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Increased Glucose Variability Is Associated With Major Adverse Events After Coronary Artery Bypass
ConclusionsIncreased 24-hour, but not 12-hour, postoperative GV following CABG is a predictor of poor outcomes. Preoperative HbA1c is not associated with MAEs after adjusting for postoperative mean glucose and GV.Graphical abstract
Source: The Annals of Thoracic Surgery - August 7, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Bilateral Internal Mammary Artery Use in Diabetic Patients: Friend or Foe?
ConclusionsIn this statewide analysis, diabetic patients who received BIMA grafts (compared with diabetic patients with LIMA grafts or nondiabetic patients with BIMA grafts) had higher O/E ratios for composite morbidity/mortality as a result of higher O/E ratios for major complications.
Source: The Annals of Thoracic Surgery - September 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Preoperative Ultrasonography Screening for Carotid Artery Stenosis in Lung Cancer Patients
ConclusionsPreoperative CAS is a simple and useful tool for detecting carotid artery stenosis. Administration of perioperative anticoagulant therapy to preoperative patients with lung cancer and carotid artery stenosis identified by CAS may prevent postoperative stroke and cardiovascular events.
Source: The Annals of Thoracic Surgery - September 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Bilateral Internal Mammary Artery Utilization in Diabetics: Friend or Foe?
Conclusions In this statewide analysis, diabetics who received BIMA grafts (compared to diabetics with LIMA grafts or non-diabetics with BIMA grafts) had higher O/E ratios for composite morbidity/mortality as a result of higher O/E ratios for major complications.
Source: The Annals of Thoracic Surgery - June 20, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hypothermia and Selective Antegrade Cerebral Perfusion Is Safe for Arch Repair in Type A Dissection
Conclusions Unilateral selective antegrade cerebral perfusion with moderate hypothermic circulatory arrest remains a safe strategy for cerebral protection during emergent surgical repair of acute type A dissection and provides equivalent outcomes for both limited and extensive aortic arch reconstruction. Based on these data, unilateral selective antegrade cerebral perfusion and moderate hypothermic circulatory arrest may represent an optimal strategy for cerebral protection in this acute setting.
Source: The Annals of Thoracic Surgery - August 25, 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

One-Year Outcomes of Transcatheter Aortic  Valve Implantation Using the Direct Aortic Approach
Conclusions The DA approach provides a feasible alternative for patients with challenging anatomic features that may otherwise preclude use of the TAVI procedure.
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

Anterior Leaflet Augmentation With CorMatrix Porcine Extracellular Matrix in Twenty-Five Patients: Unexpected Patch Failures and Histologic Analysis
Conclusions For type III MR, a large anterior leaflet patch technique with porcine ECM was associated with a 32% recurrence rate of severe MR related directly to patch failure. Further research and development should be performed on the use of ECM materials with a goal to decrease the failure rate experienced in this study.
Source: The Annals of Thoracic Surgery - September 8, 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

Aortic Root Replacement in Octogenarians Offers Acceptable Perioperative and Late Outcomes
Conclusions Octogenarians can safely undergo aortic root replacement with moderately worse but acceptable perioperative mortality and late survival. Further studies are necessary to determine which subset of octogenarians are at the highest operative risk and may benefit from a conservative approach.
Source: The Annals of Thoracic Surgery - October 17, 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

Midterm Outcome of Coronary Artery Bypass Grafting in Young Patients: A Multicenter Italian Study
Conclusions Patients less than 50 years of age undergoing CABG have an excellent outcome compared with elderly patients. These data indicate that despite its premature onset, coronary artery disease in young patients does not have a more aggressive course than that in older patients.
Source: The Annals of Thoracic Surgery - August 11, 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

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