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Interactive Cardiovascular and Thoracic Surgery

Hari Padmanabhan, Keith Siau, Alan M Nevill, Ian Morgan, James Cotton, Alex Ng, Matthew J Brookes, Heyman Luckraz
OBJECTIVES: Preoperative anaemia is a strong predictor of blood transfusion requirements and must be assessed for appropriate optimization before elective surgery. Iron therapy is a transfusion-sparing approach effective for increasing haemoglobin concentrations. However, its role in elective cardiac surgery and the optimal route of administration remain unknown. This single-centre, non-blinded, randomized, controlled trial compared the effectiveness of intravenous ferric carboxymaltose therapy with oral iron for anaemic patients undergoing elective cardiac surgery...
August 9, 2018: Interactive Cardiovascular and Thoracic Surgery
Thomas Martens, Martin Kostolny, Helen Spencer, Nagarajan Muthialu
Pulmonary arterial hypertension after arterial switch operation for transposition of the great arteries is rare. Lung transplantation can be the last option in cases of failed medical therapy. We report 2 paediatric patients who underwent lung transplantation for this indication. Altered hilar anatomy, mediastinal adhesions and haemostatic control represent the main technical challenges. Volume-reduction surgery is sometimes necessary to address altered cardiopulmonary relationships while expanding the donor pool...
August 9, 2018: Interactive Cardiovascular and Thoracic Surgery
Fleur M M Meijer, Philippine Kies, Monique R M Jongbloed, Mark G Hazekamp, David R Koolbergen, Nico A Blom, Albert de Roos, Martin J Schalij, Hubert W Vliegen
OBJECTIVES: In repaired tetralogy of Fallot, surgical pulmonary valve replacement (PVR) is in certain cases required. Our institution reported earlier about 26 patients who received a pulmonary homograft via PVR. To date, we have data from more than 17 years of follow-up. The aim of this retrospective study was to evaluate the late haemodynamic and clinical outcomes in this predefined patient group. METHODS: Between 1993 and 2001, 26 patients underwent PVR for pulmonary regurgitation (58% men; 30...
August 8, 2018: Interactive Cardiovascular and Thoracic Surgery
Andrzej Polanczyk, Michal Podgorski, Maciej Polanczyk, Natasha Veshkina, Ireneusz Zbicinski, Ludomir Stefanczyk, Christoph Neumayer
OBJECTIVES: Our goal was to present a novel non-invasive approach for assessment of aortic wall displacement to describe its biomechanical properties during the cardiac cycle. METHODS: The fluid-structure interaction (FSI) technique was used to reconstruct aortic wall displacement based on computed tomography angiography and 2-dimensional speckle-tracking technique (2DSTT) data collected from 20 patients [10 with healthy aortas (AA) and 10 with abdominal aortic aneurysms (AAAs)]...
August 7, 2018: Interactive Cardiovascular and Thoracic Surgery
Douglas Bell, Sudesh Prabhu, Kim Betts, Robert Justo, Prem Venugopal, Tom R Karl, Nelson Alphonso
OBJECTIVES: This study aims to assess the performance of tissue-engineered bovine pericardium (CardioCel®) at 24 months and beyond when used for the repair of congenital heart defects. METHODS: Between October 2012 and November 2014, CardioCel was implanted in 135 patients (140 procedures and 195 implants). Applications included the closure of septal defects (98, 50.3%), repair of pulmonary arteries (63, 32.3%), intra-atrial/intraventricular baffles (10, 5.1%), repair of systemic arteries (15, 7...
August 7, 2018: Interactive Cardiovascular and Thoracic Surgery
Carina T Domingues, Milan Milojevic, Daniel J F M Thuijs, Nicolas M van Mieghem, Joost Daemen, Ron T van Domburg, A Pieter Kappetein, Stuart J Head
OBJECTIVES: The Heart Team has been recommended as standard care for patients with coronary artery disease (CAD). However, little is known about the real benefits, potential treatment delays and late outcomes of this approach. Our goal was to determine the safety and feasibility of multidisciplinary Heart Team decision making for patients with CAD. METHODS: We retrospectively assessed 1000 consecutive cases discussed by the Heart Team between November 2010 and January 2012...
