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Feasibility and Outcomes of Transcatheter Aortic Valve Implantation Using the Left Axillary Artery as Primary Access Site
ConclusionsThis is the first study reporting outcome after transcatheter aortic valve implantation using the LAA as default access. We conclude that it is highly feasible and safe with low rates of major vascular complications, bleeding, and stroke.Visual Abstract
Source: The Annals of Thoracic Surgery - January 26, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Society of Thoracic Surgeons Intermacs Database Annual Report: Evolving Indications, Outcomes, and Scientific Partnerships
ConclusionsWith the evolution of MCS, patient phenotype and outcomes are also changing over time. CF LVAD support is increasingly being used in the less ill patient phenotype and more patients are supported for destination therapy. Mean survival is now approaching 5 years, but adverse events, especially neurologic events, continue to have a detrimental impact on the success of CF LVAD support.
Source: The Annals of Thoracic Surgery - January 26, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

A Novel Toroidal-Flow Left Ventricular Assist Device Minimizes Blood Trauma: Implications of Improved Ventricular Assist Device Hemocompatibility
ConclusionsThe TORVAD design, with markedly lower shear stress and pulsatile flow, caused significantly less blood trauma that the HeartMate II. LVADs with reduced blood trauma are likely to improve clinical outcomes and expand LVAD therapy into patients with less advanced heart failure.
Source: The Annals of Thoracic Surgery - December 24, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Antithrombotic Strategies after Bioprosthetic Aortic Valve Replacement: A Systematic Review
ConclusionsTreatment with warfarin or aspirin both lead to similar outcomes after surgical bAVR. Combining aspirin with warfarin may lead to a small decrease in thromboembolism and mortality but is accompanied by increased bleeding. For TAVR patients, aspirin is equivalent to DAPT for reducing thromboembolism and mortality, with a possible decrease in bleeding.
Source: The Annals of Thoracic Surgery - November 18, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Prothrombin complex concentrate in cardiac surgery: A systematic review and meta-analysis
ConclusionsIn patients with significant bleeding following cardiac surgery, PCC administration seems to be more effective than FFP in reducing perioperative blood transfusions. No additional risks of thromboembolic events or other adverse reactions were observed. Randomized controlled trials are needed to definitively establish the safety of PCC in cardiac surgery.
Source: The Annals of Thoracic Surgery - November 18, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Complete sternal-sparing HeartMate 3 implantation: a case series of ten consecutive patients
ConclusionsOur early outcomes suggest that the CSS approach may reduce the incidence of right ventricular failure, bleeding, intubation time and ICU length of stay. Further studies are needed to fully elucidate the advantages of CSS LVAD implantation compared with median sternotomy.
Source: The Annals of Thoracic Surgery - November 14, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Factors Associated with Prolonged Survival in Left Ventricular Assist Device Recipients
ConclusionsPreoperative diabetes and amiodarone use were associated with poor long-term survival in LVAD recipients. Development of early complications of stroke, gastrointestinal bleeding, hemolysis, or pump thrombosis was also associated with poor long-term survival. Early diagnosis and treatment of these complications may improve survival in LVAD recipients.
Source: The Annals of Thoracic Surgery - October 12, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Feasibility and Outcomes of TAVI using the Left Axillary Artery as Primary Access Site
ConclusionsThis is the first study reporting on outcome after TAVI using the LAA as default access. We conclude that it is highly feasible and safe with low rates of major vascular complications, bleeding and stroke.
Source: The Annals of Thoracic Surgery - October 5, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Aged 50 Years and Younger
ConclusionsThe increased risk of reoperation for bAVR and major bleeding incidents for mAVR was not reflected in midterm and long-term survival differences between the two groups. Our results suggest that bAVR may be an acceptable prosthesis choice for some patients aged 50 years and younger, although the results should be taken with caution.Visual Abstract
Source: The Annals of Thoracic Surgery - September 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Valvectomy Versus Replacement for the Surgical Treatment of Tricuspid Endocarditis
ConclusionsTricuspid valve endocarditis patients who undergo tricuspid valve excision, repair, and replacement have similar 30-day operative mortality, as defined by The Society of Thoracic Surgeons. Excision patients have significantly lower unplanned readmission rates at 1 year. Tricuspid valvectomy is an acceptable initial treatment in this high-risk group as part of a surgical strategy to identify patients who are candidates for eventual valve replacement. Further study of long-term outcomes and survival is warranted.
Source: The Annals of Thoracic Surgery - August 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

A Systemic Review and Meta-Analysis of Sutureless Aortic Valve Replacement Versus Transcatheter Aortic Valve Implantation
ConclusionsOur meta-analysis of observational studies demonstrates that early mortality is lower after SU-AVR than after TAVI in selected patients. The rates of stroke and pacemaker implant are comparable between procedures; however, the incidence of paravalvular leak is higher after TAVI.
Source: The Annals of Thoracic Surgery - August 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Fate of the Aortic Arch Following Surgery on the Aortic Root and Ascending Aorta in Bicuspid Aortic Valve
ConclusionsProphylactic arch replacement during aortic root and ascending aortic surgery in patients with bicuspid aortic valve is not supported. Our data do not support long-term surveillance of the rest of the aorta in this population.
Source: The Annals of Thoracic Surgery - August 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Frailty on Outcomes in Acute Type A Aortic Dissection
ConclusionsFrailty, as defined using a 7-component frailty index, can serve as an independent predictor of the risk of late mortality in patients undergoing an ATAAD. Such frailty markers, all of which are easily assessed preoperatively, may provide valuable information for patient counseling and risk stratification before aortic surgery.
Source: The Annals of Thoracic Surgery - August 4, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Coronary Revascularization With Single Versus Bilateral Mammary Arteries: Is It Time to Change?
ConclusionsIn a large regional experience, BIMA is associated with no upfront risk of adverse events and improved long-term survival compared with SIMA. Our results indicate that BIMA conduits should be considered more frequently during coronary artery bypass grafting due to their demonstrated survival advantage.
Source: The Annals of Thoracic Surgery - July 23, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Valvectomy versus Replacement for the Surgical Treatment of Tricuspid Endocarditis
Conclusions Tricuspid valve excision, repair, and replacement have similar 30-day operative mortality, as defined by the STS, in TV endocarditis patients and significantly lower unplanned readmission rates at one year in the excision patients. Tricuspid valvectomy is an acceptable initial treatment in this high-risk group as part of a surgical strategy to identify patients who are candidates for eventual valve replacement. Further study of long term outcomes and survival is warranted.
Source: The Annals of Thoracic Surgery - May 17, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

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