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Interactive Cardiovascular and Thoracic Surgery

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https://www.readbyqxmd.com/read/28329172/the-obesity-paradox-is-still-there-a-risk-analysis-of-over-15-000-cardiosurgical-patients-based-on-body-mass-index
#1
Martin Hartrumpf, Ralf-Uwe Kuehnel, Johannes M Albes
OBJECTIVES: Obesity is an ever-growing problem in contemporary cardiac surgery. Although it accounts for many perioperative comorbidities, it has not been shown to increase mortality. Body mass index (BMI) is therefore not considered in the European System for Cardiac Operative Risk Evaluation (EuroSCORE). We sought to confirm whether this holds true for our own single-centre patient population. METHODS: Data from 15 314 consecutive patients receiving major cardiac surgery at our institution were analysed...
March 18, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329247/coronary-endarterectomy-with-coronary-artery-bypass-graft-decreases-graft-patency-compared-with-isolated-coronary-artery-bypass-graft-a-meta-analysis
#2
Yangwu Song, Fei Xu, Junzhe Du, Jiqiang Zhang, Wei Feng
OBJECTIVES: This meta-analysis aims to assess the graft patency quantitatively and statistically. METHODS: Eleven observational studies were identified by systematic literature search, incorporating 3311 patients undergoing coronary endarterectomy (CE) + coronary artery bypass graft (CABG) and 3990 undergoing isolated CABG, which were analysed using random-effects modelling. Heterogeneity, quality of scoring and risk of bias were assessed and reangiographic outcomes were documented...
March 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329055/chylous-pericardial-effusion-after-pulmonary-lobectomy
#3
Weixiong Yang, Canqiao Luo, Zhenguo Liu, Chao Cheng
Chylous pericardial effusion is a rarely reported complication of lung cancer surgery. Here, we report a case of an elderly man who suffered chylous pericardial effusion after radical right upper lung resection for cancer. The massive chylous effusion first occurred in the pericardium, drained to the right chest after the drainage of the hydropericardium and subsequently moved back to the pericardium again. Lymphoscintigraphy examination indicated that a chylous fistula was present in the plane of the tracheal carina...
March 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329159/concomitant-therapy-off-pump-coronary-revascularization-and-transcatheter-aortic-valve-implantation
#4
Samir Ahad, Kristina Wachter, Christian Rustenbach, Alina Stan, Stephan Hill, Tim Schäufele, Adrian Ursulescu, Ulrich F W Franke, Hardy Baumbach
OBJECTIVES: Significant coronary artery disease (CAD) is common among patients evaluated for transcatheter aortic valve implantation (TAVI). Only little data exist on outcome of patients undergoing concomitant off-pump coronary revascularization and TAVI. The goal of this study was to analyse the impact of concomitant off-pump revascularization on early clinical outcome and 2-year follow-up of patients undergoing TAVI. METHODS: A total of 70 patients with significant CAD and aortic valve stenosis were included between January 2011 and January 2016...
March 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329213/postoperative-pulmonary-complications-and-rehabilitation-requirements-following-lobectomy-a-propensity-score-matched-study-of-patients-undergoing-video-assisted-thoracoscopic-surgery-versus-thoracotomy%C3%A2
#5
Paula Agostini, Sebastian T Lugg, Kerry Adams, Nelia Vartsaba, Maninder S Kalkat, Pala B Rajesh, Richard S Steyn, Babu Naidu, Alison Rushton, Ehab Bishay
OBJECTIVES: : Video-assisted thoracoscopic surgical (VATS) lobectomy is increasingly used for curative intent lung cancer surgery compared to open thoracotomy due to its minimally invasive approach and associated benefits. However, the effects of the VATS approach on postoperative pulmonary complications (PPC), rehabilitation and physiotherapy requirements are unclear; our study aimed to use propensity score matching to investigate this. METHODS: Between January 2012 and January 2016 all consecutive patients undergoing lobectomy via thoracotomy or VATS were prospectively observed...
