshuis, Niels van Royen, the RadboudUMC TAVI working group, Helmut Gehlmann, Michel Verkroost, Peter Kievit, Leen van Garsse, Guillaume Geuzebroek Tags: ADULT – Original Submission Source Type: research

Effect of hospital and surgeon procedure volumes on the incidence of intraoperative conversion during off-pump coronary artery bypass grafting
This study therefore evaluated the effect of procedure volume on the incidence of conversion in OPCAB using nationwide data. We analyzed 31,361 patients who underwent primary, non-emergent, isolated OPCAB during 2013 –2016 reported in the Japan Cardiovascular Surgery Database. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 23, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Chikara Ueki, Hiroyuki Yamamoto, Noboru Motomura, Hiroaki Miyata, Ryuzo Sakata, Hiroshi Tsuneyoshi Tags: ADULT – Original Submission Source Type: research

A Comparison of Frozen Elephant Trunk, Aortic Balloon Occlusion, and Hybrid Repair for Total Arch Replacement
This study aimed to compare clinical outcomes of patients treated by total arch replacement (TAR) with frozen elephant trunk (FET), aortic balloon occlusion (ABO) technique and hybrid arch repair (HAR). Between January 2017 and July 2019, 643 consecutive patients with aortic arch diseases were eligible for TAR, including 356 in conventional FET, 112 in ABO based on FET, and 175 in HAR. A retrospective cohort analysis of perioperative results was undertaken, performed with inverse probability weighting. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 23, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Shenghua Liang, Yanxiang Liu, Bowen Zhang, Yunfeng Li, Hongwei Guo, Yi Shi, Xiaogang Sun Tags: ADULT – Original Submission Source Type: research

Impact that Day of the Week has on Length of Stay for Video-Assisted Lobectomy
We aimed to analyze the effect that the day of the week for video-assisted thoracoscopic surgery (VATS) lobectomy has on length of stay (LOS). A retrospective review identified all patients who underwent VATS lobectomy at a single institution from January 2016 to July 2017. In total, 208 patients were divided into two groups based on timing of their operation: Operations performed on Monday, Tuesday or Wednesday were defined as ‘early in the week’ and those performed on Thursday or Friday were defined as ‘late in the week.’ We then propensity-matched 81 pairs of patients and analyzed perioperative d...
Source: Seminars in Thoracic and Cardiovascular Surgery - November 23, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Stevan S. Pupovac, Paul C. Lee, Julissa Jurado, Kevin Hyman, Larry Glassman, David Zeltsman Tags: THORACIC – Original Submission Source Type: research

Aortic Regurgitation Index ratio is a strong predictor of one-year mortality after transcatheter aortic valve implantation using self-expanding devices
Grading PVL at the time of TAVI deployment is challenging. Per-procedural invasive hemodynamic measurements could serve to optimize PVL grading and predict outcome after TAVI. The aim of this study was to compare hemodynamic measures of paravalvular leak and their prognostic relevance in self-expanding TAVI devices. Between December 2008 and December 2017 consecutive patients treated for severe symptomatic aortic valve stenosis with self-expanding devices were prospectively studied. Peri-procedural hemodynamic measurements, echocardiographic data as well as clinical follow-up according to VARC-2 criteria were prospectively...
Source: Seminars in Thoracic and Cardiovascular Surgery - November 23, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Marleen van Wely, Kees van der Wulp, Max Rooijakkers, Priya Vart, Wim Morshuis, Niels van Royen, the RadboudUMC TAVI working group, Helmut Gehlmann, Michel Verkroost, Peter Kievit, Leen van Garsse, Guillaume Geuzebroek Tags: ADULT – Original Submission Source Type: research

Inflammatory and Antioxidant Gene Transcripts: A Novel Profile in Postoperative Atrial Fibrillation
This study aimed to identify specific gene transcripts of atrial inflammation, inflammatory handling, and oxidative stress associated with POAF. Left atrial tissue was obtained from 50 patients undergoing intended degenerative mitral repair who did not have any of the following risk factors for POAF: history of atrial fibrillation or other arrhythmia, left atrial diameter greater than 6.0 cm, or left ventricular ejection fraction less than 40%. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 23, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Tessa M.F. Watt, Kellianne C. Kleeman, Alexander A. Brescia, E Mitchell Seymour, Ara Kirakosyan, Shazli P. Khan, Liza M. Rosenbloom, Shannon L. Murray, Matthew A. Romano, Steven F. Bolling, Michigan Mitral Research Group (MMRG) Tags: ADULT – Original Submission Source Type: research

