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257 * minimally invasive mitral valve surgery without aortic cross clamping and with femoral cannulation is not associated with increased risk for stroke compared to traditional mitral valve surgery: a propensity score matched analysis
Conclusion: These results suggest an MI fibrillating heart approach for MV surgery was not associated with greater incidence of stroke/TIA. All MI MV surgeries with fibrillatory arrest were performed by surgeons experienced in the MI approach. In the presence of highly experienced surgeons, the MI approach using fibrillatory arrest did not increase risk for perioperative stroke.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Ad, N., Holmes, S. D., Pritchard, G., Massimiano, P. S. Tags: Long-term results of mitral valve surgery Source Type: research

Postoperative stroke related to cardiac surgery in octogenarians
CONCLUSIONS Incidence of postoperative stroke after CPB was not significantly higher in our octogenarian population. Although in younger patients peripheral vascular disease and cardiac rhythm disturbances were significant risk factors, it seems that factors related to intraoperative brain oxygenation (secondary to preoperative anaemia) are the most critical determinant of stroke in the elderly.
Source: Interactive CardioVascular and Thoracic Surgery - April 21, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Carrascal, Y., Guerrero, A. L., Blanco, M., Valenzuela, H., Pareja, P., Laguna, G. Tags: Adult Cardiac Source Type: research

Incidence and causes of silent and symptomatic stroke following surgical and transcatheter aortic valve replacement: a comprehensive review
Stroke associated with aortic valve replacement in calcific aortic stenosis, either via transcatheter implantation (TAVR) or via surgical replacement (SAVR), is one of the most devastating complications. However, data concerning the clinical impact and incidence of clinical and silent stroke complicating SAVR and TAVR are varying. This comprehensive review of the literature explores the genuine incidence of neurological events after these procedures. Additionally, potential factors responsible for the discrepancies in stroke rates in the current literature are analysed and a lack of uniform neurological definitions and sta...
Source: Interactive CardioVascular and Thoracic Surgery - August 21, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Grabert, S., Lange, R., Bleiziffer, S. Tags: Extracorporeal circulation, History Adult Cardiac Source Type: research

Outcomes after early or late timing of surgery for infective endocarditis with ischaemic stroke: a retrospective cohort study
CONCLUSIONS Early timing of surgery for infective endocarditis patients with ischaemic stroke was not associated with higher in-hospital mortality or complications after admission. Early timing of surgery may not be contraindicated for infective endocarditis patients with ischaemic stroke.
Source: Interactive CardioVascular and Thoracic Surgery - October 19, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Morita, K., Sasabuchi, Y., Matsui, H., Fushimi, K., Yasunaga, H. Tags: Cardiac - physiology, Basic research vascular Adult Cardiac Source Type: research

074-i * off-pump coronary artery bypass reduces early stroke in octogenarians: a meta-analysis of 18,000 patients
Conclusion: Coronary artery bypass in octogenarians can be performed with low early mortality. Number of grafts is lesser in the OPCABG cohort. While stroke rates are higher with conventional surgery, all other adverse events are comparable. Future randomised trials are needed to define the role of off-pump surgery in this high-risk cohort.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Altarabsheh, S. E., Deo, S., Rabab'h, A., Sharma, V., Lim, J. Y., Cho, Y. H., Park, S. J. Tags: Adult cardiac rapid response 1 Source Type: research

262 * changes in cerebral oximetry and haemodynamics during off-pump coronary artery bypass: mechanism for perioperative stroke?
Conclusion: Cerebral oxygenation may be impaired during OPCAB with delayed recovery by closure despite normalisation of cardiac output. This prolonged desaturation was not artefactual or related to patient posture. We recommend the routine monitoring of cerebral oximetry during OPCAB to prevent brain injury.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Al-Badawi, T., Witts, S., Howell, L., Richards, R., Rozario, C., Hartley, M., Tang, A. Tags: Developments in coronary artery bypass graft Source Type: research

Red blood cell transfusion is a determinant of neurological complications after cardiac surgery
CONCLUSIONS Transfusion of more than 2 units of RBCs after cardiac surgery is associated with a significantly increased risk of postoperative stroke and TIA.
Source: Interactive CardioVascular and Thoracic Surgery - January 20, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Mariscalco, G., Biancari, F., Juvonen, T., Zanobini, M., Cottini, M., Banach, M., Murphy, G. J., Beghi, C., Angelini, G. D. Tags: Electrophysiology - arrhythmias Adult Cardiac Source Type: research