March 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329189/mid-term-results-of-zone-0-thoracic-endovascular-aneurysm-repair-after-ascending-aorta-wrapping-and-supra-aortic-debranching-in-high-risk-patients
#6
Felice Pecoraro, Mario Lachat, Michael Hofmann, Neal S Cayne, Lyubov Chaykovska, Zoran Rancic, Gilbert Puippe, Thomas Pfammatter, Nicola Mangialardi, Frank J Veith, Dominique Bettex, Francesco Maisano, Thomas A Neff
OBJECTIVES: Surgical repair of aneurysmal disease involving the ascending aorta, aortic arch and eventually the descending aorta is generally associated with significant morbidity and mortality. A less invasive approach with the ascending wrapping technique (WT), supra-aortic vessel debranching (SADB) and thoracic endovascular aneurysm repair (TEVAR) in zone 0 was developed to reduce the associated risk in these patients. METHODS: During a 10-year period, consecutive patients treated by the ascending WT, SADB and TEVAR in zone 0 were included...
March 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329267/right-ventricular-recovery-after-bilateral-lung-transplantation-for-pulmonary-arterial-hypertension%C3%A2
#7
Thomas M Gorter, Erik A M Verschuuren, Dirk J van Veldhuisen, Elke S Hoendermis, Michiel E Erasmus, Harm J Bogaard, Anton Vonk Noordegraaf, Rolf M F Berger, Joost P van Melle, Tineke P Willems
OBJECTIVES: Pulmonary arterial hypertension (PAH) is a progressive and often fatal disease characterized by increased pulmonary vascular resistance (PVR) and right ventricular (RV) failure. End-stage PAH is often an indication for a lung transplant (LTX). Our goal was to study ventricular recovery using cardiac magnetic resonance imaging late after LTX. METHODS: We studied 10 patients with PAH who underwent isolated bilateral LTX. RV and left ventricular (LV) volumes, function and mass were measured...
March 3, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329210/right-atrium-positioning-for-exposure-of-right-pulmonary-veins-during-off-pump-atrial-fibrillation-ablation
#8
Grzegorz Suwalski, Robert Emery, Jakub Mróz, Kamil Kaczejko, Leszek Gryszko, Andrzej Cwetsch, Andrzej Skrobowski
OBJECTIVES: Concomitant surgical ablation of atrial fibrillation (AF) is recommended for patients undergoing off-pump coronary revascularization in the presence of this arrhythmia. Achievement of optimal visualization of pulmonary veins while maintaining stable haemodynamic conditions is crucial for proper completion of the ablation procedure. This study evaluates the safety and feasibility of right atrial positioning using a suction-based cardiac positioner as opposed to compressive manoeuvres for exposure during off-pump surgical ablation for AF...
March 3, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329325/comparison-of-radial-and-bilateral-internal-thoracic-artery-grafting-in-patients-with-peripheral-vascular-disease%C3%A2
#9
Dmitry Pevni, Yanai Ben-Gal, Rephael Mohr, Nadav Teich, Zvi Raviv, Amir Kramer, Yosef Paz, Benjamin Medalion, Nahum Nesher
OBJECTIVES: The composite T-graft with radial artery (RA) attached end-to-side to the left internal thoracic artery (ITA) provides arterial myocardial revascularization without the increased risk of deep sternal wound infection associated with harvesting 2 ITAs. However, many surgeons are reluctant to use RA in patients with peripheral vascular disease (PVD) due to concerns regarding the quality of the conduit in this subset of patients. The purpose of this study is to compare early- and long-term outcomes of arterial grafting with bilateral ITAs (BITA) to that of single ITA and RA in patients with PVD...
