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Cabg and avr

Brent Klinkhammer
Background: A history of coronary artery bypass graft (CABG) is a common compelling indication for transcatheter aortic valve replacement (TAVR). However, there is little data on how these patients compare to other TAVR patients. In this study, the short and long-term outcomes of these TAVR patients after CABG are defined. Methods: A retrospective chart review case-control study of 337 consecutive patients who underwent a TAVR for severe aortic stenosis at Sanford Health in Fargo ND was performed to determine if a history of prior CABG was associated with worse outcomes after TAVR as compared to a TAVR cohort without a history of CABG...
February 2018: Cardiology Research
Weiang Yan, Pallav Shah, Brett Hiebert, Zlatko Pozeg, Nitin Ghorpade, Rohit K Singal, Rizwan A Manji, Rakesh C Arora
OBJECTIVES: Long-term quality of life following open surgical valve replacement is an increasingly important outcome to patients and their caregivers. This study examines non-institutionalized survival and rehospitalization within our surgical aortic valve replacement (AVR) and mitral valve replacement (MVR) populations. METHODS: A retrospective single-centre study of all consecutive open surgical valve replacements between 1995 and 2014 was undertaken. Clinical data were linked to provincial administrative data for 3219 patients who underwent AVR, MVR or double (aortic and mitral) valve replacement with or without concomitant coronary artery bypass grafting (CABG)...
February 14, 2018: Interactive Cardiovascular and Thoracic Surgery
Lily E Johnston, Emily A Downs, Robert Hawkins, Mohamed Quader, Alan Speir, Jeff Rich, Leora Yarboro, Gorav Ailawadi
BACKGROUND: The technical expertise required for treatment of coronary and structural heart valve disease differs. Correlation between center-specific mortality after coronary artery bypass grafting (CABG) and valve operations has not been demonstrated. This study tested the hypothesis that risk-adjusted outcomes between coronary and valve procedures do not correlate within centers. METHODS: Records of patients undergoing isolated CABG, isolated aortic valve (AVR), or isolated mitral valve (MVR) procedures from 2008-2015 in a multi-institutional STS database were used to generate observed-to-expected (OE) ratios for morbidity and mortality...
January 27, 2018: Annals of Thoracic Surgery
Santiago Garcia, Rosemary Kelly, Mackenzie Mbai, Sergey Gurevich, Brett Oestreich, Demetris Yannopoulos, Selcuk Adabag
BACKGROUND: Transfemoral transcatheter aortic valve replacement (TAVR) was superior to surgical aortic valve replacement (SAVR) in the placement of aortic transcatheter valves (PARTNER) 2A trial (P2). The generalizability of the trial results to the broader population of patients with intermediate surgical risk remains unknown. OBJECTIVE: To compare the outcomes of SAVR and TAVR among patients with intermediate surgical risk treated in the VA Healthcare System. METHODS: We retrospectively analyzed the clinical characteristics and outcomes on all SAVR (1987-2014) and TAVR procedures (2015-2017) performed at the Minneapolis VA Healthcare System...
January 9, 2018: Catheterization and Cardiovascular Interventions
Bartłomiej Perek, Veronica Casadei, Mateusz Puślecki, Sebastian Stefaniak, Dawid Maison, Adrian Gwizdała, Anna Perek, Łukasz Szarpak, Marek Jemielity
BACKGROUND: Aortic stenosis and coronary artery disease (CAD) sharing similar risk factors are associated with aging of human population. AIM: The purpose of this study was to examine if age affects clinical presentation, intraoperative management and outcomes of patients that undergo simultaneous operations of aortic valve replacement (AVR) and coronary artery bypass grafting (CABG). METHODS: The study involved 452 consecutive patients with the age of 64...
January 9, 2018: Kardiologia Polska
Antonino S Rubino, Carmelo Mignosa
BACKGROUND: Aim of this study was to assess the potential differences in respecting the principles of goal-directed perfusion between aortic valve replacement with sutureless vs conventional stented bioprostheses. METHODS: Data from 94 consecutive patients undergoing aortic valve replacement with Perceval sutureless valve, with or without concomitant CABG, were compared to a contemporary cohort of 116 patients receiving conventional stented bioprostheses. Propensity score matching was used to reduce selection bias...
December 14, 2017: Minerva Cardioangiologica
Oscar Millan-Iturbe, Fadi J Sawaya, Jacob Lønborg, Danny H F Chow, Gintautas Bieliauskas, Thomas Engstrøm, Lars Søndergaard, Ole De Backer
Transcatheter aortic valve replacement (TAVR) has become an established therapeutic option for patients with symptomatic, severe aortic stenosis. The optimal treatment strategy for concomitant coronary artery disease (CAD) has not been tested prospectively in a randomized clinical trial. This study aimed to describe the degree of CAD, revascularization strategies, and long-term clinical outcomes in a large-scale all-comers TAVR-population. Nine hundred and forty-four consecutive patients underwent TAVR. Obstructive CAD was reported in 224 patients (23...
