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Interactive Cardiovascular and Thoracic Surgery

Prashant N Mohite, Anton Sabashnikov, Achim Koch, Raj Binu, Ashok Padukone, Sundip Kaul, Olaf Maunz, Diana García-Sáez, Bartlomiej Zych, Mubassher Husain, Fabio De Robertis, Aron-Frederik Popov, André R Simon
OBJECTIVES: Post-cardiotomy cardiogenic shock (PCCS) results in substantial morbidity and mortality, whereas refractory cases require mechanical circulatory support (MCS). The aim of the study was to compare extracorporeal membrane oxygenation (ECMO) and ventricular assist devices (VADs) utilized in the management of PCCS. METHODS: In total, 56 consecutive patients who developed PCCS from 2005 to 2014 required MCS as a bridge to decision-24 were supported with a VAD and 32 with an ECMO...
June 13, 2018: Interactive Cardiovascular and Thoracic Surgery
Giacomo Murana, Jacopo Alfonsi, Carlo Savini, Carlo Mariani, Giuditta Coppola, Valeria Lo Coco, Emanuele Pilato, Davide Pacini, Roberto Di Bartolomeo
OBJECTIVES: If mitral valve repair is not feasible, mitral valve replacement remains the only option. Based on our overall experience with the On-X mitral valve, the aim of this study was to investigate early and late outcomes after mitral valve replacement using this latest generation prosthesis. METHODS: From 1998 to 2016, 600 patients received an On-X prosthesis in the mitral position. Of them, we excluded all patients who had combined aortic procedures and retrospectively analysed 318 consecutive patients who had a mitral valve replacement...
June 12, 2018: Interactive Cardiovascular and Thoracic Surgery
Tanwier T T K Ramdjan, Elisabeth M J P Mouws, Charles Kik, Jolien W Roos-Hesselink, Ad J J C Bogers, Natasja M S de Groot
OBJECTIVES: Atrial tachyarrhythmia, including atrial fibrillation (AF), atrial flutter (AFL) and intra-atrial reentrant tachycardia (IART), occur frequently in patients with congenital heart disease (CHD), who may undergo multiple surgical procedures throughout life. However, data on the effectiveness of concomitant arrhythmia surgery in CHD patients are scarce. METHODS: Outcome of concomitant arrhythmia surgery for AF or AFL/IART was examined in 66 successive patients [31 men (47%); age at surgery: 56 ± 14 (24-78) years] with various CHD...
June 11, 2018: Interactive Cardiovascular and Thoracic Surgery
Darko Radakovic, Dragan Opacic, Jochen Börgermann, Wan Chin Hsieh, Manuel Krutzinna, Jan Gummert, Anas Aboud
OBJECTIVES: Prognosis after pericardiectomy for constrictive pericarditis (CP) is affected by the aetiology of the constriction as well as by concomitant cardiac and non-cardiac disease, including liver dysfunction. However, few data exist on the risk stratification that accounts for liver function in patients with CP. We evaluated the effectiveness of the model for end-stage liver disease (MELD) score, an established measure of liver dysfunction, in predicting long-term survival and identifying other risk factors for death...
June 9, 2018: Interactive Cardiovascular and Thoracic Surgery
Tamim A Haidari, Rene H Petersen, Birgitte G Skov, Jesper Ravn
Different types of oxidized cellulose have been used for haemorrhage control in thoracic surgery, abdominal surgery and neurosurgery. Oxidized resorbable cellulose (Gelita-cel) is a new haemostatic agent. Once saturated with blood, it swells and makes a gelatinous mass that formats as a fibrin clot. We have performed a prospective observational cohort study of patients operated for lung cancer or suspected lung cancer using Gelita-cel as a haemostatic agent. Between October 2010 and April 2012, 477 patients were operated in our department for lung cancer...
June 5, 2018: Interactive Cardiovascular and Thoracic Surgery
Tomasz Plonek, Malgorzata Zak, Bartosz Rylski, Mikolaj Berezowski, Martin Czerny, Friedhelm Beyersdorf, Marek Jasinski, Jaroslaw Filipiak
OBJECTIVES: The risk of aortic dissection should be assessed based not only on the aortic diameter, but also on other biomechanical parameters that have an impact on the stress in the aortic wall. This study evaluates very rare clinical scenarios of patients with both pre- and post-dissection computed tomography (CT) images and evaluates whether an increased wall stress correlates with the localization of an intimal entry tear in Type A aortic dissection. METHODS: CT-angiography images of 4 patients performed shortly prior to and after developing Type A aortic dissection were evaluated...
