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Heart Surgery Forum

Curt Tribble Md
To paraphrase the lyrics of a song by Matchbox Twenty ("It's 3AM, I must be lonely"), it's 3 AM, I must be on a Lear jet. We're heading out to get a pair of lungs for a transplant. It's pitch black out tonight, and there's small rain falling. At least it's not ice or snow, which we've heard is falling to the north of us. I am glad that we'll be heading south on this run. These organ procurement runs tend to violate one of the basic safety rules of flying, which is to avoid, whenever possible, being required to fly...
June 8, 2018: Heart Surgery Forum
Li Jiang, Sai Chen, Zhao Jian, Yingbin Xiao
Surgery is a definitive treatment for patients with type A aortic dissection. The aim of this study was to identify and analyze the risk factors for permanent neurological dysfunction (PND) and 30-day mortality in patients following total arch replacement and stented elephant trunk implantation in the descending aorta. Methods: The clinical data of 85 consecutive patients who underwent this surgical procedure between December 2013 and May 2017 were reviewed. Multivariate logistic regression analysis was performed to determine the independent predictors of postoperative PND and 30-day mortality...
May 30, 2018: Heart Surgery Forum
Ahmed Fouad Ahmed, Mohammed Nabil Abd Al Jawad
BACKGROUND: Proper visualization has always been the cornerstone for conducting proper cardiac interventions. Although many incisions have been described for mitral valve exposure, the feasibility of some comes at the expense of proper exposure. When it comes to a small left atrium, larger incisions may venture into critically situated structures, creating a heavy toll of increased morbidity and mortality. We aim to evaluate the safety and efficacy of a superior left atrium approach for mitral valve interventions and left atrial mass resection, particularly in a small left atrium...
May 29, 2018: Heart Surgery Forum
Henri Johannes Haapanen, Johanna Herajärvi, Hannu-Pekka Honkanen, Caius Mustonen, Hannu Tuominen, Ulla Puistola, Vesa Anttila, Tatu Juvonen
In experimental settings, remote ischemic preconditioning (RIPC) has shown a positive effect regarding spinal cord protection after local ischemia. In this study, we conducted spinal cord immunohistochemistry to demonstrate the protective effect of RIPC after 24 hours of the regional ischemia. Methods: Twenty piglets were randomized into an RIPC group (n = 10) and a control group (n = 10). The RIPC group underwent transient left hind limb ischemia before systematic left subclavian artery and segmental artery occlusion at the level of the diaphragm...
May 29, 2018: Heart Surgery Forum
Hannan Dalyanoglu, Arash Mehdiani, Jan Philipp Minol, Nihat Firat Sipahi, Hug Aubin, Udo Boeken, Alfred Müller, Hisaki Makimoto, Artur Lichtenberg, Bernhard Korbmacher
Postoperative, new-onset atrial fibrillation (POAF) is one of the most common complications after cardiosurgical procedures. Vernakalant has been reported to be effective in the conversion of POAF. The aim of this study was to evaluate the efficacy and safety of vernakalant for atrial fibrillation after cardiac operations, and to investigate predictors for the success of vernakalant treatment. Patients and Methods: Post-cardiac surgery patients with new-onset of atrial fibrillation (AF) were consecutively enrolled in this study...
May 25, 2018: Heart Surgery Forum
Fei Xu, Yangwu Song, Wei Feng, Xuan Li, Junzhe Du
BACKGROUND: This study was conducted to explore the impact of renal dysfunction on short-term and mid-term outcomes in elderly patients. METHODS: Patients over 65 years of age receiving surgical ventricular restoration (SVR) were included in the study. They were stratified through estimated glomerular filtration rate (eGFR), with a cutoff point of 60 mL/min/1.73m2. Risk-adjusted analysis, including propensity score matching, was carried out to compare short-term and mid-term outcomes between the two groups of patients...
May 24, 2018: Heart Surgery Forum
Liwen Bao, Jiechun Huang, Fangrui Wang, Liewen Pang, Yiqing Wang, Haiming Shi
Constrictive pericarditis (CP) is defined as impaired diastolic cardiac function caused by a calcified and thickened pericardium. We assessed the clinical characteristics and time to diagnosis, as well as patient prognosis after pericardiectomy. Methods: We analyzed the records of 36 CP patients who underwent pericardiectomy at Huashan Hospital, China, between 2012 and 2015. Clinical manifestations, length of time to diagnosis, laboratory parameters, and diagnostic imaging results were examined. All patients underwent pericardiectomy, and were assessed post-operatively for quality of life and improvement of cardiac function using the Minnesota Living with Heart Failure Questionnaire (MLHFQ)...
