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Source: The Journal of Thoracic and Cardiovascular Surgery

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Total 276 results found since Jan 2013.

Biological versus mechanical prostheses for aortic valve replacement
The objective was to compare long-term survival and major adverse cardiac and cardiovascular events (ie, stroke, reoperation, and major bleeding) within this population.
Source: The Journal of Thoracic and Cardiovascular Surgery - February 5, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Emiliano A. Rodr íguez-Caulo, Oscar R. Blanco-Herrera, Elisabet Berastegui, Javier Arias-Dachary, Souhayla Souaf-Khalafi, Gertrudis Parody-Cuerda, Gregorio Laguna, SPAVALVE Study Group Tags: Adult Source Type: research

Reply: We still have more to do in our life
In their letter, Harky and colleagues1 discuss our article regarding total arch replacement in elderly patients.2 They listed their own patients, 24 octogenarians who underwent some thoracic aortic surgery using deep hypothermic circulatory arrest between April 2003 and December 2016. They report elective mortality of 16.7%, stroke rate of 22%, and urgent mortality of 33.3% for those undergoing deep hypothermic circulatory arrest, with only just more than half being discharged home. Based on their results, they state that elective surgery for thoracic injury in octogenarians is barely acceptable.
Source: The Journal of Thoracic and Cardiovascular Surgery - January 21, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Yutaka Okita, Yuki Ikeno, Kenji Okada Tags: Letter to the Editor Source Type: research

Reply from authors: We still have more to do in our life
In their letter, Harky and colleagues1 discuss our article regarding total arch replacement in elderly patients.2 They listed their own patients, 24 octogenarians who underwent some thoracic aortic surgery using deep hypothermic circulatory arrest between April 2003 and December 2016. They report elective mortality of 16.7%, stroke rate of 22%, and urgent mortality of 33.3% for those undergoing deep hypothermic circulatory arrest, with only just more than half being discharged home. Based on their results, they state that elective surgery for thoracic injury in octogenarians is barely acceptable.
Source: The Journal of Thoracic and Cardiovascular Surgery - January 21, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Yutaka Okita, Yuki Ikeno, Kenji Okada Tags: Adult: Aorta: Letters to the Editor Source Type: research

Commentary: The case for a comprehensive clinical, basic, and translational research strategy to understand, prevent, detect, and treat cerebrovascular injury in Fontan patients
In this issue of the Journal, the Australian and New-Zealand Fontan Registry Research group compares long-term rates of cerebrovascular injury, thrombosis, bleeding, bone mineral density, and quality of life in Fontan patients receiving warfarin and those receiving aspirin.1 Their take-home messages are (1) asymptomatic cerebrovascular injury is a frequent occurrence in Fontan patients, including stroke (39%), microhemorrhage (96%), and white matter injury (86%); (2) warfarin does not seem to protect against the risk of cerebrovascular injury when compared with aspirin; and (3) warfarin is associated with a greater risk of...
Source: The Journal of Thoracic and Cardiovascular Surgery - January 19, 2021 Category: Cardiovascular & Thoracic Surgery Authors: David Kalfa Tags: Commentary Source Type: research

Is bilateral internal thoracic artery truly better for older patients?
The selection of the second graft conduit remains a matter of debate. To address this point, the Arterial Revascularization Trial (ART) was performed, but this large randomized controlled trial did not prove the benefit of bilateral internal thoracic artery (BITA) graft over single internal thoracic artery (SITA) graft with regard to all-cause mortality, myocardial infarction, or stroke at postoperative 10  years, and a subgroup analysis showed no interaction according to age.1
Source: The Journal of Thoracic and Cardiovascular Surgery - January 16, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Xingjian Hu, Yin Wang Tags: Letter to the Editor Source Type: research

Commentary: Innominate artery cannulation for antegrade cerebral perfusion: Keeping the light bulb lit
Peterson and colleagues1 report the results of a randomized trial comparing axillary versus innominate artery cannulation for antegrade cerebral perfusion (ACP) during hypothermic circulatory arrest (HCA) in 111 patients undergoing proximal aortic arch surgery. The primary safety outcome was the presence of new severe ischemic lesions on diffusion-weighted magnetic resonance imaging (DW-MRI) and was no different in patients cannulated via the axillary artery (38.8%) or innominate artery (34%). Secondary safety outcomes of stroke/transient ischemic attack were also similar between groups (7.1% axillary and 3.6% innominate; ...
Source: The Journal of Thoracic and Cardiovascular Surgery - November 23, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Adam R. Williams, Edward P. Chen Tags: Commentary Source Type: research

Commentary: Radiographic stroke: The silent killer?
Source: The Journal of Thoracic and Cardiovascular Surgery - November 21, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Bradley G. Leshnower Source Type: research