June 4, 2018: Interactive Cardiovascular and Thoracic Surgery
Do Jung Kim, Hyun-Chel Joo, Seung-Hyun Lee, Byung-Chul Chang, Sak Lee
OBJECTIVES: The aim of this study was to examine long-term clinical outcomes and to assess the eventual need for aortic valve replacement (AVR) in patients with mild aortic valve disease (AVD) at the time of mitral valve replacement. METHODS: Between 1990 and 2015, 1231 patients undergoing mitral valve replacement were reviewed, stratifying subjects as those with AVD (n = 363) or without AVD (NA; n = 868). Primary end points were progressive AVD (grade ≥ II) and subsequent AVR...
June 4, 2018: Interactive Cardiovascular and Thoracic Surgery
Ryosuke Muraki, Arudo Hiraoka, Kazuyuki Nagata, Kosuke Nakajima, Tomoya Oshita, Masahisa Arimichi, Genta Chikazawa, Hidenori Yoshitaka, Taichi Sakaguchi
OBJECTIVES: Although total blood volume (TBV) is central to the estimation of the haemodilution rate during cardiopulmonary bypass (CPB), conventional formulas lack sufficient accuracy. The aim of this study was to establish a new formula using ideal body weight (BW) with adjustment for gender or age to estimate TBV for a more accurate prediction of the haemodilution rate during CPB. METHODS: A total of 214 consecutive patients who underwent cardiac surgery with CPB were included in this study...
June 4, 2018: Interactive Cardiovascular and Thoracic Surgery
Anna L Meyer, Jens Garbade
The rotary blood pump (the HeartWare® Ventricular Assist Device) from HeartWare® (Medtronic) is an established left ventricular assist device and usually implanted via sternotomy. To reduce the invasiveness of the implant procedure and to optimize the position of the inflow cannula, we propose an alternative implant technique with an extrapericardial placement of the pump via left anterolateral minithoracotomy. However, the minimally invasive approach is not suitable in patients in need of an additional cardiac procedure or with thrombus formation in the left atrial appendix...
June 3, 2018: Interactive Cardiovascular and Thoracic Surgery
Tomohiko Harunari, Yukio Sekiguchi, Kojiro Ogawa, Kenji Kuroki, Miyako Igarashi, Akihiko Nogami, Kazutaka Aonuma
OBJECTIVES: The purpose of this study was to examine the factors affecting the outcome of successful lead extraction with an excimer laser sheath, which have not been clearly elucidated. METHODS: Between January 2011 and December 2016 in our institution, 372 leads were intravenously extracted from 176 patients (mean age, 67 ± 15 years; 83% male) with the use of an excimer laser sheath. The mean time since lead implantation was 7.1 ± 6.7 years. Indications for this procedure were infection (76...
June 3, 2018: Interactive Cardiovascular and Thoracic Surgery
Claudio Andreetti, Cecilia Menna, Antonio D'Andrilli, Mohsen Ibrahim, Federico Venuta, Mario Santini, Erino Angelo Rendina, Alfonso Fiorelli
Several techniques have been previously proposed to fix silicone stents for subglottic tracheal stenosis. However, they require special tools or cumbersome manoeuvres. The proposed modified procedure offers a potential alternative fixing technique using absorbable suture buried subcutaneously and not requiring special devices. This procedure was successfully performed in 27 patients with inoperable complex subglottic stenosis. The mean distance from vocal folds, the mean length and mean diameter of stenosis were 17 ± 2 mm, 20 ± 2...
June 2, 2018: Interactive Cardiovascular and Thoracic Surgery
Fabio Barili, Alessandro Parolari, Pieter A Kappetein, Nick Freemantle
Heterogeneity in meta-analysis describes differences in treatment effects between trials that exceed those we may expect through chance alone. Accounting for heterogeneity drives different statistical methods for summarizing data and, if heterogeneity is anticipated, a random-effects model will be preferred to the fixed-effects model. Random-effects models assume that there may be different underlying true effects estimated in each trial which are distributed about an overall mean. The confidence intervals (CIs) around the mean include both within-study and between-study components of variance (uncertainty)...
June 2, 2018: Interactive Cardiovascular and Thoracic Surgery
Koichi Sughimoto, Yasutaka Hirata, Norimichi Hirahara, Hiroaki Miyata, Takaaki Suzuki, Arata Murakami, Kagami Miyaji, Shinichi Takamoto
OBJECTIVES: Atrioventricular valve replacement is the last option to treat the atrioventricular valve regurgitation in single ventricle. This study investigates the mid-term outcomes of the atrioventricular valve replacement based on the Japan Cardiovascular Surgery Database registry. METHODS: From 2008 to 2014, 56 patients [34 males (61%) and 22 females (39%)] with a single ventricular circulation, underwent atrioventricular valve replacement. Questionnaires were collected to review operative data, mid-term mortality, morbidity and redo replacement...
