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Interactive Cardiovascular and Thoracic Surgery

journal
https://www.readbyqxmd.com/read/28077510/mitral-implant-of-the-inovare-transcatheter-heart-valve-in-failed-surgical-bioprostheses-a-novel-alternative-for-valve-in-valve-procedures
#1
Diego Felipe Gaia, Ademir Massarico Braz, Matheus Simonato, Danny Dvir, João Roberto Breda, Gustavo Calado Ribeiro, Carolina Baeta Ferreira, José Augusto Marcondes Souza, Enio Buffolo, José Honório Palma
OBJECTIVES: Reoperative procedure for the treatment of a failed mitral bioprosthesis is associated with considerable risk. In some cases, mortality is high and might contraindicate the benefit of the procedure. The minimally invasive valve-in-valve (ViV) transcatheter mitral valve implant offers an alternative less-invasive approach, reducing morbidity and mortality. The objective of this paper was to evaluate the mitral ViV approach using the Braile Inovare prosthesis. METHODS: The transcatheter balloon-expandable Braile Inovare prosthesis was used in 12 cases...
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28077509/the-basic-approach-a-single-centre-experience-with-a-cost-reducing-model-for-paediatric-cardiac-extracorporeal-membrane-oxygenation
#2
Massimo A Padalino, Chiara Tessari, Alvise Guariento, Anna C Frigo, Vladimiro L Vida, Andrea Marcolongo, Fabio Zanella, Michael J Harvey, Ravi R Thiagarajan, Giovanni Stellin
OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) is a lifesaving but expensive therapy in terms of financial, technical and human resources. We report our experience with a 'basic' ECMO support model, consisting of ECMO initiated and managed without the constant presence of a bedside specialist, to assess safety, clinical outcomes and financial impact on our health system. METHODS: We did a retrospective single-centre study of paediatric cardiac ECMO between January 2001 and March 2014...
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28073988/posteromedial-papillary-muscle-rupture-due-to-squeezing-of-the-left-anterior-descending-coronary-artery
#3
Kaoru Hattori, Kozo Fukui, Nobuaki Suzuki, Kazuo Ito
An unusual case of posteromedial papillary muscle (PPM) rupture due to isolated left anterior descending (LAD) artery ischaemia, associated with severe myocardial bridge contraction, is presented. The unusual blood supply to the PPM was associated with its apical origin and apex-forming LAD.
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28073987/neutrophil-lymphocyte-ratio-and-risk-of-atrial-fibrillation-after-thoracic-surgery
#4
Kevin J Walsh, Kay See Tan, Hao Zhang, David Amar
OBJECTIVES: Postoperative atrial fibrillation (POAF) occurs frequently in patients after noncardiac thoracic surgery and has been associated with increased morbidity and risk of stroke. Recent studies have shown conflicting results on the role of neutrophil-lymphocyte ratio (NLR) and its association with the development of POAF after cardiac surgery. Our goal was to determine whether an association exists between NLR and the incidence of POAF after non-cardiac thoracic surgery. METHODS: Using a database of 259 consecutive patients age 60 or older who had anatomic lung resection or oesophagectomy for oncologic resection, we compared preoperative, postanaesthesia care unit and postoperative day 1 NLR between patients who did and did not develop POAF during their hospitalization using Fisher's exact test or logistic regression...
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28073986/does-the-addition-of-postoperative-radiotherapy-to-adjuvant-chemotherapy-offer-any-benefit-in-patients-with-non-small-cell-lung-cancer-and-mediastinal-lymphadenopathy
#5
Georgios Koulaxouzidis, Levon Toufektzian, Leanne Ashrafian, Lukacs Veres
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether the addition of postoperative radiotherapy (PORT) to adjuvant chemotherapy offers any benefit in patients undergoing curative resection for non-small cell lung cancer found to harbour mediastinal lymphadenopathy. A total of 77 papers were identified using the reported search, of which 11 represented the best evidence to answer the clinical question. Only studies reporting on survival data of patients receiving adjuvant chemotherapy with and without PORT were included in this analysis...
