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Source: The Journal of Thoracic and Cardiovascular Surgery
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Total 276 results found since Jan 2013.
Outcomes of surgical aortic valve replacement for severe aortic stenosis: Incorporation of left ventricular systolic function and stroke volume index
We sought to a) assess predictors of mortality in consecutive patients with severe aortic stenosis (AS) undergoing aortic valve replacement (AVR) and b) determine if there are differences in mortality, separated on the basis of different AS subtypes and left ventricular stroke volume index (LV-SVI).
Source: The Journal of Thoracic and Cardiovascular Surgery - March 11, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Roosha Parikh, Andrew L. Goodman, Tyler Barr, Joseph F. Sabik, Lars G. Svensson, L Leonardo Rodriguez, Bruce W. Lytle, Richard A. Grimm, Brian P. Griffin, Milind Y. Desai Source Type: research
Can we make stroke during cardiac surgery a never event?
Stroke has been and continues to be the Achilles heel of cardiac surgery. Periprocedural neurologic events during cardiac surgery remain prevalent, with stroke reported in 2.0% to 4.6% of patients undergoing cardiac surgery and increasing to at least 12.8% in octogenarians.1-3 The fear of stroke or other adverse neurologic outcomes, including so-called pump head, is a deterrent for patients to undergo the otherwise successful, life-saving operations that we perform. The interpretation of the SYNTAX trial “that with coronary artery bypass grafting (CABG) the patient is trading a 3 times higher risk of stroke (2.2% vs 0.6%...
Source: The Journal of Thoracic and Cardiovascular Surgery - February 28, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Michael Mack Tags: Editorial commentary Source Type: research
Does Preoperative Carotid Stenosis Screening Reduce Perioperative Stroke in Patients Undergoing Coronary Artery Bypass Grafting?
Source: The Journal of Thoracic and Cardiovascular Surgery - February 9, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Khalil Masabni, Sajjad Raza, Eugene H. Blackstone, Heather L. Gornik, Joseph F. Sabik Source Type: research
Protecting the aorta during transcatheter aortic valve replacement: Have we found the answer?
Neurologic injury ranging from transient cognitive dysfunction to catastrophic permanent stroke constitutes the single main morbidity of cardiac surgery and largely affects modern transcatheter aortic valve replacement (TAVR).1-3 Today, the incidence of cerebrovascular events after TAVR ranges from 3% to 7%.4 In the current report, Samim and colleagues5 have explored one of the novel embolic protection devices (EPDs) aimed at reducing these extremely pervasive complications that often carry surmountable challenges to the patient in terms of a reduction in functional status and quality of life, and the healthcare provider i...
Source: The Journal of Thoracic and Cardiovascular Surgery - December 6, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Hanna A. Jensen, Amjad Syed, Vinod H. Thourani Tags: Editorial commentary Source Type: research
Postoperative atrial fibrillation and total dietary antioxidant capacity in patients undergoing cardiac surgery: The Polyphemus Observational Study
Postoperative atrial fibrillation is a major cause of morbidity and mortality for stroke after cardiac surgery. Both systemic inflammation and oxidative stress play a role in the initiation of postoperative atrial fibrillation after cardiac surgery. The possible association between long-term intake of antioxidant-rich foods and postoperative atrial fibrillation incidence was examined in patients undergoing cardiac surgery.
Source: The Journal of Thoracic and Cardiovascular Surgery - November 21, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Simona Costanzo, Amalia De Curtis, Veronica di Niro, Marco Olivieri, Mariarosaria Morena, Carlo Maria De Filippo, Eugenio Caradonna, Vittorio Krogh, Mauro Serafini, Nicoletta Pellegrini, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello, Polyp Tags: Perioperative management Source Type: research
Composite vein grafting: Is it a “Y's” decision?
Composite grafting techniques from the in situ left internal thoracic artery (LITA) has many theoretic advantages, which include a reduction in stroke by minimizing aortic manipulation along with greater utilization of available conduits.1 Although this technique has become popular with multiarterial grafting,2 arteriovenous composites are less accepted because of poor patency and flow dynamics.3 Excellent results have been reported in a recently published randomized trial, however, which showed that the saphenous vein grafts (SVGs) harvested with a minimal manipulation no-touch technique were not inferior to the right int...
Source: The Journal of Thoracic and Cardiovascular Surgery - November 21, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Saswata Deb, Domingos S.R. Souza, Stephen E. Fremes Tags: Acquired cardiovascular disease Source Type: research
To give or not to give? Are we ready to use noninvasive monitors to guide fluid management in cardiothoracic surgical patients?
Ensuring adequate cardiac output to meet the metabolic demands of the body's tissues is the central tenet of management for the postoperative cardiac surgical patient.1-3 The most common therapy in the early postoperative period to promote this is the use of intravenous fluids. Fluids are typically infused with the goal of optimizing the Frank-Starling relationship of ventricular end-diastolic volume (preload) and stroke volume to optimize cardiac output and thus forward flow and oxygen delivery.
Source: The Journal of Thoracic and Cardiovascular Surgery - October 17, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Rakesh C. Arora Tags: Perioperative management Source Type: research
Don't touch that aorta!
