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Five Year Outcomes from the US Pivotal Trial of Valiant Captivia Stent Graft for Blunt Aortic Injury
ConclusionsThis multicenter clinical trial describes excellent 5-year outcomes and durable exclusion of blunt thoracic aortic injury using a novel stent graft system. TEVAR with this endograft appears to be a safe and effective treatment option for patients with BTAI.
Source: The Annals of Thoracic Surgery - January 26, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Valve-Sparing Root Replacement vs Composite Valve Grafting in Aortic Root Dilation: A Meta-Analysis
ConclusionsAortic valve sparing appears to be safe, and associated with reduced late mortality, thromboembolism/stroke and bleeding compared with composite valve grafting. Late durability is equivalent. Aortic valve sparing should be considered in patients with favorable aortic valve morphology.Graphical abstract
Source: The Annals of Thoracic Surgery - January 23, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Dissection of Arch Branches Alone: An Indication for Aggressive Arch Management in Type A Dissection?
ConclusionsIn acute type A aortic dissection, 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.Visual Abstract
Source: The Annals of Thoracic Surgery - January 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Cerebral Perfusion on Outcomes of Aortic Surgery: The Society of Thoracic Surgeons Adult Cardiac Surgery Database Analysis
ConclusionsFor patients without aortic dissection and who require more than 30 minutes of circulatory arrest, optimal cerebral protection strategies are deep hypothermia with either antegrade or retrograde cerebral perfusion and moderate hypothermia with antegrade cerebral perfusion.
Source: The Annals of Thoracic Surgery - January 21, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-term Outcomes of Mosaic Versus Perimount Mitral Replacements: 17-year Follow-up of 940 Implants
ConclusionsIn long-term follow-up, of patients younger than 65 years of age undergoing mitral valve replacement, bovine pericardial valves experienced earlier and more frequent structural valve deterioration than porcine valves.Graphical abstract
Source: The Annals of Thoracic Surgery - December 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Mitigating the Risk: Transfusion or Reoperation for Bleeding After Cardiac Surgery
ConclusionsWhile reoperation for bleeding is associated with morbidity after cardiac surgery, substantial transfusion without reoperation appears to increase morbidity compared to a limited-transfusion reoperative approach. Better timing for reoperation and guided transfusion approaches may mitigate morbidity compared to substantial transfusion alone.
Source: The Annals of Thoracic Surgery - December 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Degenerative Mitral Valve Repair Simplified: An Evolution to Universal Artificial Cordal Repair
ConclusionsArtificial cordal repair for all patients with degenerative MR simplifies MV repair and yields equivalent, excellent outcomes compared to a tailored resectional approach.
Source: The Annals of Thoracic Surgery - December 19, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Fatal stroke after reoperation for lobar torsion
We report a case of an upper lobe torsion occurring at postoperative day one after a full thoracoscopic combined middle lobectomy and S6 segmentectomy. Lung detorsion resulted in a fatal cerebral infarction.
Source: The Annals of Thoracic Surgery - December 19, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Does the aortic annulus dilate following aortic root remodelling?
ConclusionsThere was no significant aortic annular dilatation in selected patients undergoing remodelling VSRR. Our data does not support routine use of annuloplasty in patients with annular diameter ≤25mm.
Source: The Annals of Thoracic Surgery - December 16, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Novel Formula to Calculate Three-Dimensional 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 - December 14, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Comparative Outcomes of Transcarotid and Transsubclavian Transcatheter Aortic Valve Replacement
ConclusionsThe transcarotid and the transsubclavian approaches have similar safety and efficacy outcomes. The transcarotid approach had a shorter procedure duration and a trend toward lower fluoroscopy duration and radiation exposure.
Source: The Annals of Thoracic Surgery - December 14, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Complications After Cardiac Operation on One-Year Patient-Reported Outcomes
ConclusionsAlthough cardiac surgical patients have PROs scores similar to the general population, complications after cardiac operation continue to negatively influence patient quality of life 1 year after surgery. Use of NIH-PROMIS shows that prolonged ventilation and renal failure have the largest impact on 1-year patient-reported outcomes.
Source: The Annals of Thoracic Surgery - December 14, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-term Outcomes of Stand-Alone Maze IV for Persistent or Long-standing Persistent Atrial Fibrillation
ConclusionsThis study confirmed the safety and efficacy in the long term (7 years) of the stand-alone Cox-Maze IV surgical procedure for persistent or long-standing persistent AF. Indeed, more than 70% of the patients were in sinus rhythm off class I or III AADs and off oral anticoagulation.Visual Abstract
Source: The Annals of Thoracic Surgery - December 14, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Cardiac Transplantation Using Hearts with Transient Dysfunction: Role of Takotsubo Like Phenotype Running Head: Takotsubo Like Syndrome in Donor Hearts
ConclusionsIn the largest analysis of transplanted donor hearts with transient LVSD, 1 in 4 had RWMAs on the initial TTE; but this was not associated with adverse post-transplant outcomes. Donor hearts with initial LVSD should be pursued irrespective of TTS-like hypokinesis or other RWMAs.Graphical abstract
Source: The Annals of Thoracic Surgery - December 7, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Thrombocytopenia After Cardiopulmonary Bypass is Associated with Increased Morbidity and Mortality
ConclusionsPost-operative thrombocytopenia is independently associated with post-operative mortality, AKI, infection, stroke, and prolonged ICU and hospital LOS. Serial platelet monitoring may help identify patients at higher risk of post-operative complications. Further studies investigating strategies to reduce post-operative thrombocytopenia, including reducing CPB time, are needed.
Source: The Annals of Thoracic Surgery - December 7, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

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