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Transatrial Cannulation of the Left Ventricle for Acute Type A Aortic Dissection: A 5-Year Experience
Conclusions In patients undergoing surgery for AAD, transatrial cannulation of the left ventricle proved to be a safe and easy cannulation method that significantly reduced postoperative complications.
Source: The Annals of Thoracic Surgery - January 13, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Moderate Versus Deep Hypothermia With Unilateral Selective Antegrade Cerebral Perfusion for Acute Type A Dissection
Conclusions Moderate HCA with uSACP is an effective circulation management strategy that provides excellent cerebral and visceral protection during emergent ATAAD repair. In the setting of antegrade cerebral perfusion, deep hypothermia does not provide any additional benefit.
Source: The Annals of Thoracic Surgery - October 30, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Predicted Risk of Mortality, Transfusion, and Postoperative Outcomes in Isolated Primary Valve Operations
Conclusions Increased PROM yielded higher risks of transfusion. Postoperative outcomes were worse in patients who received a transfusion. This study suggests that the association between transfusion and clinical outcomes may be partly explained by the higher PROM among patients who ultimately received transfusions.
Source: The Annals of Thoracic Surgery - October 17, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Left Subclavian Artery Fenestration: A Novel Treatment Strategy for Acute Type A Aortic Dissection
Conclusions The LSA fenestration technique during total arch replacement combined with stented elephant trunk implantation for acute type A aortic dissection is reliable and effective for patients who have no dissection at the LSA. Furthermore, because the simplified surgical procedure largely shortens the time of operation, it effectively improves the patient’s prognosis.
Source: The Annals of Thoracic Surgery - September 5, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Contemporary Outcomes of Coronary Artery Bypass Grafting Among Patients With Insulin-Treated and Non–Insulin-Treated Diabetes
Conclusions Patients with diabetes undergoing CABG have substantially increased risk of major adverse events. Patients with ITDM represent an especially high-risk group.
Source: The Annals of Thoracic Surgery - August 25, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Effect of Institutional Volume on Complications and Their Impact on Mortality After Pediatric Heart Transplantation
Conclusions No association was observed between institutional volume and adjusted or unadjusted long-term survival. High-volume institutions have a significantly lower rate of postoperative complications after pediatric OHT. This association does not correlate with increased subsequent mortality in low-volume institutions. Given these findings, strategies integral to the allocation of allografts in adult transplantation, such as regionalization of care, may not be as relevant to pediatric OHT.
Source: The Annals of Thoracic Surgery - August 21, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of Open Repair of Mycotic Descending Thoracic and Thoracoabdominal Aortic Aneurysms
Conclusions Open repair of mycotic descending thoracic and thoracoabdominal aortic aneurysms remains the gold standard of therapy. Aggressive intraoperative debridement with in situ prosthetic reconstruction permits a high rate of success in this very high risk cohort of patients. Lifelong antibiotic suppression therapy may prevent late prosthetic graft infection.
Source: The Annals of Thoracic Surgery - August 14, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes for Transcatheter Aortic Valve Replacement in Nonagenarians
Conclusions Extreme-aged nonagenarian patients may have excellent outcomes from TAVR at 30-day and midterm follow-up. Alternative access TAVR is associated with higher morbidity and mortality than transfemoral TAVR. Referral for TAVR of nonagenarians should not be precluded based on age alone.
Source: The Annals of Thoracic Surgery - July 17, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Evolution in the Management of Aberrant Subclavian Arteries and Related Kommerell Diverticulum
Conclusions Aberrant subclavian arteries and associated Kommerell diverticulum can be treated with acceptable rates of mortality and morbidity. The evolution toward an endovascular approach did not appear to affect late outcomes, suggesting that the choice of treatment should be based on patient-specific anatomy and associated comorbidities.
Source: The Annals of Thoracic Surgery - April 23, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Coronary Artery Bypass Grafting After Percutaneous Intervention Has Higher Early Mortality: A Meta-Analysis
Conclusions Patients undergoing CABG after prior percutaneous therapy have a higher incidence of myocardial infarction and mortality in the postoperative period. However, midterm survival is comparable in both cohorts.
Source: The Annals of Thoracic Surgery - April 10, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Off-Pump Coronary Artery Bypass Reduces Early Stroke in Octogenarians: A Meta-Analysis of 18,000 Patients
Conclusions Coronary artery bypass in octogenarians can be performed safely with low early mortality. Although off-pump operations reduce the risk of early stroke, all other adverse events are comparable in on- and off-pump coronary artery bypass operations. Data regarding late mortality is at present limited; however, both on- and off-pump procedures appear to produce comparable survival.
Source: The Annals of Thoracic Surgery - March 17, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Comparison of 30-Day Outcomes of Transfemoral Versus Transapical Approach for Transcatheter Aortic Valve Replacement: A Single-Center US Experience
Conclusions The TA approach has similar early safety outcomes when compared with the TF approach. The TA approach is more procedurally efficient when compared with the TF approach.
Source: The Annals of Thoracic Surgery - March 6, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Propensity Adjusted Analysis of Open and Endovascular Thoracic Aortic Repair for Chronic Type B Dissection: A Twenty-Year Evaluation
Conclusions Intervention for CBAD can be performed with excellent results, either by an open or endovascular approach. The higher rate of treatment failure after TEVAR warrants modification of current device design or endovascular approach before broad application of this treatment strategy.
Source: The Annals of Thoracic Surgery - February 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Autologous Platelet-Rich Plasma Reduces Transfusions During Ascending Aortic Arch Repair: A Prospective, Randomized, Controlled Trial
Conclusions The use of aPRP reduced allogeneic transfusions during ascending and transverse aortic arch repair with deep hypothermic circulatory arrest. This translated to less acute renal failure, decreased length of stay, and lower transfusion costs. Further studies examining the coagulation factors of aPRP are required.
Source: The Annals of Thoracic Surgery - February 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Unilateral Versus Bilateral Cerebral Perfusion for Acute Type A Aortic Dissection
Conclusions As one of the largest single-center studies of the efficacy of u-ACP and b-ACP in patients with type A aortic dissection, operative mortality, stroke, temporary neurologic dysfunction, and renal failure rates were similar in both. In this intrinsically complex disease, survival is the most important outcome; u-ACP may provide cardiac surgeons with valuable technical simplicity during challenging procedures, and b-ACP may be justified for circulatory arrest times of more than 30 minutes.
Source: The Annals of Thoracic Surgery - December 30, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

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