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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

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

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

Clinical Leaflet Thrombosis in Transcatheter and Surgical Bioprosthetic Aortic Valves by Four-Dimensional Computed Tomography
ConclusionsOne-third of patients with clinical or echocardiographic indications suggestive of leaflet thrombosis were found to have evidence of leaflet thrombosis using 4DCT. This allowed tailored anticoagulation therapy with resolution of the thrombus in most patients and avoiding unnecessary anticoagulation in the remaining two-thirds of patients.Visual Abstract
Source: The Annals of Thoracic Surgery - November 16, 2018 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

Fatal Neurologic Dysfunction During Continuous-flow Left Ventricular Assist Device Support
ConclusionsOur study elucidates the characteristics and risk factors of patients who died of ND during CF-LVAD support. Further studies are required to find ways to decrease the incidence of fatal ND during CF-LVAD support.
Source: The Annals of Thoracic Surgery - November 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Model for End Stage Liver Disease Score Independently Predicts Mortality in Cardiac Surgery
ConclusionsIncreasing MELD score, INR, and bilirubin all independently increase risk of operative mortality. Since high rates of missing data currently limit utilization of MELD, efforts to simplify and improve data collection would help improve future risk models.
Source: The Annals of Thoracic Surgery - January 10, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Valve-Sparing Root Replacement Provides Excellent Midterm Outcomes for Bicuspid Valve Aortopathy
ConclusionsVSRR can be safely and effectively performed in young patients with bicuspid valve anatomy regardless of degree of preoperative 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.Visual Abstract
Source: The Annals of Thoracic Surgery - January 26, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early Extubation Without Increased Adverse Events in High-Risk Cardiac Surgical Patients
ConclusionsA prudent and diligent multifaceted 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 - January 26, 2019 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 hypothermic circulatory arrest for degenerative pathology. The proposed simple, accurate model can quantify risk and facilitate physician-patient counseling before possible surgical intervention.
Source: The Annals of Thoracic Surgery - February 20, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Addition of Aortic Root Procedures during Elective Arch Surgery Does Not Confer Added Morbidity nor Mortality
ConclusionsThe addition of an aortic root procedure during elective aortic arch surgery lengthens cardiopulmonary bypass and aortic crossclamp times but does not increase postoperative morbidity nor mortality.
Source: The Annals of Thoracic Surgery - March 7, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Physician-Modified Thoracic Stent-Grafts for the arch after surgical treatment of type A dissection
ConclusionsThe use of physician modified thoracic stent-grafts for the treatment of dissecting aortic arch aneurysm after surgical treatment of acute type A dissection is both feasible and effective. Durability concerns will need to be assessed in future studies.Graphical abstract
Source: The Annals of Thoracic Surgery - March 20, 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

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

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