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Source: The Journal of Thoracic and Cardiovascular Surgery
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Total 276 results found since Jan 2013.
Cerebrovascular complications after cardiac surgery: It is time to track and treat large vessel occlusion
We read with a great interest the recent article by Sheriff and colleagues1 concerning large vessel occlusion (LVO) stroke after cardiothoracic surgery (CTS). Sheriff and colleagues1 conducted a monocenter study of their own database, with 5947 patients being reviewed between July 2013 and April 2018. Among 148 patients with cerebrovascular complications within 30 days of surgery, 10.1% had LVO. Almost half of these patients were considered candidates for emergency thrombectomy, with encouraging functional outcome at 3 months.
Source: The Journal of Thoracic and Cardiovascular Surgery - December 3, 2019 Category: Cardiovascular & Thoracic Surgery Authors: R émi Schweizer, Matthias Jacquet-Lagrèze, Jean-Luc Fellahi Tags: Letter to the Editor Source Type: research
Commentary: Silent brain lesions add noise to the on- versus off-pump coronary artery bypass grafting debate
The debate between on-pump (ONCABG) and off-pump coronary artery bypass grafting (OPCABG) has waged on for more than 30 years. Early proponents favored OPCABG based on the hypothesis that removing cardiopulmonary bypass (CPB) from the operation would mitigate perioperative complications such as stroke. However, after 3 large randomized controlled trials (Randomized On/Off Bypass [ROOBY], Coronary Artery Bypass Surg ery Off or On Pump Revascularization Study [CORONARY], and German Off Pump Coronary Artery Bypass Grafting in Elderly Patients [GOPCABE]) failed to show a difference in stroke rate between ONCABG and OPCABG,1-...
Source: The Journal of Thoracic and Cardiovascular Surgery - November 26, 2019 Category: Cardiovascular & Thoracic Surgery Authors: William C. Frankel, Tom C. Nguyen Tags: Commentary Source Type: research
Commentary: Silent brain lesions after coronary artery bypass grafting —Reexamining the sound of silence
Stroke remains one of the most feared complications after coronary artery bypass grafting (CABG) and is associated with as much as 10 times greater in-hospital mortality.1 Although large series have investigated clinical cerebrovascular events and identified risk factors, such as history of cerebrovascular disease or prolonged cardiopulmonary bypass time, subclinical neurologic events and their long-term impact remain poorly understood.2,3 These so-called silent infarcts refer to new brain lesions on postoperative imaging in patients without any correlating focal neurologic findings.
Source: The Journal of Thoracic and Cardiovascular Surgery - November 13, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Andrew M. Vekstein, Shu S. Lin Tags: Commentary Source Type: research
Commentary: Coming to terms with stroke and “brain lesions” in cardiac surgery
Source: The Journal of Thoracic and Cardiovascular Surgery - October 9, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Keshava Rajagopal Source Type: research
Stroke after type A aortic dissection repair: Can we do better?
We thank Hawkins and colleagues1 for their commentary “Stroke After Type A Aortic Dissection Repair - A Web of Risk With No Single Answer” regarding our recently published article,2 in which we sought to examine the incidence and factors associated with acute stroke after type A repair. Undoubtedly, stroke is a common and deadly complication after type A repair, and yet limited effort has been done to prevent this morbid complication. It is worth mentioning that Hawkins and colleagues3 have shown that the rate of stroke after type A repair has not changed in the last 2 decades (>10% since 2003).
Source: The Journal of Thoracic and Cardiovascular Surgery - September 23, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Mehrdad Ghoreishi, Sari D. Holmes, Bradley S. Taylor Tags: Letter to the Editor Source Type: research
Commentary: Optimal Perfusion Strategy for Stroke Risk Reduction in Type A Aortic Dissection Repair – Still Unresolved?
Source: The Journal of Thoracic and Cardiovascular Surgery - September 8, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Konstantin von Aspern, Christian D. Etz, Michael A. Borger Source Type: research
The optimum arterial cannulation site during open aortic arch repair: is it the axillary artery?
I read with interest the article by Kim and colleagues1 about axillary artery (AA) cannulation in open aortic arch repair. Their propensity-matched, retrospective analysis included 116 patients in each cohort of AA and non-AA cannulation. The primary outcome from the study was early postoperative embolic stroke, whereas the secondary outcomes were in-hospital mortality and major operative complications. They concluded a lower rate of embolic stroke in axillary cohort (2.6% vs 8.5%, P = .46), as well as lower in-hospital and 30-day mortality rates (P
Source: The Journal of Thoracic and Cardiovascular Surgery - August 19, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Amer Harky Tags: Letter to the Editor Source Type: research
Discussion
Dr Mehrdad Ghoreishi (Baltimore, Md). Stroke after type A repair is a highly morbid complication with an incidence of up to 30% in multiple studies. There are currently no randomized data or large retrospective studies to guide the surgical strategies to prevent or decrease the risk of stroke. Five questions that we want to answer that may affect the stroke rate are 1: The effect of cannulation strategy on neurologic outcomes, including going axillary, femoral, or direct aorta. Second is temperature management.
