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Novel Formula to calculate 3-D 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 - June 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of Repair of Kommerell’s Diverticulum
ConclusionsOpen and endovascular approaches have a high success rate and low mortality risk. Selection of the specific type of intervention should be based on patient’s anatomy, additional needed procedures, and comorbid conditions.
Source: The Annals of Thoracic Surgery - June 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Preoperative anemia and outcomes in cardiovascular surgery: systematic review and meta-analysis
ConclusionsPreoperative anemia is associated with adverse outcomes following cardiac surgery. These findings support the addition of preoperative anemia to future risk prediction models, and as a target for risk modification.
Source: The Annals of Thoracic Surgery - June 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Steps forward in minimally invasive cardiac surgery: 10-year experience
ConclusionsThe present study shows the considerable and attractive results of our decision making process based on the tailored approach: the 10-year outcome analysis demonstrates a trend toward a progressive decrease in the overall rate of post-operative complications and a significant protective effect of the tailored approach on the occurrence of stroke.
Source: The Annals of Thoracic Surgery - June 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Neurologic Deficit After Aortic Arch Replacement: The Influence of the Aortic Atherosclerosis
ConclusionsAtherothrombotic lesions found by objectively graded computed tomography were predictors of neurologic deficit. Retrograde perfusion in the presence of a distal atherothrombotic lesion should be avoided whenever possible. Strategies based on the full assessment of the whole aortic morphologic characteristics appear to be mandatory. Anticoagulation therapy should be performed carefully to avoid intracranial hemorrhagic changes.Visual Abstract
Source: The Annals of Thoracic Surgery - June 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Reversal and Resumption of Antithrombotic Therapy in LVAD-Associated Intracranial Hemorrhage
ConclusionsReversal of anticoagulation appears safe after LVAD-associated intracranial hemorrhage, though inadequate reversal was common. Resumption of warfarin ± antiplatelet was associated with fewer fatal and nonfatal thrombotic events compared with antiplatelets alone, though more nonfatal hemorrhage events occurred.
Source: The Annals of Thoracic Surgery - June 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Characterizing Risks Associated with Mitral Annular Calcification in Mitral Valve Replacement
ConclusionsThe presence of MAC alone, regardless of severity, was independently associated with increased operative mortality and adverse postoperative outcomes. Even after adjusting for attendant cardiovascular and metabolic comorbidities, centers with low MV case volumes were found to have worse outcomes after MVR.Graphical abstract
Source: The Annals of Thoracic Surgery - June 15, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Model for End-Stage Liver Disease Score Independently Predicts Mortality in Cardiac Surgery
ConclusionsIncreasing MELD score, international normalized ratio, and bilirubin all independently increase risk of operative mortality. Because high rates of missing data currently limit utilization of MELD, efforts to simplify and improve data collection would help improve future risk models.
Source: The Annals of Thoracic Surgery - May 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Neurologic Outcomes in Aortic Arch Repair With Frozen Elephant Trunk Versus 2-Stage Hybrid Repair
ConclusionsBoth single-stage and 2-stage hybrid arch replacements are effective approaches for treating complex aortic arch diseases. Early deaths and neurological outcomes in the single-stage group are comparable to those in the combined 2-stage group. Furthermore, in this series, patients who had a single-stage hybrid procedure had a higher survival rate at 2 years.
Source: The Annals of Thoracic Surgery - May 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early Outcomes after Thoracoabdominal Aortic Aneurysm Repair with Hypothermic Circulatory Arrest
ConclusionsOur extended experience with this technique confirms its safety and effectiveness when used on a routine basis. The rates of spinal cord injury and permanent renal failure are among the lowest reported in the literature. Particularly favorable outcomes were observed in younger patients and those undergoing elective operations.
Source: The Annals of Thoracic Surgery - May 12, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-term outcomes with mechanical versus biological aortic valve prosthesis in patients >70 years
ConclusionsMechanical aortic valve prosthesis is associated with worse long-term survival and increased bleeding after SAVR in patients aged>70 years. Our results suggest caution when considering mechanical aortic valve prostheses in elderly patients.
Source: The Annals of Thoracic Surgery - May 12, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Preliminary results of debranch-first technique in Frozen Elephant Trunk procedures
ConclusionsFET with debranch-first technique is safe and feasible and resulted in low mortality and morbidity rates. Further investigation is needed to compare it with standard techniques.
Source: The Annals of Thoracic Surgery - May 11, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Impact of Preoperative Clopidogrel on Outcomes Following Coronary Artery Bypass Grafting
ConclusionsCABG can be safely performed in patients with recent Clopidogrel exposure with no increased risk of early or late mortality. However, CABG should be delayed for at least 5 days if clinically feasible to minimize transfusions and reoperation risk. In patients with more urgent indications, delaying CABG at least 3 days can mitigate but not eliminate the increased bleeding risk.
Source: The Annals of Thoracic Surgery - April 28, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Complications on Resource Utilization During 90-Day Coronary Artery Bypass Graft Bundle for Medicare Beneficiaries
ConclusionsMedicare beneficiaries who have adverse events during their index CABG hospitalization will significantly affect that hospital’s financial risk. The challenge under the voluntary CABG bundled payment program will be to monitor and reduce adverse events and manage the services consumed by Medicare beneficiaries having adverse events delivered at all the venues of care.
Source: The Annals of Thoracic Surgery - April 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Open Descending and Thoracoabdominal Aortic Repairs in Patients Younger than 50 Years Old
ConclusionsPatients under 50 years old with D/TAAA have low surgical risks and open repairs can be performed with excellent short-term and durable long-term results. Open surgical repairs should be considered initially in younger patients requiring D/TAAA repairs. HTAD warrants closer postoperative surveillance.
Source: The Annals of Thoracic Surgery - April 19, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

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