Query: stroke

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Source: The Annals of Thoracic Surgery

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Total 303 results found since Jan 2013.

Long-term Outcomes of Mechanical Vs Biologic Aortic Valve Prosthesis in Patients Older Than 70 Years
ConclusionsMechanical aortic valve prosthesis is associated with worse long-term survival and increased bleeding after SAVR in patients more than 70 years old. The study results suggest caution when considering mechanical aortic valve prostheses in elderly patients.
Source: The Annals of Thoracic Surgery - October 24, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

TAVR After Prior Mitral Valve Surgery: Results from the Transcatheter Valve Therapy Registry
ConclusionsPatients with prior SMVR undergoing TAVR had similar 30-day outcomes, slightly higher 1-year mortality, and no increase in early PVL compared to those without previous SMVR. Prior SMVR should not preclude TAVR in appropriately selected patients.
Source: The Annals of Thoracic Surgery - October 24, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Total endovascular repair of the aortic arch: initial experience in the Netherlands
ConclusionsTotal endovascular aortic arch repair using the Relay Branch device is technically feasible and effective in excluding aortic arch pathology. The observed stroke rate in the initial experience, however, was considerable. Although appealing, this new lesser-invasive technique should be carefully introduced, and its progress thoroughly evaluated.
Source: The Annals of Thoracic Surgery - October 5, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-Term Single Centre Outcomes of Patients with Chronic Renal Dialysis Undergoing Cardiac Surgery
CONCLUSIONSCardiac surgery in DD-CRF patients is associated with high morbidity and mortality. Interestingly, overall mortality was mainly none cardiac-related, where elderly patients or those presented with CHF had the worst life expectancy. However, subsequent kidney transplantation positively impact long-term survival in such patients.
Source: The Annals of Thoracic Surgery - September 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Cerebral Perfusion on Outcomes of Aortic Surgery: STS Adult Cardiac Database Analysis
ConclusionsFor patients without dissection and requiring>30 minutes circulatory arrest, optimal cerebral protection strategies are deep hypothermia with either antegrade or retrograde cerebral perfusion; or moderate hypothermia with antegrade cerebral perfusion.
Source: The Annals of Thoracic Surgery - September 26, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic Valve Replacement in Bioprosthetic Failure:Insights from The Society of Thoracic Surgeons National Database
ConclusionsThe number of patients undergoing SAVR for degenerated bioprosthesis is decreasing in U.S, particularly among older and high-risk patients. These trends may reflect the adoption of valve-in-valve transcatheter aortic valve replacement for degenerated bioprosthesis after its FDA approval in 2015.
Source: The Annals of Thoracic Surgery - September 24, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Impact of Preoperative Clopidogrel on Outcomes After Coronary Artery Bypass Grafting
ConclusionsCABG can be safely performed in patients with recent clopidogrel exposure with no increased risk of early or late mortality. However, CABG should be delayed for at least 5 days, if clinically feasible, to minimize transfusions and reoperation risk. In patients with more urgent indications, delaying CABG at least 3 days can mitigate but not eliminate the increased bleeding risk.
Source: The Annals of Thoracic Surgery - September 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Stroke on LVAD: moving from the preoperative patient stratification to the postoperative prevention (Reply)
Publication date: Available online 14 September 2019Source: The Annals of Thoracic SurgeryAuthor(s): Masashi Kawabori, Chitaru Kurihara, Jeffrey A. Morgan
Source: The Annals of Thoracic Surgery - September 14, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Cardiac Surgery in Patients with Opioid Use Disorder: An Analysis of 1.7 Million Surgeries
ConclusionsOUD among cardiac surgery patients is associated with prolonged hospitalization and increased risk of postoperative morbidity, and mainly driven by the patient’s preoperative risk factors. Strategies to minimize these risk factors at prehospitalization level is warranted to curb the opioid epidemic and improve overall outcomes in this vulnerable population.
Source: The Annals of Thoracic Surgery - September 1, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Epiaortic Ultrasound to Prevent Stroke in Coronary Artery Bypass Grafting (Commentary)
Publication date: Available online 29 August 2019Source: The Annals of Thoracic SurgeryAuthor(s): George L. Hicks
Source: The Annals of Thoracic Surgery - August 30, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Results of left ventricular reconstruction with and without mitral valve surgery
ConclusionsThe clinical outcomes of left ventricular reconstruction are comparable to those of left ventricular reconstruction plus mitral valve surgery in patients with left aneurysm and moderate mitral regurgitation.
Source: The Annals of Thoracic Surgery - August 28, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Risk factors for atrial fibrillation recurrence post Cox-maze IV performed without pre-exclusion