Flow Dynamics in Anomalous Aortic Origin of a Coronary Artery in Children: Importance of the Intramural Segment
This study aims to assess the differences in pressure, fractional flow reserve (FFR) and coronary flow (with increasing pressure) of the proximal coronary artery in patients with anomalous aortic origin of a coronary artery (AAOCA) with a confirmed ischemic event, without ischemic events, and before and after unroofing surgery, and compare to a patient with normal coronary arteries. Patient-specific flow models were 3D printed for 3 subjects with anomalous right coronary arteries with intramural course, 2 of whom had documented ischemia, and compared with a patient with normal coronaries. (Source: Seminars in Thoracic and ...
Source: Seminars in Thoracic and Cardiovascular Surgery - November 23, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Hoda Hatoum, Rajesh Krishnamurthy, Jayanthi Parthasarathy, Dorma C. Flemister, Carly M. Krull, Benjamin A. Walter, Carlos M. Mery, Silvana Molossi, Lakshmi Prasad Dasi Tags: CONGENITAL – Original Submission Source Type: research

Discussion
ROSS BREMNER: And we'll move on with “Risk Factors for Failed Bridging to Lung Transplantation with Extracorporeal Membrane Oxygenation” to be presented by Sarah Tsou and her colleagues at UCSF.Sarah? (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Discussion
Dr Camille L. Hancock Friesen (Dallas, TX): I'd like to thank the authors for providing me with your manuscript to pore over in advance and thank you for having the courage to start a prospective randomized trial in an area that is truly the holy grail for pediatric cardiac surgery; trying to answer theongoing question of how to produce the best technical repair at the same time as minimizing morbidity. To summarize, you took 95 patients undergoing 2-ventricle aortic reconstruction, with or without closure of ASD and VSD, randomized patients equally to 1 of 3 perfusion strategies: hypothermic circulatory arrest, or 1 of th...
Source: Seminars in Thoracic and Cardiovascular Surgery - November 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Association Officers
(Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Contents
(Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 21, 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 - November 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Commentary: PCI vs CABG in Patients With CKD —Which is Best?
Coronary artery disease (CAD) is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). The optimal revascularization strategy for patients with CKD is unknown. Percutaneous coronary interventions (PCI) with drug eluting stents results in decreased periprocedural mortality, but is associated with increased restenosis and less freedom from long-term major adverse cardiovascular events (MACE). Coronary artery bypass graft (CABG) surgery reduces the need for a re-revascularization procedure, but is associated with increased perioperative morbidity and mortality. (Source: Seminars in Thorac...
Source: Seminars in Thoracic and Cardiovascular Surgery - November 20, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Harold L. Lazar Tags: ADULT – Commentary Source Type: research

Commentary: Time to Put the Floxes Back in Their Boxes?
Fluoroquinolones are one of the most frequently prescribed antibiotics for respiratory and genitourinary infections, with millions of prescriptions annually within the United States alone.1 Concerns have emerged regarding the safety profile of this antibiotics class, principally focused on connective tissue pathologies. Since 2008, “black box” warnings have been serially added to the fluoroquinolone family, starting with tendinitis and tendon rupture and growing to include myasthenia gravis complications, peripheral neuropathy, and central nervous system complications. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 20, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Clancy W. Mullan, Arnar Geirsson Tags: ADULT – Commentary Source Type: research

Commentary: Time to Put the -Floxes Back In Their Boxes?
Fluoroquinolones are one of the most frequently prescribed antibiotics for respiratory and genitourinary infections, with millions of prescriptions annually within the United States alone.1 Concerns have emerged regarding the safety profile of this antibiotics class, principally focused on connective tissue pathologies. Since 2008, “black box” warnings have been serially added to the fluoroquinolone family, starting with tendinitis and tendon rupture and growing to include myasthenia gravis complications, peripheral neuropathy, and central nervous system complications. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 20, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Clancy W. Mullan, Arnar Geirsson Tags: ADULT – Commentary Source Type: research

