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Preoperative Venoarterial Extracorporeal Membrane Oxygenation Slashes Risk Score in Advanced Structural Heart Disease
ConclusionsECMO can be used as a bridge to heart valve or septal defect surgery in severely decompensated patients. Through recovery of end-organ function, ECMO may allow surgical correction of structural heart disease in patients considered inoperable or convert a salvage situation to an elective operation.
Source: The Annals of Thoracic Surgery - September 18, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Determinants of Reverse Remodeling of the Left Atrium After Transaortic Myectomy
ConclusionsLeft atrial volume decreases significantly after surgical relief of left ventricular outflow tract obstruction. Early changes likely reflect lower LA pressure due to gradient relief and abolishment of mitral regurgitation, and late reduction suggests continued reverse remodeling.
Source: The Annals of Thoracic Surgery - July 23, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Determinants of Reverse Remodeling of the Left Atrium Following Transaortic Myectomy
Conclusions Left atrial volume decreases significantly following surgical relief of left ventricular outflow tract obstruction. Early changes likely reflect lower LA pressure due to gradient relief and abolishment of mitral regurgitation, and late reduction suggests continued reverse remodeling.
Source: The Annals of Thoracic Surgery - April 20, 2018 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

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

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

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

Outcomes on Continuous Flow Left Ventricular Assist Devices: A Single Institutional 9-Year Experience
Conclusions These data indicate excellent survival for BTT and DT patients on long-term LVAD support. However, for LVAD therapy to become a plausible alternative to heart transplantation, we need to further decrease the incidence of postoperative complications.
Source: The Annals of Thoracic Surgery - May 9, 2016 Category: Cardiovascular & Thoracic Surgery 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

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

Impact of Ultrafiltration on Kidney Injury After Cardiac Surgery: The Michigan Experience
Conclusions Patients exposed to CUF had a higher adjusted risk of AKI. Clinical teams should consider lower volumes of CUF among patients with low creatinine clearance to minimize the risk of AKI.
Source: The Annals of Thoracic Surgery - July 22, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hemiarch and Total Arch Surgery in Patients With Previous Repair of Acute Type I Aortic Dissection
Conclusions In patients with previous acute type I aortic dissection repair, hemiarch and total arch operations have respectable morbidity and survival rates. Congestive heart failure predicts operative death, long-term mortality, and our adverse event endpoint. Cardiopulmonary bypass time predicts operative mortality, and female sex and circulatory arrest time predict long-term mortality.
Source: The Annals of Thoracic Surgery - June 23, 2015 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

Postoperative Atrial Fibrillation After Thoracic Aortic Surgery
Conclusions Several risk factors contribute to the incidence of POAF after thoracic aortic surgery. We found that POAF significantly increased 30-day operative mortality (p < 0.0001). Our findings can be used to develop a risk stratification system for the prediction of POAF.
Source: The Annals of Thoracic Surgery - December 30, 2014 Category: Cardiovascular & Thoracic Surgery 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

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