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Source: The Journal of Thoracic and Cardiovascular Surgery
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Total 276 results found since Jan 2013.
Coarctation of aorta aneurysm with aberrant right subclavian artery and single carotid artery: Surgical and perfusion strategies
We present the surgical and perfusion strategy that we used to maintain cerebral and spinal cord perfusion during repair, thereby preventing devastating complications of stroke and paraplegia. Written patient consent was obtained for this case report.
Source: The Journal of Thoracic and Cardiovascular Surgery - September 27, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Balasubramoniam Kavumkal Rajagopalan, Rajesh Jose, Nazar Puthukudiyil Kader, Praveen Kerala Varma Tags: Case Report Source Type: research
Mitral repair in symptom-free patients with normal ventricles: Becoming the new normal?
We have all been there. A young, vigorous woman referred to you with severe asymptomatic mitral regurgitation is in your office to discuss surgical repair. You proceed to describe the incision you are going to make somewhere on her chest; the 1% to 2% risk of bleeding, stroke, infection, heart failure, and death; the fact that she may end up with a prosthetic mitral valve requiring lifelong anticoagulation; and the fact that she is going to have to miss a month or more of her Pilates classes because the American College of Cardiology and American Heart Association Task Force on Practice Guidelines (ACC/AHA) says that it is...
Source: The Journal of Thoracic and Cardiovascular Surgery - September 5, 2018 Category: Cardiovascular & Thoracic Surgery Authors: David D. Yuh Tags: Editorial Commentary Source Type: research
Commentary: Mitral repair in symptom-free patients with normal ventricles: Becoming the new normal?
We have all been there. A young, vigorous woman referred to you with severe asymptomatic mitral regurgitation is in your office to discuss surgical repair. You proceed to describe the incision you are going to make somewhere on her chest; the 1% to 2% risk of bleeding, stroke, infection, heart failure, and death; the fact that she may end up with a prosthetic mitral valve requiring lifelong anticoagulation; and the fact that she is going to have to miss a month or more of her Pilates classes because the American College of Cardiology and American Heart Association Task Force on Practice Guidelines (ACC/AHA) says that it is...
Source: The Journal of Thoracic and Cardiovascular Surgery - September 4, 2018 Category: Cardiovascular & Thoracic Surgery Authors: David D. Yuh Tags: Commentary Source Type: research
In pursuit of the optimal hemocompatible left ventricular assist device
Left ventricular assist device (LVAD) implantation is a firmly established treatment modality for advanced heart failure; however, major complications such as nonsurgical bleeding, driveline infections, pump thrombosis, and stroke limit wider application to patients with less severe heart failure. Of note, more than 60% of patients who receive a continuous flow LVAD experience such severe adverse events within the first year.1
Source: The Journal of Thoracic and Cardiovascular Surgery - August 29, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Shuab Omer Tags: Editorial Commentary Source Type: research
Early left ventricular assist device-related strokes: Turn up the flow, turn down the embolism?
Despite technical and surgical advances in continuous-flow left ventricular assist devices (LVADs), stroke remains a major complication. In the eighth annual Interagency Registry for Mechanically Assisted Circulatory Support report,1 stroke dominates as the major cause of death between 6 months and 4 years of device support. Previously identified risk factors for stroke in LVAD patients include pump thrombosis, infection, blood pressure, gastrointestinal bleeding, and excessive antithrombotic treatment.
Source: The Journal of Thoracic and Cardiovascular Surgery - August 3, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Mark Helmers, Pavan Atluri Tags: Editorial Commentary Source Type: research
Comparing apples with oranges: The funfair of statistics
The CHA2DS2-VASc score estimates the risk of stroke in patients with atrial fibrillation.1,2 The CHA2DS2-VASc score accounts for congestive heart failure; hypertension; age of at least 75 years (doubled); diabetes mellitus; previous stroke, transient ischemic attack or thromboembolism (doubled); vascular disease; age 65 to 74 years; and sex category (female). Should the CHA2DS2-VASc score be considered as a categorical or a continuous factor, if the patients have an incremental in crease in risk of death, stroke, or bleeding?
Source: The Journal of Thoracic and Cardiovascular Surgery - August 3, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Ari A. Mennander Tags: Editorial Commentary Source Type: research
Performance of CHA2DS2-VASc Score for Stroke Prediction after Surgical Aortic Valve Replacement
Stroke is a frequent complication occurring early and late after surgical aortic valve replacement (SAVR). There is an unmet clinical need for simple tools to assess postoperative stroke risk. We sought to assess the predictive performance of CHA2DS2-VASc score in patients undergoing SAVR with a bioprosthesis.
Source: The Journal of Thoracic and Cardiovascular Surgery - July 28, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Tuomas Kiviniemi, Joonas Lehto, Maunu Nissinen, Tuomo Nieminen, Juha Hartikainen, Markus Malmberg, Fredrik Yannopoulos, Jyri Savolainen, Pasi Karjalainen, K E Juhani Airaksinen, Stefano Rosato, Fausto Biancari Source Type: research
Reinventing the atrial fibrillation wheel
In this issue of the Journal, Mehta and colleagues1 report their 10-year experience with “De Novo Atrial Fibrillation After Mitral Valve Surgery,” defined as new-onset atrial fibrillation (AF) occurring more than 90 days after discharge. The cause was heterogeneous, with half of the patients having degenerative pathology. The incidence of de novo AF was 14% and 23% at 5 and 10 yea rs, respectively. Multivariable risk factors were tricuspid valve surgery, aortic valve surgery, and older age. Obviously, significantly more patients with AF were anticoagulated, with a strong but not significant trend toward an increased risk of stroke.
