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The SYNTAX score is correlated with long-term outcomes of coronary artery bypass grafting for complex coronary artery lesions
CONCLUSIONS The SYNTAX score is correlated with long-term outcomes, in terms of MACCEs, after conventional CABG for complex coronary lesions and is prognostic of long-term outcomes of CABG for patients with complex lesions.
Source: Interactive CardioVascular and Thoracic Surgery - June 19, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Cho, Y., Shimura, S., Aki, A., Furuya, H., Okada, K., Ueda, T. Tags: Molecular biology, History Adult Cardiac Source Type: research

Longevity and admission to nursing home according to age after isolated coronary artery bypass surgery: a nationwide cohort study
CONCLUSIONS The majority of all patients selected for CABG surgery in Denmark between 1996–2012, including the elderly, were able to live independently at home without the need of home care for many years after CABG. The risk of nursing home admission was small and dependent on the patient's age, sex and preoperative comorbidities.
Source: Interactive CardioVascular and Thoracic Surgery - May 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Thorsteinsson, K., Andreasen, J. J., Mortensen, R. N., Kragholm, K., Torp-Pedersen, C., Gislason, G., Kober, L., Fonager, K. Tags: Molecular biology Adult Cardiac Source Type: research

Results of surgical aortic valve replacement and transapical transcatheter aortic valve replacement in patients with previous coronary artery bypass grafting
CONCLUSIONS Reported differences in mortality and morbidity after TaTAVR and RAVR reflect differences in baseline risk profiles. Given the lower trend for renal complications, patients at higher perioperative renal risk might be better served by TaTAVR.
Source: Interactive CardioVascular and Thoracic Surgery - May 25, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Onorati, F., D'Onofrio, A., Biancari, F., Salizzoni, S., De Feo, M., Agrifoglio, M., Mariscalco, G., Lucchetti, V., Messina, A., Musumeci, F., Santarpino, G., Esposito, G., Santini, F., Magagna, P., Beghi, C., Aiello, M., Ratta, E. D., Savini, C., Troise, Tags: Molecular biology, Transplantation - heart, Basic research vascular Adult Cardiac Source Type: research

How revascularization on the beating heart with cardiopulmonary bypass compares to off-pump? A meta-analysis of observational studies
Off-pump coronary artery bypass surgery has been a controversial area of debate and the outcome profile of the technique has been thoroughly investigated. Scepticism regarding the reported outcomes and the conduct of the randomized trials comparing this technique with conventional on-pump coronary artery bypass surgery has been widely voiced, and the technique of off-pump surgery remains as an infrequently adopted approach to myocardial revascularization worldwide. Criticisms of the technique are related to lower rates of complete revascularization and its unknown long-term consequences, the significant detrimental effects...
Source: Interactive CardioVascular and Thoracic Surgery - December 26, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Sepehripour, A. H., Chaudhry, U. A., Suliman, A., Kidher, E., Sayani, N., Ashrafian, H., Harling, L., Athanasiou, T. Tags: Education, Molecular biology, Myocardial protection Adult Cardiac Source Type: research

Safety and efficacy of glucose-insulin-potassium treatment in coronary artery bypass graft surgery and percutaneous coronary intervention
The purpose of this meta-analysis was to evaluate protective effects of glucose–insulin–potassium (GIK) on outcomes after coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). We systematically searched Medline/Pubmed, Elsevier, Embase, Web of Knowledge and Google Scholar. A total of 1206 studies were retrieved during the extensive literature search of all major databases; however, 38 trials reporting the end-point of interest were selected. We performed a pooled analysis of outcomes following PCI: incidence of cardiac arrest [odds ratio (OR) of 0.91; 95% confidence interval (CI): ...
Source: Interactive CardioVascular and Thoracic Surgery - October 19, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Ali-Hassan-Sayegh, S., Mirhosseini, S. J., Zeriouh, M., Dehghan, A. M., Shahidzadeh, A., Karimi-Bondarabadi, A. A., Sabashnikov, A., Popov, A.-F. Tags: Congestive Heart Failure Adult Cardiac Source Type: research

Protective effects of corticosteroids in coronary artery bypass graft surgery alone or combined with valvular surgery: an updated and comprehensive meta-analysis and systematic review
This systematic review with meta-analysis sought to determine the protective effects of corticosteroids on clinical outcomes following coronary artery bypass grafting (CABG). Medline, Embase, Elsevier and Sciences online database as well as Google scholar literature were used for selecting appropriate studies with randomized controlled design. The effect sizes measured were odds ratio (OR) for categorical variables and weighted mean difference with 95% confidence interval (CI) for calculating differences between mean values of duration of hospitalization in intervention and control groups. Values of P < 0.1 for Q-test o...
Source: Interactive CardioVascular and Thoracic Surgery - May 28, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Ali-Hassan-Sayegh, S., Mirhosseini, S. J., Haddad, F., Karimi-bondarabadi, A. A., Shahidzadeh, A., Weymann, A., Popov, A.-F., Sabashnikov, A. Tags: Cardiac - pharmacology, Coronary disease Adult Cardiac Source Type: research

Off-pump no-touch technique: 3-year results compared with the SYNTAX trial
CONCLUSIONS The results at the 3-year follow-up showed the safety and efficacy of OPCAB no-touch technique. The OPCAB no-touch technique may improve patients' outcome by minimizing the morbidity and the neurological complications. Prospective controlled trials are needed to confirm these results.
Source: Interactive CardioVascular and Thoracic Surgery - April 22, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Arrigoni, S. C., Mecozzi, G., Grandjean, J. G., Hillege, J. L., Kappetein, A. P., Mariani, M. A. Tags: Cardiac - other, Coronary disease Adult Cardiac Source Type: research