Commentary: Left atrial appendage excision reduces long-term stroke rates —is it the operation or the treatment of atrial fibrillation?
Surgical management of the left atrial appendage (LAA) reduces the rate of cerebrovascular accidents (CVA).1-8 In this edition of the Journal, Duan and colleagues9 present their findings on the incidence of CVA in 1136 patients with atrial fibrillation (AF) undergoing surgical LAA treatment over a 10-year period. Approximately one third underwent LAA excision, LAA extracardiac ligation, and LAA intracardiac suture, respectively. With an average follow-up of 48.7  months, there was no difference in long-term survival.
Source: The Journal of Thoracic and Cardiovascular Surgery - October 28, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Alison F. Ward, Richard Lee Tags: Commentary Source Type: research

Commentary: Left Atrial Appendage Excision Reduces Long Term Stroke Rates —Is it the Operation or the Treatment of Atrial Fibrillation?
Source: The Journal of Thoracic and Cardiovascular Surgery - October 28, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Alison F. Ward, Richard Lee Source Type: research

Commentary: Left atrial appendage excision reduces long-term stroke rates —is it the operation or the treatment of atrial fibrillation?
Surgical management of the left atrial appendage (LAA) reduces the rate of cerebrovascular accidents (CVA).1-8 In this edition of the Journal, Duan and colleagues9 present their findings on the incidence of CVA in 1136 patients with atrial fibrillation (AF) undergoing surgical LAA treatment over a 10-year period. Approximately one third underwent LAA excision, LAA extracardiac ligation, and LAA intracardiac suture, respectively. With an average follow-up of 48.7  months, there was no difference in long-term survival.
Source: The Journal of Thoracic and Cardiovascular Surgery - October 28, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Alison F. Ward, Richard Lee Tags: Commentary Source Type: research

Commentary: Expanding the utility of the Ross procedure —Proceed with caution
Clinical equipoise remains regarding the Ross procedure and its utility. The choice of conduit for aortic valve replacement in adults continues to represent a significant challenge for some clinicians and must be carefully tailored to each individual patient.1 The ideal valve procedure should carry a low incidence of stroke and other valve-related complications and be durable, reliable, anticoagulation-free, and fairly reproducible by a wide array of young and experienced surgeons. Continued technical improvements to the Ross procedure have expanded its indications over the past 2  decades, making it a viable option in older patients.
Source: The Journal of Thoracic and Cardiovascular Surgery - October 22, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Ramsey S. Elsayed, Craig J. Baker, Vaughn A. Starnes Tags: Commentary Source Type: research

Commentary: Expanding the utility of the Ross procedure —Proceed with caution
Clinical equipoise remains regarding the Ross procedure and its utility. The choice of conduit for aortic valve replacement in adults continues to represent a significant challenge for some clinicians and must be carefully tailored to each individual patient.1 The ideal valve procedure should carry a low incidence of stroke and other valve-related complications and be durable, reliable, anticoagulation-free, and fairly reproducible by a wide array of young and experienced surgeons. Continued technical improvements to the Ross procedure have expanded its indications over the past 2  decades, making it a viable option in older patients.
Source: The Journal of Thoracic and Cardiovascular Surgery - October 22, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Ramsey S. Elsayed, Craig J. Baker, Vaughn A. Starnes Tags: Commentary Source Type: research

Moderate aortic dilatation should not be ignored at primarily nonaortic cardiac surgery
We read with interest the article by Idrees and colleagues1 addressing the important issue of whether prophylactic ascending aortic replacement confers additional risk when performed as a concomitant procedure to primarily nonaortic cardiac surgery. Analyzing 647 patients submitted to a combined cardioaortic procedure who were propensity-matched to a non-aortic surgery cohort, they showed no incremental risk for in-hospital stroke (1.4% vs 1.1%) or mortality (0.93% vs 0.46%).
Source: The Journal of Thoracic and Cardiovascular Surgery - September 10, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Metesh Acharya, Marjan Jahangiri Tags: Letter to the Editor Source Type: research

Reply: concomitant aortic replacement: how proactive should we be?
There is a growing body of literature demonstrating that concomitant aortic replacement at the time of elective cardiac surgery can be safely performed. In a recent article by Idrees and colleagues1 in the Journal, they compare a cohort undergoing combined cardiac and aortic procedures with those undergoing cardiac surgery alone and found no difference in rate of in hospital stroke (1.4% vs 1.1%) or mortality (0.93% vs 0.46%). Current guidelines recommend concomitant replacement of the ascending aorta with dilation measuring greater than 4.5 to 5.5  cm diameter depending on risk factors.
Source: The Journal of Thoracic and Cardiovascular Surgery - August 26, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Nathan Haywood, Irving L. Kron Tags: Letter to the Editor Source Type: research

Commentary: It's all in your head
Ischemic stroke remains among the most serious potential complications following cardiac surgery. With a reported incidence of 1.6% to 5.5%, stroke leads to increased mortality coupled with long-term disability in>50% of patients.1 The cause of ischemic stroke is multifactorial, with embolism and hypotension during surgery known predisposing factors. Cerebral atherosclerosis (CAS), particularly of the major intracranial arteries (ICAS), is an increasingly identified cause of stroke worldwide, particularly prevalent in Asian, African American, and Hispanic populations.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 28, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Kevin P. Landolfo, William D. Freeman Tags: Commentary Source Type: research