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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

The Standardized Concept of Moderate-to-Mild ( ≥28°C) Systemic Hypothermia During Selective Antegrade Cerebral Perfusion for All-Comers in Aortic Arch Surgery: Single-Center Experience in 587 Consecutive Patients Over a 15-Year Period
Conclusions Current data suggest that selective ACP in combination with moderate-to-mild systemic hypothermia offers sufficient neurologic and visceral organ protection to all-comers requiring aortic arch surgery without pathological or procedural limitations.
Source: The Annals of Thoracic Surgery - June 17, 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

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

The Carotid Artery As a Preferred Alternative Access Route For Transcatheter Aortic Valve Replacement
Conclusions In our US community hospital setting, TC-TAVR is a safe alternative to TF-TAVR in appropriate patients and has evolved to be our alternative access route of choice if TF access is not feasible.
Source: The Annals of Thoracic Surgery - March 6, 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

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

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

Moderate Ischemic Mitral Regurgitation After Posterolateral Myocardial Infarction in Sheep Alters Left Ventricular Shear but Not Normal Strain in the Infarct and Infarct Borderzone
Conclusions Moderate CIMR alters radial circumferential shear strain after posterolateral MI in sheep. Further studies are needed to determine the effect of shear strain on myocyte hypertrophy and the effect of mitral repair on myocardial strain.
Source: The Annals of Thoracic Surgery - February 8, 2016 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

Myocardial Protection During Aortic Arch Repair in a Piglet Model: Beating Heart Technique Compared With Crystalloid Cardioplegia
Conclusions The BH technique is associated with improved contractility compared with standard CC. There is comparable ischemic damage in both groups, with an earlier rise in blood levels of troponin T after BH and more fluctuation of serum electrolytes with CC. Evidence of ischemic changes should dissuade one from using the BH technique imprudently.
Source: The Annals of Thoracic Surgery - August 30, 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

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 Outcomes of the Maze Procedure Combined With Mitral Valve Repair: Risk of Thromboembolism Without Anticoagulation Therapy
Conclusions Adopting appropriate selection criteria for discontinuing anticoagulation therapy, the majority of patients receiving concomitant mitral repair and the Maze procedure can discontinue warfarin with excellent long-term safety profiles.
Source: The Annals of Thoracic Surgery - June 23, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

A Randomized Multicenter Trial of Minimally Invasive Rapid Deployment Versus Conventional Full Sternotomy Aortic Valve Replacement
Conclusions RDAVR by the MIS approach is associated with significantly reduced myocardial ischemic time and better valvular hemodynamic function than FS-AVR with a conventional stented bioprosthesis. Rapid deployment valves may facilitate the performance of MIS-AVR.
Source: The Annals of Thoracic Surgery - December 30, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

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