May 24, 2018: Heart Surgery Forum
Xian Zhu, Zhanglong Hu, LIli Fang, Jie Li, Haifeng Cheng, Daming Jiang
Hemolysis combined with renal injury is a rare but serious complication after mitral valve repair. Here, we report two representative cases of hemolysis combined with renal injury. Although timely reoperation was not possible for several reasons, different clinical outcomes were observed that could aid in future decisions.
May 17, 2018: Heart Surgery Forum
Arndt H Kiessling, Harald Keller, Anton Moritz
OBJECTIVES: Minimal extracorporeal circulation techniques and systems (MiECC) may reduce the negative side effects of conventional extracorporeal circulation (ECC). However, it is still unclear as to what this is caused by, the reduced priming volume and hemodilution, or the avoidance of blood-air contact and dispersion of mediastinal debris into the systemic circulation. The aim of the trial was the comparison of MiECC to an open ECC setup (openECC) or a system with reduced blood air and debris interaction (closeECC)...
May 16, 2018: Heart Surgery Forum
HongChang Guo, Yang Wang, Wenhui Wu, Yongqiang Lai
Patients with patent ductus arteriosus (PDA) are usually detected and treated during childhood, however, some are not detected until adulthood. In addition, heart failure, severe pulmonary hypertension, and calcification of the ductus may also exist. Transcatheter occlusion has become a widely used technique for the closure of small to moderate sized PDAs since Cambier first reported use of Gianturco coils for transcatheter closure of PDA in 1992 [Cambier 1992]. In the case studies reported here, the one-stage hybrid procedure for PDA combined with other cardiac anomalies in adults was applied with satisfactory results...
May 16, 2018: Heart Surgery Forum
Pengxiong Zhu, Xiaofeng Ye, Qiang Zhao
Descending aorta interruption is an extremely rare congenital defect. Conventional repair with end-to-end anastomoses is often a surgical challenge in view of the extensive collateral vessels that develop on the chest wall and inside the chest cavity. Extra-anatomic bypass is the preferred technique for the surgical repair of this entity, which avoids the network of collateral vessels, enables simultaneous treatment of associated lesions, and in all likelihood reduces morbidity and mortality. Here we describe an extra-anatomic bypass from the ascending aorta to the bilateral iliac arteries in a 24-year-old woman using vascular grafts (MAQUET Holding B...
May 16, 2018: Heart Surgery Forum
Alev Kılıcgedik, Abdulrahman Naser, Ahmet Seyfeddin Gurbuz, Seyhmus Kulahcioglu, Ruken Bengi Bakal, Tuba Unkun, Fatih Yilmaz, Gokhan Kahveci, Cevat Kirma
BACKGROUND: The use of the CHA2DS2-VASc scoring system and red cell distribution width (RDW) as post-op Atrial Fibrillation (POAF) predictors may be promising for the identification of patients that are at a higher risk of POAF. METHODS: A total of 358 patients (57 patients with POAF, and 301 patients with non-POAF ) with sinus rhythm undergoing a coronary artery bypass graft (CABG) operation were included in the study retrospectively. Preoperative RDW levels and electrocardiograms with sinus rhythm were recorded...
May 16, 2018: Heart Surgery Forum
Yalcin Guzelhan, Cenk Conkbayir, Murat Ugurlucan, Cenk Eray Yildiz, Ufuk Alpagut, Nilgun Bozbuga
The present study was designed to evaluate the relationship between gender and coexisting anxiety in patients undergoing coronary artery surgery. Materials and Methods: A total of 137 patients (41 women and 96 men with a mean age 66.1 ± 6.0 years) patients underwent state and trait anxiety evaluation at baseline (preoperatively) and at six months after (postoperatively) coronary artery bypass graft (CABG). Anxiety symptoms were assessed at enrollment using the Spielberger State-Trait Anxiety Inventory (STAI)...