A multicentre Spanish study for multivariate prediction of perioperative in-hospital cerebrovascular accident after coronary bypass surgery: the PACK2 score
CONCLUSIONS PACK2 risk scale shows good predictive accuracy in the data analysed and could be useful in clinical practice for decision making and patient selection.
Source: Interactive CardioVascular and Thoracic Surgery - July 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Hornero, F., Martin, E., Rodriguez, R., Castella, M., Porras, C., Romero, B., Maroto, L., Perez De La Sota, E., on behalf of the Working Group on Arrhythmia Surgery and Cardiac Pacing of the Spanish Society for Cardiovascular and Thoracic Surgery (SECTCV) Tags: Adult Cardiac Source Type: research

HEARTSTRING enabled no-touch proximal anastomosis for off-pump coronary artery bypass grafting: current evidence and technique
Surgical revascularization remains the standard of care for many patients. Off-pump coronary artery bypass grafting (OPCAB) without cardiopulmonary bypass (CPB) has evolved during the past 20 years, and as such can significantly reduce the occurrence of neurological complications. While avoiding the aortic cross-clamping required in conventional on-pump techniques, OPCAB results in a lower incidence of stroke. However, clamp-related risk of stroke remains if partial or side-biting clamps are applied for proximal anastomoses. Others and we have demonstrated that no-touch ‘anaortic’ approaches avoiding any clampi...
Source: Interactive CardioVascular and Thoracic Surgery - August 16, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Emmert, M. Y., Grunenfelder, J., Scherman, J., Cocchieri, R., van Boven, W.-J. P., Falk, V., Salzberg, S. P. Tags: Coronary Source Type: research

064 * ten-year results of redo aortic valve surgery in current practice: results from the multicentre european redo cardiac operations research database (record) initiative
Conclusions: rAVR still achieve satisfactory results. Baseline risk-factors and perioperative complications affecting outcome can be targets for TAVR and for improvements in perioperative management respectively.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Onorati, F., Biancari, F., De Feo, M., Mariscalco, G., Messina, A., Santarpino, G., Santini, F., Faggian, G. Tags: Aortic valve replacement: Long-term outcomes Source Type: research

284 * the impact of preoperative neurological events in patients suffering from native infective valve endocarditis
Conclusions: NVE complicated by neurological events remains a challenging disease with high mortality and morbidity. Cardiac surgical intervention is still associated with impaired outcome but seems not to aggravate preoperative existing neurological symptoms in the observed time interval.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Wilbring, M., Matschke, K., Tugtekin, S. M. Tags: Unpopular problems Source Type: research

224 * what is the best surgical strategy for aortic disease in redo scenarios? a comparison between traditional aortic valve replacement and transapical transcatheter aortic valve implantation from two real-world multicentre surgical registries
Conclusion: Outcome differences between RAVR and TaTAVI in redo scenarios reflect methodological differences and different baseline risk-profiles. Propensity-matched patients show comparable outcome data, which slightly favour TaTAVI.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Onorati, F. E., D'Onofrio, A., Gerosa, G., Faggian, G. Tags: Transcatheter aortic valve implantation: The treatment of choice Source Type: research

300 * influence of different pacemaker stimulation modes in patients with ventricular hypertrophy
Conclusion: An increase in the heart rate does not lead to a notable drop in stroke volume postoperatively in left-ventricular hypertrophy; hence a rise in cardiac output can be anticipated up to a rate of 100 bpm. A standardised response in terms of an ideal pacemaker stimulation mode could not be identified.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Kiessling, A. H., Elhadouchi, L., Miskovic, A., Reyher, C., Stock, U. A., Moritz, A. Tags: Infective endocarditis and outcomes Source Type: research

Results of surgical aortic valve replacement and transapical transcatheter aortic valve replacement in patients with previous coronary artery bypass grafting
CONCLUSIONS Reported differences in mortality and morbidity after TaTAVR and RAVR reflect differences in baseline risk profiles. Given the lower trend for renal complications, patients at higher perioperative renal risk might be better served by TaTAVR.
Source: Interactive CardioVascular and Thoracic Surgery - May 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Onorati, F., D'Onofrio, A., Biancari, F., Salizzoni, S., De Feo, M., Agrifoglio, M., Mariscalco, G., Lucchetti, V., Messina, A., Musumeci, F., Santarpino, G., Esposito, G., Santini, F., Magagna, P., Beghi, C., Aiello, M., Ratta, E. D., Savini, C., Troise, Tags: Molecular biology, Transplantation - heart, Basic research vascular Adult Cardiac Source Type: research

055 * simultaneous hybrid carotid stenting and coronary bypass surgery versus concomitant open carotid and coronary bypass surgery: a pilot feasibility study
Conclusions: Our results show that the hybrid procedure of carotid stenting and coronary surgery might be a good therapeutic option for this high-risk population of patients. Further, extended studies are needed to assess the proper value of this procedure.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Micovic, S., Sagic, D., Boskovic, S., Radak, D., Milojevic, P., Nezic, D., Dokic, O., Dukanovic, B. Tags: Controversies in coronary artery surgery II Source Type: research

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