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Should we consider beating-heart on-pump coronary artery bypass grafting over conventional cardioplegic arrest to improve postoperative outcomes in selected patients?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether beating-heart on-pump coronary artery bypass grafting (BH-ONCAB) offered superior mortality and morbidity outcomes when compared with conventional on-pump coronary artery bypass grafting (C-ONCAB). Morbidity outcomes consisted of renal failure, stroke (transient or permanent), myocardial infarction, angina, congestive cardiac failure, reintervention and arrhythmias. Best evidence papers investigating BH-ONCAB versus C-ONCAB were considered. Where data were duplicated, the more credible evidence-based ...
Source: Interactive CardioVascular and Thoracic Surgery - March 19, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Al Jaaly, E., Chaudhry, U. A. R., Harling, L., Athanasiou, T. Tags: Molecular biology, Myocardial protection Adult Cardiac Source Type: research

Off-pump or on-pump beating heart: which technique offers better outcomes following coronary revascularization?
A best evidence topic was written according to a structured protocol. The question addressed was whether on-pump beating heart coronary artery bypass (BH-ONCAB) surgery has a different outcome profile in comparison to off-pump coronary artery bypass (OPCAB). A total of 205 papers were found by systematic search of which 7 provided the largest and most recent outcome analysis comparing BH-ONCAB with OPCAB, and represented the best evidence to answer the clinical question. The authors, date, journal, study type, population, main outcome measures and results were tabulated. Reported outcome measures included mortality, stroke...
Source: Interactive CardioVascular and Thoracic Surgery - March 19, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Sepehripour, A. H., Chaudhry, U. A. R., Harling, L., Athanasiou, T. Tags: Molecular biology, Myocardial protection Adult Cardiac Source Type: research

The safety of deep hypothermic circulatory arrest in aortic valve replacement with unclampable aorta in non-octogenarians
CONCLUSIONS Postoperative neurological events and operative mortality were, respectively, 3- and 4-fold higher in octogenarians undergoing AVR using DHCA. Such patients may represent suitable candidates for TAVR if favourable outcomes are demonstrated in patients with atherosclerotic aortas. Surgical AVR remains the standard treatment option with excellent outcomes for patients <80 years old with unclampable aortas.
Source: Interactive CardioVascular and Thoracic Surgery - December 18, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Kaneko, T., Neely, R. C., Shekar, P., Javed, Q., Asghar, A., McGurk, S., Gosev, I., Byrne, J. G., Cohn, L. H., Aranki, S. F. Tags: Cerebral protection, Great vessels, Valve disease Adult Cardiac Source Type: research

264 * results of total arterial versus conventional versus hybrid myocardial revascularisation: a propensity match analysis of long-term follow-up
Conclusion: Total arterial revascularisation provides improved outcomes at mid-term follow-up compared with conventional or hybrid revascularisation. The latter technique is particularly associated with a significantly higher incidence of late myocardial infarction and repeat revascularisation.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Muneretto, C., Repossini, A., Di Bacco, L., Bisleri, G. Tags: Developments in coronary artery bypass graft Source Type: research

074-i * off-pump coronary artery bypass reduces early stroke in octogenarians: a meta-analysis of 18,000 patients
Conclusion: Coronary artery bypass in octogenarians can be performed with low early mortality. Number of grafts is lesser in the OPCABG cohort. While stroke rates are higher with conventional surgery, all other adverse events are comparable. Future randomised trials are needed to define the role of off-pump surgery in this high-risk cohort.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Altarabsheh, S. E., Deo, S., Rabab'h, A., Sharma, V., Lim, J. Y., Cho, Y. H., Park, S. J. Tags: Adult cardiac rapid response 1 Source Type: research

089 * innominate artery cannulation for proximal aortic surgery: outcomes and neurologic events in 263 patients
Conclusion: Innominate artery cannulation can be performed safely and poses a low risk of neurologic events in procedures requiring hypothermic circulatory arrest. This artery may be considered the optimal perfusion site for delivering ACP.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Preventza, O., Garcia, A., Tuluca, A., Henry, M., Bakaeen, F., Omer, S., Cornwell, L., Coselli, J. S. Tags: Part II: Cannulation issues in aortic surgery: Doing things right or doing the right things Source Type: research

126 * extra-anatomic revascularisation for distal occlusion of the left or right common carotid artery in acute type a aortic dissection with cerebral malperfusion
Conclusion: Extra-anatomic bypass for distal LCCA or RCCA occlusion presents a valuable bail-out technique to restore cerebral perfusion during AADA repair, potentially reducing the increased incidence of neurological complications in patients with cerebral malperfusion.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Luehr, M., Etz, C. D., Lehmkuhl, L., Misfeld, M., Bakhtiary, F., Borger, M., Mohr, F. Tags: Complicated type A aortic dissection: Malperfusion and outcome Source Type: research

Who might benefit from early aspirin after coronary artery surgery?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether early administration of aspirin might optimize vein graft patency. More than 250 papers were found using the reported search, of which 4 new papers in addition to the previous 7 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. Early postoperative aspirin administered within 6 h following coronary artery bypass grafting (CABG) has been show...
Source: Interactive CardioVascular and Thoracic Surgery - August 14, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Gukop, P., Gutman, N., Bilkhu, R., Karapanagiotidis, G. T. Tags: Cardiac - physiology, Education, Congestive Heart Failure, Molecular biology Adult Cardiac Source Type: research

297 * conventional thoracoabdominal aortic aneurysm repair after frozen elephant trunk operation
Conclusions: Conventional TAAA repair following frozen elephant trunk operation is a feasible and safe procedure, which is facilitated by the fact of a proximal anastomosis with the endovascular prosthesis in the distal part of the descending aorta and a convenient possibility to clamp the endograft in the middle part of the downstream aorta.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Folkmann, S., Weiss, G., Pisarik, H., Moidl, R., Gorlitzer, M., Grabenwoger, M. Tags: Thoracoabdominal aortic surgery: Proven concepts and new strategies Source Type: research

151 * comparison of intermittent cold versus intermittent warm blood cardioplegia in 2200 adult cardiac surgery patients
Conclusions: In elective cardiac surgery, there was no difference in clinical outcome between cold and warm blood cardioplegia. In emergency patients, however, with most of them operated on in acute coronary syndrome, warm cardioplegia might be an option to improve outcome.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Trescher, K., Gleiss, A., Boxleitner, M., Dietl, W., Kassal, H., Holzinger, C., Podesser, B. Tags: Cardiac potpourri Source Type: research

Early and mid-term results of off-pump endarterectomy of the left anterior descending artery
CONCLUSIONS We conclude that off-pump endarterectomy of the LAD is a viable option for patients with diffuse LAD disease.
Source: Interactive CardioVascular and Thoracic Surgery - February 11, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Takahashi, M., Gohil, S., Tong, B., Lento, P., Filsoufi, F., Reddy, R. C. Tags: Adult Cardiac Source Type: research