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Source: The Journal of Thoracic and Cardiovascular Surgery
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Total 276 results found since Jan 2013.
Meta-analysis of the messenger: The price of small trials diverting our attention from the real target
The meta-analysis of Kowalewski and colleagues1 appearing in this issue of the Journal has presented a thorough comparison of on- and off-pump coronary artery bypass grafting with regard to 3 perioperative outcomes: death, myocardial infarction, and stroke. Data were presented to confirm that there was no selection bias in the articles, and Forest plot analyses were performed to provide the reader with confidence that the trials were relatively homogeneous as the confidence intervals generally overlapped.
Source: The Journal of Thoracic and Cardiovascular Surgery - August 24, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Fraser Rubens Tags: Editorial commentary Source Type: research
Off-Pump CABG Improves Short-Term Outcomes in High Risk Patients As Compared to On-Pump CABG: Meta-analysis
Off-pump CABG significantly reduced postoperative stroke compared to on-pump CABG. Additionally, benefits from off-pump CABG arise in high risk patients.
Source: The Journal of Thoracic and Cardiovascular Surgery - August 14, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Mariusz Kowalewski, Wojciech Pawliszak, Pietro Giorgio Malvindi, Marek Pawel Bokszanski, Damian Perlinski, Giuseppe Maria Raffa, Magdalena Ewa Kowalkowska, Katarzyna Zaborowska, Eliano Pio Navarese, Michalina Kolodziejczak, Janusz Kowalewski, Giuseppe Tar Source Type: research
Surgical approach to continuous-flow left ventricular assist device explantation: A comparison of outcomes
We retrospectively reviewed data from 27 heart failure patients who completed a protocol for weaning from continuous-flow left ventricular assist device support to examine the outcomes of four different approaches to device removal. We found no association between removal approach and postoperative length of stay, stroke, reoperation, or survival.
Source: The Journal of Thoracic and Cardiovascular Surgery - August 13, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Andrew C.W. Baldwin, Elena Sandoval, George V. Letsou, Hari R. Mallidi, William E. Cohn, O.H. Frazier Source Type: research
Preservation of left ventricular function after degenerative mitral valve repair: Refocusing on timing, techniques, and teaching
Changes in left ventricular (LV) size and function are expected after correction of severe chronic degenerative mitral regurgitation. Although it was previously thought that a postoperative decrease in ejection fraction (EF) was related to inadequate myocardial protection, it is now recognized that elimination of regurgitant volume after mitral valve repair is often associated with an increase in LV end-systolic volume, producing a decline in EF while maintaining normal or increased LV stroke volume.
Source: The Journal of Thoracic and Cardiovascular Surgery - July 18, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Rakesh M. Suri, Maurice Enriquez-Sarano, Hartzell V. Schaff Tags: Editorial: Acquired mitral valve Source Type: research
Piggyback technique facilitates off-pump coronary artery bypass graft by using a proximal anastamostic device with arterial conduits
We report our outcomes with a novel piggyback technique with the Heartstring III Proximal Seal System (Maquet Deutschland GmbH, Medizinische Geräte und Instrumente Großhandel, Rastatt, Germany).
Source: The Journal of Thoracic and Cardiovascular Surgery - June 5, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Bobby Yanagawa, Vicente Orozco-Sevilla, Amit Pawale, John D. Puskas Tags: Surgical technique Source Type: research
Treating valvular heart disease has never been one size fits all
The case report by Capestro and colleagues in this issue of the Journal illustrates the many therapeutic options cardiac surgeons now have at their disposal to treat complex valvular heart disease.1 Capestro and colleagues have described a difficult patient scenario that occurs commonly after homograft implantation. The rate of structural valve deterioration with homografts approaches nearly 40% at 10 years, and the accompanying extensive calcification of these prostheses complicates reoperative aortic valve replacement surgery by predisposing toward paravalvular leaks, the implantation of small prostheses, and perioperative stroke.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 5, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Hersh Maniar Tags: Editorial commentary Source Type: research
In-hospital mortality and stroke after surgical aortic valve replacement: A nationwide perspective
Stroke is a widely recognized complication after aortic valve replacement (AVR), especially among elderly patients. The literature contains substantial variability in reports of the actual incidence of stroke after AVR among high-risk patients. Our objective was to define risk of stroke in patients undergoing surgical AVR, using a large national database.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 4, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Shikhar Agarwal, Aatish Garg, Akhil Parashar, Lars G. Svensson, E. Murat Tuzcu, Jose L. Navia, Stephanie Mick, Samir R. Kapadia Tags: Acquired cardiovascular disease Source Type: research
In-hospital Mortality and Stroke Following Surgical Aortic Valve Replacement: A Nationwide Perspective
Stroke is a widely recognized complication following aortic valve replacement (AVR), especially among elderly patients. Significant heterogeneity exists in the current literature around the actual incidence of stroke following AVR among high-risk patients. Our objective was to define risk of stroke in patients undergoing surgical AVR from a large national database.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 4, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Shikhar Agarwal, Aatish Garg, Akhil Parashar, Lars G. Svensson, E. Murat Tuzcu, Jose Navia, Stephanie Mick, Samir R. Kapadia Source Type: research
Respect the aorta
A severely atherosclerotic aorta (Figure 1) frightens most cardiac surgeons. Placement of a clamp on the heavily diseased aorta can lead to stroke or embolic events to any organ. To address the question of whether placement of 1 or 2 clamps on the aorta for coronary artery bypass surgery (CABG) reduces the risk of stroke or mortality, Araque and colleagues1 retrospectively report on 9797 patients who underwent isolated on-pump CABG between 1993 and 2010. They excluded high-risk patients (off-pump CABG, reoperative surgery, cardiogenic shock, inotrope medications, and emergency or salvage surgery), leaving a cohort of 8497 patients.
