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Impact of Surgical Stroke on the Early and Late Outcomes After Thoracic Aortic Operations
Conclusions Surgical stroke is associated with high hospital mortality and PNDs that decrease late survival and the physical component score of the QOL survey.
Source: The Annals of Thoracic Surgery - April 10, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Unilateral Versus Bilateral Cerebral Perfusion for Acute Type A Aortic Dissection
Conclusions As one of the largest single-center studies of the efficacy of u-ACP and b-ACP in patients with type A aortic dissection, operative mortality, stroke, temporary neurologic dysfunction, and renal failure rates were similar in both. In this intrinsically complex disease, survival is the most important outcome; u-ACP may provide cardiac surgeons with valuable technical simplicity during challenging procedures, and b-ACP may be justified for circulatory arrest times of more than 30 minutes.
Source: The Annals of Thoracic Surgery - December 30, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

Deep Hypothermia + Retrograde Cerebral Perfusion vs. Moderate Hypothermia + Antegrade Cerebral Perfusion for Arch Surgery
ConclusionsAlthough there was no significant difference in clinically evident neurologic injury, this pilot study suggests that MHCA+ACP may be associated with a higher incidence of radiographic neurologic injury than DHCA+RCP in patients undergoing elective hemiarch replacement.
Source: The Annals of Thoracic Surgery - November 16, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes after thoracic endovascular aortic repair with overstenting of the left subclavian artery
ConclusionsEvery 10th patient with LSA overstenting and no revascularization developed left arm malperfusion. No LSA revascularization, extensive aortic coverage with two or more endografts, and coronary artery disease increased the risk for permanent paraplegia, left-hemispherical stroke, and left arm malperfusion. Patients should undergo LSA revascularization to prevent left vertebral artery-associated central neurologic complications and to maintain upper-left extremity perfusion.
Source: The Annals of Thoracic Surgery - December 1, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Deep Hypothermia With Retrograde Cerebral Perfusion Versus Moderate Hypothermia With Antegrade Cerebral Perfusion for Arch Surgery
ConclusionsAlthough there was no significant difference in clinically evident neurologic injury, this pilot study suggests that MHCA+ACP may be associated with a higher incidence of radiographic neurologic injury than DHCA+RCP in patients undergoing elective hemiarch replacement.
Source: The Annals of Thoracic Surgery - March 27, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hypothermia and Selective Antegrade Cerebral Perfusion Is Safe for Arch Repair in Type A Dissection
Conclusions Unilateral selective antegrade cerebral perfusion with moderate hypothermic circulatory arrest remains a safe strategy for cerebral protection during emergent surgical repair of acute type A dissection and provides equivalent outcomes for both limited and extensive aortic arch reconstruction. Based on these data, unilateral selective antegrade cerebral perfusion and moderate hypothermic circulatory arrest may represent an optimal strategy for cerebral protection in this acute setting.
Source: The Annals of Thoracic Surgery - August 25, 2017 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

Posterior Circulation Ischemia or Occlusion in Five Adults With Failing Fontan Circulation
Conclusions In adults with failing Fontan circulation there is a potential for neurologic complications as a result of venous congestion with elevated central venous pressures, and aberrant posterior circulation. The patient’s history and brain imaging may be used to identify at-risk patients and to tailor perioperative management during Fontan conversion or heart transplantation to mitigate the risk for brainstem ischemia.
Source: The Annals of Thoracic Surgery - May 19, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Right Minithoracotomy for Mitral Valve Surgery: Impact of Tailored Strategies on Early Outcome
Conclusions Right minithoracotomy MVS can routinely be performed with favorable outcomes in all comers when perfusion strategies and clamping techniques are carefully selected after proper evaluation of the patient’s preoperative characteristics.
Source: The Annals of Thoracic Surgery - July 17, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Novel Rotational Speed Modulation System Used With Venoarterial Extracorporeal Membrane Oxygenation
Conclusions Our system enabled an increase in coronary arterial flow and a decrease in LV work load and afterload during VA-ECMO. The system offers the effects of VA-ECMO and an IABP in a single device.
Source: The Annals of Thoracic Surgery - July 12, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes of Elective Aortic Hemiarch Reconstruction for Aneurysmal Disease in the Elderly
Conclusions Although elderly patients have a more prolonged recovery after elective aortic hemiarch reconstruction for aneurysmal disease, outcomes are acceptable with low operative mortality and with the majority being discharged home. Moderate hypothermic circulatory arrest with antegrade cerebral perfusion is a safe strategy for this cohort. Advanced age alone should not be viewed as a contraindication in these cases.
Source: The Annals of Thoracic Surgery - October 18, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of isolated cerebral perfusion technique for aortic arch aneurysm repair in elderly patients
ConclusionsICP during total aortic arch replacement presents an acceptable procedure for elderly patients with severely atherosclerotic aortas.
Source: The Annals of Thoracic Surgery - October 10, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Steps forward in minimally invasive cardiac surgery: 10-year experience
ConclusionsThe present study shows the considerable and attractive results of our decision making process based on the tailored approach: the 10-year outcome analysis demonstrates a trend toward a progressive decrease in the overall rate of post-operative complications and a significant protective effect of the tailored approach on the occurrence of stroke.
Source: The Annals of Thoracic Surgery - June 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Total Arch Replacement Under Flow Monitoring During Selective Cerebral Perfusion Using a Single Pump ORIGINAL ARTICLES: ADULT CARDIAC
Conclusions Flow monitoring showed that selective perfusion using a single pump adequately distributed flow among all supraaortic vessels. This monitoring system might help to improve brain protection and outcomes during total aortic arch replacement.
Source: The Annals of Thoracic Surgery - December 31, 2012 Category: Cardiovascular & Thoracic Surgery Authors: Shimizu, H., Matayoshi, T., Morita, M., Ueda, T., Yozu, R. Tags: Great vessels ORIGINAL ARTICLES: ADULT CARDIAC Source Type: research

Aortopulmonary Window and the Interrupted Aortic Arch: Midterm Results With Use of the Single-Patch Technique
Conclusions Primary anatomic repair of APW associated with IAA can be safely performed. The efficiency of the single-patch technique was confirmed by the restoration of normal functional anatomy of the great arteries and aortic arch during follow-up.
Source: The Annals of Thoracic Surgery - December 30, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

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