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Thoracoscopic Ablation With Appendage Ligation Versus Medical Therapy for Stroke Prevention: A Proof-of-Concept Randomized Trial
Conclusions: This small proof-of-concept study showed that TPVIAL improved QOL on two subscores and restored normal sinus rhythm in all but one patient, and it showed the potential to prevent secondary stroke. A larger study will be needed.
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - March 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation: a systematic review and network meta-analysis of randomized controlled trials.
CONCLUSIONS: LAA occlusion appears to preserve the benefits of oral anticoagulation therapy for stroke prevention in patients with AF, but the current evidence is of low quality. PMID: 28215062 [PubMed - as supplied by publisher]
Source: The Journal of Cardiovascular Surgery - February 16, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Hanif H, Belley-Cote EP, Alotaibi A, Dvirnik N, Neupane B, Beyene J, Eikelboom JW, Holmes D, Whitlock RP Tags: J Cardiovasc Surg (Torino) Source Type: research

The impact of CHADS2 score on late stroke after the Cox maze procedure
Conclusions: The risk of stroke or transient ischemic attack in patients after a surgical Cox maze procedure was low and not associated with CHADS2 score or warfarin use. Given the known risks of warfarin, we recommend discontinuation of anticoagulation 3 months after the procedure if the patient has no evidence of atrial fibrillation, has discontinued antiarrhythmic medications, and is without any other indication for systemic anticoagulation.
Source: The Journal of Thoracic and Cardiovascular Surgery - July 23, 2012 Category: Cardiovascular & Thoracic Surgery Authors: Mitchell Pet, Jason O. Robertson, Marci Bailey, Tracey J. Guthrie, Marc R. Moon, Jennifer S. Lawton, Andrew Rinne, Ralph J. Damiano, Hersh S. Maniar Tags: Acquired Cardiovascular Disease Source Type: research

Mitral valve repair and bioprosthetic replacement without postoperative anticoagulation does not increase the risk of stroke or mortality ADULT CARDIAC
CONCLUSIONS Despite current guidelines recommending postoperative anticoagulation following MVRR or bioprosthetic replacement, the avoidance of warfarin does not increase perioperative complications and has no impact on intermediate survival. Accordingly, a prospective randomized study to adjudicate the role of extended warfarin thromboprophylaxis in mitral valve surgery is warranted.
Source: European Journal of Cardio-Thoracic Surgery - June 13, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Schwann, T. A., Engoren, M., Bonnell, M., Clancy, C., Khouri, S., Kabour, A., Jamil, T., Habib, R. H. Tags: ADULT CARDIAC Source Type: research

Safety of percutaneous left atrial appendage closure with the amplatzer cardiac plug in patients with atrial fibrillation and contraindications to anticoagulation
Conclusion: Percutaneous LAA closure with the ACP in patients with contraindications to oral anticoagulation is safe. The stroke and bleeding risk after percutaneous LAA closure is lower than predicted by conventional risk scores. © 2013 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - December 11, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Jens Wiebe, Stefan Bertog, Jennifer Franke, Olga Wettstein, Katharina Lehn, Ilona Hofmann, Laura Vaskelyte, Horst Sievert Tags: Original Study Source Type: research

Long Term Outcomes and Anticoagulation in Mitral Valve Surgery - A Report from the Society of Thoracic Surgeons Database
CONCLUSIONS: Anticoagulation was used in less than half of mitral valve surgery. In MVrep patients, warfarin was associated with increased bleeding and was not protective against either stroke or mortality. In BMVR patients, warfarin was associated with a modest survival benefit, increased bleeding and equivalent stroke risk. NOAC was associated with increased adverse outcomes.PMID:37308066 | DOI:10.1016/j.athoracsur.2023.05.025
Source: The Annals of Thoracic Surgery - June 12, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Thomas A Schwann Andrew M Vekstein Daniel T Engelman Dylan Thibault Joanna Chikwe Milo Engoren Mario Gaudino Sreekanth Vemulapalli Vinod Thourani Gorav Ailawadi Anthony Rousou Robert H Habib Source Type: research

Evaluation of the efficacy and safety of dual antiplatelet therapy with or without warfarin in patients with a clinical indication for DAPT and chronic anticoagulation: A meta‐analysis of observational studies
Conclusions: All‐cause mortality appears similar in patients treated with TT or DAPT although TT was associated with higher rates of major bleeding and a lower risk for ischemic stroke. © 2015 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - September 10, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Chirag Bavishi, Anna Koulova, Sripal Bangalore, Ashwin Sawant, Saurav Chatterjee, Sameer Ather, Jose Valencia, Nikolaus Sarafoff, Andrea Rubboli, Juhani K. Airaksinen, Gregory Y. H. Lip, Jacqueline E. Tamis‐Holland Tags: Coronary Artery Disease Source Type: research

10-year results of On-X bileaflet mechanical heart valve in the aortic position: low target INR regimen in Japanese
ConclusionsAVR using On-X valve with low target INR regimen and low-dose aspirin resulted in a significantly low risk of bleeding.
Source: General Thoracic and Cardiovascular Surgery - April 19, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Non-Vitamin K Antagonist Oral Anticoagulant vs Warfarin for Post Cardiac Surgery Atrial Fibrillation.
CONCLUSIONS: NOACs are associated with a reduction in post-operative LOS, without excess bleeding or other short-term complications, compared to warfarin. These findings support the broader use of NOACs as a safe alternative to warfarin in patients with post-cardiac surgery AF at elevated stroke risk and acceptable bleeding risk. PMID: 33440173 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - January 10, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Nauffal V, Trinquart L, Osho A, Sundt TM, Lubitz SA, Ellinor PT Tags: Ann Thorac Surg Source Type: research

232 * early anticoagulation therapy after bioprosthetic aortic valve implantation: comparing warfarin versus aspirin
Conclusions: This is to date the largest randomized trial comparing warfarin to aspirin as early anticoagulation therapy after implantation of bioprosthetic aortic valves. The results are not conclusive, but aspirin therapy seems as safe as warfarin therapy, and with significantly fewer gastrointestinal bleeding events, three months after surgery.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Rafiq, S., Steinbruchel, D. A., Moeller, C. H., Lund, J., Thiis, J. J., Koeber, L., Lilleoer, N. B., Olsen, P. S. Tags: Decision-making in aortic valve repair Source Type: research

Simultaneous Carotid Artery Stenting and Heart Surgery: Expanded Experience of Hybrid Surgical Procedures
Conclusions Same-day hybrid approach appeared safe in terms of early and long-term results not only for CAS and isolated CABG but also for CAS and noncoronary isolated procedures. In complex cases, the rate of stroke and myocardial infarction seemed low; in-hospital mortality, as expected, was higher. Long-term survival appeared similarly satisfactory, thus confirming the hybrid approach as a valid therapeutic option for all patients with significant internal carotid artery stenosis associated with coronary and other cardiac lesions, at least for noncomplex cases.
Source: The Annals of Thoracic Surgery - February 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Left atrial appendage closure: First in man with the 4th generation watchman device
ConclusionsLAA closure with the 4th generation WATCHMAN device is feasible and safe. New technical features may contribute to a better performance of the occluder, particularly regarding the risk of pericardial effusions. © 2015 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - September 10, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Jakob Ledwoch, Jennifer Franke, Maik Gonzaga, Stefan Bertog, Annkathrin Braut, Ilona Hofmann, Laura Vaskelyte, Sameer Gafoor, Vivek Reddy, Horst Sievert Tags: Valvular and Structural Heart Diseases Source Type: research

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