ConclusionsThe Cox maze IV procedure performed without pre-exclusions showed reasonable survival rates. Although AF recurred in patients with longer AFD, they fared well with significant increases in stroke volume. Concomitant atrial volume reduction may have contributed to these additional benefits.
Source: The Annals of Thoracic Surgery - August 28, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Endovascular Repair of Ascending Aortic Disease in High-Risk Patients Yields Favorable Outcome
ConclusionsAscending aortic stent placement for ascending aortic disease is feasible and is associated with favorable aortic remodeling. Despite persistent perfusion to the false lumen in a subset of patients, there is minimal aortic dilation at short-term follow-up with excellent survival.
Source: The Annals of Thoracic Surgery - August 28, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Failure to rescue contributes to center-level differences in mortality after lung transplantation
ConclusionsDifferences in rates of Failure to Rescue contribute significantly to per-center variability in mortality following LTx. FTR can serve as a quality metric to identify opportunities for improvement in management of perioperative adverse events.
Source: The Annals of Thoracic Surgery - August 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hemolysis and Nonhemorrhagic Stroke During Venoarterial Extracorporeal Membrane Oxygenation
ConclusionsHemolysis at low levels during VA ECMO support is associated with subsequent nonhemorrhagic stroke.
Source: The Annals of Thoracic Surgery - August 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Survival After Myectomy for Obstructive Hypertrophic Cardiomyopathy: What Causes Late Mortality?
ConclusionsThis study, using 2 independent sources to verify vital status and cause of mortality, confirms that survival after septal myectomy is excellent. Hypertrophic cardiomyopathy was identified as the primary cause of death in less than 20%, with mortality in most patients unrelated to hypertrophic cardiomyopathy.
Source: The Annals of Thoracic Surgery - August 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Surgical Treatment for Stand-Alone Atrial Fibrillation in North America
ConclusionsSteady growth of stand-alone SA operations was noted. Procedures performed either on-pump or off-pump were relatively safe. However, intraoperative conversion was associated with significantly higher morbidity and mortality. Patient selection, improvement of surgical techniques, and long-term follow-up should be emphasized to improve decision-making and outcome.
Source: The Annals of Thoracic Surgery - August 19, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Epiaortic Ultrasound to Prevent Stroke in Coronary Artery Bypass Grafting
ConclusionsAvoiding aortic manipulation is associated with the lowest risk of stroke in patients undergoing CABG. When manipulation of the ascending aorta is planned, EAU is effective in guiding the surgical strategy to reduce the risk for embolic stroke in these patients.
Source: The Annals of Thoracic Surgery - August 15, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Dissection of Arch Branches Alone an Indication for Aggressive Arch Management in Type A Dissection?
ConclusionsIn ATAAD, dissection of arch branches alone should not be an indication for routine zone 1/2/3 arch replacement; however, zone 1/2/3 arch replacement could be considered to prevent future reoperations in select patients.Graphical abstract
Source: The Annals of Thoracic Surgery - August 10, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Aortic Atherosclerosis Burden on Outcomes of Surgical Aortic Valve Replacement
ConclusionsModerate/severe aortic atherosclerosis was associated with an increased risk of adverse events following SAVR. Epiaortic ultrasound may serve as a useful adjunct for identifying patients who may benefit from strategies to reduce atheroembolic complications during SAVR.
Source: The Annals of Thoracic Surgery - August 8, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Increased Glucose Variability Is Associated With Major Adverse Events After Coronary Artery Bypass
ConclusionsIncreased 24-hour, but not 12-hour, postoperative GV following CABG is a predictor of poor outcomes. Preoperative HbA1c is not associated with MAEs after adjusting for postoperative mean glucose and GV.Graphical abstract
Source: The Annals of Thoracic Surgery - August 8, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Stroke on LVAD: moving from the preoperative patient stratification to the postoperative prevention
Publication date: Available online 7 August 2019Source: The Annals of Thoracic SurgeryAuthor(s): Angelo M. Dell’Aquila, Henryk Welp
Source: The Annals of Thoracic Surgery - August 8, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Bleeding Revision on Outcomes After Left Ventricular Assist Device Implantation
ConclusionsA bleeding revision is associated with significantly reduced survival and substantially increased morbidity during LVAD support. Preoperative, intraoperative, and postoperative prophylactic strategies may help to prevent this life-threatening complication.
Source: The Annals of Thoracic Surgery - July 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Physician-Modified Thoracic Stent Grafts for the Arch After Surgical Treatment of Type A Dissection