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28069729/systematic-review-on-the-predictive-ability-of-frailty-assessment-measures-in-cardiac-surgery
#6
REVIEW
Yusuf S Abdullahi, Leonidas V Athanasopoulos, Roberto P Casula, Marco Moscarelli, Mark Bagnall, Hutan Ashrafian, Thanos Athanasiou
OBJECTIVES: Patient frailty is increasingly recognised as contributing to adverse postoperative outcomes in cardiothoracic surgery. The goal of this review is to evaluate the predictive ability of frailty scoring systems and their limitations in risk assessment of patients undergoing cardiac surgery. METHODS: Frailty studies were identified by searching electronic databases. Studies in which the measuring instrument was defined as a multidimensional tool focusing on a population undergoing cardiac operations were included...
January 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28062681/dialyzer-based-cell-salvage-system-a-superior-alternative-to-conventional-cell-salvage-in-off-pump-coronary-artery-bypass-grafting
#7
Amber Malhotra, Pankaj Garg, Arvind Kumar Bishnoi, Pranav Sharma, Vivek Wadhawa, Komal Shah, Sanjay Patel, Umesh Kumar Ahirwar, Dayesh Rodricks, Himani Pandya
OBJECTIVES: Our goal was to test the hypothesis that the use of a dialyzer-based cell salvage system during off-pump coronary artery bypass grafting (OPCABG) reduces requirements for homologous blood transfusions (HBT) and improves postoperative haemtochemical parameters. METHODS: Data were prospectively collected for 222 patients who had OPCABG using 3 different cell salvage techniques: (1) dialyzer-based cell salvage (DBCS) (n = 75), (2) conventional cell salvage (CCS) (n = 73) and (3) without cell salvage (WCS) (n = 74)...
January 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28062680/mitral-valve-replacement-using-a-handmade-construct-in-an-infant
#8
Steven Bibevski, Alexandra Levy, Frank G Scholl
We recently reported the feasibility of a handmade left atrioventricular valve using decellularized extracellular matrix for 3 months in a failed repair of AV canal defect. We present the use of an extracellular matrix mitral valve for 9 months in an infant with an un-repairable congenitally malformed valve. The valve functioned perfectly without anticoagulation until the patient expired from non-cardiac complications of their fibrillin gene defect. This report adds further experience using valves made from extracellular matrix in the systemic ventricle both in terms of application and in terms of short-term durability of the construct...
January 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28062679/posterior-uniportal-video-assisted-thoracoscopic-surgery-for-resection-of-the-apical-segment-of-the-right-lower-lobe-followed-by-completion-lobectomy
#9
Davor Stamenovic, Antje Messerschmidt
Uniportal thoracoscopic resections offer less pain and better cosmetic results. They are usually performed through an antero-lateral incision. Posterior uniportal approach has not been described yet. A 65-year-old female was admitted to our clinic for the treatment of an adenocarcinoma, located in the apical segment of the right lower lobe. Owing to the ideal location and size, anatomical segment resection and radical lymphadenectomy was planned. Fissureless video-assisted thoracoscopic resection of the apical segment of the right lower lobe, using a uniportal posterior approach was performed, followed by mediastinal lymphadenectomy...
January 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040772/three-dimensional-virtual-bronchoscopy-using-a-tablet-computer-to-guide-real-time-transbronchial-needle-aspiration
#10
Alfonso Fiorelli, Antonio Raucci, Roberto Cascone, Alfonso Reginelli, Davide Di Natale, Carlo Santoriello, Antonio Capuozzo, Roberto Grassi, Nicola Serra, Mario Polverino, Mario Santini
OBJECTIVES: We proposed a new virtual bronchoscopy tool to improve the accuracy of traditional transbronchial needle aspiration for mediastinal staging. METHODS: Chest-computed tomographic images (1 mm thickness) were reconstructed with Osirix software to produce a virtual bronchoscopic simulation. The target adenopathy was identified by measuring its distance from the carina on multiplanar reconstruction images. The static images were uploaded in iMovie Software, which produced a virtual bronchoscopic movie from the images; the movie was then transferred to a tablet computer to provide real-time guidance during a biopsy...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040771/transplantation-in-a-patient-on-extracorporeal-membrane-oxygenation-with-infective-endocarditis-pericarditis-and-heparin-induced-thrombocytopenia
#11
Eunise Chen, Nicholas Clarke, Lynn Huffman, Matthias Peltz
Heart failure patients with pacemaker or defibrillator-associated endocarditis in cardiogenic shock have few treatment options. We present a case of an INTERMACS I patient who developed device infection, sepsis, bacterial pericarditis and heparin-induced thrombocytopenia. The patient was stabilized with extracorporeal membrane oxygenation and successfully transplanted.
