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In DeBakey Type I Aortic Dissection, Bovine Aortic Arch Is Associated With Arch Tears and Stroke
Conclusions BAA is an independent predictor for the distinctive location of the entry site in the aortic arch and risk factor for stroke.
Source: The Annals of Thoracic Surgery - August 17, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Endoaortic Clamping Does Not Increase the Risk of Stroke in Minimal Access Mitral Valve Surgery: A Multicenter Experience
Conclusions Once procedural proficiency is acquired, endoaortic balloon clamping in MIMVS is a safe and effective technique. Despite the fact that this patient cohort also includes combined and redo procedures, the observed mortality and stroke rate compared favorably with the existing literature on primary isolated mitral valve surgery irrespective of the approach.
Source: The Annals of Thoracic Surgery - July 7, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Institutional Variation in Mortality After Stroke After Cardiac Surgery: An Opportunity for Improvement
Conclusions Institutional variation, more so than individual patient risk factors, is highly associated with postoperative stroke and FTR rates after stroke after cardiac surgery. Postoperative stroke remains significantly associated with mortality and morbidity. Institutional practice patterns may confer a disproportionate influence on postoperative stroke independent of case mix. Understanding differences between high and low performing centers is essential to improving outcomes, costs, and hospital quality.
Source: The Annals of Thoracic Surgery - July 17, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Valve-Sparing Root Replacement vs Composite Valve Grafting in Aortic Root Dilation: A Meta-Analysis
ConclusionsAortic valve sparing appears to be safe, and associated with reduced late mortality, thromboembolism/stroke and bleeding compared with composite valve grafting. Late durability is equivalent. Aortic valve sparing should be considered in patients with favorable aortic valve morphology.Graphical abstract
Source: The Annals of Thoracic Surgery - January 23, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

One-Year Outcomes of Transcatheter Aortic  Valve Replacement in Patients With End-Stage Renal Disease
Conclusions Early mortality in patients with ESRD is comparable to previously published data on extreme-risk patients without ESRD, but our data suggest a higher mortality rate at 1 year for ESRD patients, likely due to comorbid conditions. Stroke and major vascular injury are infrequent, and improved valve hemodynamics are maintained at 1 year.
Source: The Annals of Thoracic Surgery - April 18, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Impact of Specific Preoperative Organ Dysfunction in Patients Undergoing Aortic Valve Replacement ORIGINAL ARTICLES: ADULT CARDIAC
Conclusions The presence of chronic renal failure most profoundly decreases survival, followed by severe chronic obstructive pulmonary disease and prior stroke. Furthermore, multiple OD systems significantly decrease short- and long-term survival.
Source: The Annals of Thoracic Surgery - February 28, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Thourani, V. H., Chowdhury, R., Gunter, R. L., Kilgo, P. D., Chen, E. P., Puskas, J. D., Halkos, M. E., Lattouf, O. M., Cooper, W. A., Guyton, R. A. Tags: Valve disease ORIGINAL ARTICLES: ADULT CARDIAC Source Type: research

Contemporary Outcomes of Repeat Aortic Valve Replacement: A Benchmark for Transcatheter Valve-in-Valve Procedures
Conclusions Re-AVR is now performed with an acceptable operative mortality, which is higher than primary AVR. The overall incidence of stroke, vascular complication, and postoperative aortic insufficiency was low although higher than primary AVR. These results may serve as a benchmark for future analysis of valve-in-valve transcatheter aortic valve replacement and may have an effect on future choice of transcatheter aortic valve replacement vs re-AVR.
Source: The Annals of Thoracic Surgery - July 22, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Transapical and Transaortic Transcatheter Aortic Valve Replacement in the United States
Conclusions Patients undergoing TAo TAVR are older, more likely female, and have significantly higher STS predicted risk of mortality scores than patients operated on by TA access. There were no risk-adjusted differences between TA and TAo access in mortality, stroke, or readmission rates as long as 1 year after TAVR.
Source: The Annals of Thoracic Surgery - July 30, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Comparison of the Performance of a Sutureless Bioprosthesis With Two Pericardial Stented Valves on Small Annuli: An In  Vitro Study
Conclusions All of the valves tested provided good fluid dynamic performances. The sutureless bioprosthesis provided the best performance with the least hindrance to flow behavior. From the hydrodynamic perspective, the sutureless prosthesis may present an advance in the evolution of bioprostheses, ensuring low gradients and potential for low incidence of patient-prosthesis mismatch even in small annuli.
Source: The Annals of Thoracic Surgery - August 17, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

A Systemic Review and Meta-Analysis of Sutureless Aortic Valve Replacement Versus Transcatheter Aortic Valve Implantation
ConclusionsOur meta-analysis of observational studies demonstrates that early mortality is lower after SU-AVR than after TAVI in selected patients. The rates of stroke and pacemaker implant are comparable between procedures; however, the incidence of paravalvular leak is higher after TAVI.
Source: The Annals of Thoracic Surgery - August 21, 2018 Category: Cardiovascular & Thoracic Surgery 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

Outcomes in Nonagenarians Undergoing Transcatheter Aortic Valve Replacement in the PARTNER-I Trial
Conclusions A TAVR can be performed in nonagenarians with acceptable short- and mid-term outcomes. Although TF- and TA-TAVR outcomes are not directly comparable, TA-TAVR appears to carry a higher risk of early death without a difference in intermediate-term mortality. Age alone should not preclude referral for TAVR in nonagenarians.
Source: The Annals of Thoracic Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic Valve Replacement in the Moderately Elevated Risk Patient: A Population-Based Analysis of Outcomes
Conclusions This population-based contemporary assessment suggests moderate-risk patients undergoing AVR experience favorable outcomes. Although increasing PROM is important in preoperative evaluation of risk, preexisting pulmonary hypertension and indication for operation are among other factors that should be considered as TAVR expands into this group of patients.
Source: The Annals of Thoracic Surgery - June 17, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Right Minithoracotomy for Mitral Valve Surgery: Impact of Tailored Strategies on Early Outcome
Conclusions Right minithoracotomy MVS can routinely be performed with favorable outcomes in all comers when perfusion strategies and clamping techniques are carefully selected after proper evaluation of the patient’s preoperative characteristics.
Source: The Annals of Thoracic Surgery - July 17, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early Prognosis of Reduction Ascending Aortoplasty in Patients With Aortic Valve Disease: A Single Center ’s Experience
Conclusions Reduction ascending aortoplasty shows good early results in patients with aortic valve disease and dilatation of the ascending aorta. Redilatation tends to happen in patients with BAV, and long-term follow-up is necessary.
Source: The Annals of Thoracic Surgery - January 18, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

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