August 7, 2018: Interactive Cardiovascular and Thoracic Surgery
Axel Dimberg, Ulrica Alström, Mikael Janiec
OBJECTIVES: Re-exploration for bleeding after cardiac surgery increases the risk of other severe postoperative complications and early mortality. Patients re-explored for bleeding after coronary artery bypass grafting are potentially subject to threats to graft patency. Our goal was to assess the effects of re-exploration for bleeding regarding the incidence of coronary angiographies, the need for coronary reintervention and mortality during long-term follow-up. METHODS: Within the SWEDEHEART registry, all isolated coronary artery bypass operations with a single internal mammary artery and saphenous vein graft in patients aged 40-80 between the years 2005 and 2015 were identified...
August 7, 2018: Interactive Cardiovascular and Thoracic Surgery
Buntaro Fujita, Wolfram-Hubertus Zimmermann
The current state-of-the-art treatment for heart failure patients is aimed at delaying disease progression, relieving symptoms, reducing morbidity and improving survival. Cardiac regeneration of the injured heart, however, is not achieved. Currently, numerous alternative treatment approaches aiming at cardiac regeneration are under investigation. Myocardial tissue engineering strategies follow the idea of in vitro generation of myocardium-like structures for epicardial transplantation. Recently, this field has made tremendous advances regarding in vitro optimization of tissue-engineered constructs, and valuable data have been generated in small animal models...
August 3, 2018: Interactive Cardiovascular and Thoracic Surgery
Bo Yu, ZhenHua Liu, Chao Xue, JinCheng Liu, Jian Yang, ZhenXiao Jin, ShiQiang Yu, WeiXun Duan
OBJECTIVES: The aim of this study was to evaluate the safety and feasibility of total arch repair with open placement of a novel double-branched stent graft for acute Type A aortic dissection (TAAD). METHODS: We retrospectively analysed the effect of the double-branched stent graft for total aortic arch placement with acute TAAD from December 2013 to February 2015. The effectiveness of the open placement of the double-branched stent graft was estimated by complete thrombus obliteration of the false lumen surrounding it on computed tomography angiography...
August 1, 2018: Interactive Cardiovascular and Thoracic Surgery
Jakub Sunavsky, Buntaro Fujita, Stephan Ensminger, Jochen Börgermann, Michiel Morshuis, Uwe Fuchs, Olaf Oldenburg, Jan F Gummert, Uwe Schulz
OBJECTIVES: As waiting times for a heart transplant (HTx) increase, the decision of whether a patient should have a high urgent (HU) listing or mechanical circulatory support becomes crucial for further prognosis. The aim of this study was to determine the characteristics that predict failure of an HU listing (death/delisting due to urgent mechanical circulatory support implant or poor clinical condition), the 5-year survival rate, the 1-year post-transplant survival rate and the prognostic accuracy of the cardiac allocation score of patients on the HU list...
July 31, 2018: Interactive Cardiovascular and Thoracic Surgery
Michael Daley, Yves d'Udekem
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'In [patients undergoing Fontan completion], does [a younger age at operation] result in [better long-term exercise capacity and prognosis]?'. Altogether, 304 papers were found using the reported search, of which 10 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...
July 31, 2018: Interactive Cardiovascular and Thoracic Surgery
Yuji Tominaga, Hiroaki Kawata, Shigemitsu Iwai, Sanae Yamauchi, Yosuke Kugo, Moyu Hasegawa, Futoshi Kayatani, Kunihiko Takahashi, Hisaaki Aoki
OBJECTIVES: In patients with pulmonary atresia with an intact ventricular septum (PA/IVS), there are no reports about the impact of sinusoidal communication (SC) on left ventricular (LV) performance after a Fontan operation; therefore, the purpose of this study was to fill this gap in the literature. METHODS: We performed a single-centre, retrospective study of 46 patients with PA/IVS. Nineteen patients who underwent the Fontan procedure were enrolled and divided into 2 groups: those with SC (SC group) and those without SC (N group)...
July 31, 2018: Interactive Cardiovascular and Thoracic Surgery
Serkan Yazgan, Ahmet Ucvet, Soner Gursoy, Ozgur Samancilar, Tarik Yagci
OBJECTIVES: Pathological N2 (pN2) involvement has a negative impact on prognosis in patients operated on due to non-small-cell lung cancer (NSCLC). pN2 disease may cause skip (pN0N2) or non-skip (pN1N2) metastases with pathological N1 (pN1) involvement. The effect of pN2 subgroups on prognosis is still controversial. We analysed the effect of pN1 disease and single-station pN2 disease subgroups on survival outcomes. METHODS: The medical records of patients who underwent anatomical lung resection due to NSCLC at a single centre between January 2007 and January 2017 were prospectively collected and retrospectively analysed...
