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https://www.readbyqxmd.com/read/29683812/current-trends-in-aortic-root-surgery-the-mini-bentall-approach
#1
Djamila Abjigitova, Georgia Panagopoulos, Oleg Orlov, Vishal Shah, Konstadinos A Plestis
OBJECTIVE: The mini-sternotomy approach is becoming a widespread technique for aortic valve surgery. However, its safety for aortic root replacement has yet to be established. The aim of the present study was to compare the operative outcomes of patients who underwent aortic root replacement via upper mini-sternotomy (mini-Bentall) to patients who underwent Bentall procedure via median sternotomy (full-sternotomy Bentall). METHODS: Between November 1998 and November 2016, 91 consecutive patients underwent full-sternotomy Bentall procedure and 26 patients underwent mini-Bentall procedure...
April 20, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29682123/a-case-of-traumatic-retrograde-type-a-aortic-dissection-accompanied-by-multiorgan-injuries
#2
Katsuaki Tsukioka, Tetsuya Kono, Kohei Takahashi, Hiromu Kehara, Shuichi Urashita, Kazunori Komatsu
A 75-year-old woman was involved in a traffic accident and suffered retrograde type A aortic dissection, multiple rib fractures, and grade II hepatic injury accompanied by intraperitoneal bleeding. We performed total arch replacement using an open stent graft with cardiopulmonary bypass and circulatory arrest. This procedure requires anticoagulation and hypothermia, which are principally contraindicated in severe trauma patients. However, this situation was resolved by managing the patient non-operatively for 7 days, confirming the stabilization of other injured organs, and then performing the surgery...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29681570/single-femoral-venous-drainage-versus-both-vena-cava-drainage-in-isolated-repeat-tricuspid-valve-surgery
#3
Runsheng Peng, Hui Shi, Jun Ba, Chunsheng Wang
To assess the potential advantages of minimally invasive surgery using a single femoral venous drainage method versus femoral venous and superior vena cava or jugular venous drainage method during repeat tricuspid valve surgery.From January 2010 to December 2016, 50 repeat tricuspid valve procedures were performed using a minimally invasive approach without aortic cross-clamping at our institution. The arterial cannula was inserted into the femoral artery, and at the same time, the venous cannula was placed in the femoral vein in 28 patients (FV group) during cardiopulmonary bypass (CPB)...
April 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29680865/comparison-of-midterm-outcomes-of-transcatheter-aortic-valve-implantation-in-patients-with-and-without-previous-coronary-artery-bypass-grafting
#4
Hideyuki Kawashima, Yusuke Watanabe, Ken Kozuma, Akihisa Kataoka, Makoto Nakashima, Hirofumi Hioki, Fukuko Nagura, Yugo Nara, Shinichi Shirai, Norio Tada, Motoharu Araki, Toru Naganuma, Futoshi Yamanaka, Hiroshi Ueno, Minoru Tabata, Kazuki Mizutani, Akihiro Higashimori, Kensuke Takagi, Masanori Yamamoto, Kentaro Hayashida
The midterm safety and feasibility of transcatheter aortic valve implantation (TAVI) for patients with a history of coronary artery bypass graft (CABG) and high operative risk are unclear. This study compared the midterm outcomes of patients undergoing TAVI with or without previous CABG surgery. Between October 2013 and July 2016, 1,613 patients underwent TAVI according to the Optimized CathEter vAlvular iNtervention (OCEAN)-TAVI registry (previous CABG: n = 120; no previous CABG: n = 1493). The propensity score comprised the variables of the Society of Thoracic Surgeons Score, previous myocardial infarction, peripheral artery disease, chronic kidney disease > stage 2 (estimated glomerular filtration rate < 60 mL/min/1...
April 21, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29678647/post-mortem-retrieval-of-arterial-allografts-preliminary-results
#5
Dorian Verscheure, Julien Gaudric, Jérémie Jayet, Philippe Tresson, Mohamed Jarraya, Pierre Julia, Marc Coggia, Laurent Chiche, Fabien Koskas
OBJECTIVES: Cryopreserved arterial allografts are vascular substitutes used for arterial reconstructions in a septic field. Their use remains however limited by the shortage of donors. One of the possibilities to address this lack of grafts is to multiply the sources of retrieval. The objective of this preliminary study was the evaluation of the early clinical results and the microbiological safety of arterial grafts retrieved after death. MATERIAL AND METHODS: In addition to the standard conditions of arterial sampling the criteria of inclusion for postmortem retrieval comprised the refrigeration of the body of the donor within four hours following the death, a 24-hour time limit from the death, and the availability of an adapted place for retrieval (surgical unit or death chamber respecting the required aseptic conditions)...