Source: The Journal of Thoracic and Cardiovascular Surgery - May 7, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Jennifer S. Lawton Tags: Acquired cardiovascular disease: Coronary Source Type: research
On-pump coronary artery bypass graft operation: Is one crossclamp application better than two?
This study reports our experience with variable degrees of aortic manipulation (ie, single vs double [partial occlusion] aortic crossclamp techniques) and its influence on rate of operative stroke.
Source: The Journal of Thoracic and Cardiovascular Surgery - April 8, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Juan C. Araque, Kevin L. Greason, Zhuo Li, Courtney N. Heins, John M. Stulak, Richard C. Daly, Lyle D. Joyce, Rakesh M. Suri, Chaim Locker, Hartzell V. Schaff Tags: Acquired cardiovascular disease Source Type: research
On-pump coronary artery bypass graft operation: is one cross-clamp application better than two?
This study reports our experience with variable degrees of aortic manipulation (i.e., single versus double [partial occlusion] aortic cross-clamp techniques) and its influence on rate of operative stroke.
Source: The Journal of Thoracic and Cardiovascular Surgery - April 8, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Juan C. Araque, Kevin L. Greason, Zhuo Li, Courtney N. Heins, John M. Stulak, Richard C. Daly, Lyle D. Joyce, Rakesh M. Suri, Chaim Locker, Hartzell V. Schaff Source Type: research
Cryptic Recurrent Mitral valve Excrescence’s: a rare cause of stroke
Source: The Journal of Thoracic and Cardiovascular Surgery - March 31, 2015 Category: Cardiovascular & Thoracic Surgery Authors: David Rose, Andrew Knowles, Mark Sissons, Joseph Zacharias Source Type: research
Cryptic recurrent mitral valve excrescences: A rare cause of stroke
Mesothelial monocytic intracardiac excrescence is considered a benign cardiovascular lesion, but because of its very particular morphology and considering its recurrent behavior, we suggest for this rare valve lesion a strategy to replace the valve rather than attempting a repair.
Source: The Journal of Thoracic and Cardiovascular Surgery - March 31, 2015 Category: Cardiovascular & Thoracic Surgery Authors: David Rose, Andrew Knowles, Mark Sissons, Joseph Zacharias Tags: Case report Source Type: research
The paradox of surgical management of patients with low-flow, low-gradient aortic stenosis
In this issue of the Journal, Parikh and colleagues1 elegantly analyze the institutional outcomes of aortic valve replacement (AVR) at the Cleveland Clinic to illustrate the potential impact of low-flow, low-gradient aortic stenosis (LFLGAS) on 5-year post-AVR mortality. Despite quite acceptable initial operative outcomes, a fifth of their 875 consecutive patients who underwent surgical AVR for severe stenosis during a 2-year period were dead at 5 years. Preoperative left ventricular stroke volume index (LVSVI) was used to identify both LFLGAS with low ejection fraction (EF) and paradoxic LFLGAS with an EF of 50% or greater.
Source: The Journal of Thoracic and Cardiovascular Surgery - March 21, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Vinay Badhwar, John S. Ikonomidis, Jeffrey P. Jacobs Tags: Editorial commentary Source Type: research
The Addition of Hemi-arch Replacement to Aortic Root Surgery Does Not Affect Safety
Hemi-arch reconstruction is the conventional approach for proximal aortic arch replacement but carries risks of neurologic events and coagulopathy. Addition of hemi-arch reconstruction to aortic root replacement may prevent future arch pathology. In this series, addition of a hemi-arch had low mortality and did not increase stroke or bleeding complications.
Source: The Journal of Thoracic and Cardiovascular Surgery - March 19, 2015 Category: Cardiovascular & Thoracic Surgery Authors: S.C. Malaisrie, B. Duncan, C.K. Mehta, M.V. Badiwala, D. Rinewalt, J. Kruse, Z. Li, A.-C. Andrei, P.M. McCarthy Source Type: research
