Query: stroke

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Source: The Annals of Thoracic Surgery

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Total 306 results found since Jan 2013.

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

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

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

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

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

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

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

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

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

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

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

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

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

Long-Term Outcomes for Patients With Stroke After Coronary and Valve Surgery
Conclusions Postoperative 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 - June 22, 2018 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

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

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

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

A More Specific Anticoagulation Regimen Is Required for Patients After the Cox-Maze Procedure
Conclusions Our results indicate that the decision to discontinue OAC after the Cox-Maze procedure should not be based solely on CHADS2 scores; rather, rhythm status, echocardiographic findings, and patient risk for bleeding should be considered. These findings underscore the need for an OAC protocol for patients who have undergone the Cox-Maze procedure with appropriate LAA management.
Source: The Annals of Thoracic Surgery - October 12, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

Posterior Papillary Muscle Anchoring Affects Remote Myofiber Stress and Pump Function: Finite Element Analysis
Conclusions PPMA reduces remote myofiber stress, which is proportional to the absolute distance of relocation and independent of anchoring point. Aggressive use of PPMA techniques to reduce remote myofiber stress may accelerate reverse LV remodeling without impairing LV function.
Source: The Annals of Thoracic Surgery - October 12, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

Coronary Artery Surgery Versus Percutaneous Coronary Intervention in Octogenarians: Long-Term Results
Conclusions In this real-world setting, surgical coronary revascularization remains the standard of care for patients with left main or multivessel disease. The long-term outcomes of current percutaneous coronary intervention technology in octogenarians are yet to be determined with adequately powered prospective randomized studies.
Source: The Annals of Thoracic Surgery - December 11, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

Surgical Ventricular Restoration: Is There Any Difference in Outcome Between Anterior and Posterior Remodeling?
Conclusions Patients presenting with posterior remodeling showed worse clinical signs of angina and congestive heart failure (CHF) and a higher proportion of moderate to severe MR; however in the present experience early and long-term outcomes after SVR seemed to be unaffected by remodeling location.
Source: The Annals of Thoracic Surgery - December 11, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

A Randomized Multicenter Trial of Minimally Invasive Rapid Deployment Versus Conventional Full Sternotomy Aortic Valve Replacement
Conclusions RDAVR by the MIS approach is associated with significantly reduced myocardial ischemic time and better valvular hemodynamic function than FS-AVR with a conventional stented bioprosthesis. Rapid deployment valves may facilitate the performance of MIS-AVR.
Source: The Annals of Thoracic Surgery - December 30, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

Unilateral Versus Bilateral Cerebral Perfusion for Acute Type A Aortic Dissection
Conclusions As one of the largest single-center studies of the efficacy of u-ACP and b-ACP in patients with type A aortic dissection, operative mortality, stroke, temporary neurologic dysfunction, and renal failure rates were similar in both. In this intrinsically complex disease, survival is the most important outcome; u-ACP may provide cardiac surgeons with valuable technical simplicity during challenging procedures, and b-ACP may be justified for circulatory arrest times of more than 30 minutes.
Source: The Annals of Thoracic Surgery - December 30, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

Postoperative Atrial Fibrillation After Thoracic Aortic Surgery
Conclusions Several risk factors contribute to the incidence of POAF after thoracic aortic surgery. We found that POAF significantly increased 30-day operative mortality (p < 0.0001). Our findings can be used to develop a risk stratification system for the prediction of POAF.
Source: The Annals of Thoracic Surgery - December 30, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

Operative Mortality and Complication Risk Model for All Major Cardiovascular Operations in Japan
Conclusions These risk models increased the discriminatory power of former models. Thus, our models can be said to reflect the current state of Japan. With respect to major complications, useful feedback can now be provided through the Japan Cardiovascular Surgery Database Web-based system.
Source: The Annals of Thoracic Surgery - December 30, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortopulmonary Window and the Interrupted Aortic Arch: Midterm Results With Use of the Single-Patch Technique
Conclusions Primary anatomic repair of APW associated with IAA can be safely performed. The efficiency of the single-patch technique was confirmed by the restoration of normal functional anatomy of the great arteries and aortic arch during follow-up.
Source: The Annals of Thoracic Surgery - December 30, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

