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Long-Term Risk of Ischemic Stroke After the Cox-Maze III Procedure for Atrial Fibrillation
Conclusions This multicenter study showed a low incidence of perioperative and long-term postoperative ischemic stroke/TIA after CM-III. Although general risk of ischemic stroke/TIA was reduced, patients with CHA2DS2-VASc score 2 or greater had a higher risk compared with score 0 or 1. Complete left atrial appendage excision may be an important reason for the low ischemic stroke rate.
Source: The Annals of Thoracic Surgery - July 20, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Stroke After Left Ventricular Assist Device Implantation: Outcomes in the Continuous-Flow Era
Conclusions Stroke while on CF-LVAD support was associated with significant mortality. To reduce the risk of stroke, it is essential to further elucidate risk factors, to optimize anticoagulation, and to further understand the impact of LVAD-related infections.
Source: The Annals of Thoracic Surgery - June 10, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

A More Specific Anticoagulation Regimen Is Required for Patients After the Cox-Maze Procedure
Conclusions Our results indicate that the decision to discontinue OAC after the Cox-Maze procedure should not be based solely on CHADS2 scores; rather, rhythm status, echocardiographic findings, and patient risk for bleeding should be considered. These findings underscore the need for an OAC protocol for patients who have undergone the Cox-Maze procedure with appropriate LAA management.
Source: The Annals of Thoracic Surgery - October 12, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Impact of Specific Preoperative Organ Dysfunction in Patients Undergoing Aortic Valve Replacement ORIGINAL ARTICLES: ADULT CARDIAC
Conclusions The presence of chronic renal failure most profoundly decreases survival, followed by severe chronic obstructive pulmonary disease and prior stroke. Furthermore, multiple OD systems significantly decrease short- and long-term survival.
Source: The Annals of Thoracic Surgery - February 28, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Thourani, V. H., Chowdhury, R., Gunter, R. L., Kilgo, P. D., Chen, E. P., Puskas, J. D., Halkos, M. E., Lattouf, O. M., Cooper, W. A., Guyton, R. A. Tags: Valve disease ORIGINAL ARTICLES: ADULT CARDIAC Source Type: research

Transapical and Transaortic Transcatheter Aortic Valve Replacement in the United States
Conclusions Patients undergoing TAo TAVR are older, more likely female, and have significantly higher STS predicted risk of mortality scores than patients operated on by TA access. There were no risk-adjusted differences between TA and TAo access in mortality, stroke, or readmission rates as long as 1 year after TAVR.
Source: The Annals of Thoracic Surgery - July 30, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

CHADS2 Score Predicts Postoperative Atrial Fibrillation in Patients Undergoing Elective Pulmonary Lobectomy
Conclusions Although multiple risk factors for PAF have been described, no easily applicable clinical model exists. Observed rate of PAF was significantly lower then the previously described 12% when CHADS2 was 0. CHADS2 can predict PAF in patients undergoing elective lobectomy and can identify patients to selectively institute prophylactic measures in patients at the greatest risk, such as patients with score of 2 or greater. Further validation of this model is warranted in a larger group.
Source: The Annals of Thoracic Surgery - April 18, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Risk factors for atrial fibrillation recurrence post Cox-maze IV performed without pre-exclusion
ConclusionsThe Cox maze IV procedure performed without pre-exclusions showed reasonable survival rates. Although AF recurred in patients with longer AFD, they fared well with significant increases in stroke volume. Concomitant atrial volume reduction may have contributed to these additional benefits.
Source: The Annals of Thoracic Surgery - August 28, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Survival and Quality of Life for Nonagenarians After Cardiac Surgery ORIGINAL ARTICLES: ADULT CARDIAC
Conclusions Survival in nonagenarians is comparable after CABG or valve surgery. Redo surgery, stroke, and increasing age are significant hazards for mortality. Nonagenarians can undergo cardiac surgery with acceptable mortality and quality of life.
Source: The Annals of Thoracic Surgery - April 30, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Caceres, M., Cheng, W., De Robertis, M., Mirocha, J. M., Czer, L., Esmailian, F., Khoynezhad, A., Ramzy, D., Kass, R., Trento, A. Tags: Coronary disease, Valve disease ORIGINAL ARTICLES: ADULT CARDIAC Source Type: research