Source: The Journal of Thoracic and Cardiovascular Surgery - July 15, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Isidore Dinga Madou, Tsuyoshi Kaneko, Sary F. Aranki Tags: Editorial Commentary Source Type: research
Straight deep hypothermic circulatory arrest: Cling to old fashion or not?
We read with great interest the study by Damberg and colleagues1 showing excellent results after aortic surgery with straight deep hypothermic circulatory arrest (DHCA) without cerebral perfusion. Antegrade cerebral perfusion (ACP) was not performed to avoid potential air/particulate embolism and hypoperfusion or hyperperfusion. They demonstrated that straight DHCA (DHCA time within 50 minutes) was a safe and effective method of brain protection in patients at their center, associated with favorable short-term mortality (2.9%) and stroke rate (2%), as well as late survival (estimated 1- and 5-year survivals 92.2% and 81....
Source: The Journal of Thoracic and Cardiovascular Surgery - July 13, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Shujie Yan, Bingyang Ji, Song Lou Tags: Adult: Other: Letter to the Editor Source Type: research
Risk of stroke early after implantation of a left ventricular assist device
Stroke is one of the major adverse events after left ventricular assist device (LVAD) implantation. Risk of stroke is the highest immediately after LVAD implantation and then increases again in chronic periods. There is no study which analyzed risk factors for stroke in acute phase, we investigated the risk factors for stroke in acute phase after LVAD implantation in the present study.
Source: The Journal of Thoracic and Cardiovascular Surgery - July 3, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Takaaki Samura, Daisuke Yoshioka, Koichi Toda, Ryoto Sakaniwa, Mikito Shimizu, Shigeru Miyagawa, Yasushi Yoshikawa, Hiroki Hata, Shunsuke Saito, Yasushi Sakata, Yoshiki Sawa Source Type: research
Higher-quality evidence needed before abandoning proven therapies: Comment
We have concerns regarding the recent publication by Murashita and colleagues1 on a small retrospective cohort of patients undergoing Cox Maze IV ablation and left atrial appendage (LAA) occlusion. The authors found a low rate of stroke (
Source: The Journal of Thoracic and Cardiovascular Surgery - June 15, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Graham R. McClure, Emilie P. Belley-Cote, Richard P. Whitlock Tags: Adult: Arrhythmias: Letter to the editor Source Type: research
Providing equipoise in the management of patients after surgical ablation with the Cox-Maze IV
We thank McClure and colleagues1 for their contributions to the field of stroke prevention in atrial fibrillation and for their interest in our study on oral anticoagulation (OAC) after the Cox-Maze IV operation.2 These colleagues make 4 comments in their letter to the Editor1 that require a response: (1) the impact of small sample size on conclusions, (2) their accounting of strokes and the group without OAC, (3) the need to follow the guidelines and continue OAC, and (4) the applicability of left atrial appendage occlusion studies to guide clarity on OAC management after surgical ablation.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 15, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Takashi Murashita, Harold G. Roberts, Lawrence M. Wei, J. Scott Rankin, Vinay Badhwar Tags: Adult: Arrhythmias: Letter to the editor Source Type: research
The limitations of observational data in assessing surgical left atrial appendage ligation
We read with interest the study by Juo and colleagues, which examined outcomes in a cohort of patients with atrial fibrillation who underwent surgical left atrial appendage (LAA) ligation concomitantly with coronary artery bypass grafting. The authors evaluated the short-term efficacy and safety of LAA ligation in 20,664 patients among a sample of 234,642 patients from the Nationwide Inpatient Sample, and reported no significant differences in postoperative stroke, mortality, bleeding, and pericardial complications.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 14, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Saurabh Gupta, Emilie P. Belley-C ôté, Richard P. Whitlock Tags: Letter to the editor Source Type: research
Fatal Complications Associated With Surgical Left Atrial Appendage Exclusion
We report two patients with AF and dilated left atria that underwent concomitant LAA exclusion with resultant myocardial tearing at the site of exclusion.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 4, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Mahmoud Sleiman Wehbe, Nicolas Doll, Denis Merk Source Type: research
Multivessel coronary artery disease and poor left ventricle function: It is consistent and clear, coronary artery bypass grafting wins again
Superiority of coronary artery bypass grafting (CABG) to medical therapy in patients with impaired ventricular function (ie, ejection fraction ≤ 35%) has been shown in clinical trials.1,2 Observational studies have also demonstrated greater survival in patients with an impaired left ventricle undergoing CABG compared with those that are treated with percutaneous coronary intervention (PCI).3,4 Although these studies unanimously demons trated that the incidence of early stroke, renal failure, and other complications were higher in the CABG group, having a better survival rate favors CABG over PCI in the treatment of pa...
Source: The Journal of Thoracic and Cardiovascular Surgery - May 28, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Saina Attaran, William S. Weintraub, Vinod H. Thourani Tags: Editorial commentary Source Type: research
