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Outcomes in 937 Intermediate-Risk Patients Undergoing Surgical Aortic Valve Replacement in PARTNER-2A
Conclusions In this adjudicated prospective study, SAVR in intermediate-risk patients had excellent results at 2 years. However, there were more in-hospital strokes than expected, most likely attributable to mandatory neurologic assessment after the procedure. No pronounced structural valve deterioration was found during 2-year follow-up. Continued long-term surveillance remains important.
Source: The Annals of Thoracic Surgery - April 22, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Valvectomy versus Replacement for the Surgical Treatment of Tricuspid Endocarditis
Conclusions Tricuspid valve excision, repair, and replacement have similar 30-day operative mortality, as defined by the STS, in TV endocarditis patients and significantly lower unplanned readmission rates at one year in the excision patients. Tricuspid valvectomy is an acceptable initial treatment in this high-risk group as part of a surgical strategy to identify patients who are candidates for eventual valve replacement. Further study of long term outcomes and survival is warranted.
Source: The Annals of Thoracic Surgery - May 17, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Use of an Automated Suture Fastening Device in Minimally Invasive Aortic Valve Replacement
Conclusions In mAVR, the CK device was associated with reduced aortic cross-clamp time while providing equivalent clinical outcomes. Larger studies are needed to confirm the efficacy, safety, and cost-effectiveness of the CK device in minimally invasive aortic valve surgery.
Source: The Annals of Thoracic Surgery - June 22, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Coronary Revascularization With Single Versus Bilateral Mammary Arteries: Is It Time to Change?
ConclusionsIn a large regional experience, BIMA is associated with no upfront risk of adverse events and improved long-term survival compared with SIMA. Our results indicate that BIMA conduits should be considered more frequently during coronary artery bypass grafting due to their demonstrated survival advantage.
Source: The Annals of Thoracic Surgery - July 23, 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

Valvectomy Versus Replacement for the Surgical Treatment of Tricuspid Endocarditis
ConclusionsTricuspid valve endocarditis patients who undergo tricuspid valve excision, repair, and replacement have similar 30-day operative mortality, as defined by The Society of Thoracic Surgeons. Excision patients have significantly lower unplanned readmission rates at 1 year. Tricuspid valvectomy is an acceptable initial treatment in this high-risk group as part of a surgical strategy to identify patients who are candidates for eventual valve replacement. Further study of long-term outcomes and survival is warranted.
Source: The Annals of Thoracic Surgery - August 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of Planned Two-Stage Hybrid Aortic Repair With Dacron-Replaced Proximal Landing Zone
ConclusionsPlanned two-stage HAR with open first-stage proximal aortic replacement, followed by second-stage TEVAR with Dacron-replaced PLZ yields excellent short-term and long-term results, including low rates of reintervention likely due to the long-segment PLZ within the Dacron-replaced aorta. The technique should be considered in patients with even mild (>4.0 cm) ascending aortic dilation in whom HAR is otherwise the preferred treatment option.
Source: The Annals of Thoracic Surgery - August 24, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Clinical Leaflet Thrombosis in Transcatheter and Surgical Bioprosthetic Aortic Valves by 4DCT
ConclusionsIn patients with clinical or echocardiographic indications suggestive of leaflet thrombosis, 1/3rd of patients were found to have evidence of leaflet thrombosis using 4DCT. This allowed tailored anticoagulation therapy with resolution of the thrombus in most patients avoiding unnecessary anticoagulation in the remaining 2/3rds of patients.
Source: The Annals of Thoracic Surgery - August 26, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Valve Sparing Root Replacement Provides Excellent Mid-Term Outcomes for Bicuspid Valve Aortopathy
ConclusionsVSRR can be safely and effectively performed in young patients with bicuspid valve anatomy regardless of degree of pre-operative AI. Valve function is durable and the incidence of valve-related complications is low. VSRR is an attractive and potentially superior option to conventional root replacement in appropriately selected patients with bicuspid aortopathy.
Source: The Annals of Thoracic Surgery - October 5, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Surgical outcomes in Behcet’s disease patients with severe aortic regurgitation
ConclusionsThe findings suggest that mechanical root replacement combined with a low post-operative C-reactive protein level maintained through adjunctive immunomodulation therapy may lead to optimal surgical outcomes in Behcet’s disease associated with severe aortic regurgitation.
Source: The Annals of Thoracic Surgery - October 10, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Robotic-Assisted Surgical Ablation of Atrial Fibrillation Combined with Mitral Valve Surgery
ConclusionsSurgical AF ablation using robotic-assistance in the setting of mitral valve surgery showed excellent safety and favorable long-term clinical outcomes.
Source: The Annals of Thoracic Surgery - October 12, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Clinical Outcomes of Mitral Valve Reoperations in the United States: An Analysis of the Society of Thoracic Surgeons National Database
ConclusionsDespite a high-risk patient profile, surgical outcomes of reoperative MVS were acceptable, particularly in elective cases with prior mitral valve surgery and without endocarditis.
Source: The Annals of Thoracic Surgery - October 24, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Emergency Use of Branched Thoracic Endovascular Repair in the Treatment of Aortic Arch Pathologies
Conclusions: Our experience provided an early insight to the feasibility and safety of b-TEVAR in emergency situation, although the early reintervention rate was not negligible. The endograft was versatile with potential off-the-shelf use in future.
Source: The Annals of Thoracic Surgery - October 30, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

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