July 31, 2018: Interactive Cardiovascular and Thoracic Surgery
Pedro N M P Coelho, Luís M R P C Miranda, Pedro M P Barros, José I G Fragata
OBJECTIVES: Cardiac surgery has little effect on life expectancy in elderly patients. Thus, improving the quality of life should be the main factor affecting therapeutic decisions. Most studies on quality of life in elderly patients undergoing cardiac surgery report improvement but have limitations. Consequently, we assessed improvements in the quality of life of elderly patients undergoing elective cardiac surgery, identified influencing variables and established patterns of mental and physical health variations in the first year postoperatively...
July 31, 2018: Interactive Cardiovascular and Thoracic Surgery
Ayse Cetinkaya, Peter Bramlage, Markus Schönburg, Manfred Richter
We report on a 61-year-old man with a previously unknown interruption of the inferior vena cava who was scheduled to undergo minimally invasive mitral and tricuspid valve surgery. We aimed to establish a cardiopulmonary bypass using femorofemoral cannulation under transoesophageal echocardiography. In spite of multiple attempts, the positioning of the venous wire in the right atrium was not accomplished. The intervention was subsequently performed by an open sternotomy. Further to the intervention, the patient underwent thoraco-abdominal multislice computed tomography that excluded the presence of an abdominal tumour or vena cava thrombosis but revealed atresia of the inferior vena cava...
July 31, 2018: Interactive Cardiovascular and Thoracic Surgery
Dehua Wu, Jingxiang Wu, Ming Chen, Chunyu Ji, Meiying Xu
OBJECTIVES: This study aims to examine the effects of amiodarone in restoring sinus rhythm in patients with new-onset atrial fibrillation during thoracic operations. METHODS: A total of 12 305 consecutive patients undergoing elective lung/oesophageal surgery were screened. Data analysis included 416 patients with new-onset atrial fibrillation not receiving any antiarrhythmic agents (control group, n = 235) or receiving amiodarone (amiodarone group, n = 181)...
July 31, 2018: Interactive Cardiovascular and Thoracic Surgery
Paneer Selvam Krishna Moorthy, Sivakumar Sivalingam, Jeswant Dillon, Pau Kiew Kong, Mohd Azhari Yakub
OBJECTIVES: Contemporary experience in mitral valve (MV) repair for children with rheumatic heart disease (RHD) is limited, despite the potential advantages of repair over replacement. We reviewed our long-term outcomes of rheumatic MV repair and compared them with the outcomes of MV replacement in children with RHD. METHODS: This study is a review of 419 children (≤18 years) with RHD who underwent primary isolated MV surgery between 1992 and 2015, which comprised MV repair (336 patients; 80...
July 30, 2018: Interactive Cardiovascular and Thoracic Surgery
Yuhao Wu, Xin Jin, Hongyu Kuang, Tiewei Lv, Yonggang Li, Yuehang Zhou, Chun Wu
A meta-analysis was performed to compare the outcomes between surgery and balloon angioplasty (BA) for native coarctation of the aorta in paediatric patients. Electronic databases, including PubMed, EMbase, Medline and Cochrane Library were searched systematically for literature aimed mainly at comparing the therapeutic effects for native coarctation of the aorta administered by surgery or BA. Corresponding data sets were extracted and 2 reviewers independently assessed the methodological quality. Ten studies meeting the inclusive criteria were identified involving a total of 723 subjects...
July 28, 2018: Interactive Cardiovascular and Thoracic Surgery
Alix Marhic, Bassel Dakhil, Gaëtan Plantefeve, Rym Zaimi, Viorel Oltean, Patrick Bagan
OBJECTIVES: The benefits of a rehabilitation programme before lung surgical resection for cancer remain to be defined. The purpose of this observational study was to assess the efficacy of preoperative rehabilitation and postoperative rehabilitation on short- and long-term outcomes in patients who were at high operative risk. METHODS: Between January 2010 and December 2012, 20 consecutive non-operable patients (16 men and 4 women, mean age 66 years) with clinical N0 lung cancer were included...
July 28, 2018: Interactive Cardiovascular and Thoracic Surgery
Eyupserhat Calik, Bilgehan Erkut
Type A aortic dissection is a condition that can lead to death, and within minutes, it requires an immediate surgical intervention. Despite surgical protection techniques, graft materials and technological advances, there is still a 30% mortality rate associated with surgical treatment. Endovascular repair of aortic dissections can be performed with promising results in high-risk patients.
July 27, 2018: Interactive Cardiovascular and Thoracic Surgery
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