April 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29675439/coronary-events-in-patients-presenting-for-repair-of-acute-type-a-aortic-dissection
#6
Paul C Tang, Shahab A Akhter, Satoru Osaki, Lucian Lozonschi, Takushi Kohmoto, Nilto C De Oliveira
Background: Preoperative coronary angiography is often not performed in acute Type A dissection. We examined differences in the incidence of pre-existing coronary disease and subsequent coronary events between patients undergoing acute Type A dissection repair and patients undergoing elective proximal aortic aneurysm repair. Methods: From 2000 to 2015, there were 154 acute Type A dissection repairs and 457 elective proximal aortic aneurysm repairs. We performed a retrospective review to evaluate preoperative coronary disease and postoperative coronary interventions such as percutaneous coronary intervention (PCI) and coronary bypass grafting (CABG)...
June 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29670772/left-circumflex-artery-rupture-with-left-atrial-tamponade-and-functional-mitral-stenosis
#7
Weiting Huang, Khaled Mohamed Emadeldin Moheb Hammad, Victor Tar Toong Chao, Khung Keong Yeo
The growth in percutaneous transluminal devices has enabled operators to tackle more complex, native, and post-bypass surgery anatomy. However, complications such as coronary artery dissection, coronary perforation, retrograde aortic dissection, arrhythmias, and acute coronary syndrome still occur with resulting mortality rates of up to 4.2% in complex interventions. Perforation of the circumflex artery is of particular interest in view of its position and relation to the surrounding cardiac structures. This is a site of potential fluid collection, and as the left atrium is fixed to the parietal pericardium at the entry of the pulmonary veins, fluid in the oblique sinus can accumulate enough pressure to compress the left atrium and the coronary sinus...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29669969/surgical-aortic-valve-replacement-in-octogenerians-in-the-era-of-transcatheter-aortic-valve-replacement
#8
Takashi Yamauchi, Takano Hiroshi, Koichi Toda, Yoshiki Sawa
BACKGROUND: The hospital mortality rate in >80-year-old patients undergoing surgical aortic valve replacement (SAVR) is reportedly satisfactory, but how such patients' functional status both at discharge and during the postoperative hospitalization period might affect their quality of life and medical costs remains unclear.Methods and Results:The adverse events of 161 patients aged >80 years who underwent SAVR with or without coronary artery bypass grafting were retrospectively investigated...
April 17, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29668501/transcaval-valve-in-valve-in-valve-aortic-valve-replacement-for-bioprosthetic-valve-degeneration
#9
A Claire Watkins, Chandan M Devireddy, Talal Al-Atassi, Amy E Simone, Jessica Forcillo, Vinod H Thourani
A 74-year-old man presented with progressive dyspnea on exertion. History included peripheral arterial disease and coronary artery bypass grafting with aortic valve replacement 12 years ago. Subsequently, the surgical valve developed severe stenosis and moderate insufficiency. He underwent a transapical valve-in-valve transcatheter aortic valve replacement 5 years before presentation. This second valve developed a mean gradient of 66 mm Hg with mild insufficiency. The patient was treated with a third aortic valve using an alternative transcaval approach, significantly alleviating his symptoms...
April 17, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29668339/in-hospital-outcomes-after-rotational-atherectomy-in-patients-with-low-ejection-fraction
#10
Yusuke Watanabe, Toru Naganuma, Hiroyoshi Kawamoto, Hisaaki Ishiguro, Sunao Nakamura
OBJECTIVES: This study evaluated angiographic success and in-hospital outcomes of percutaneous coronary intervention (PCI) with rotational atherectomy (RA) in patients with low left ventricular ejection fraction (LVEF). DESIGN: Between January 2010 and March 2014, 272 consecutive patients with heavily calcified lesions underwent elective PCI with RA. Of these, 33 patients had LVEF ≤35% (low LVEF group), whereas 237 patients had LVEF >35% (preserved LVEF group)...
April 18, 2018: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/29667902/myocardial-protection-following-del-nido-cardioplegia-in-pediatric-cardiac-surgery
#11
Debasish Panigrahi, Saibal Roychowdhury, Rahul Guhabiswas, Emmanuel Rupert, Mrinalendu Das, Pradeep Narayan
Background This study was designed to compare myocardial protection with del Nido cardioplegia and conventional blood cardioplegia in children undergoing cardiac surgery in Risk Adjustment for Congenital Heart Surgery categories 1 and 2. Methods Sixty patients were randomized into 2 groups receiving del Nido cardioplegia solution or conventional blood cardioplegia. Myocardial injury was assessed using biochemical markers (troponin I and creatine kinase-MB). Vasoactive-inotropic scores were calculated to compare inotropic requirements...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29658871/new-onset-ventricular-arrhythmias-in-patients-with-left-ventricular-dysfunction-after-coronary-surgery-incidence-risk-factors-and-prognosis
#12
Nan Cheng, Changqing Gao, Rong Wang, Ming Yang, Lin Zhang
BACKGROUND: The incidence, risk factors, and long-term prognosis of new-onset ventricular tachycardia (VT) and ventricular fibrillation (VF) after coronary artery bypass graft surgery (CABG) in patients with impaired left ventricular function have not been thoroughly examined. Methods: This study enrolled 612 consecutive patients with impaired left ventricular function (ejection fraction <50%) undergoing CABG at a single institution between March, 1996, and September, 2015. Outcomes were analyzed and compared, including in-hospital mortality and long-term survival...
