• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

The Addition of Hemi-arch Replacement to Aortic Root Surgery Does Not Affect Safety
Hemi-arch reconstruction is the conventional approach for proximal aortic arch replacement but carries risks of neurologic events and coagulopathy. Addition of hemi-arch reconstruction to aortic root replacement may prevent future arch pathology. In this series, addition of a hemi-arch had low mortality and did not increase stroke or bleeding complications.
Source: The Journal of Thoracic and Cardiovascular Surgery - March 19, 2015 Category: Cardiovascular & Thoracic Surgery Authors: S.C. Malaisrie, B. Duncan, C.K. Mehta, M.V. Badiwala, D. Rinewalt, J. Kruse, Z. Li, A.-C. Andrei, P.M. McCarthy Source Type: research

Bleeding and Cerebral Injury Following Aortic Arch Repair: Two Achilles’ Heels
Aortic arch surgery continues to be hampered by the potentially devastating complications of bleeding and stroke. Ongoing efforts by cardiovascular surgeons have resulted in improvements in results, but further advancement is still required.
Source: The Journal of Thoracic and Cardiovascular Surgery - September 5, 2015 Category: Cardiovascular & Thoracic Surgery Authors: John S. Ikonomidis Source Type: research

Bleeding and cerebral injury following aortic arch repair: Two chinks in the armor
Aortic arch repair remains a complex, technically challenging procedure, even in the most experienced of hands. It has been very interesting to watch the progression of techniques and strategies employed to overcome the ever-present risks of stroke and hemorrhage associated with these operations. The question is, Have we made progress?
Source: The Journal of Thoracic and Cardiovascular Surgery - September 5, 2015 Category: Cardiovascular & Thoracic Surgery Authors: John S. Ikonomidis Tags: Expert opinion Source Type: research

Discussion
Dr T. E. MacGillivray (Boston, Mass). Thank you very much, Dr Pomar, Dr Sundt. I am grateful to Dr Masabni for sending me a copy of his manuscript in advance, and I congratulate you on an excellent presentation. Back when I was a cardiac surgery resident, one of my attendings would frequently lament, “If it weren't for the bleeding and the strokes, cardiac surgery would be the greatest job in the world!” Although we all know that bleeding eventually stops, the catastrophic impact of stroke can last forever.
Source: The Journal of Thoracic and Cardiovascular Surgery - November 13, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Take me to your bleeder: Recombinant factor VIIa —finding its way in cardiac surgery
In this issue of the Journal, Dr Zindovic and colleagues1 examined whether data from the Nordic Consortium for Acute Type A Aortic Dissection database indicated that use of recombinant factor VIIa (rFVIIa) was associated with mortality, stroke, or renal replacement therapy after acute type A aortic dissection (ATAAD) surgical repair. Bleeding in ATAAD repair is a concern to all surgeons performing such operations. Any adjunct to attenuate bleeding is appreciated, and in ATAAD, rFVIIa has been suggested to do so.
Source: The Journal of Thoracic and Cardiovascular Surgery - September 4, 2017 Category: Cardiovascular & Thoracic Surgery Authors: John Bozinovski Tags: Editorial commentary Source Type: research

You can't always get what you want
In the current issue of the Journal, Schnittman and colleagues1 provide an elegant retrospective analysis of isolated mitral valve replacement (MVR) operations in patients aged 18 to 50  years using New York and California administrative claims data. They found an alarming overall trend in the increase in bioprostheses (BPs) from 10% to 34% between 1997 and 2014. After excluding endocarditis and congenital abnormalities, they laudably examined 373 comprehensively propensity-matche d pairs of isolated MVR receiving mechanical prostheses (MPs) versus BP from 1997 to 2006 to assess 15-year survival and readmissions for strok...
Source: The Journal of Thoracic and Cardiovascular Surgery - September 16, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Harold G. Roberts, Lawrence M. Wei, Vinay Badhwar Tags: Editorial commentary Source Type: research

Timing of surgery for pulmonary embolism: An evolving paradigm
The article in this issue of the Journal from Lee and coworkers1 presents the outcome of acute pulmonary embolism (PE) from a statewide database in New York State between 1999 and 2013. Although the study has inherent limitations because of the use of a large, disparate database, Lee and coworkers1 noted several important points. The 30-day mortality was similar between patients treated with thrombolysis and those treated with surgical embolectomy. Thrombolysis was associated with a lower risk of major bleeding but with a higher risk of stroke.
Source: The Journal of Thoracic and Cardiovascular Surgery - October 20, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Marc de Perrot Tags: Editorial commentary Source Type: research

We don't know what we need to know about atrial fibrillation
Atrial fibrillation (AF) is encountered in older patients and sometimes preoperatively in patients undergoing coronary artery bypass (CAB). Prior single-center studies, Society of Thoracic Surgeons database studies, and a Cochrane review indicate that AF is associated with increased risk for these patients.1-3 The meta-analysis from Saxena and colleagues4 confirms these prior reports and notes an association of preoperative AF with higher stroke, renal failure, reoperation for bleeding, prolonged ventilation, and higher early and late mortality.
Source: The Journal of Thoracic and Cardiovascular Surgery - January 5, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Patrick M. McCarthy Tags: Editorial commentary Source Type: research