ConclusionsThe use of physician-modified thoracic stent grafts for the treatment of dissecting aortic arch aneurysm after surgical treatment of acute type A dissection is feasible and effective. Durability concerns will need to be assessed in future studies.Visual Abstract
Source: The Annals of Thoracic Surgery - July 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Direct Cannulation in Minimally Invasive Cardiac surgery with limited resources
ConclusionsIn our experience, this approach is a reliable platform for a variety of MICS procedures and has resulted in low complication rates. The technique can be applied safely to both paediatric and adult population. Also, it is very cost effective as regular instruments and cannulas are used.
Source: The Annals of Thoracic Surgery - July 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-term outcomes of stand-alone Maze IV for persistent/long-standing persistent atrial fibrillation
ConclusionsThis study confirmed the safety and efficacy at long-term (7 years) of the stand-alone Maze IV surgical procedure for persistent/long-standing persistent AF. Indeed, more than 70% of the pts were in SR off class I/III AADs and off oral anticoagulation.Graphical abstract
Source: The Annals of Thoracic Surgery - July 18, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Complications After Cardiac Surgery on One-Year Patient Reported Outcomes
ConclusionsWhile cardiac surgical patients have PRO scores similar to the general population, complications after cardiac surgery continue to negatively influence patient quality of life one-year after surgery. Using the NIH-PROMIS, prolonged ventilation and renal failure have the largest impact on one-year patient reported outcomes.
Source: The Annals of Thoracic Surgery - July 17, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Transcatheter and Surgical Aortic Valve Replacement in Patients with Recent Acute Heart Failure
ConclusionsRecent AHF is associated with increased risk of mortality and morbidity after SAVR and TAVR. These findings suggest that AS patients should be referred for invasive treatment before the development of clinically evident heart failure.
Source: The Annals of Thoracic Surgery - July 8, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Comparative Outcomes of Transcarotid and Trans-subclavian Transcatheter Aortic Valve Replacement
ConclusionsThe transcarotid and the trans-subclavian approaches have similar safety and efficacy outcomes. The transcarotid approach had a shorter procedure duration and a trend towards lower fluoroscopy duration and radiation exposure.
Source: The Annals of Thoracic Surgery - July 5, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Novel Formula to calculate 3-D Angle between Inflow Cannula and Device Body of HeartMate II LVAD
ConclusionsWe established a novel formula to mathematically calculate actual 3D angles between inflow cannula and device body of HeartMate II. The formula would help investigators to validate their findings of the relationship between 2D projected angle (from CXR) and device thrombosis.
Source: The Annals of Thoracic Surgery - June 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of Repair of Kommerell’s Diverticulum
ConclusionsOpen and endovascular approaches have a high success rate and low mortality risk. Selection of the specific type of intervention should be based on patient’s anatomy, additional needed procedures, and comorbid conditions.
Source: The Annals of Thoracic Surgery - June 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hemolysis and Non-Hemorrhagic Stroke during Venoarterial Extracorporeal Membrane Oxygenation
ConclusionsHemolysis at low levels during VA ECMO support is associated with subsequent non-hemorrhagic stroke.
Source: The Annals of Thoracic Surgery - April 12, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Development and Application of a Risk Prediction Model for In-Hospital Stroke After Transcatheter Aortic Valve Replacement – A Report from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry
ConclusionsA risk model for in-hospital stroke following TAVR was developed from the STS/ACC TVT Registry and used to estimate site-specific stroke performance. This model can serve as a valuable resource for quality improvement, clinical decision-making, and patient counseling.
Source: The Annals of Thoracic Surgery - December 8, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-Term Outcomes for Patients With Stroke After Coronary and Valve Surgery
ConclusionsPostoperative stroke often leads to high mortality and poor long-term outcomes. Patients who experienced a severe stroke and underwent neurosurgical procedures also exhibited poor outcomes. Patients and their families should be informed of relatively high mortality and poor long-term outcomes before neurosurgical operation.
Source: The Annals of Thoracic Surgery - July 10, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early Operation in Patients With Mitral Valve Infective Endocarditis and Acute Stroke Is Safe
Conclusions MV surgery for IE and acute stroke can be performed early with a low risk of postoperative neurologic complications. When indicated, surgical intervention for MV IE complicated by acute stroke should not be delayed.
Source: The Annals of Thoracic Surgery - November 11, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