March 2, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329135/low-target-inr-anticoagulation-is-safe-in-selected-aortic-valve-patients-with-the-medtronic-open-pivot-mechanical-prosthesis-long-term-results-of-a-propensity-matched-comparison-with-standard-anticoagulation
#10
Thierry Bové, Yves Van Belleghem, Katrien François, Frank Caes, Michel De Pauw, Yves Taeymans, Guido J Van Nooten
OBJECTIVES: To investigate the long-term results of a low international normalized ratio (INR)-anticoagulation program in selected patients after aortic valve replacement (AVR) with the Medtronic Open Pivot mechanical heart valve (OPMHV). METHODS: From January 1993 to December 2012, 909 OPMHV valves were used for single AVR. Patients with preserved sinus rhythm and left ventricular function (Low-INR, n  = 552), were managed to an INR of 1.5-2.5 and compared to patients (Standard-INR, n  = 357) treated with standard anticoagulation (INR 2...
March 2, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329326/liposomal-bupivacaine-versus-bupivacaine-epinephrine-after-video-assisted-thoracoscopic-wedge-resection%C3%A2
#11
Salvatore A Parascandola, Jessica Ibañez, Graham Keir, Jacqueline Anderson, Michael Plankey, Deanna Flynn, Candice Cody, Lorenzo De Marchi, Marc Margolis, M Blair Marshall
OBJECTIVES: The purpose of this research is to compare liposomal bupivacaine and bupivacaine/epinephrine for intercostal blocks related to analgesic use and length of stay following video-assisted thoracoscopic wedge resection. METHODS: A retrospective study of patients undergoing video-assisted thoracoscopic wedge resection from 2010 to 2015 was performed. We selected patients who stayed longer than 24 h in hospital. Primary outcomes were length of stay and postoperative analgesic use at 12-h intervals from 24 to 72 h...
March 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329284/contemporary-outcome-of-unplanned-right-ventricular-assist-device-for-severe-right-heart-failure-after-continuous-flow-left-ventricular-assist-device-insertion
#12
Daisuke Yoshioka, Hiroo Takayama, Reshad A Garan, Veli K Topkara, Jiho Han, Paul Kurlansky, Melana Yuzefpolskaya, Paolo C Colombo, Yoshifumi Naka, Koji Takeda
OBJECTIVES: The timely use of a right ventricular assist device (RVAD) becomes necessary for severe right heart failure (RHF) after left ventricular assist device (LVAD) insertion. This study evaluates outcomes in patients who required unplanned RVAD support early after continuous-flow (CF) LVAD insertion. METHODS: We retrospectively reviewed 305 patients who underwent HeartMate II/HeartWare CF-LVAD insertion between 2009 and 2014. Twenty-seven (9%) patients required unplanned RVAD for severe RHF early after LVAD insertion...
March 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329271/short-and-long-term-results-after-prosthetic-mitral-valve-implantation-in-patients-with-severe-mitral-annulus-calcification%C3%A2
#13
Ronny Ben-Avi, Boris Orlov, Leonid Sternik, Alexander Kogan, Rafael Kuperstien, Amjad Shalabi, Eilon Ram, Alexander Lipey, Ehud Raanani
OBJECTIVES: To investigate short- and long-term outcomes of a conservative decalcification approach in mitral valve replacement (MVR) surgery in the presence of mitral annulus calcification (MAC). METHODS: Of the 1038 patients who underwent MVR, 133 (13%) had significant MAC with at least 30% of the annular circumference heavily calcified. In most patients, the surgical approach to MAC included conservative decalcification, supra-annular prosthesis implantation and insertion of a pericardial patch between the MV annulus and the prosthesis...
March 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329292/surgical-septal-myectomy-or-alcohol-septal-ablation-which-approach-offers-better-outcomes-for-patients-with-hypertrophic-obstructive-cardiomyopathy
#14
Shi Sum Poon, Mark Field, Dhiraj Gupta, Duke Cameron
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether surgical septal myectomy (SM) is more beneficial than alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy. Altogether 218 articles were found using the reported search, of which 15 studies represented the best evidence to answer the clinical question. There were 14 observational studies and 1 meta-analysis study. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these articles are tabulated...