In this issue of the Journal of Thoracic and Cardiovascular Surgery, a multidisciplinary research group from Emory University present important information regarding surgical technical maneuvers to reduce the incidence of stroke in the perioperative period after coronary artery bypass operations (CABG).1 They discuss stroke rates in 12,079 patients divided into 3 groups with different methods of aortic manipulation. The authors should be congratulated for their extensive data collection and rigorous analysis.
Source: The Journal of Thoracic and Cardiovascular Surgery - October 2, 2014 Category: Cardiovascular & Thoracic Surgery Authors: John W. Hammon Tags: Editorial commentary Source Type: research
To cool or not to cool?
To cool or not to cool—that is the question that is raised by the recent study by Greason and colleagues1 appearing in this issue of the Journal. Greason and colleagues1 used the Society of Thoracic Surgeons database to evaluate patients undergoing nonemergency on-pump isolated coronary artery bypass grafting (CABG) with specific attention to the effect of lowest intraoperative recorded core body temperature on the primary end point of operative mortality and secondary end points of stroke, reoperation for bleeding, and a combined infection end point.
Source: The Journal of Thoracic and Cardiovascular Surgery - September 30, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Jennifer S. Lawton Tags: Editorial commentary Source Type: research
Neuromonitoring during cardiothoracic surgery: The signal and the noise
Neurologic complications in the perioperative period for patients undergoing cardiac surgery are associated with significant morbidity and mortality. Even when a stroke is not clinically evident, lesser degrees of postoperative cognitive dysfunction may be noticed by the patient or detected by robust neurocognitive testing, and such level of dysfunction may be one of the more common adverse outcomes after cardiac surgery.1 Cardiac surgical procedures can affect the regional or global perfusion of the brain in 1 of 2 ways, either by gaseous or particulate embolization from a proximal site or a decrease in perfusion due to p...
Source: The Journal of Thoracic and Cardiovascular Surgery - September 25, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Abe DeAnda Tags: Editorial commentary Source Type: research
Acute ascending aortic dissection: Support for limited distal repair
Despite the significant evolution of the surgical treatment of acute type A aortic dissection, repair remains a challenge and is associated with significant morbidity and mortality. Controversy remains regarding the proximal and distal extent of aortic resection in patients undergoing such repairs. Although replacement of the entire transverse aortic arch may prevent the need for additional surgical intervention later, this approach incurs increased risks of stroke and mortality; if repair is extended beyond the left subclavian artery, there is the additional risk of paraplegia.
Source: The Journal of Thoracic and Cardiovascular Surgery - September 25, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Joseph S. Coselli Tags: Editorial commentary Source Type: research
A study of brain protection during total arch replacement comparing antegrade cerebral perfusion versus hypothermic circulatory arrest, with or without retrograde cerebral perfusion: Analysis based on the Japan Adult Cardiovascular Surgery Database
Analysis of 8,169 elective total arch replacements from 2009 - 2012 in the Japan Adult Cardiovascular Surgery Database disclosed comparable mortality and stroke rates but shorter ICU stay in 7,038 patients undergoing antegrade cerebral perfusion compared to 1,141 patients undergoing hypothermic circulatory arrest, with or without retrograde cerebral perfusion.
Source: The Journal of Thoracic and Cardiovascular Surgery - September 18, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Yutaka Okita, Hiroaki Miyata, Noboru Motomura, Shinichi Takamoto Source Type: research
Avoiding aortic clamping during coronary artery bypass grafting reduces postoperative stroke
The purpose of this study was to determine whether the incidence of postoperative stroke could be reduced by eliminating aortic clamping during coronary artery bypass grafting.
Source: The Journal of Thoracic and Cardiovascular Surgery - September 14, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Emmanuel Moss, John D. Puskas, Vinod H. Thourani, Patrick Kilgo, Edward P. Chen, Bradley G. Leshnower, Omar M. Lattouf, Robert A. Guyton, Kathryn E. Glas, Michael E. Halkos Tags: Acquired cardiovascular disease Source Type: research
Avoiding aortic clamping during CABG reduces postoperative stroke
This review of 12,079 patients evaluated the effect of aortic manipulation strategies on stroke following CABG. Stroke risk was independently associated with the degree of aortic manipulation, with the no-touch technique having the lowest risk. This suggests that avoiding aortic manipulation may minimize the incidence of stroke following CABG.
Source: The Journal of Thoracic and Cardiovascular Surgery - September 14, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Emmanuel Moss, John D. Puskas, Vinod H. Thourani, Patrick Kilgo, Edward P. Chen, Bradley G. Leshnower, Omar M. Lattouf, Robert A. Guyton, Kathryn E. Glas, Michael E. Halkos Source Type: research
Surgical revascularization for patients with diabetes: Do all roads lead to Rome?
The BARI 2D trial (Bypass Angioplasty Revascularization Investigation 2 Diabetes Trial)1 randomly allocated patients with type 2 diabetes and stable coronary artery disease (CAD) and evidence of myocardial ischemia to undergo, at the discretion of the treating physician, either early revascularization with a percutaneous intervention (PCI) or coronary artery bypass grafting (CABG) with optimal medical therapy (OMT), or OMT alone. Patients in the OMT group were also randomly assigned to insulin-sensitizing strategy (metformin and thiazolidinedione) or an insulin-providing strategy (insulin or secretagogue.) The 5-year follo...
Source: The Journal of Thoracic and Cardiovascular Surgery - August 28, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Tomas A. Salerno Tags: Editorial commentary Source Type: research