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040770/effect-of-bioprostheses-anti-calcification-treatment-comparative-follow-up-between-mitroflow-lx-and-magna-pericardial-xenografts-using-a-propensity-score-weighted-analysis
#12
Arnau Blasco-Lucas, Eduard Permanyer, María-Llanos Pérez, Juan Manuel Gracia-Baena, Remedios Ríos, Kelly Casós, Manuel Galiñanes
OBJECTIVES: The efficacy of anti-calcification treatment of bioprosthetic heart valves remains unclear. The aim of this study was to compare the clinical outcomes between Mitroflow LX valve, without anti-calcification treatment, and the Carpentier-Edwards Perimount Magna (P-Magna), with anti-calcification treatment. METHODS: Between 2005 and 2012, 625 consecutive patients underwent aortic valve replacement either with a Mitroflow LX (n = 329) or a P-Magna (n = 296)...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040769/evidence-of-subannular-and-left-ventricular-morphological-differences-in-patients-with-bicuspid-versus-tricuspid-aortic-valve-stenosis-magnetic-resonance-imaging-based-analysis
#13
Kushtrim Disha, Georg Dubslaff, Mina Rouman, Beatrix Fey, Michael A Borger, Alex J Barker, Thomas Kuntze, Evaldas Girdauskas
OBJECTIVES: Prospective analysis of left ventricular (LV) morphological/functional parameters in patients with bicuspid versus tricuspid aortic valve (TAV) stenosis undergoing aortic valve replacement (AVR) surgery. METHODS: A total of 190 consecutive patients with BAV (n = 154) and TAV stenosis (n = 36) (mean age 61 ± 8 years, 65% male) underwent AVR ± concomitant aortic surgery from January 2012 through May 2015. All patients underwent preoperative cardiac magnetic resonance imaging in order to evaluate: (i) left ventricular outflow tract (LVOT) dimensions, (ii) length of anterior mitral leaflet (AML), (iii) end-systolic and end-diastolic LV wall thickness, (iv) LV area, (v) LV end-systolic and end-diastolic diameters (LVESD, LVEDD), (vi) LV end-diastolic and end-systolic volumes (LVEDV, LVESV) and (vii) maximal diameter of aortic root...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040768/extrathymic-malignancies-associated-with-thymoma-a-forty-year-experience-at-a-single-institution
#14
Toshiko Kamata, Shigetoshi Yoshida, Hironobu Wada, Taiki Fujiwara, Hidemi Suzuki, Takahiro Nakajima, Takekazu Iwata, Yukio Nakatani, Ichiro Yoshino
OBJECTIVES: Patients with thymoma are reported to have an increased risk for developing second malignancies. The aim of this study was to assess the incidence of second malignancies among patients with thymoma. We focused especially on the impact that lung cancer has on survival in these patients. METHODS: Three hundred and thirty-five patients who underwent surgery for thymoma in Chiba University Hospital from January 1971 to November 2012 were included in this study...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040767/endocardial-linear-infarct-exclusion-technique-for-infarcted-lateral-wall
#15
Hitoshi Yaku, Suguru Ohira, Sachiko Yamazaki, Kiyoshi Doi, Hidetake Kawajiri, Kazuki Morimoto, Satoshi Numata
We report a novel method of surgical ventricular restoration for an infarcted lateral wall: the endocardial linear infarct exclusion technique. First, transmural ventriculotomy is performed at the centre of the scar longitudinally along the coronary artery. Second, the inner layer is sutured in a longitudinal direction with 4-0 polypropylene continuous sutures to approximate the border between the normal and infarcted myocardium. Finally, the outer layer is closed with a combination of interrupted buttress and continuous over-and-over sutures with outer felt reinforcement...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040766/valve-sparing-aortic-root-replacement-for-a-prolapsing-asymmetric-valve
#16
Daisuke Takahashi, Norihiko Shiiya, Naoki Washiyama, Katsushi Yamashita