Early and Long-Term Mortality in 536 Patients After the Cox-Maze III Procedure: A National Registry-Based Study ORIGINAL ARTICLES: ADULT CARDIAC
Conclusions Registry-based follow-up showed low early and long-term cardiovascular mortality and no stroke-related mortality. This is important baseline information when evaluating current surgical and nonsurgical treatment of atrial fibrillation.
Source: The Annals of Thoracic Surgery - April 30, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Albage, A., Jideus, L., Stahle, E., Johansson, B., Berglin, E. Tags: Electrophysiology - arrhythmias ORIGINAL ARTICLES: ADULT CARDIAC Source Type: research

Coronary Artery Surgery Versus Percutaneous Coronary Intervention in Octogenarians: Long-Term Results
Conclusions In this real-world setting, surgical coronary revascularization remains the standard of care for patients with left main or multivessel disease. The long-term outcomes of current percutaneous coronary intervention technology in octogenarians are yet to be determined with adequately powered prospective randomized studies.
Source: The Annals of Thoracic Surgery - December 11, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Subclavian Intraaortic Balloon Pump: A Compelling Bridge Device for Advanced Heart Failure
Conclusions The SC-IABP provided excellent hemodynamic support with minimal morbidity and mortality, allowed for extensive rehabilitation, and permitted more than 90% of patients to receive their intended therapy. Therefore, SC-IABP is a compelling bridge device for patients with advanced congestive heart failure.
Source: The Annals of Thoracic Surgery - July 28, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Restrictive Mitral Valve Annuloplasty: Prognostic Implications of Left Ventricular Forward Flow
Conclusions In patients with severe secondary MR treated with surgical repair, LV forward flow was independently associated with better survival and lower risk of the combined endpoint.
Source: The Annals of Thoracic Surgery - October 18, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Continuous-Flow Left Ventricular Assist Device Survival Improves with Multidisciplinary Approach
ConclusionsImplementing a comprehensive multidisciplinary approach substantially improved outcomes for CF-LVAD recipients.
Source: The Annals of Thoracic Surgery - March 8, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Preload Sensitivity in Cardiac Assist Devices REVIEWS
With implantable cardiac assist devices increasingly proving their effectiveness as therapeutic options for end-stage heart failure, it is important for clinicians to understand the unique physiology of device-assisted circulation. Preload sensitivity as it relates to cardiac assist devices is derived from the Frank-Starling relationship between human ventricular filling pressures and ventricular stroke volume. In this review, we stratify the preload sensitivity of 17 implantable cardiac assist devices relative to the native heart and discuss the effect of preload sensitivity on left ventricular volume unloading, levels of...
Source: The Annals of Thoracic Surgery - December 31, 2012 Category: Cardiovascular & Thoracic Surgery Authors: Fukamachi, K., Shiose, A., Massiello, A., Horvath, D. J., Golding, L. A. R., Lee, S., Starling, R. C. Tags: Mechanical Circulatory Assistance REVIEWS Source Type: research

Variation in Warfarin Thromboprophylaxis After Mitral Valve Repair: Does Equipoise Exist and Is a Randomized Trial Warranted? ORIGINAL ARTICLES: ADULT CARDIAC
Conclusions At present, half of patients are prescribed warfarin after isolated mitral valve repair in North American cardiac surgical practice which may impact the length of hospital stay. Although patient-level predictors of warfarin prescription exist, center- and surgeon-level variations are prominent. There is a pressing need for a randomized trial both to guide therapy and to ascertain the potential for resource conservation.
Source: The Annals of Thoracic Surgery - May 29, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Suri, R. M., Thourani, V. H., He, X., Brennan, J. M., O'Brien, S. M., Rankin, J. S., Schaff, H. V., Gammie, J. S. Tags: Valve disease ORIGINAL ARTICLES: ADULT CARDIAC Source Type: research

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