Relationship of Single Ventricle Filling and Preload to Total Cavopulmonary Connection Hemodynamics
Conclusions Flow-independent TCPC power loss is inversely related with ventricular end-diastolic and stroke volumes. Elevated power losses may contribute to impaired diastolic filling and limited preload reserve in single ventricle patients.
Source: The Annals of Thoracic Surgery - January 23, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of Open Repair for Chronic Descending Thoracic Aortic Dissection
Conclusions Open repairs of chronic descending thoracic aortic aneurysm dissections can be performed with respectable morbidity and mortality. Neurologic deficit remains low with the use of adjuncts, and early deaths are directly related to preoperative renal status. Reintervention on the involved aortic segment is low. These results allow comparisons with endovascular repair for chronic aortic dissection.
Source: The Annals of Thoracic Surgery - January 23, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Propensity Adjusted Analysis of Open and Endovascular Thoracic Aortic Repair for Chronic Type B Dissection: A Twenty-Year Evaluation
Conclusions Intervention for CBAD can be performed with excellent results, either by an open or endovascular approach. The higher rate of treatment failure after TEVAR warrants modification of current device design or endovascular approach before broad application of this treatment strategy.
Source: The Annals of Thoracic Surgery - February 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Autologous Platelet-Rich Plasma Reduces Transfusions During Ascending Aortic Arch Repair: A Prospective, Randomized, Controlled Trial
Conclusions The use of aPRP reduced allogeneic transfusions during ascending and transverse aortic arch repair with deep hypothermic circulatory arrest. This translated to less acute renal failure, decreased length of stay, and lower transfusion costs. Further studies examining the coagulation factors of aPRP are required.
Source: The Annals of Thoracic Surgery - February 19, 2015 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