Valve-sparing aortic root replacement remains challenging for patients with eccentric severe aortic regurgitation when the cusps are totally asymmetric. We report a case of successful reimplantation operation for such a lesion. Because free margin lengths from commissure to Arantius body of the adjacent two cusps were matched while inter-commissural distances were totally different, right coronary cusp prolapse was corrected by asymmetrically aligning the position and height of three commissures without cusp plication...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040765/classification-and-outcomes-of-extended-arch-repair-for-acute-type-a-aortic-dissection-a-systematic-review-and-meta-analysis
#17
REVIEW
Holly N Smith, Munir Boodhwani, Maral Ouzounian, Richard Saczkowski, Alexander J Gregory, Eric J Herget, Jehangir J Appoo
OBJECTIVES: Distal extent of repair in patients undergoing surgery for acute Type A aortic dissection (ATAAD) is controversial. Emerging hybrid techniques involving open and endovascular surgery have been reported in small numbers by select individual centres. A systematic review and meta-analysis was performed to investigate the outcomes following extended arch repair for ATAAD. A classification system is proposed of the different techniques to facilitate discussion and further investigation...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040764/high-preoperative-monocyte-count-high-density-lipoprotein-ratio-is-associated-with-postoperative-atrial-fibrillation-and-mortality-in-coronary-artery-bypass-grafting
#18
Hüseyin Saskin, Kazim Serhan Ozcan, Seyhan Yilmaz
OBJECTIVES: The monocyte to high-density lipoprotein ratio has recently emerged as an indicator of inflammation and oxidative stress. The aim of this study was to evaluate the association of the monocyte to high-density lipoprotein ratio with postoperative atrial fibrillation and mortality in coronary artery bypass grafting. METHODS: Six hundred and sixty-two patients who were in sinus rhythm preoperatively and who had isolated coronary artery bypass grafting were retrospectively included in the study...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040763/feasibility-and-clinical-outcome-after-minimally-invasive-valve-sparing-aortic-root-replacement
#19
Kristina Wachter, Ulrich F W Franke, Rashmi Yadav, Ragi Nagib, Adrian Ursulescu, Samir Ahad, Hardy Baumbach
OBJECTIVES: This study aims to examine the feasibility and clinical course after minimally invasive David procedure compared with those via a conventional median sternotomy. METHODS: One hundred and ninety-two consecutive patients who underwent elective valve-sparing aortic root replacement (David procedure) with or without additional cusp repair for aortic regurgitation (n = 17, 8.9%), dilatation of the aortic root (n = 95, 49.5%) or a combination of both pathologies (n = 80, 41...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28040762/glial-fibrillary-acidic-protein-plasma-levels-are-correlated-with-degree-of-hypothermia-during-cardiopulmonary-bypass-in-congenital-heart-disease-surgery
#20
Luca Vedovelli, Massimo Padalino, Sara D'Aronco, Giovanni Stellin, Carlo Ori, Virgilio P Carnielli, Manuela Simonato, Paola Cogo
OBJECTIVES: Improved congenital heart defect (CHD) operations have reduced operative mortality to 3%. The major concern is now long-term neurological outcomes. We measured plasma glial fibrillary acidic protein (GFAP), an early marker of brain injury, during different phases of cardiopulmonary bypass (CPB), to correlate the increase of GFAP to clinical parameters or specific operative phases. METHODS: We performed a prospective, single-centre, observational study in children undergoing cardiac operations...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
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