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

Long-Term Risk of Ischemic Stroke After the Cox-Maze III Procedure for Atrial Fibrillation
Conclusions This multicenter study showed a low incidence of perioperative and long-term postoperative ischemic stroke/TIA after CM-III. Although general risk of ischemic stroke/TIA was reduced, patients with CHA2DS2-VASc score 2 or greater had a higher risk compared with score 0 or 1. Complete left atrial appendage excision may be an important reason for the low ischemic stroke rate.
Source: The Annals of Thoracic Surgery - July 20, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Stroke Volume Ratio Predicts Redilatation of the Right Ventricle After Pulmonary Valve Replacement
Conclusions The preoperative stroke volume ratio can predict redilatation of the right ventricle after pulmonary valve replacement and the degree of right ventricular myocardial fibrosis.
Source: The Annals of Thoracic Surgery - March 25, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Trends, Predictors, and Outcomes of Stroke After Surgical Aortic Valve Replacement in the United States
Conclusions The incidence of stroke after AVR has decreased but remains a significant cause of morbidity in medium- and high-risk patients. Superior outcomes can be achieved in medium- to high-risk patients at high-volume centers.
Source: The Annals of Thoracic Surgery - November 27, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Left Subclavian Arterial Coverage and Stroke During Thoracic Aortic Endografting: A Systematic Review
We report a systematic review of 63 studies comprising more than 3,000 patients. We conclude that stroke risk after TEVAR is increased by LSA coverage, and that LSA revascularization reduces stroke risk. LSA revascularization may lower the rate of posterior stroke. TEVAR for aneurysm is associated with increased stroke risk compared to TEVAR for dissection.
Source: The Annals of Thoracic Surgery - November 17, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Epidemiology of Stroke in Pediatric Cardiac Surgical Patients Supported With Extracorporeal Membrane Oxygenation
Conclusions This multicenter analysis demonstrates that pediatric cardiac surgical patients on ECMO are at high risk of stroke; younger or underweight patients and those with longer ECMO duration are at greatest risk, independent of procedural complexity. Future study is necessary to determine how anticoagulation or other clinical practices can be modified to reduce stroke incidence.
Source: The Annals of Thoracic Surgery - August 21, 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

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

Stroke After Left Ventricular Assist Device Implantation: Outcomes in the Continuous-Flow Era
Conclusions Stroke while on CF-LVAD support was associated with significant mortality. To reduce the risk of stroke, it is essential to further elucidate risk factors, to optimize anticoagulation, and to further understand the impact of LVAD-related infections.
Source: The Annals of Thoracic Surgery - June 10, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Anemia Is a Risk Factor of New Intraoperative Hemorrhagic Stroke During Valve Surgery for Endocarditis
Conclusions Intraoperative hemorrhagic stroke was not rare, and ectopic hemorrhagic stroke, associated with preoperative anemia, was more prevalent than hemorrhagic transformation of existing cerebral lesions.
Source: The Annals of Thoracic Surgery - May 14, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Surgical Stroke on the Early and Late Outcomes After Thoracic Aortic Operations
Conclusions Surgical stroke is associated with high hospital mortality and PNDs that decrease late survival and the physical component score of the QOL survey.
Source: The Annals of Thoracic Surgery - April 10, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Off-Pump Coronary Artery Bypass Reduces Early Stroke in Octogenarians: A Meta-Analysis of 18,000 Patients
Conclusions Coronary artery bypass in octogenarians can be performed safely with low early mortality. Although off-pump operations reduce the risk of early stroke, all other adverse events are comparable in on- and off-pump coronary artery bypass operations. Data regarding late mortality is at present limited; however, both on- and off-pump procedures appear to produce comparable survival.
Source: The Annals of Thoracic Surgery - March 17, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Postoperative Blood Urea Nitrogen Is Associated With Stroke in Cardiac Surgical Patients
Conclusions In these analyses, we identified BUN as a marker of heightened postoperative stroke risk after cardiac surgical procedures. Postoperative risk markers may improve assessment of delayed postoperative strokes.
Source: The Annals of Thoracic Surgery - February 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research