Comparison of 30-Day Outcomes of Transfemoral Versus Transapical Approach for Transcatheter Aortic Valve Replacement: A Single-Center US Experience
Conclusions The TA approach has similar early safety outcomes when compared with the TF approach. The TA approach is more procedurally efficient when compared with the TF approach.
Source: The Annals of Thoracic Surgery - March 6, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Moderate Versus Deep Hypothermic Circulatory Arrest for Elective Aortic Transverse Hemiarch Reconstruction
Conclusions MHCA with antegrade cerebral perfusion yields excellent and equivalent outcomes to DHCA for elective aortic hemiarch reconstruction. MHCA significantly improves intraoperative times and, importantly, reduces transfusion requirements compared with DHCA with a retrograde cerebral perfusion strategy.
Source: The Annals of Thoracic Surgery - March 30, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of Atrioventricular Valve Operation in Patients With Fontan Circulation
Conclusions The AV valve operation done before, during, or after the Fontan operation is associated with low operative mortality but a high reoperation rate with significant risk of late death, transplantation, and persistent AV valve regurgitation.
Source: The Annals of Thoracic Surgery - March 30, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Coronary Artery Bypass Grafting After Percutaneous Intervention Has Higher Early Mortality: A Meta-Analysis
Conclusions Patients undergoing CABG after prior percutaneous therapy have a higher incidence of myocardial infarction and mortality in the postoperative period. However, midterm survival is comparable in both cohorts.
Source: The Annals of Thoracic Surgery - April 10, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Evolution in the Management of Aberrant Subclavian Arteries and Related Kommerell Diverticulum
Conclusions Aberrant subclavian arteries and associated Kommerell diverticulum can be treated with acceptable rates of mortality and morbidity. The evolution toward an endovascular approach did not appear to affect late outcomes, suggesting that the choice of treatment should be based on patient-specific anatomy and associated comorbidities.
Source: The Annals of Thoracic Surgery - April 23, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Does Thoracoscopic Surgery Decrease the Morbidity of Combined Lung and Chest Wall Resection?
Conclusions Thoracoscopic chest wall resection was feasible, expanded our case selection, and reduced prosthetic reconstruction. It did not, however, protect frail, elderly patients reliably. Briefer, less traumatic operations may be needed for this cohort.
Source: The Annals of Thoracic Surgery - April 24, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Minimally Invasive Port Access Approach for Reoperations on the Mitral Valve
Conclusions The port access approach can be safely adopted for reoperations on the MV without compromising postoperative mortality or MV function.
Source: The Annals of Thoracic Surgery - May 12, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Transapical Versus Transaortic Transcatheter Aortic Valve Implantation: A Systematic Review
Publication date: Available online 20 May 2015 Source:The Annals of Thoracic Surgery Author(s): Ben Dunne , Darren Tan , Daniel Chu , Victor Yau , Jinguo Xiao , Kwok Ming Ho , Gerald Yong , Robert Larbalestier Two alternative approaches for transcatheter aortic valve implantation (TAVI) exist for patients unsuitable for the transfemoral approach; the transapical and the transaortic approaches. It is unclear as to which approach has superior short-term outcomes. A systematic review and meta-analysis was performed to answer this question. Mortality was equivalent in the 2 groups. There was a trend toward a lower rate of s...
Source: The Annals of Thoracic Surgery - May 20, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of Treatment of Nonagenarians With Severe Aortic Stenosis
Conclusions Treatment of AS approximates natural life expectancy in select nonagenarians, with no significant difference in long-term survival between SAVR and TAVR. Importantly, patient quality of life improved at 1 year. With appropriate selection, nonagenarians with severe AS can benefit from treatment.
Source: The Annals of Thoracic Surgery - May 23, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early and Late Outcomes After Complete Aortic Replacement
Conclusions Complete aortic replacement can be performed with acceptable rates of morbidity and mortality. Most of these patients were younger, had associated dissection, and required multiple stages for completion. As endovascular techniques advance proximally into the ascending aorta and complete endovascular aortic repair comes closer to reality, studies like this will allow comparison.
Source: The Annals of Thoracic Surgery - June 10, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hospital Readmissions After Continuous-Flow Left Ventricular Assist Device Implantation: Incidence, Causes, and Cost Analysis
Conclusions Gastrointestinal bleeding and CF-LVAD–related infections were the leading causes of readmission. Patients with a CF-LVAD spent 93% of their time out of hospital after implantation, and readmissions did not have a negative impact on long-term survival. New approaches to minimize these adverse events will continue to improve the efficacy and decrease the cost of CF-LVAD therapy.
Source: The Annals of Thoracic Surgery - June 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-Term Outcomes of the Maze Procedure Combined With Mitral Valve Repair: Risk of Thromboembolism Without Anticoagulation Therapy
Conclusions Adopting appropriate selection criteria for discontinuing anticoagulation therapy, the majority of patients receiving concomitant mitral repair and the Maze procedure can discontinue warfarin with excellent long-term safety profiles.
Source: The Annals of Thoracic Surgery - June 23, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hemiarch and Total Arch Surgery in Patients With Previous Repair of Acute Type I Aortic Dissection
Conclusions In patients with previous acute type I aortic dissection repair, hemiarch and total arch operations have respectable morbidity and survival rates. Congestive heart failure predicts operative death, long-term mortality, and our adverse event endpoint. Cardiopulmonary bypass time predicts operative mortality, and female sex and circulatory arrest time predict long-term mortality.
Source: The Annals of Thoracic Surgery - June 23, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Low Incidence of Paravalvular Leakage With the Balloon-Expandable Sapien 3 Transcatheter Heart Valve
Conclusions The present study shows excellent clinical and hemodynamic outcomes of high-risk transapical valve replacement patients treated with the new S3 THV. The S3 THV shows a low incidence of postoperative aortic regurgitation, with 98% presenting with less than mild aortic regurgitation.
Source: The Annals of Thoracic Surgery - June 24, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early Operation for Endocarditis Complicated by Preoperative Cerebral Emboli Is Not Associated With Worsened Outcomes
Conclusions Early surgical intervention in patients with IE complicated by preoperative septic cerebral emboli does not lead to significantly worse postoperative outcomes. Early surgical intervention for IE after embolic stroke warrants consideration, particularly in patients with high-risk features such as S aureus or annular abscess, or both.
Source: The Annals of Thoracic Surgery - June 24, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research