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Postoperative Hypoglycemia Is Associated With Worse Outcomes After Cardiac Operations
Conclusions Postoperative hypoglycemia is associated with both mortality and major morbidity after cardiac operations. The combination of both hyperglycemia and hypoglycemia represents a substantial increase in risk. Although it remains unclear whether hypoglycemia is a cause, an early warning sign, or a result of adverse events, this study suggests that hypoglycemia may be an important event in the postoperative period after cardiac operations.
Source: The Annals of Thoracic Surgery - January 18, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of a Less-Invasive Approach for Proximal Aortic Operations
Conclusions A J incision is a feasible technique for primary isolated elective proximal aortic operations, with a low risk of complications similar to those of full sternotomy, but with the advantages of shorter intensive care unit and hospital stays, lower costs, and better cosmesis.
Source: The Annals of Thoracic Surgery - January 18, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Predictors of Atrial Fibrillation After Coronary Artery Bypass Grafting: A  Bayesian Analysis
Conclusions This prospective Bayesian analysis identified five independent preoperative predictors of POAF after isolated CABG with cardiopulmonary bypass: CHA2DS2-VASc score, severe obesity, preoperative β-blocker use, preoperative antiplatelet therapy, and renal failure. The main interest in the CHA2DS2-VASc score as a predictor of POAF is that it is a simple and widely used bedside tool. Patients with these independent predictors of POAF may constitute a target population to test preventive strategies, such as non-antiarrhythmic and antiarrhythmic drugs.
Source: The Annals of Thoracic Surgery - December 18, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Clinical Outcomes of the David V Valve-Sparing Root Replacement Compared With Bioprosthetic Valve-Conduits for Aortic Root Aneurysms
Conclusions VSRR and BIO result in equivalent operative mortality and morbidity with similar midterm survival and valve durability. VSRR is an effective alternative to BIO for aortic root pathologic conditions; however, careful patient selection is paramount.
Source: The Annals of Thoracic Surgery - December 10, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Society of Thoracic Surgeons Mitral Valve Repair/Replacement Plus Coronary Artery Bypass Grafting Composite Score: A Report of The Society of Thoracic Surgeons Quality Measurement Task Force
Conclusions An STS composite performance measure was developed for MVRR + CABG operations. This measure may be useful for outcome assessment, quality improvement, patient counseling, clinical research, and public reporting.
Source: The Annals of Thoracic Surgery - December 6, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Open Repair of Thoracoabdominal Aortic Aneurysm in Patients 50 Years Old and  Younger
Conclusions Early outcomes of open TAAA repair were excellent for patients 50 years old or younger, despite the fact that these patients typically required extensive repairs.
Source: The Annals of Thoracic Surgery - December 6, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of Dialysis-Dependent Patients After Cardiac Operations in a Single-Center Experience of 483 Patients
Conclusions Patients with DD CRF undergoing cardiac operations have high perioperative and medium-term mortality, particularly in the presence of combined aortic and mitral valve pathologic conditions, active endocarditis, and poor left ventricular function.
Source: The Annals of Thoracic Surgery - December 6, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Anterior Leaflet Augmentation With CorMatrix Porcine Extracellular Matrix in Twenty-Five Patients: Unexpected Patch Failures and Histologic Analysis
Conclusions For type III MR, a large anterior leaflet patch technique with porcine ECM was associated with a 32% recurrence rate of severe MR related directly to patch failure. Further research and development should be performed on the use of ECM materials with a goal to decrease the failure rate experienced in this study.
Source: The Annals of Thoracic Surgery - September 8, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Failure to Rescue Rates After Coronary Artery Bypass Grafting: An Analysis From The Society of Thoracic Surgeons Adult Cardiac Surgery Database
Conclusions CABG mortality rates vary directly with FTR, but complication rates have little relation to death. FTR rates derived from The Society of Thoracic Surgeons data can serve as national benchmarks. Predicted FTR rates may facilitate patient counseling, and FTR O/E ratios have promise as valuable quality metrics.
Source: The Annals of Thoracic Surgery - July 19, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

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

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

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

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

Outcomes After Elective Proximal Aortic Replacement: A Matched Comparison of Isolated Versus Multicomponent Operations
Conclusions Elective ascending aortic replacement is safe and effective. Ascending aneurysms should be treated aggressively even when encountered in patients undergoing a multicomponent operation. An aggressive approach to replacement of the ascending aorta may be warranted given the increased risk of stroke during a subsequent reoperation.
Source: The Annals of Thoracic Surgery - March 7, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Results of Open Surgical Repair in Patients With Marfan Syndrome and Distal Aortic Dissection
Conclusions In these patients with MFS with aortic dissection, open TAAA repair incurred reasonable operative risk, but improvements are needed to reduce rates of renal failure. Extent II TAAA repair does not appear to increase operative risk in patients with MFS.
Source: The Annals of Thoracic Surgery - February 12, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

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