June 2, 2018: Interactive Cardiovascular and Thoracic Surgery
Alberto Dominguez-Rodriguez, Jennifer T Thibodeau, Colby R Ayers, Alejandro Jimenez-Sosa, Pilar Garrido, Javier Montoto, Pablo C Prada-Arrondo, Pedro Abreu-Gonzalez, Mark H Drazner
OBJECTIVES: Bendopnea is a recently described symptom of advanced heart failure. Its prevalence and prognostic utility in other cardiac conditions are unknown. METHODS: We prospectively enrolled 108 consecutive patients (75 ± 3 years, 68% men) with severe symptomatic aortic stenosis referred for surgical aortic valve replacement (SAVR). Preoperatively, patients were tested for bendopnea, which was considered to be present when dyspnoea occurred within 30 s of bending forward...
June 2, 2018: Interactive Cardiovascular and Thoracic Surgery
Rick Schreurs, Samuel Heuts, Ehsan Natour, Roberto Lorusso
This case report describes a coronary bypass surgery case in which cardioplegic arrest was impossible due to an aortacoronary fistula that was visualized using 3-dimensional computer tomography (CT) angiography postoperatively. Aortacoronary fistulas are protective in coronary artery disease but can severely complicate cardiac surgery and might require CT imaging in the preoperative workup.
June 2, 2018: Interactive Cardiovascular and Thoracic Surgery
Mona Sharghbin, Leila L Benhassen, Troels Lading, Tommy Bechsgaard, Søren Nielsen Skov, Diana M Røpcke, Sten Lyager Nielsen, J Michael Hasenkam, Peter Johansen
OBJECTIVES: Increasing evidence shows that annular stabilization is essential in most aortic valve repair procedures. However, a standardized comparison of the 2 commonly used annuloplasty procedures is lacking. We hypothesized that the Dacron ring is more rigid than the polytetrafluoroethylene suture, whereas both procedures decrease annular dimensions. The aim of this study was to compare the biomechanical properties of the ring and suture techniques with native aortic roots in vitro...
June 1, 2018: Interactive Cardiovascular and Thoracic Surgery
Lucia Manuri, Rita Emanuela Calaciura, Andrea De Zorzi, Lilia Oreto, Massimiliano Raponi, Anja Lehner, Nikolaus Haas, Salvatore Agati
Transcatheter creation or enlargement of an atrial septal defect has been used to promote adequate blood flow and mixing in some forms of congenital heart defects or as a relief valve in right or left atrial hypertension, resulting in better cardiac output and/or systemic saturation. We report a case of a 4-year-old male affected by complex congenital heart disease who was admitted for management of severe cyanosis following a staged pericardial fenestrated Fontan procedure. Transoesophageal echocardiogram showed a wide fenestration of 9 mm in size with a severely dilated pericardial Fontan system...
May 30, 2018: Interactive Cardiovascular and Thoracic Surgery
Pascale Sulser, Kuno Lehmann, Macé M Schuurmans, Walter Weder, Ilhan Inci
OBJECTIVES: Abdominal surgery after lung transplantation is an important factor for major morbidity and mortality. Herein, we describe the incidence and outcome of abdominal surgery occurring early or late after transplantation. METHODS: Overall, 315 patients who underwent lung transplantation between January 2000 and December 2013 at our institution were included in a prospective database. Perioperative parameters were assessed, and complications were graded according to the Clavien-Dindo Classification...
May 28, 2018: Interactive Cardiovascular and Thoracic Surgery
Takaya Hoashi, Hajime Ichikawa, Tomohiro Nakata, Masatoshi Shimada, Hideto Ozawa, Akihiko Higashida, Kenichi Kurosaki, Suzu Kanzaki, Isao Shiraishi
OBJECTIVES: The objective of this study was to assess the utility of 3D printed heart models of congenital heart disease for preoperative surgical simulation. METHODS: Twenty patient-specific 3D models were created between March 2015 and August 2017. All operations were performed by a young consultant surgeon who had no prior experience with complex biventricular repair. All 15 patients with balanced ventricles had outflow tract malformations (double-outlet right ventricle in 7 patients, congenitally corrected transposition of great arteries in 5, transposition of great arteries in 1, interrupted aortic arch Type B in 1, tetralogy of Fallot with pulmonary atresia and major aortopulmonary collateral arteries in 1)...
May 28, 2018: Interactive Cardiovascular and Thoracic Surgery
Joel L Ramirez, Johannes R Kratz, Georg M Wieselthaler
Giant coronary artery aneurysms are rare and have variable presentations, which range from an incidental finding to sudden death. We report a case of a female presenting with chest pain and signs of cardiac tamponade who underwent a computed tomography (CT) pulmonary embolus protocol and was found to have haemopericardium with accumulation of contrast adjacent to the aorta. She underwent emergent sternotomy and was found to have a ruptured giant right coronary artery aneurysm, which was ligated and bypassed...
May 25, 2018: Interactive Cardiovascular and Thoracic Surgery
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