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Aortic Valve Replacement in Bioprosthetic Failure:Insights from The Society of Thoracic Surgeons National Database
ConclusionsThe number of patients undergoing SAVR for degenerated bioprosthesis is decreasing in U.S, particularly among older and high-risk patients. These trends may reflect the adoption of valve-in-valve transcatheter aortic valve replacement for degenerated bioprosthesis after its FDA approval in 2015.
Source: The Annals of Thoracic Surgery - September 24, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Open Descending and Thoracoabdominal Aortic Repairs in Patients Younger than 50 Years Old
ConclusionsPatients under 50 years old with D/TAAA have low surgical risks and open repairs can be performed with excellent short-term and durable long-term results. Open surgical repairs should be considered initially in younger patients requiring D/TAAA repairs. HTAD warrants closer postoperative surveillance.
Source: The Annals of Thoracic Surgery - April 19, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of Isolated Tricuspid Valve Surgery Have Improved in the Modern Era
ConclusionsIn the current era with careful patient selection and periprocedural management, isolated TV surgery can be performed with lower morbidity and mortality than has traditionally been reported with good long term survival. These outcomes can also serve as a benchmark for catheter-based tricuspid valve intervention outcomes.
Source: The Annals of Thoracic Surgery - April 2, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Endovascular Versus Open Repair For Chronic Type B Dissection Treatment: A meta-analysis
ConclusionsThis recent non -randomised data shows early ER benefit, unsustained at mid-term. Reintervention is higher after ER, necessitating improved technique. However, OS is exempt neither from reintervention nor rupture. Both techniques have their place, but patient selection is key.
Source: The Annals of Thoracic Surgery - November 25, 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

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

Does Surgical Ablation Energy Source Affect Long-Term Success of the Concomitant Cox Maze Procedure?
Conclusions Concomitant CM procedures performed with cryothermal energy alone or combined with bipolar radiofrequency ablation are safe and exceedingly effective. The association of cryothermal energy alone with higher rates of sinus rhythm and stroke reduction should be investigated further.
Source: The Annals of Thoracic Surgery - June 17, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of Dialysis-Dependent Patients After Cardiac Operations in a Single-Center Experience of 483 Patients
Conclusions Patients with DD CRF undergoing cardiac operations have high perioperative and medium-term mortality, particularly in the presence of combined aortic and mitral valve pathologic conditions, active endocarditis, and poor left ventricular function.
Source: The Annals of Thoracic Surgery - December 6, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Prolonged Cross-Clamping During Aortic Valve Replacement Is an Independent Predictor of Postoperative Morbidity and Mortality: Analysis of the Japan Cardiovascular Surgery Database
Conclusions Prolonged ACCD offers an independent predictor of postoperative morbidity and mortality after isolated AVR for AS despite recent technologic advances and surgical refinements.
Source: The Annals of Thoracic Surgery - September 10, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement for Severe Aortic Stenosis in Patients With Chronic Kidney Disease Stages 3b to 5
Conclusions CKD stages 3b to 5 increases the risk of mortality after TAVI and SAVR. In this subset of patients, SAVR was associated with somewhat better early and late survival. The risk of acute kidney injury was higher after SAVR. These findings suggest that CKD stages 3b to 5 does not contraindicate SAVR. Strategies to prevent severe acute kidney injury should be implemented with either SAVR or TAVI.
Source: The Annals of Thoracic Surgery - July 19, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Reexploration for Bleeding and Its Association With Mortality After Cardiac Surgery
Conclusions Excessive bleeding leading to reexploration is associated with a twofold increased early postoperative mortality rate. Reexploration for bleeding is also associated with mortality beyond 90 days after operation.
Source: The Annals of Thoracic Surgery - June 27, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic Valve Replacement in the Moderately Elevated Risk Patient: A Population-Based Analysis of Outcomes
Conclusions This population-based contemporary assessment suggests moderate-risk patients undergoing AVR experience favorable outcomes. Although increasing PROM is important in preoperative evaluation of risk, preexisting pulmonary hypertension and indication for operation are among other factors that should be considered as TAVR expands into this group of patients.
Source: The Annals of Thoracic Surgery - June 17, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Moderate Versus Deep Hypothermia With Unilateral Selective Antegrade Cerebral Perfusion for Acute Type A Dissection
Conclusions Moderate HCA with uSACP is an effective circulation management strategy that provides excellent cerebral and visceral protection during emergent ATAAD repair. In the setting of antegrade cerebral perfusion, deep hypothermia does not provide any additional benefit.
Source: The Annals of Thoracic Surgery - October 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

Is Total Arch Replacement Associated With Worse Outcomes During Repair of Acute Type A Aortic Dissection?
Conclusions Acute type A aortic dissection remains a challenge associated with significant mortality and morbidity. When compared with a less aggressive resection, total arch replacement performed in an individualized fashion can be associated with acceptable early and late outcomes for ATAAD and was not associated with worse outcomes.
Source: The Annals of Thoracic Surgery - August 11, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

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