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HVAD Cannula Position and Hemocompatibility-related Adverse Events
ConclusionsHVAD cannula coronal angle was associated with reduced right ventricular function and HRAE. Prospective studies evaluating surgical techniques to ensure optimal device positioning and its effects on HRAEs are warranted.
Source: The Annals of Thoracic Surgery - February 6, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Valve-Sparing Root Replacement vs Composite Valve Grafting in Aortic Root Dilation: A Meta-Analysis
ConclusionsAortic valve sparing appears to be safe, and associated with reduced late mortality, thromboembolism/stroke and bleeding compared with composite valve grafting. Late durability is equivalent. Aortic valve sparing should be considered in patients with favorable aortic valve morphology.Graphical abstract
Source: The Annals of Thoracic Surgery - January 23, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

Mitigating the Risk: Transfusion or Reoperation for Bleeding After Cardiac Surgery
ConclusionsWhile reoperation for bleeding is associated with morbidity after cardiac surgery, substantial transfusion without reoperation appears to increase morbidity compared to a limited-transfusion reoperative approach. Better timing for reoperation and guided transfusion approaches may mitigate morbidity compared to substantial transfusion alone.
Source: The Annals of Thoracic Surgery - December 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of Repair of Kommerell Diverticulum
ConclusionsOpen and endovascular approaches have a high success rate and low mortality risk. Selection of the specific type of intervention should be based on patient anatomy, additional needed procedures, and comorbid conditions.
Source: The Annals of Thoracic Surgery - November 22, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-term Outcomes of Mechanical Vs Biologic Aortic Valve Prosthesis in Patients Older Than 70 Years
ConclusionsMechanical aortic valve prosthesis is associated with worse long-term survival and increased bleeding after SAVR in patients more than 70 years old. The study results suggest caution when considering mechanical aortic valve prostheses in elderly patients.
Source: The Annals of Thoracic Surgery - October 24, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Impact of Preoperative Clopidogrel on Outcomes After Coronary Artery Bypass Grafting
ConclusionsCABG can be safely performed in patients with recent clopidogrel exposure with no increased risk of early or late mortality. However, CABG should be delayed for at least 5 days, if clinically feasible, to minimize transfusions and reoperation risk. In patients with more urgent indications, delaying CABG at least 3 days can mitigate but not eliminate the increased bleeding risk.
Source: The Annals of Thoracic Surgery - September 20, 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

The Impact of Preoperative Clopidogrel on Outcomes Following Coronary Artery Bypass Grafting
ConclusionsCABG can be safely performed in patients with recent Clopidogrel exposure with no increased risk of early or late mortality. However, CABG should be delayed for at least 5 days if clinically feasible to minimize transfusions and reoperation risk. In patients with more urgent indications, delaying CABG at least 3 days can mitigate but not eliminate the increased bleeding risk.
Source: The Annals of Thoracic Surgery - April 28, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Complete Sternal-Sparing HeartMate 3 Implantation: A Case Series of 10 Consecutive Patients
ConclusionsOur early outcomes suggest that the CSS approach may reduce the incidence of right ventricular failure, bleeding, intubation time, and intensive care unit 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 - March 27, 2019 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

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

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

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

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