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Relationship of Aortic Stiffness to Exercise and Ventricular Volumes in Single Ventricles
ConclusionsSV patients with reconstructed aortas demonstrate increased aortic stiffness, increasing afterload on the ventricle. Native DAo stiffness distal to the reconstruction is inversely correlated with exercise performance, presumably to decrease impedance mismatch maintaining homogeneity of the aortic wall. This information suggests a possible mechanism for decreased exercise performance in SV patients with aortic reconstructions.
Source: The Annals of Thoracic Surgery - April 6, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Survival Following Myectomy for Obstructive Hypertrophic Cardiomyopathy-What Causes Late Mortality?
ConclusionsThis study, using two independent sources to verify vital status and cause of mortality, confirms that survival following septal myectomy is excellent. Hypertrophic cardiomyopathy was identified as the primary cause of death in less than 20%, with mortality in most patients unrelated to hypertrophic cardiomyopathy.
Source: The Annals of Thoracic Surgery - April 10, 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

The Impact of Preoperative Clopidogrel on Outcomes Following Coronary Artery Bypass Grafting
ConclusionsCABG can be safely performed in patients with recent Clopidogrel exposure with no increased risk of early or late mortality. However, CABG should be delayed for at least 5 days if clinically feasible to minimize transfusions and reoperation risk. In patients with more urgent indications, delaying CABG at least 3 days can mitigate but not eliminate the increased bleeding risk.
Source: The Annals of Thoracic Surgery - April 28, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Preliminary results of debranch-first technique in Frozen Elephant Trunk procedures
ConclusionsFET with debranch-first technique is safe and feasible and resulted in low mortality and morbidity rates. Further investigation is needed to compare it with standard techniques.
Source: The Annals of Thoracic Surgery - May 11, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Neurologic Outcomes in Aortic Arch Repair With Frozen Elephant Trunk Versus 2-Stage Hybrid Repair
ConclusionsBoth single-stage and 2-stage hybrid arch replacements are effective approaches for treating complex aortic arch diseases. Early deaths and neurological outcomes in the single-stage group are comparable to those in the combined 2-stage group. Furthermore, in this series, patients who had a single-stage hybrid procedure had a higher survival rate at 2 years.
Source: The Annals of Thoracic Surgery - May 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Model for End-Stage Liver Disease Score Independently Predicts Mortality in Cardiac Surgery
ConclusionsIncreasing MELD score, international normalized ratio, and bilirubin all independently increase risk of operative mortality. Because 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 - May 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Characterizing Risks Associated with Mitral Annular Calcification in Mitral Valve Replacement
ConclusionsThe presence of MAC alone, regardless of severity, was independently associated with increased operative mortality and adverse postoperative outcomes. Even after adjusting for attendant cardiovascular and metabolic comorbidities, centers with low MV case volumes were found to have worse outcomes after MVR.Graphical abstract
Source: The Annals of Thoracic Surgery - June 15, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Comparative Outcomes of Transcarotid and Trans-subclavian Transcatheter Aortic Valve Replacement
ConclusionsThe transcarotid and the trans-subclavian approaches have similar safety and efficacy outcomes. The transcarotid approach had a shorter procedure duration and a trend towards lower fluoroscopy duration and radiation exposure.
Source: The Annals of Thoracic Surgery - July 4, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Complications After Cardiac Surgery on One-Year Patient Reported Outcomes
ConclusionsWhile cardiac surgical patients have PRO scores similar to the general population, complications after cardiac surgery continue to negatively influence patient quality of life one-year after surgery. Using the NIH-PROMIS, prolonged ventilation and renal failure have the largest impact on one-year patient reported outcomes.
Source: The Annals of Thoracic Surgery - July 16, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-term outcomes of stand-alone Maze IV for persistent/long-standing persistent atrial fibrillation
ConclusionsThis study confirmed the safety and efficacy at long-term (7 years) of the stand-alone Maze IV surgical procedure for persistent/long-standing persistent AF. Indeed, more than 70% of the pts were in SR off class I/III AADs and off oral anticoagulation.Graphical abstract
Source: The Annals of Thoracic Surgery - July 18, 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 feasible and effective. Durability concerns will need to be assessed in future studies.Visual Abstract
Source: The Annals of Thoracic Surgery - July 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

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

Survival After Myectomy for Obstructive Hypertrophic Cardiomyopathy: What Causes Late Mortality?
ConclusionsThis study, using 2 independent sources to verify vital status and cause of mortality, confirms that survival after septal myectomy is excellent. Hypertrophic cardiomyopathy was identified as the primary cause of death in less than 20%, with mortality in most patients unrelated to hypertrophic cardiomyopathy.
Source: The Annals of Thoracic Surgery - August 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Failure to rescue contributes to center-level differences in mortality after lung transplantation
ConclusionsDifferences in rates of Failure to Rescue contribute significantly to per-center variability in mortality following LTx. FTR can serve as a quality metric to identify opportunities for improvement in management of perioperative adverse events.
Source: The Annals of Thoracic Surgery - August 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

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