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Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement for Severe Aortic Stenosis in Patients With Chronic Kidney Disease Stages 3b to 5
Conclusions CKD stages 3b to 5 increases the risk of mortality after TAVI and SAVR. In this subset of patients, SAVR was associated with somewhat better early and late survival. The risk of acute kidney injury was higher after SAVR. These findings suggest that CKD stages 3b to 5 does not contraindicate SAVR. Strategies to prevent severe acute kidney injury should be implemented with either SAVR or TAVI.
Source: The Annals of Thoracic Surgery - July 19, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Right Minithoracotomy for Mitral Valve Surgery: Impact of Tailored Strategies on Early Outcome
Conclusions Right minithoracotomy MVS can routinely be performed with favorable outcomes in all comers when perfusion strategies and clamping techniques are carefully selected after proper evaluation of the patient’s preoperative characteristics.
Source: The Annals of Thoracic Surgery - July 17, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Scimitar Syndrome Repair in Adults: Intermediate-Term Results Using an Extracardiac Conduit
Conclusions Correction of scimitar syndrome with an extracardiac conduit can be easily and safely performed in adults, with excellent intermediate-term durability, without graft thrombi or stenosis. This technique avoids deep hypothermic circulatory arrest when the SV is short or enters the IVC in an unusually caudad location.
Source: The Annals of Thoracic Surgery - July 15, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Minimally Invasive Mitral Valve Surgery Provides Excellent Outcomes Without Increased Cost: A Multi-Institutional Analysis
Conclusions Compared with conventional sternotomy, mini-MVR in the “real world” demonstrated no differences in rates of major morbidity, but it was associated with shorter length of stay and fewer transfusions. Contrary to our hypothesis, mini-MVR can be performed with similar total hospital costs as conventional sternotomy. In summary, minimally invasive mitral surgical procedure in select patients can provide superior outcomes without increased cost.
Source: The Annals of Thoracic Surgery - June 27, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Reexploration for Bleeding and Its Association With Mortality After Cardiac Surgery
Conclusions Excessive bleeding leading to reexploration is associated with a twofold increased early postoperative mortality rate. Reexploration for bleeding is also associated with mortality beyond 90 days after operation.
Source: The Annals of Thoracic Surgery - June 27, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic Valve Replacement in the Moderately Elevated Risk Patient: A Population-Based Analysis of Outcomes
Conclusions This population-based contemporary assessment suggests moderate-risk patients undergoing AVR experience favorable outcomes. Although increasing PROM is important in preoperative evaluation of risk, preexisting pulmonary hypertension and indication for operation are among other factors that should be considered as TAVR expands into this group of patients.
Source: The Annals of Thoracic Surgery - June 17, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Branched Endovascular Therapy of the Distal Aortic Arch: Preliminary Results of the Feasibility Multicenter Trial of the Gore Thoracic Branch Endoprosthesis
Conclusions Total endovascular repair of distal zone 2 arch aortic aneurysms can be achieved with a novel branched arch endograft. Future studies will evaluate the feasibility of this approach for aneurysms encompassing the brachiocephalic trunk and left carotid artery.
Source: The Annals of Thoracic Surgery - June 2, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Propensity Matched Analysis of del Nido Cardioplegia in Adult Coronary Artery Bypass Grafting: Initial Experience With 100 Consecutive Patients
Conclusions In our initial experience, DC provided equivalent myocardial protection and clinical outcomes to BC in adult isolated CABG patients. DC was associated with lower cardiopulmonary bypass glucose levels than BC and demonstrated the feasibility of single-dose administration for routine coronary operations.
Source: The Annals of Thoracic Surgery - May 19, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Posterior Circulation Ischemia or Occlusion in Five Adults With Failing Fontan Circulation
Conclusions In adults with failing Fontan circulation there is a potential for neurologic complications as a result of venous congestion with elevated central venous pressures, and aberrant posterior circulation. The patient’s history and brain imaging may be used to identify at-risk patients and to tailor perioperative management during Fontan conversion or heart transplantation to mitigate the risk for brainstem ischemia.
Source: The Annals of Thoracic Surgery - May 19, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Transapical Transcatheter Valve-in-Valve Implantation for Failed Mitral Bioprostheses: Gradient, Symptoms, and Functional Status in 18 High-Risk Patients Up to 5 Years
Conclusions Mitral valve-in-valve implantation allows good clinical and hemodynamic results. In our series, the appearance of a significant gradient at follow-up was not associated with echocardiographic signs of structural deterioration, and was possibly related to the size of the transcatheter and recipient valve.
Source: The Annals of Thoracic Surgery - May 18, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Does a Higher Society of Thoracic Surgeons Score Predict Outcomes in Transfemoral and Alternative Access Transcatheter Aortic Valve Replacement?
Conclusions As expected, non-TF patients were at a higher risk than TF patients for procedural morbidity and death. Although no differences were observed in 30-day deaths or morbidity in different STS PROM subgroups, those undergoing non-TF TAVR at a higher STS PROM (>8%) had higher 1-year mortality. When applicable, TF TAVR remains the procedure of choice in high- or extreme-risk patients undergoing TAVR.
Source: The Annals of Thoracic Surgery - May 18, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Resection of Intraabdominal Tumors With Cavoatrial Extension Using Deep Hypothermic Circulatory Arrest
Conclusions Intraabdominal malignancies with cavoatrial extension can be safely resected. Excellent local tumor control can be anticipated. Long-term surveillance is necessary to detect recurrence.
Source: The Annals of Thoracic Surgery - May 9, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes on Continuous Flow Left Ventricular Assist Devices: A Single Institutional 9-Year Experience
Conclusions These data indicate excellent survival for BTT and DT patients on long-term LVAD support. However, for LVAD therapy to become a plausible alternative to heart transplantation, we need to further decrease the incidence of postoperative complications.
Source: The Annals of Thoracic Surgery - May 9, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Midterm Impact of Transcatheter Aortic Valve Replacement on Surgical Aortic Valve Replacement in Michigan
Conclusions TAVR implementation in Michigan has dramatically increased overall SAVR volume. This phenomenon has occurred with a concomitant decrease in preoperative risk profile and has improved early SAVR outcomes, particularly at TAVR hospitals, but surprisingly not in patients considered at high preoperative risk. As TAVR use increases, these issues may be further clarified and elucidated.
Source: The Annals of Thoracic Surgery - May 3, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Validation of the European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) Bleeding Severity Definition
Conclusions The E-CABG bleeding severity classification seems to be a valuable tool in the assessment of the severity and prognostic effect of perioperative bleeding in cardiac operations.
Source: The Annals of Thoracic Surgery - April 19, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

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