Preoperative renal impairment and off-pump coronary artery bypass grafting: The jury is still out
The superiority of off-pump or on-pump coronary artery bypass grafting (CABG) remains to be demonstrated. Through the years, retrospective and prospective studies have suggested that off-pump CABG is associated with improved outcomes, such as reduced renal injury, reduced bleeding and need for transfusion, and shortened hospital stay. The Randomized On/Off Bypass trial, however, demonstrated that off-pump CABG led to lower 5-year survival and event-free survival than did on-pump CABG.1 The more robust CABG Off or On Pump Revascularization Study, in contrast, showed that the rate of the composite outcome of death, stroke, m...
Source: The Journal of Thoracic and Cardiovascular Surgery - April 7, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Mustafa Zakkar, Gianni D. Angelini Tags: Editorial commentary Source Type: research

The limitations of observational data in assessing surgical left atrial appendage ligation
We read with interest the study by Juo and colleagues, which examined outcomes in a cohort of patients with atrial fibrillation who underwent surgical left atrial appendage (LAA) ligation concomitantly with coronary artery bypass grafting. The authors evaluated the short-term efficacy and safety of LAA ligation in 20,664 patients among a sample of 234,642 patients from the Nationwide Inpatient Sample, and reported no significant differences in postoperative stroke, mortality, bleeding, and pericardial complications.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 14, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Saurabh Gupta, Emilie P. Belley-C ôté, Richard P. Whitlock Tags: Letter to the editor Source Type: research

Mitral repair in symptom-free patients with normal ventricles: Becoming the new normal?
We have all been there. A young, vigorous woman referred to you with severe asymptomatic mitral regurgitation is in your office to discuss surgical repair. You proceed to describe the incision you are going to make somewhere on her chest; the 1% to 2% risk of bleeding, stroke, infection, heart failure, and death; the fact that she may end up with a prosthetic mitral valve requiring lifelong anticoagulation; and the fact that she is going to have to miss a month or more of her Pilates classes because the American College of Cardiology and American Heart Association Task Force on Practice Guidelines (ACC/AHA) says that it is...
Source: The Journal of Thoracic and Cardiovascular Surgery - September 5, 2018 Category: Cardiovascular & Thoracic Surgery Authors: David D. Yuh Tags: Editorial Commentary Source Type: research

In pursuit of the optimal hemocompatible left ventricular assist device
Left ventricular assist device (LVAD) implantation is a firmly established treatment modality for advanced heart failure; however, major complications such as nonsurgical bleeding, driveline infections, pump thrombosis, and stroke limit wider application to patients with less severe heart failure. Of note, more than 60% of patients who receive a continuous flow LVAD experience such severe adverse events within the first year.1
Source: The Journal of Thoracic and Cardiovascular Surgery - August 29, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Shuab Omer Tags: Editorial Commentary Source Type: research

Commentary: Mitral repair in symptom-free patients with normal ventricles: Becoming the new normal?
We have all been there. A young, vigorous woman referred to you with severe asymptomatic mitral regurgitation is in your office to discuss surgical repair. You proceed to describe the incision you are going to make somewhere on her chest; the 1% to 2% risk of bleeding, stroke, infection, heart failure, and death; the fact that she may end up with a prosthetic mitral valve requiring lifelong anticoagulation; and the fact that she is going to have to miss a month or more of her Pilates classes because the American College of Cardiology and American Heart Association Task Force on Practice Guidelines (ACC/AHA) says that it is...
Source: The Journal of Thoracic and Cardiovascular Surgery - September 4, 2018 Category: Cardiovascular & Thoracic Surgery Authors: David D. Yuh Tags: Commentary Source Type: research

Commentary: Nuisance or nemesis? Postoperative atrial fibrillation increases long-term mortality regardless of sex
Postoperative atrial fibrillation (POAF) complicates approximately 30% of coronary artery bypass grafting (CABG) procedures.1 POAF has been associated with perioperative adverse outcomes including stroke, reoperation for bleeding, myocardial infarction, and pacemaker use.1,2 Patients with POAF are known to have a significantly increased risk of mortality in short-term, midterm, and long-term follow-up. POAF also lengthens hospital stay by 3 to 5  days and increases hospitalization cost from $10,000 to $20,000 per patient.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 5, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Malak Elbatarny, Derrick Y. Tam, Stephen E. Fremes Tags: Commentary Source Type: research

Commentary: Postpericardial syndrome after cardiac surgery: Is it really benign?
Lehto and colleagues1 report on the long-term outcomes of postpericardiotomy syndrome (PPS) occurring after aortic valve replacement (AVR) surgery. The patient cohort was drawn from 2 large Finnish multi-institutional clinical trial databases, namely CAREAVR (Consortium of Studies in the Field of Atrial Fibrillation, Stroke, and Bleeding in Patients Undergoing Aortic Valve Replacement) and CAREBANK (Cardiovascular Research Consortium---A Prospective Project to Identify Biomarkers of Morbidity and Mortality in Cardiovascular Interventional Patients),1 in which a total of 671 AVR patients (bioprosthesis, n  = 361 and mecha...
Source: The Journal of Thoracic and Cardiovascular Surgery - March 11, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Suk Jung Choo Tags: Commentary Source Type: research

Pages: 1  2  3