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Can the temporary use of right ventricular assist devices bridge patients with acute right ventricular failure after cardiac surgery to recovery?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Can the temporary use of right ventricular assist devices (RVADs) bridge patients to recovery who suffer acute right ventricular failure after cardiac surgery? More than 183 papers were found using the reported search, of which 13 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Indications for surgical intervention included coronary artery bypas...
Source: Interactive CardioVascular and Thoracic Surgery - March 17, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Lang, S. A., O'Neill, B., Waterworth, P., Bilal, H. Tags: Adult Cardiac Source Type: research

Should patients with asymptomatic significant carotid stenosis undergo simultaneous carotid and cardiac surgery?
This study included patients with unilateral severe (>70%) asymptomatic carotid stenosis requiring CABG. An earlier partly randomized trial also showed better outcomes for patients undergoing simultaneous procedures (P = 0.045). Interestingly, systematic reviews previously failed to show compelling evidence supporting prophylactic CEA. This could be partly due to the fact that these reviews collectively analyse different cohort qualities. Neurological studies have, however, shown reduced cognitive and phonetic quality and function in patients with unilateral and bilateral asymptomatic carotid artery stenosis. Twenty-one...
Source: Interactive CardioVascular and Thoracic Surgery - March 17, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Ogutu, P., Werner, R., Oertel, F., Beyer, M. Tags: Adult Cardiac Source Type: research

Comparing coronary artery bypass grafting with drug-eluting stenting in patients with diabetes mellitus and multivessel coronary artery disease: a meta-analysis
CONCLUSIONS Percutaneous coronary intervention with DES in patients with diabetes and multivessel CAD is safe, but has a high risk of long-term repeat revascularization. CABG should remain the standard procedure for diabetic patients with multivessel CAD.
Source: Interactive CardioVascular and Thoracic Surgery - February 15, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Li, X., Kong, M., Jiang, D., Dong, A. Tags: Adult Cardiac Source Type: research

Impact of occult renal impairment on early and late outcomes following coronary artery bypass grafting
CONCLUSIONS ORI was an independent risk factor for early and late death as well as cardiovascular events in patients undergoing CABG with normal SCr levels. A more accurate evaluation of renal function through a combination of SCr and estimated GFR is needed in patients with normal SCr levels.
Source: Interactive CardioVascular and Thoracic Surgery - September 24, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Marui, A., Okabayashi, H., Komiya, T., Tanaka, S., Furukawa, Y., Kita, T., Kimura, T., Sakata, R., the CREDO-Kyoto Investigators Tags: Coronary Source Type: research

227 * differences in clinical outcomes after contemporary coronary artery bypass grafting in the united states and europe: insights from the syntax randomized trial and registry
Conclusions: MACCE rates during three-year follow-up in the SYNTAX trial were significantly higher in the US as opposed to Europe. However, this appears to be entirely driven by increased rates of repeat PCI.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Head, S., Mohr, F., Mack, M. J., Serruys, P. W., Morice, M., Holmes, D. R., Feldman, T., Dawkins, K., Kappetein, A. P. Tags: Coronary artery bypass grafting II Source Type: research

228 * minimally invasive direct coronary bypass grafting versus percutaneous coronary intervention for single-vessel disease: a systematic review with meta-analysis of 2731 patients
Conclusions: The present systematic review underscores the superiority of MIDCAB over PCI for the treatment of single-vessel disease of the LAD.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Deppe, A. C., Liakopoulos, O. J., Kuhn, E. W., Slottosch, I., Scherner, M., Rahmanian, P., Choi, Y., Wahlers, T. Tags: Coronary artery bypass grafting II Source Type: research

232 * early anticoagulation therapy after bioprosthetic aortic valve implantation: comparing warfarin versus aspirin
Conclusions: This is to date the largest randomized trial comparing warfarin to aspirin as early anticoagulation therapy after implantation of bioprosthetic aortic valves. The results are not conclusive, but aspirin therapy seems as safe as warfarin therapy, and with significantly fewer gastrointestinal bleeding events, three months after surgery.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Rafiq, S., Steinbruchel, D. A., Moeller, C. H., Lund, J., Thiis, J. J., Koeber, L., Lilleoer, N. B., Olsen, P. S. Tags: Decision-making in aortic valve repair Source Type: research