Commentary: 2.36 Centimeters between Pedicled IMA Hell to Skeletonized IMA Heaven
In this met- analysis, the authors searched the literature, to compare studies reporting short-term outcomes with the use of the traditional pedicled harvest technique of the left internal mammary artery (LIMA) versus the use of the skeletonized LIMA technique.1 Apparently, it was hard to extract available data in literature for LIMA only, since most of the studies mix terms and relate mostly to both bilateral internal mammary arteries(BIMA) grafting. I commend the authors for their diligence to retrieve the accurate data available and for their interest in an important topic that seems to be unfortunately overlooked and n...
Source: Seminars in Thoracic and Cardiovascular Surgery - November 20, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Chaim Locker Tags: ADULT – Commentary Source Type: research

Commentary: pci vs cabg in patients with ckd —-which is best?
Coronary artery disease (CAD) is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). The optimal revascularization strategy for patients with CKD is unknown. Percutaneous Coronary Interventions (PCI) with Drug Eluting Stents (DES) results in decreased periprocedural mortality, but is associated with increased restenosis and less freedom from long term Major Adverse Cardiovascular Events (MACE). Coronary Artery Bypass Graft (CABG) surgery reduces the need for a re-revascularization procedure, but is associated with increased perioperative morbidity and mortality. (Source: Seminars in ...
Source: Seminars in Thoracic and Cardiovascular Surgery - November 20, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Harold L. Lazar Source Type: research

Impact of Timing of Smoking Cessation on 30-day Outcomes in Veterans Undergoing Lobectomy for Cancer
This study compares thirty-day outcomes after lobectomy between active smokers, recent quitters, and non-smokers. Patients who underwent lobectomy for cancer at national Veterans Affairs medical centers from 2012-2018 were retrospectively identified in the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 15, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Michael A. Napolitano, Ethan S. Rosenfeld, Sheena W. Chen, Andrew D. Sparks, Jared L. Antevil, Gregory D. Trachiotis Tags: THORACIC – Original Submission Source Type: research

Commentary: Minimally Invasive Surgery in N2 Stage IIIA Lung Cancer: Time for Caution Not Time to Throw Caution to the Wind
When initially introduced, minimally invasive (thoracoscopic and later robotic) surgery (MIS) for lung cancer resection was limited to peripheral stage I lung cancers without chest wall involvement and without hilar and mediastinal adenopathy.1 With experience, thoracic surgeons subsequently learned to perform more challenging MIS resections, including those with hilar adenopathy and tumors requiring sleeve lobectomy or pneumonectomy.1 One of the greatest challenges that thoracic surgeons face, even utilizing thoracotomy, is the resection of N2 stage IIIA lung cancer, particularly following induction chemo(radio)therapy. (...
Source: Seminars in Thoracic and Cardiovascular Surgery - November 13, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Robert B. Cameron Tags: THORACIC – Commentary Source Type: research

Commentary: Minimally-invasive surgery in N2 Stage IIIA lung cancer: time for caution not time to throw caution to the wind
When initially introduced, minimally-invasive (thoracoscopic and later robotic) surgery (MIS) for lung cancer resection was limited to peripheral stage I lung cancers without chest wall involvement and without hilar and mediastinal adenopathy.1 With experience, thoracic surgeons subsequently learned to perform more challenging MIS resections, including those with hilar adenopathy and tumors requiring sleeve lobectomy or pneumonectomy.1 One of the greatest challenges that thoracic surgeons face, even utilizing thoracotomy, is the resection of N2 stage IIIA lung cancer, particularly following induction chemo(radio)therapy. (...
Source: Seminars in Thoracic and Cardiovascular Surgery - November 13, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Robert B. Cameron Tags: THORACIC – Commentary Source Type: research

Commentary: Toward less traumatic, not just less invasive, surgery
As surgeons, we are well aware of the magnitude of the traumatic stress response when we perform “big operations.” An esophagectomy is associated with a significant stress response; the fluid requirements following this operation is a telling consequence. In an attempt to decrease this traumatic stress response, surgeons have spent the last two decades trying to decrease the size of incisio ns and have moved toward minimally invasive laparoscopic or thoracoscopic and robotic resections and, more recently, toward enhanced recovery after surgery (ERAS) protocols based on available clinical evidence. (Source: Semi...
Source: Seminars in Thoracic and Cardiovascular Surgery - November 11, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Ross M. Bremner Tags: THORACIC – Commentary Source Type: research