December 7, 2017: Catheterization and Cardiovascular Interventions
Buntaro Fujita, Stephan Ensminger, Timm Bauer, Helge Möllmann, Andreas Beckmann, Raffi Bekeredjian, Sabine Bleiziffer, Elke Schäfer, Christian W Hamm, Friedrich W Mohr, Hugo A Katus, Wolfgang Harringer, Thomas Walther, Christian Frerker
OBJECTIVES: Surgical aortic valve replacement (sAVR) is coming under close scrutiny with the recent upswing in the use of less invasive approaches. The aim of this analysis was to identify current trends in patient selection, procedural characteristics and outcomes after sAVR in Germany. METHODS: We analysed data from 42 776 patients included in the German Aortic Valve Registry who underwent sAVR with and without coronary artery bypass surgery (CABG) between 2011 and 2015...
March 1, 2018: European Journal of Cardio-thoracic Surgery
Parwis B Rahmanian, Süreyya Kaya, Kaveh Eghbalzadeh, Hruy Menghesha, Navid Madershahian, Thorsten Wahlers
BACKGROUND: The aim of this study was to evaluate the effects of rapid deployment aortic valve replacement (RDAVR) on surgical outcome and hemodynamics compared with standard aortic valve replacement (AVR). METHODS: One hundred sixty-three RDAVR patients (isolated, n = 67; combined with coronary artery bypass graft surgery [CABG], n = 96) were compared with a propensity matched control group (n = 163). Primary endpoints included association between valve type and procedure times, prosthesis size, transvalvular gradient, and indexed effective orifice area...
January 2018: Annals of Thoracic Surgery
Rohan Khera, Ambarish Pandey, Thomas Koshy, Colby Ayers, Brahmajee K Nallamothu, Sandeep R Das, Mark H Drazner, Michael E Jessen, Ajay J Kirtane, Timothy J Gardner, James A de Lemos, Deepak L Bhatt, Dharam J Kumbhani
Importance: Identifying high-performing surgical valve centers with the best surgical outcomes is challenging. Hospital surgical volume is a frequently used surrogate for outcomes. However, its ability to distinguish low-performing and high-performing hospitals remains unknown. Objective: To examine the association of hospital procedure volume with hospital performance for aortic and mitral valve (MV) surgical procedures. Design, Setting, and Participants: Within an all-payer nationally representative data set of inpatient hospitalizations, this study identified 682 unique hospitals performing surgical aortic valve replacement (SAVR) and MV replacement and repair with or without coronary artery bypass grafting (CABG) between 2007 and 2011...
November 8, 2017: JAMA Cardiology
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
del Nido cardioplegia (DC) offers prolonged cardiac protection with single-dose administration and has been shown to be safe in adult CABG surgery. We set out to evaluate the efficacy of cardiac protection and clinical outcomes of DC versus standard blood cardioplegia (BC) in minimally invasive aortic valve surgery. From August 2011 to May 2016, 178 patients underwent minimally invasive aortic valve replacement (mini-AVR) with BC (n = 101) or DC (n = 77). Ministernotomy or right minithoracotomy was utilized for surgical access...
November 2, 2017: Seminars in Thoracic and Cardiovascular Surgery
Akshat Saxena, Sohaib A Virk, Sebastian R A Bowman, Richmond Jeremy, Paul G Bannon
BACKGROUND: Cardiac surgical units must balance trainee education with the duty to provide optimal patient care. This is particularly challenging with valvular surgery, given the lower volume and increased complexity of these procedures. The present meta-analysis was conducted to assess the impact of trainee operator status on clinical outcomes following valvular surgery. METHODS: Medline, Embase and CENTRAL databases were systematically searched for studies reporting clinical outcomes according to the training status of the primary operator (consultant or trainee)...
October 27, 2017: Heart, Lung & Circulation
Raphael Hamad, Anthony Nguyen, Éric Laliberté, Denis Bouchard, Yoan Lamarche, Ismail El-Hamamsy, Philippe Demers
OBJECTIVE: del Nido solution (DNS) is a single-dose cardioplegia designed for pediatric use proposed to offer superior myocardial protection in adults. However, few data support this claim. We hypothesized that DNS and modified blood cardioplegia solution (BS) provide equivalent safety in combined adult valve surgery. METHODS: Between November 2014 and December 2015, 25 patients underwent primary aortic valve replacement and concomitant coronary artery bypass grafting (CABG) with DNS...