How safe is it to train residents to perform off-pump coronary artery bypass surgery?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was, in [patients undergoing off-pump CABG] are [postoperative mortality and morbidity outcomes] acceptable when performed by [trainees]? Altogether more than 597 papers were found using the reported search, of which 8 represented the best evidence to answer the clinical question. Six retrospective cohort studies directly compared the performance of trainees and experienced surgeons in off-pump coronary artery bypass graft surgery. Of the remaining papers, one recorded the performance of trainees in on- and off-p...
Source: Interactive CardioVascular and Thoracic Surgery - April 22, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Smith, T. A., Asimakopoulos, G. Tags: Electrophysiology - arrhythmias, Molecular biology Adult Cardiac Source Type: research

Should we consider beating-heart on-pump coronary artery bypass grafting over conventional cardioplegic arrest to improve postoperative outcomes in selected patients?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether beating-heart on-pump coronary artery bypass grafting (BH-ONCAB) offered superior mortality and morbidity outcomes when compared with conventional on-pump coronary artery bypass grafting (C-ONCAB). Morbidity outcomes consisted of renal failure, stroke (transient or permanent), myocardial infarction, angina, congestive cardiac failure, reintervention and arrhythmias. Best evidence papers investigating BH-ONCAB versus C-ONCAB were considered. Where data were duplicated, the more credible evidence-based ...
Source: Interactive CardioVascular and Thoracic Surgery - March 19, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Al Jaaly, E., Chaudhry, U. A. R., Harling, L., Athanasiou, T. Tags: Molecular biology, Myocardial protection Adult Cardiac Source Type: research

Off-pump or on-pump beating heart: which technique offers better outcomes following coronary revascularization?
A best evidence topic was written according to a structured protocol. The question addressed was whether on-pump beating heart coronary artery bypass (BH-ONCAB) surgery has a different outcome profile in comparison to off-pump coronary artery bypass (OPCAB). A total of 205 papers were found by systematic search of which 7 provided the largest and most recent outcome analysis comparing BH-ONCAB with OPCAB, and represented the best evidence to answer the clinical question. The authors, date, journal, study type, population, main outcome measures and results were tabulated. Reported outcome measures included mortality, stroke...
Source: Interactive CardioVascular and Thoracic Surgery - March 19, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Sepehripour, A. H., Chaudhry, U. A. R., Harling, L., Athanasiou, T. Tags: Molecular biology, Myocardial protection Adult Cardiac Source Type: research

Red blood cell transfusion is a determinant of neurological complications after cardiac surgery
CONCLUSIONS Transfusion of more than 2 units of RBCs after cardiac surgery is associated with a significantly increased risk of postoperative stroke and TIA.
Source: Interactive CardioVascular and Thoracic Surgery - January 20, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Mariscalco, G., Biancari, F., Juvonen, T., Zanobini, M., Cottini, M., Banach, M., Murphy, G. J., Beghi, C., Angelini, G. D. Tags: Electrophysiology - arrhythmias Adult Cardiac Source Type: research

Preoperative atrial fibrillation and outcome in patients undergoing on-pump or off-pump coronary bypass surgery: lessons learned from the GOPCABE trial
CONCLUSIONS AF at admission is a significant risk factor for elderly patients undergoing coronary bypass grafting. However, this risk is not altered by performing bypass grafting off pump.
Source: Interactive CardioVascular and Thoracic Surgery - December 18, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Boning, A., Diegeler, A., Hilker, M., Zacher, M., Reents, W., Faerber, G., Doenst, T., for the GOPCABE investigators Tags: Molecular biology, Myocardial infarction, Myocardial protection, Transplantation - heart Adult Cardiac Source Type: research

The safety of deep hypothermic circulatory arrest in aortic valve replacement with unclampable aorta in non-octogenarians
CONCLUSIONS Postoperative neurological events and operative mortality were, respectively, 3- and 4-fold higher in octogenarians undergoing AVR using DHCA. Such patients may represent suitable candidates for TAVR if favourable outcomes are demonstrated in patients with atherosclerotic aortas. Surgical AVR remains the standard treatment option with excellent outcomes for patients <80 years old with unclampable aortas.
Source: Interactive CardioVascular and Thoracic Surgery - December 18, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Kaneko, T., Neely, R. C., Shekar, P., Javed, Q., Asghar, A., McGurk, S., Gosev, I., Byrne, J. G., Cohn, L. H., Aranki, S. F. Tags: Cerebral protection, Great vessels, Valve disease Adult Cardiac Source Type: research

Meta-analysis of three randomized controlled trials comparing coronary artery bypass grafting with percutaneous coronary intervention using drug-eluting stenting in patients with diabetes
CONCLUSIONS In patients with diabetes, PCI was associated with no difference in death and MI at 1 year. However, at 5 years, PCI was associated with a higher incidence of death and MI. PCI was associated with a higher incidence of RRV but a lower incidence of stroke.
Source: Interactive CardioVascular and Thoracic Surgery - November 22, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Fanari, Z., Weiss, S. A., Zhang, W., Sonnad, S. S., Weintraub, W. S. Tags: Molecular biology Adult Cardiac Source Type: research

044 * open aortic arch replacement in high risk patients: the gold standard
Conclusion: Open TAR can be performed with low mortality and morbidity and excellent long-term results even in high-risk patients. Total endovascular repair may represent an option for patients not suitable for open surgery.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Iafrancesco, M., Ranasinghe, A., Dronavalli, V., Adam, D., Claridge, M., Riley, P., McCafferty, I., Mascaro, J. Tags: Part I: Aortic arch interventions: Debranching, rebranching, stenting and beyond Source Type: research

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