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Intraoperative Cerebral Perfusion Disturbances During Transcatheter Aortic Valve Replacement
Conclusions Cerebral oximetry reacted promptly to rapid ventricular pacing with significant desaturation and hyperemia a common occurrence. However, no association between this intraoperative insult and objective neurologic injury was detected.
Source: The Annals of Thoracic Surgery - August 16, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Assessment of Commonly Used Frailty Markers for High- and Extreme-Risk Patients Undergoing Transcatheter Aortic Valve Replacement
Conclusions Among high- and extreme-risk patients undergoing TAVR, our new frailty model was more discriminative of 30-day mortality than The Society of Thoracic Surgeons predicted risk of mortality. New cutoff values for frailty indicators were identified and will require further validation.
Source: The Annals of Thoracic Surgery - November 16, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Transapical Mitral Valve Implantation for Native Mitral Valve Stenosis Using a Balloon-Expandable Prosthesis
Conclusions TMV implantation using the SAPIEN 3 aortic prosthesis in patients with heavy annular calcification is feasible and represents a reasonable bailout option for inoperable patients. However, several limitations need to be considered in this special patient population.
Source: The Annals of Thoracic Surgery - November 16, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Elective David I Procedure Has Excellent Long-Term Results: 20-Year Single-Center Experience
Conclusions The valve-sparing David I procedure has excellent short- and long-term results. Erosion due to supposed leaflet contact with the straight tube graft was not observed in any patient, proving that using a straight graft has no negative impact on the leaflets. The “spared valve” (being native living tissue) seems to be more resistant to infection than prosthetic valves.
Source: The Annals of Thoracic Surgery - December 2, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Evolution of Simplified Frozen Elephant Trunk Repair for Acute DeBakey Type I Dissection: Midterm Outcomes
Conclusions Simplified FET for treating acute DeBakey type I dissection has evolved and remained safe. It promotes aortic remodeling, and simplifies management of chronic aortic complications.
Source: The Annals of Thoracic Surgery - December 6, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Safety of Moderate Hypothermia With Antegrade Cerebral Perfusion in Total Aortic Arch Replacement
Conclusions In this series, TOTAL with MHCA and ACP can be safely performed with acceptable operative risk. MHCA and ACP represent an effective strategy for TOTAL and may obviate the need for DHCA.
Source: The Annals of Thoracic Surgery - December 10, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Direct Aortic Access for Transcatheter Aortic Valve Replacement Using a Self-Expanding Device
Conclusions When femoral access is not feasible, DA access allows effective delivery of the valve but incurs an increased risk of death and adverse events, potentially the result of procedural differences.
Source: The Annals of Thoracic Surgery - January 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Durability of Aortic Valve Cusp Repair With and Without Annular Support
Conclusions Valve repair is effective and durable for treating aortic valve dysfunction. Greater severity of AR preoperatively is associated with higher likelihood of repair failure. Commissural figure-of-8 suspension sutures and repair with annular support have the best long-term durability.
Source: The Annals of Thoracic Surgery - February 16, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Sixteen-Year Experience of David and Bentall Procedures in Acute Type A Aortic Dissection
Conclusions Both the David and Bentall procedures are appropriate surgical approaches for aortic root replacement in select patients with an acute type A aortic dissection.
Source: The Annals of Thoracic Surgery - February 16, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Comparison of Endoaortic and Transthoracic Aortic Clamping in Less-Invasive Mitral Valve Surgery
Conclusions Despite recent concerns arising about EAC, this large multicenter study shows equivalence in terms of safety and effectiveness of this technique compared with TTC. Reduction in postoperative bleeding was observed in the EAC group despite the higher rate of complex redo cases.
Source: The Annals of Thoracic Surgery - February 16, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Aortic Valve Reoperation Following Stentless Bioprosthesis: Short- and Long-Term Outcomes
Conclusions Aortic valve reoperation following stentless valve implantation can be performed with low operative mortality and favorable long-term survival.
Source: The Annals of Thoracic Surgery - April 4, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

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

Hemiarch Reconstruction Vs Clamped Aortic Anastomosis for Concomitant Ascending Aortic Aneurysm
Conclusions Hemiarch replacement using DHCA with RCP does not increase the risk of operative complications compared to a normothermic, clamped-distal aortic anastomosis, and therefore its use should not be limited when planning complex multi-procedural reconstructions during elective ascending thoracic aortic replacement with concomitant cardiac surgery.
Source: The Annals of Thoracic Surgery - May 4, 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

Development of a Risk Prediction Model and Clinical Risk Score for Isolated Tricuspid Valve Surgery
ConclusionsMortality and major morbidity after isolated tricuspid valve surgery can be predicted using preoperative patient data from The Society of Thoracic Surgeons National Adult Cardiac Database. A simple clinical risk score predicts mortality and major morbidity after isolated tricuspid valve surgery. This score may facilitate perioperative counseling and identification of suitable patients for tricuspid valve surgery.
Source: The Annals of Thoracic Surgery - July 5, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

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