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Surgical repair of distal aortic arch aneurysm with distal extension: sternotomy versus thoracotomy
ConclusionsThe sternotomy approach showed better outcomes in terms of operative mortality, stroke, and pneumonia, as well as long-term survival compared to thoractomy. These results suggested that the sternotomy approach was more appropriate for patients with distal aortic arch aneurysms with distal extensions.
Source: The Annals of Thoracic Surgery - November 16, 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

Risk Prediction Model for Major Adverse Outcome in Proximal Thoracic Aortic Surgery
ConclusionsThe current study identified risk factors for major adverse outcome after proximal thoracic aortic surgery with HCA for degenerative pathology. The proposed simple, accurate model can quantify risk and facilitate physician-patient counseling prior to possible surgical intervention.
Source: The Annals of Thoracic Surgery - November 9, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early extubation without increased adverse events in high risk cardiac surgical patients
ConclusionsA prudent and diligent multi-faceted early extubation protocol may be successful in high risk cardiac surgical patients without an increase in adverse outcomes. A larger study is needed in the future to confirm the finding.
Source: The Annals of Thoracic Surgery - November 3, 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

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

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

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

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

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

Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Aged 50 Years and Younger
ConclusionsThe increased risk of reoperation for bAVR and major bleeding incidents for mAVR was not reflected in midterm and long-term survival differences between the two groups. Our results suggest that bAVR may be an acceptable prosthesis choice for some patients aged 50 years and younger, although the results should be taken with caution.Visual Abstract
Source: The Annals of Thoracic Surgery - September 21, 2018 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

Minimally Invasive Approaches to Surgical Aortic Valve Replacement: A Meta-Analysis
ConclusionsMinimally invasive approaches to AVR yield excellent outcomes in high volume centers. They reduce hospital stay and incidence of post-operative atrial fibrillation, and, therefore, should be considered in patients undergoing AVR. However, the operative approach should be selected according to surgeon’s technical expertise and what is best for specific patient profile.
Source: The Annals of Thoracic Surgery - September 6, 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

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