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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

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

One-Year Outcomes of Transcatheter Aortic  Valve Replacement in Patients With End-Stage Renal Disease
Conclusions Early mortality in patients with ESRD is comparable to previously published data on extreme-risk patients without ESRD, but our data suggest a higher mortality rate at 1 year for ESRD patients, likely due to comorbid conditions. Stroke and major vascular injury are infrequent, and improved valve hemodynamics are maintained at 1 year.
Source: The Annals of Thoracic Surgery - April 18, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Deep Hypothermia + Retrograde Cerebral Perfusion vs. Moderate Hypothermia + Antegrade Cerebral Perfusion for Arch Surgery
ConclusionsAlthough there was no significant difference in clinically evident neurologic injury, this pilot study suggests that MHCA+ACP may be associated with a higher incidence of radiographic neurologic injury than DHCA+RCP in patients undergoing elective hemiarch replacement.
Source: The Annals of Thoracic Surgery - November 16, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Deep Hypothermia With Retrograde Cerebral Perfusion Versus Moderate Hypothermia With Antegrade Cerebral Perfusion for Arch Surgery
ConclusionsAlthough there was no significant difference in clinically evident neurologic injury, this pilot study suggests that MHCA+ACP may be associated with a higher incidence of radiographic neurologic injury than DHCA+RCP in patients undergoing elective hemiarch replacement.
Source: The Annals of Thoracic Surgery - March 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Late Neurologic Events After Surgery for Atrial Fibrillation: Rare but Relevant ORIGINAL ARTICLES: ADULT CARDIAC
Conclusions After surgery for AF ablation, there is ongoing low risk of LNE even when the LAA is surgically excised. Further investigation should be pursued to clarify whether a difference exists with alternative elimination techniques and in patients in whom AF is successfully eliminated.
Source: The Annals of Thoracic Surgery - December 31, 2012 Category: Cardiovascular & Thoracic Surgery Authors: Lee, R., Jivan, A., Kruse, J., McGee, E. C., Malaisrie, S. C., Bernstein, R., Lapin, B., Passman, R., Knight, B. P., McCarthy, P. M. Tags: Electrophysiology - arrhythmias ORIGINAL ARTICLES: ADULT CARDIAC 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

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

Impact of Atrial Fibrillation Duration on the Success of First-Time Concomitant Cox Maze Procedures
Conclusions Longer AF duration significantly impacted CM success and may result from extensive tissue remodeling. Patients with longer AF duration can expect reasonable success rates, especially when on AAD, and low stroke rates during follow-up. Cryoablation may reduce AF duration impact on success compared with combined bipolar radiofrequency and cryothermia.
Source: The Annals of Thoracic Surgery - July 27, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-Term Follow-Up of Cardiac Rhythm in 320 Patients After the Cox-Maze III Procedure for Atrial Fibrillation
Conclusions In a single-moment electrocardiogram evaluation 9 years after the cut-and-sew CM-III, 82% of patients were in sinus rhythm or other regular supraventricular rhythm. These findings support a long-lasting positive effect of the CM-III procedure, which is relevant when evaluating current nonpharmacologic therapies for AF.
Source: The Annals of Thoracic Surgery - December 2, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Posterior Circulation Ischemia or Occlusion in Five Adults With Failing Fontan Circulation
Conclusions In adults with failing Fontan circulation there is a potential for neurologic complications as a result of venous congestion with elevated central venous pressures, and aberrant posterior circulation. The patient’s history and brain imaging may be used to identify at-risk patients and to tailor perioperative management during Fontan conversion or heart transplantation to mitigate the risk for brainstem ischemia.
Source: The Annals of Thoracic Surgery - May 19, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Bicuspid Aortic Insufficiency With Aortic Root Aneurysm: Root Reimplantation Versus Bentall Root Replacement
Conclusions In patients with bicuspid aortic valve AI with root aneurysm, primary cusp repair with root reimplantation achieves equivalent midterm outcomes compared with Bentall root replacement.
Source: The Annals of Thoracic Surgery - September 18, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Reversal and Resumption of Antithrombotic Therapy in LVAD- Associated Intracranial Hemorrhage
ConclusionsReversal of anticoagulation appears safe following LVAD-associated intracranial hemorrhage, though inadequate reversal was common. Resumption of warfarin±antiplatelet was associated with fewer fatal and non-fatal thrombotic events compared to antiplatelets alone, though more non-fatal hemorrhage events occurred.
Source: The Annals of Thoracic Surgery - February 12, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-term outcomes with mechanical versus biological aortic valve prosthesis in patients >70 years
ConclusionsMechanical aortic valve prosthesis is associated with worse long-term survival and increased bleeding after SAVR in patients aged>70 years. Our results suggest caution when considering mechanical aortic valve prostheses in elderly patients.
Source: The Annals of Thoracic Surgery - May 12, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Reversal and Resumption of Antithrombotic Therapy in LVAD-Associated Intracranial Hemorrhage
ConclusionsReversal of anticoagulation appears safe after LVAD-associated intracranial hemorrhage, though inadequate reversal was common. Resumption of warfarin ± antiplatelet was associated with fewer fatal and nonfatal thrombotic events compared with antiplatelets alone, though more nonfatal hemorrhage events occurred.
Source: The Annals of Thoracic Surgery - June 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

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