297 * conventional thoracoabdominal aortic aneurysm repair after frozen elephant trunk operation
Conclusions: Conventional TAAA repair following frozen elephant trunk operation is a feasible and safe procedure, which is facilitated by the fact of a proximal anastomosis with the endovascular prosthesis in the distal part of the descending aorta and a convenient possibility to clamp the endograft in the middle part of the downstream aorta.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Folkmann, S., Weiss, G., Pisarik, H., Moidl, R., Gorlitzer, M., Grabenwoger, M. Tags: Thoracoabdominal aortic surgery: Proven concepts and new strategies Source Type: research

054 * hybrid surgery in patients with concomitant critical coronary and carotid artery lesions
Conclusions: Hybrid surgery in patients with concomitant critical coronary and carotid artery lesions is a safe and very effective procedure that reduces the number of complications during the surgical treatment of this severe cohort of patients.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Edemskiy, A., Chernyavskiy, A., Vinogradova, T. E., Chernyavskiy, M. Tags: Controversies in coronary artery surgery II Source Type: research

055 * simultaneous hybrid carotid stenting and coronary bypass surgery versus concomitant open carotid and coronary bypass surgery: a pilot feasibility study
Conclusions: Our results show that the hybrid procedure of carotid stenting and coronary surgery might be a good therapeutic option for this high-risk population of patients. Further, extended studies are needed to assess the proper value of this procedure.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Micovic, S., Sagic, D., Boskovic, S., Radak, D., Milojevic, P., Nezic, D., Dokic, O., Dukanovic, B. Tags: Controversies in coronary artery surgery II Source Type: research

110 * a biocompatible perfusion strategy is safe and is associated with excellent clinical outcomes and reduced blood transfusions in a contemporary series of patients undergoing coronary artery bypass grafting: a two-centre study
Conclusions: In a contemporary cohort of patients undergoing CABG, the use of the BPS is safe and effective. It is associated with excellent clinical outcomes and reduced allogeneic blood transfusions.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Shapira, O., Korach, A., Pinaud, F., Dabah, A., Bao, Y., Corbeau, J. J., de Brux, J. L., Baufreton, C. Tags: Cardiopulmonary bypass: Improving the outcome in marginal patients Source Type: research

151 * comparison of intermittent cold versus intermittent warm blood cardioplegia in 2200 adult cardiac surgery patients
Conclusions: In elective cardiac surgery, there was no difference in clinical outcome between cold and warm blood cardioplegia. In emergency patients, however, with most of them operated on in acute coronary syndrome, warm cardioplegia might be an option to improve outcome.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Trescher, K., Gleiss, A., Boxleitner, M., Dietl, W., Kassal, H., Holzinger, C., Podesser, B. Tags: Cardiac potpourri Source Type: research

183 * the use of bilateral internal thoracic arteries increases long-term survival in elderly patients: a propensity-matched analysis
Conclusions: The use of bilateral thoracic arteries improves the long-term survival after CABG, but increases the risk of postoperative sternal wound complications. A more extensive use in the elderly population should be advocated, but only in selected patients with low risk of sternal complications.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Pettinari, M., Meuris, B., Sergeant, P. Tags: Arterial revascularization Source Type: research

HEARTSTRING enabled no-touch proximal anastomosis for off-pump coronary artery bypass grafting: current evidence and technique
Surgical revascularization remains the standard of care for many patients. Off-pump coronary artery bypass grafting (OPCAB) without cardiopulmonary bypass (CPB) has evolved during the past 20 years, and as such can significantly reduce the occurrence of neurological complications. While avoiding the aortic cross-clamping required in conventional on-pump techniques, OPCAB results in a lower incidence of stroke. However, clamp-related risk of stroke remains if partial or side-biting clamps are applied for proximal anastomoses. Others and we have demonstrated that no-touch ‘anaortic’ approaches avoiding any clampi...
Source: Interactive CardioVascular and Thoracic Surgery - August 16, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Emmert, M. Y., Grunenfelder, J., Scherman, J., Cocchieri, R., van Boven, W.-J. P., Falk, V., Salzberg, S. P. Tags: Coronary Source Type: research

A multicentre Spanish study for multivariate prediction of perioperative in-hospital cerebrovascular accident after coronary bypass surgery: the PACK2 score
CONCLUSIONS PACK2 risk scale shows good predictive accuracy in the data analysed and could be useful in clinical practice for decision making and patient selection.
Source: Interactive CardioVascular and Thoracic Surgery - July 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Hornero, F., Martin, E., Rodriguez, R., Castella, M., Porras, C., Romero, B., Maroto, L., Perez De La Sota, E., on behalf of the Working Group on Arrhythmia Surgery and Cardiac Pacing of the Spanish Society for Cardiovascular and Thoracic Surgery (SECTCV) Tags: Adult Cardiac Source Type: research

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