May 11, 2018: Heart Surgery Forum
Alejandro Pizano, Felix Ramon Montes, Marisol Carreño, Dario Echeverri, Juan Pablo Umaña
BACKGROUND: Choosing a cardioplegic solution is a significant issue in modern cardiac surgery. Although different options are available, the optimal strategy for myocardial protection has not been established. The aim of this study was to compare intraoperative and postoperative effects of histidine-tryptophan-ketoglutarate (HTK) solution with those of standard blood cardioplegia with St Thomas No 2 solution. The study was conducted using a large cohort of adult patients undergoing complex cardiac surgery...
May 11, 2018: Heart Surgery Forum
Murali P Vettath, Madhu Ravisankar, Tomislov Kopjar, A V Kannan, Nitin Gangadharan
Whether coronary artery bypass grafting (CABG) should be performed on- or off-pump remains a matter of debate. We aim to present our experience with off-pump CABG. Early clinical outcome and adverse events were analyzed over the time course of the study. Methods: A total of 4310 patients undergoing isolated off- pump CABG from January 2002 until December 2016 at the Malabar Institute of Medical Sciences in India were included. Preoperative, intraoperative, and postoperative, as well as follow-up data were prospectively collected...
May 11, 2018: Heart Surgery Forum
Ren Chong-Lei, Jiang Sheng-Li, Wang Rong, Xiao Cang-Song, Wang Yao, Gao Chang-Qing
Our objective is to summarize our experience in the diagnosis and treatment of Lambl's excrescence (LE) on the aortic valve. Methods: The clinical data of 25 patients with LE admitted to our hospital from January 2010 to December 2014 were analyzed retrospectively. There were 17 males and 8 females, with the mean age of 55.7 ± 11.43 years (range: 30 to 70 years). Among the patients analyzed, eight also had cerebral embolism. All of the patients were diagnosed by transesophageal echocardiography (TEE). In seven cases, surgical treatment to remove the excrescence was successfully performed...
May 7, 2018: Heart Surgery Forum
Tatsuya Tarui, Norihiko Ishikawa, Ryuta Kiuchi, Shigeyuki Tomita, Hiroshi Ohtake, Go Watanabe
OBJECTIVE: The mitral valve plasty (MVP) technique for degenerative disease is typically leaflet resection and suturing. However, this technique is time consuming and unreproducible. To overcome this disadvantage, we developed a nonresectional folding technique, which is fast and reproducible. In this report, we examine our new folding technique in robotic MVP. METHODS: The new folding technique was performed in 10 patients (age 56 ± 15 years), and the conventional resection and suturing (RS) technique was performed in 22 patients (age 53 ± 8 years)...
May 7, 2018: Heart Surgery Forum
Vassil Gegouskov, Georgi Manchev, Vladimir Danov, Georgi Stoitsev, Sergey Iliev
BACKGROUND: During surgery for ascending aortic dissection, the dissected ascending aorta itself has traditionally been rejected as a cannulation option. The purpose of this study is to prove that direct cannulation of the ascending aorta in patients operated for acute aortic dissection type A (AADA) is at least as effective and safe as classic femoral cannulation. METHODS AND RESULTS: Between September 2008 and January 2015, we operated on 117 patients with AADA through median sternotomy...
April 30, 2018: Heart Surgery Forum
Mehmet Kaplan, Anil Karaagac, Tolga Can, Sahin Yilmaz, Mehmet Inanc Yesilkaya, Adlan Olsun, Hakki Aydogan
BACKGROUND: Hypothermia is a method of myocardial protection in cardiac surgery. This protection occurs by decreasing the metabolic demands, however, it creates susceptibility to various problems. In this study, we investigated patients operated on under normothermia (at the patient's own temperature) and hypothermia for postoperative differences. METHODS: The study was conducted between June 2015 and September 2016 with 167 patients. The patients were divided into two groups in accordance with our routine clinical practice: the normothermic group (native temperature goup; intraoperative body temperature ≥ 34°C), and the hypothermic group intraoperative body temperature  < 34°C - ≥ 28°C)...
April 18, 2018: Heart Surgery Forum
Curtis G Tribble
The preparation for a reoperative cardiac surgical case was covered in Part I of this two part review [Tribble 2018]. Part II will cover primarily intraoperative strategies and techniques.  As noted in Part I, there has been surprisingly little written about the strategies and techniques of reoperative cardiac surgery. Thus, the goal of this two-part review is to collect and collate some of the lessons, abjurations, and tenets related to reoperative cardiac surgery that may be valuable to cardiac surgeons, especially those in training or early in their careers...
April 10, 2018: Heart Surgery Forum
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