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Aortic Replacement After TEVAR-Diameter Correction With Modified Use of the Siena Prosthesis
Conclusions Using the sewing collar of the Vascutek Siena 4-branch prosthesis for diameter correction in patients undergoing TA replacement after previous TEVAR with large stent-grafts adds a useful adjunct to the armamentarium of options in a growing patient population.
Source: The Annals of Thoracic Surgery - December 2, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Elective David I Procedure Has Excellent Long-Term Results: 20-Year Single-Center Experience
Conclusions The valve-sparing David I procedure has excellent short- and long-term results. Erosion due to supposed leaflet contact with the straight tube graft was not observed in any patient, proving that using a straight graft has no negative impact on the leaflets. The “spared valve” (being native living tissue) seems to be more resistant to infection than prosthetic valves.
Source: The Annals of Thoracic Surgery - December 2, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Assessment of Commonly Used Frailty Markers for High- and Extreme-Risk Patients Undergoing Transcatheter Aortic Valve Replacement
Conclusions Among high- and extreme-risk patients undergoing TAVR, our new frailty model was more discriminative of 30-day mortality than The Society of Thoracic Surgeons predicted risk of mortality. New cutoff values for frailty indicators were identified and will require further validation.
Source: The Annals of Thoracic Surgery - November 16, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Transapical Mitral Valve Implantation for Native Mitral Valve Stenosis Using a Balloon-Expandable Prosthesis
Conclusions TMV implantation using the SAPIEN 3 aortic prosthesis in patients with heavy annular calcification is feasible and represents a reasonable bailout option for inoperable patients. However, several limitations need to be considered in this special patient population.
Source: The Annals of Thoracic Surgery - November 16, 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

The Stent Is Not to Blame: Lessons Learned With a Simplified US Version of the Frozen Elephant Trunk
Conclusions With the advent of endovascular technology, there is a clinical shift toward increased use of FET to eliminate or facilitate the second surgical stage in treating patients with extensive aortic pathology. The addition of FET to the surgical armamentarium does not seem to pose additional risk (although larger studies are needed), but judicious use is advised nonetheless. A single-piece endoprosthesis for FET instead of a customized one should be considered.
Source: The Annals of Thoracic Surgery - October 18, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Restrictive Mitral Valve Annuloplasty: Prognostic Implications of Left Ventricular Forward Flow
Conclusions In patients with severe secondary MR treated with surgical repair, LV forward flow was independently associated with better survival and lower risk of the combined endpoint.
Source: The Annals of Thoracic Surgery - October 18, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of Elective Aortic Hemiarch Reconstruction for Aneurysmal Disease in the Elderly
Conclusions Although elderly patients have a more prolonged recovery after elective aortic hemiarch reconstruction for aneurysmal disease, outcomes are acceptable with low operative mortality and with the majority being discharged home. Moderate hypothermic circulatory arrest with antegrade cerebral perfusion is a safe strategy for this cohort. Advanced age alone should not be viewed as a contraindication in these cases.
Source: The Annals of Thoracic Surgery - October 18, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic Atheroma Increases the Risk of Long-Term Mortality in 20,000 Patients
Conclusions Aortic atheromatous disease of any grade in the ascending and descending aorta is a significant long-term risk of long-term, all-cause mortality in cardiac operation patients. This association remains independent of other conventional risk factors and is not related to postoperative cerebrovascular accidents.
Source: The Annals of Thoracic Surgery - September 19, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hypothermia and Selective Antegrade Cerebral Perfusion Is Safe for Arch Repair in Type A Dissection
Conclusions Unilateral selective antegrade cerebral perfusion with moderate hypothermic circulatory arrest remains a safe strategy for cerebral protection during emergent surgical repair of acute type A dissection and provides equivalent outcomes for both limited and extensive aortic arch reconstruction. Based on these data, unilateral selective antegrade cerebral perfusion and moderate hypothermic circulatory arrest may represent an optimal strategy for cerebral protection in this acute setting.
Source: The Annals of Thoracic Surgery - August 25, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Risk of Intraatrial Thrombi After Thoracoscopic Ablation in Absence of Heparin and Appendage Closure
Conclusions Thoracoscopic ablation of AF can be associated with a risk of left atrial appendage thrombus formation and possibly also stroke. With administration of heparin during the ablation, followed by occlusion of the left atrial appendage as a part of the procedure, this risk can be effectively reduced.
Source: The Annals of Thoracic Surgery - August 25, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Managing the Left Atrial Appendage in Atrial Fibrillation: Current State of the Art
Conclusions Excision and exclusion of the left atrial appendage is safe and as effective as medical management of atrial fibrillation for stroke prevention. The choice of treatment should be made based on patients’ anatomy, history, and preference informed by an appropriate left atrial appendage management team.
Source: The Annals of Thoracic Surgery - August 19, 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

Intraoperative Cerebral Perfusion Disturbances During Transcatheter Aortic Valve Replacement
Conclusions Cerebral oximetry reacted promptly to rapid ventricular pacing with significant desaturation and hyperemia a common occurrence. However, no association between this intraoperative insult and objective neurologic injury was detected.
Source: The Annals of Thoracic Surgery - August 16, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Impact of Thoracic Endovascular Aortic Repair on Long-Term Survival in Type B Aortic  Dissection
Conclusions The treatment of uncomplicated aTBAD with optimal medical therapy results in a high incidence of surgical intervention and poor long-term survival. At the index hospitalization, TEVAR may confer a survival advantage and serve as optimal therapy for complicated and uncomplicated aTBAD patients.
Source: The Annals of Thoracic Surgery - August 16, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

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