Commentary: Using Aerospace Engineering Analyses to explore Functional Tricuspid Regurgitation
In this issue of Seminars, Jazwiec, Malinowski, et al explore Tricuspid Valve Anterior Leaflet Strains in Ovine Functional Tricuspid Regurgitation(TR).1 High fidelity pressure measurements and sonomicrometry are used to assess precise motion, geometry, and stress/strain in the tricuspid annulus, the tricuspid leaflets and the RV epicardial walls in 11 TR animals and 12 control animals. One of the authors (Raush, MK) utilized aerospace engineering analysis methodologies to assess stress, strain, and stiffness using these data. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 11, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Michael N. D'Ambra Tags: ADULT – Commentary Source Type: research

Multiple Versus Single Arterial Coronary Arterial Bypass Grafting Surgery for Multivessel Disease in Atrial Fibrillation
Observational studies suggest improved outcomes with multiple (MAG) as compared to single arterial grafting (SAG) in patients with multivessel coronary artery disease (MV-CAD) and undergoing coronary artery bypass grafting (CABG). Even though around 6% of CABG patients have pre-operative atrial fibrillation (AF), previous studies did not address MAG vs SAG comparison in this setting. Data from KROK (Polish National Registry of Cardiac Surgery Procedures) were retrospectively collected. 5,738 patients with MV-CAD and AF (77.9% men, mean age 69.0 ±8.0) undergoing isolated CABG surgery between 2006-2019 in 37 reference...
Source: Seminars in Thoracic and Cardiovascular Surgery - November 11, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Mariusz Kowalewski, Micha ł Pasierski, Radosław Litwinowicz, Marian Zembala, Natalia Piekuś-Słomka, Zdzisław Tobota, Bohdan Maruszewski, Piotr Suwalski, KROK Investigators Tags: ADULT – Original Submission Source Type: research

Personalized Blood Pressure Management During Cardiac Surgery With Cerebral Autoregulation Monitoring: A Randomized Trial
The purpose of this study was to determine if setting mean arterial pressure (MAP) targets during cardiopulmonary bypass (CPB) based on individualized cerebral autoregulation data reduces the frequency of neurological complications compared with usual care. Patients (n=460) ≥ 55 years old at risk for neurological complications were randomized to have MAP targets during CPB to be above the lower limit of transcranial Doppler determined cerebral autoregulation versus usual institutional practices. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 10, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Charles W. Hogue, Charles H. Brown, Daijiro Hori, Masa Ono, Yohei Nomura, Lauren C. Balmert, Nina Srdanovic, Jordan Grafman, Kenneth Brady, The Cerebral Autoregulation Study Group Tags: ADULT – Original Submission Source Type: research

Association Between Patient Physical Function and Length of Stay After Thoracoscopic Lung Cancer Surgery
Patient-reported outcomes (PRO) are an ideal method for measuring patient functional status. We sought to evaluate whether preoperative PRO were associated with resource utilization. We hypothesize that higher preoperative physical function PRO scores, measured via the NIH-sponsored Patient Reported Outcome Measurement Information System (PROMIS), are associated with shorter length of stay (LOS). Preoperative physical function scores were obtained using NIH PROMIS in a prospective observational study of patients undergoing minimally invasive surgery for lung cancer. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 10, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Nakul Valsangkar, Jane W. Wei, Jose N. Binongo, Allan Pickens, Manu S. Sancheti, Seth D. Force, Theresa W. Gillespie, Felix G. Fernandez, Onkar V. Khullar Tags: THORACIC – Original Submission Source Type: research

Long-Term Outcomes of Reoperation for Bleeding after Cardiac Surgery
Reexploration for excessive bleeding after cardiac surgery is a postoperative complication that has been associated with operative mortality and short-term morbidity. However, there is dearth of literature examining its long-term impact. Thus, this study sought to determine the impact of reexploration on long-term mortality in a large, contemporaneous cohort of patients. This was an observational study of open cardiac surgeries between 2010 and 2018, at a single large institution. Patients undergoing first time coronary or valvular surgery (STS indexed operations) were identified. (Source: Seminars in Thoracic and Cardiovascular Surgery)
Source: Seminars in Thoracic and Cardiovascular Surgery - November 10, 2020 Category: Cardiovascular & Thoracic Surgery Authors: James A. Brown, Arman Kilic, Edgar Aranda-Michel, Forozan Navid, Derek Serna-Gallegos, Valentino Bianco, Ibrahim Sultan Tags: ADULT – Original Submission Source Type: research