Source: The Journal of Thoracic and Cardiovascular Surgery - July 23, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research
Commentary: Stroke after type A aortic dissection repair —A web of risk with no single answer
In this issue of the Journal, Ghoreishi and colleagues1 have performed a tour de force in attempting to analyze 5 major factors potentially associated with stroke after type A aortic dissection repair. The etiology of stroke after aortic surgery is an entanglement of numerous complex factors that place patients at risk for both ischemic and embolic neurologic insults. Decisions about the extent of surgical repair, cannulation site, cerebral perfusion strategy, and degree of hypothermia are all interrelated.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 19, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Robert B. Hawkins, J. Hunter Mehaffey, John A. Kern Tags: Commentary Source Type: research
Commentary: Stroke after Type A Aortic Dissection Repair - A Web of Risk with No Single Answer
Source: The Journal of Thoracic and Cardiovascular Surgery - June 19, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Robert B. Hawkins, J.Hunter Mehaffey, John A. Kern Source Type: research
Factors Associated with Acute Stroke after Type A Aortic Dissection Repair: An Analysis of the Society of Thoracic Surgeons National Adult Cardiac Surgery Database
The Society of Thoracic Surgeons Adult Cardiac Surgery Database (STS ACSD) was used to examine the incidence and factors associated with acute stroke following type A repair.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 16, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Mehrdad Ghoreishi, Thoralf M. Sundt, Duke E. Cameron, Sari D. Holmes, Eric E. Roselli, Chetan Pasrija, James S. Gammie, Himanchu J. Patel, Joseph Bavaria, Lars G. Svensson, Bradley S. Taylor Source Type: research
Inter- and intrasite variability of mortality and stroke for sites performing both surgical and transcatheter aortic valve replacement for aortic valve stenosis in intermediate-risk patients
Multisite procedure-based randomized trials may be confounded by performance variability and variability among sites. Therefore, we studied variability in mortality and stroke after patients were randomized to surgical (SAVR) or transcatheter aortic valve replacement (TAVR) in the Placement of Aortic Transcatheter Valves-2A (PARTNER-2A) randomized trial.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 14, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Kevin L. Greason, Eugene H. Blackstone, Jeevanantham Rajeswaran, Ashley M. Lowry, Lars G. Svensson, John G. Webb, E. Murat Tuzcu, Craig R. Smith, Raj R. Makkar, Michael J. Mack, Vinod H. Thourani, Susheel K. Kodali, Martin B. Leon, D. Craig Miller Tags: Adult Source Type: research
Inter- and Intra-site Variability of Mortality and Stroke for Sites Performing both Surgical and Transcatheter Aortic Valve Replacement for Aortic Valve Stenosis in Intermediate-risk Patients
Multi-site procedure-based randomized trials may be confounded by performance variability and variability among sites. Therefore, we studied variability in mortality and stroke after patients were randomized to surgical (SAVR) or transcatheter aortic valve replacement (TAVR) in PARTNER-2A.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 14, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Kevin L. Greason, Eugene H. Blackstone, Jeevanantham Rajeswaran, Ashley M. Lowry, Lars G. Svensson, John G. Webb, E.Murat Tuzcu, Craig R. Smith, Raj R. Makkar, Michael J. Mack, Vinod H. Thourani, Susheel K. Kodali, Martin B. Leon, D.Craig Miller Source Type: research
Commentary: Atrial fibrillation after aortic valve replacement: Predict, prevent, protect
When atrial fibrillation (AF) occurs after cardiac surgery, surgeons consider the arrhythmia a nuisance rather than a complication. This reflects natural optimism. Although perioperative AF is most often self-limited, it is associated with increased risk of stroke and death, increased hospital length of stay, and increased health care costs.1 Still, we tend not to worry too much because postoperative AF tends to resolve regardless of treatment strategy.1
Source: The Journal of Thoracic and Cardiovascular Surgery - June 13, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Marc Gillinov, Edward G. Soltesz Tags: Commentary Source Type: research
Discussion
Dr A. Khoynezhad (Los Angeles, Calif). I congratulate the authors for outlining their extensive experience with 437 patients undergoing total arch replacement using the FET technique at 2 high-volume aortic centers in Europe. Pathologies treated include aneurysm, CAD, and AAD in 25% of the patient cohort. Three different hybrid grafts were used along with different cardioplegia and cannulation techniques. Risk factors for early mortality, stroke, and spinal cord ischemia were presented, and the follow-up of the patients was 100% complete.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 13, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research
