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Outcomes of Planned Two-Stage Hybrid Aortic Repair With Dacron-Replaced Proximal Landing Zone
ConclusionsPlanned two-stage HAR with open first-stage proximal aortic replacement, followed by second-stage TEVAR with Dacron-replaced PLZ yields excellent short-term and long-term results, including low rates of reintervention likely due to the long-segment PLZ within the Dacron-replaced aorta. The technique should be considered in patients with even mild (>4.0 cm) ascending aortic dilation in whom HAR is otherwise the preferred treatment option.
Source: The Annals of Thoracic Surgery - August 24, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Clinical Leaflet Thrombosis in Transcatheter and Surgical Bioprosthetic Aortic Valves by 4DCT
ConclusionsIn patients with clinical or echocardiographic indications suggestive of leaflet thrombosis, 1/3rd of patients were found to have evidence of leaflet thrombosis using 4DCT. This allowed tailored anticoagulation therapy with resolution of the thrombus in most patients avoiding unnecessary anticoagulation in the remaining 2/3rds of patients.
Source: The Annals of Thoracic Surgery - August 26, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Salvage Coronary Artery Bypass Predicts Increased Mortality during Aortic Root Surgery
ConclusionsCABG during ROOT results in increases in postoperative morbidity or mortality compared with isolated ROOT. Outcomes, however, are influenced by the specific clinical indication. CABG for CAD was associated with similar outcomes compared with isolated ROOT. Patients undergoing unplanned CABG for acute ventricular failure had the worst outcomes, thus underscoring the importance of technical success during coronary reimplantation.
Source: The Annals of Thoracic Surgery - August 29, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Preoperative Venoarterial Extracorporeal Membrane Oxygenation Slashes Risk Score in Advanced Structural Heart Disease
ConclusionsECMO can be used as a bridge to heart valve or septal defect surgery in severely decompensated patients. Through recovery of end-organ function, ECMO may allow surgical correction of structural heart disease in patients considered inoperable or convert a salvage situation to an elective operation.
Source: The Annals of Thoracic Surgery - September 18, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Frozen Elephant Trunk for Acute Type B Dissection Involving the Distal Arch in the Hybrid Repair Era
ConclusionsOpen repair of ATBAD with distal aortic arch involvement using the frozen elephant trunk procedure with LSCA-LCCA transposition obtained satisfactory outcomes. Avoidance of complications using hybrid repair, good postoperative recovery, and a low prevalence of late reintervention were achieved. The satisfactory results favored this technique for this lesion in this hybrid repair era.
Source: The Annals of Thoracic Surgery - September 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Repair of Thoracic and Thoracoabdominal Mycotic Aneurysms and Infected Aortic Grafts Using Allograft
ConclusionsRadical resection and in situ reconstruction with CPA avoids placing prosthetic material in an infected field and provides good early and midterm outcomes. However, early postoperative imaging is necessary given the risk of pseudoaneurysm formation.
Source: The Annals of Thoracic Surgery - September 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Totally Thorascopic Closure of the Left Atrial Appendage
We describe our technique for totally thoracoscopic LAA exclusion with an epicardial clip device. This approach provides a safe and likely more effective alternative to LAA management than other endocardial devices.
Source: The Annals of Thoracic Surgery - September 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early Clinical Outcomes of Hybrid Arch Frozen Elephant Trunk Repair with the Thoraflex Hybrid Graft
ConclusionsHybrid aortic arch and FET repair with the Thoraflex hybrid graft appears to be associated with good clinical outcomes, despite being early in the learning curve with this graft. Further investigation with this device is warranted to establish its role within the variations of hybrid arch repair.
Source: The Annals of Thoracic Surgery - October 4, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Valve Sparing Root Replacement Provides Excellent Mid-Term Outcomes for Bicuspid Valve Aortopathy
ConclusionsVSRR can be safely and effectively performed in young patients with bicuspid valve anatomy regardless of degree of pre-operative AI. Valve function is durable and the incidence of valve-related complications is low. VSRR is an attractive and potentially superior option to conventional root replacement in appropriately selected patients with bicuspid aortopathy.
Source: The Annals of Thoracic Surgery - October 5, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Surgical outcomes in Behcet’s disease patients with severe aortic regurgitation
ConclusionsThe findings suggest that mechanical root replacement combined with a low post-operative C-reactive protein level maintained through adjunctive immunomodulation therapy may lead to optimal surgical outcomes in Behcet’s disease associated with severe aortic regurgitation.
Source: The Annals of Thoracic Surgery - October 10, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Robotic-Assisted Surgical Ablation of Atrial Fibrillation Combined with Mitral Valve Surgery
ConclusionsSurgical AF ablation using robotic-assistance in the setting of mitral valve surgery showed excellent safety and favorable long-term clinical outcomes.
Source: The Annals of Thoracic Surgery - October 12, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Clinical Outcomes of Mitral Valve Reoperations in the United States: An Analysis of the Society of Thoracic Surgeons National Database
ConclusionsDespite a high-risk patient profile, surgical outcomes of reoperative MVS were acceptable, particularly in elective cases with prior mitral valve surgery and without endocarditis.
Source: The Annals of Thoracic Surgery - October 24, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Emergency Use of Branched Thoracic Endovascular Repair in the Treatment of Aortic Arch Pathologies
Conclusions: Our experience provided an early insight to the feasibility and safety of b-TEVAR in emergency situation, although the early reintervention rate was not negligible. The endograft was versatile with potential off-the-shelf use in future.
Source: The Annals of Thoracic Surgery - October 30, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early extubation without increased adverse events in high risk cardiac surgical patients
ConclusionsA prudent and diligent multi-faceted early extubation protocol may be successful in high risk cardiac surgical patients without an increase in adverse outcomes. A larger study is needed in the future to confirm the finding.
Source: The Annals of Thoracic Surgery - November 3, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Does Mitral Valve Calcium In Patients Undergoing Mitral Valve Replacement Portend Worse Survival?
ConclusionsConservative approach to treat MAC achieves satisfactory results. Patients with MAC have significant comorbidities contributing to a worse survival though MAC in itself is not a risk factor for mortality.
Source: The Annals of Thoracic Surgery - November 3, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

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