September 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
B Philip, P McCluskey, J Hinchion
OBJECTIVE: Postoperative delayed wound healing, surgical site infections (SSIs), and other wound complications are associated with increased morbidity and health-care costs. In cardiothoracic surgery, wound complications can have life-threatening consequences. In recent years, negative pressure wound therapy (NPWT) has been applied over closed surgical incisions to help reduce tension and protect from external contamination. We report our initial experiences using a closed incision negative pressure therapy (ciNPT) over clean, closed sternotomy incisions at an Irish tertiary referral centre...
August 2, 2017: Journal of Wound Care
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at
June 12, 2017: Journal of Thoracic and Cardiovascular Surgery
Vinay Badhwar, J Scott Rankin, Niv Ad, Maria Grau-Sepulveda, Ralph J Damiano, A Marc Gillinov, Patrick M McCarthy, Vinod H Thourani, Rakesh M Suri, Jeffrey P Jacobs, James L Cox
BACKGROUND: Surgical ablation (SA) for atrial fibrillation (AF) effectively restores sinus rhythm. Incompletely defined risk has previously limited concomitant performance of SA during cardiac operations. The study goals were to define performance trends and risk-adjusted outcomes for contemporary SA. METHODS: From July 2011 to June 2014, 86,941 patients with AF, but without endocarditis, underwent primary nonemergent cardiac operations in The Society of Thoracic Surgeons (STS) database...
August 2017: Annals of Thoracic Surgery
Katherine R Hulme, Jon van den Burg
INTRODUCTION: A cell salvage device is used in cardiac surgery with the aim of reducing allogeneic blood transfusion. Suction of blood from the operating field used for the device is often accompanied by diathermy smoke. There is limited published research to know if this blood is then contaminated with clinically significant levels of harmful chemicals from this smoke. Postoperative cardiac surgery patients are already physiologically vulnerable, making the optimization of salvaged blood worth considering...
June 1, 2017: Perfusion
John D Puskas, Joseph E Bavaria, Lars G Svensson, Eugene H Blackstone, Bartley Griffith, James S Gammie, David A Heimansohn, Jerzy Sadowski, Krzysztof Bartus, Douglas R Johnston, Jacek Rozanski, Todd Rosengart, Leonard N Girardi, Charles T Klodell, Mubashir A Mumtaz, Hiroo Takayama, Michael Halkos, Vaughn Starnes, Percy Boateng, Tomasz A Timek, William Ryan, Shuab Omer, Craig R Smith
OBJECTIVES: The COMMENCE trial was conducted to evaluate the safety and effectiveness of a novel bioprosthetic tissue for surgical aortic valve replacement (AVR). METHODS: Patients underwent clinically indicated surgical AVR with the Carpentier-Edwards PERIMOUNT™ Magna Ease™ aortic valve with RESILIA™ tissue (Model 11000A) in a prospective, multinational, multicentre (n = 27), single-arm, FDA Investigational Device Exemption trial. Events were adjudicated by an independent Clinical Events Committee; echocardiograms were analysed by an independent Core Laboratory...
September 1, 2017: European Journal of Cardio-thoracic Surgery
Aschraf El-Essawi, Mohammed Morjan, Ingo Breitenbach, Ahmed Bechri, Rene Brouwer, Wolfgang Harringer
INTRODUCTION: Safety concerns have been one of the main reasons opposing a wider acceptance of minimal invasive extracorporeal circuits (MiECC). Following an extensive experience and a multitude of modifications, we have set out to employ a modular MiECC as a universal extracorporeal circuit. METHODS: A total of 129 cardiac surgical procedures were performed by a single surgeon in 2013. Excluding procedures done under circulatory arrest or with the potential need of such, the MiECC was utilized in almost 90% of surgeries...
June 1, 2017: Perfusion
Tomasz Niklewski, Michał Zembala, Dariusz Puszczewicz, Paweł Nadziakiewicz, Wojciech Karolak, Marian Zembala
INTRODUCTION: Epiaortic ultrasound scanning (EAS) extended the use of ultrasound to the intraoperative diagnosis of aortic pathology. Surgical palpation of the ascending aorta underestimates the presence and severity of atherosclerotic plaques. Epiaortic ultrasound scanning has been used as an adjunct to transesophageal echocardiography (TEE) or as a primary direct diagnostic tool for imaging the ascending aorta as well as the aortic arch, which gained prominence as part of a multipronged intraoperative strategy to reduce atherosclerotic emboli...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
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