February 28, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329283/left-sinus-of-valsalva-aneurysm-as-a-cause-of-chronic-stable-angina
#15
Alexandre Ponti, Salah D Qanadli, Matthias Kirsch, Maxime Tapponnier
Sinus of Valsalva aneurysms are unusual, particularly when located on the left coronary sinus. They are mainly asymptomatic, however once ruptured, they are associated with high mortality. We present hereinafter an atypical case of a 71-year-old patient with an unruptured left sinus of Valsalva aneurysm causing myocardial ischaemia due to a compressed left main coronary artery. Surgical endoaneurysmorrhaphy was performed; however, a dehiscence of the suture line between the patch and the aortic wall required additional percutaneous implantation of a vascular occluder...
February 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329239/removal-of-a-giant-left-ventricular-thrombus-after-myocardial-infarction-due-to-dissection-of-left-anterior-descending-artery
#16
Philipp C Seppelt, Andreas Brcic, Matthias Karck, Gábor Szabó
Left ventricular thrombus is a frequent complication after myocardial infarction and is associated with high risk for arterial embolic complications. In addition to oral anticoagulation, surgical thrombectomy may be a promising treatment for large and mobile thrombus. We report the rare case of a 27-year-old patient who presented with a giant left ventricular thrombus after expanded and silent myocardial infarction caused by spontaneous dissection of the left anterior descending coronary artery. As conservative therapy by oral anticoagulation had failed, the thrombus was removed by performing left ventriculotomy...
February 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329206/precise-moulded-autologous-pericardial-configurations-for-aortic-cusp-reconstruction
#17
Mohammad Bashar Izzat, Khaled Hamzeh, Farouk Almohammad
OBJECTIVES: In order to facilitate surgical repair of complex aortic cusp deformities and restoration of aortic valve competence, new moulds were developed to shape the glutaraldehyde-treated autologous pericardium into precise cusp-like configurations that can be used in aortic cusp reconstruction. METHODS: The new moulds embodied the natural geometry of single aortic cusps, and a series of moulds were made available to correspond with all potential aortic cusp sizes...
February 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329138/small-intestinal-submucosa-tricuspid-valve-tube-graft-shows-growth-potential-remodelling-and-physiological-valve-function-in-a-porcine-model%C3%A2
#18
Diana M Ropcke, Christine Ilkjaer, Marcell J Tjornild, Soren N Skov, Steffen Ringgaard, Vibeke E Hjortdal, Sten L Nielsen
OBJECTIVES: Tricuspid valve reconstruction using small intestinal submucosal extracellular matrix (ECM) designed as a tube graft is possible in severe valve pathology. Using cardiac magnetic resonance imaging (MRI) and digital photograph imaging, valves were evaluated after 6 months in a porcine model. METHODS: Ten 60 kg pigs received a tricuspid valve tube graft. A baseline MRI was performed after 2 weeks ( n  = 8). A follow-up MRI was performed in three of five 6 months' survivors to assess function and haemodynamics of the tricuspid tube graft...
February 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329338/successful-treatment-of-bronchial-stenosis-after-lung-transplantation
#19
Irene T Schrijver, Bart Luijk, Ronald C A Meijer, Linda M de Heer
Treatment of stenotic anastomosis after lung transplantation can be challenging. In this case report, we present a case in which 3D computed tomography reconstructions guided the clinical decision towards operative bronchoplasty after which our patient was treated successfully.
February 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329289/repair-of-calcified-left-ventricular-pseudoaneurysm-of-long-duration
#20
Orhan Saim Demirtürk, Elif Karadeli, Utku Alemdaroglu, Mustafa Yilmaz
Cardiac pseudoaneurysm is a contained rupture of the myocardium limited by pericardial adhesions or the epicardial wall. Cardiac pseudoaneurysm may cause sudden death with a mortality of 30-45% in the first year, mostly resulting from rupture. Coronal and axial T2-weighted magnetic resonance images of a 65-year-old male patient admitted with dyspnoea, coughing and chest pain, present for the last 10 days, revealed a large pseudoaneursym of the left ventricle. Coronary bypass and left ventricular restoration operation was performed...
February 23, 2017: Interactive Cardiovascular and Thoracic Surgery
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