March 26, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29658870/descending-thoracic-aortic-aneurysm-rupture-treated-with-thoracic-endovascular-aortic-repair-in-a-patient-with-peripheral-artery-disease
#13
Ovidiu Stiru, Roxana Carmen Geana, Platon Pavel, Marian Croitoru, Cristian Boros, Ion Iovu, Vlad Anton Iliescu
Descending thoracic aortic aneurysm rupture is a life-threatening disease associated with high rates of morbidity and mortality. Treatment in these cases is a surgical emergency. Less invasive therapies for the treatment of this pathology have been developed over time. For descending thoracic aneurysm rupture, endovascular stent grafting is less invasive, life-saving, and a unique alternative to open repair. However, this approach is subject to anatomical and logistic limitations. The purpose of the present study is to report a case of an emergency endovascular repair for a ruptured thoracic aortic aneurysm in a patient with peripheral arterial disease, and to discuss some important issues related to this approach...
March 20, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29657951/distribution-of-thoracic-aortic-calcifications-in-patients-undergoing-coronary-artery-bypass-grafting
#14
Adem Ilkay Diken, Adnan Yalçınkaya, Sertan Özyalçın
Background: In procedures involving surgical maneuvers such as cannulation, clamping, or proximal anastomosis where aortic manipulation is inevitable, a preliminary assessment of atherosclerotic plaques bears clinical significance. In the present study, our aim was to evaluate the frequency and distribution of aortic calcifications in patients undergoing coronary artery bypass grafting (CABG) surgery to propose a morphological classification system. Methods: A total of 443 consecutive patients with coronary artery disease were included in this study...
October 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29657946/too-cold-to-clot-does-intraoperative-hypothermia-contribute-to-bleeding-after-aortic-surgery
#15
Louis H Stein, Gregory Rubinfeld, Leora B Balsam, Patricia Ursomanno, Abe DeAnda
Background: We determined the impact of intraoperative hypothermia on postoperative bleeding after thoracic aortic surgery. Methods: We retrospectively analyzed 98 consecutive patients who underwent aortic surgery with deep hypothermic circulatory arrest between 2010 and 2014. We evaluated lowest temperature, absolute decrease in temperature, and rewarming rate. Univariate and multivariate regression were used to determine relationships between temperature, clinical characteristics, and measures of postoperative bleeding...
August 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29652290/absent-right-superior-vena-cava-and-persistent-left-superior-vena-cava-in-a-patient-with-bicuspid-aortic-valve-with-aortic-stenosis
#16
Kushant Gupta, Vijayakanth Bhuvana, Varun Bansal, Ruma Ray, Arkalgud Sampath Kumar
Persistent left superior vena cava (LSVC) with absent right SVC (RSVC) is a rare congenital anomaly. If undetected, the condition may pose difficulties in central venous catheter insertion, pacemaker electrode insertion, and cannulation during cardiopulmonary bypass. We describe a case of persistent LSVC with absent RSVC, who was diagnosed to have bicuspid aortic valve with aortic stenosis.
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652282/perioperative-management-of-transcatheter-aortic-and-mitral-double-valve-in-valve-implantation-during-pregnancy-through-left-ventricular-apical-approach
#17
Suresh Chengode, Rahul Vijaykumar Shabadi, Ram Narayan Rao, Nasser Alkemyani, Hilal Alsabti
Pregnant women with stenotic degeneration of bioprosthetic cardiac valves may require another valve replacement procedure when their symptoms deteriorate with progression of pregnancy, but fetal mortality is higher with cardiac surgery done on cardiopulmonary bypass. Transcatheter valve-in-valve implantation may help to improve the fetal and maternal outcomes in these situations. Double valve-in-valve implantation is rare and has not been reported in a pregnant patient. We report, for the first time, the case of a pregnant woman with stenotic bioprosthetic valves in the mitral and aortic positions, who underwent a successful concomitant, transcatheter, double valve-in-valve implantation through the left ventricular apical route during the second trimester of her precious pregnancy...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652280/relationship-between-maximum-clot-firmness-in-rotem-%C3%A2-and-postoperative-bleeding-after-coronary-artery-bypass-graft-surgery-in-patients-using-clopidogrel
#18
Rasoul Azarfarin, Fereidoon Noohi, Majid Kiavar, Ziae Totonchi, Avaz Heidarpour, Amir Hendiani, Zahra Sadat Koleini, Saeid Rahimi
Background: The aim of the present study was to investigate the relationship between maximum clot firmness (MCF) in rotational thromboelastometry (ROTEM® ) and postoperative bleeding in patients on clopidogrel after emergency coronary artery bypass graft surgery (CABG). Methods: This observational study recruited 60 patients posted for emergency CABG following unsuccessful primary percutaneous coronary intervention (PCI) while on 600 mg of clopidogrel. The study population was divided into 2 groups on the basis of their MCF in the extrinsically activated thromboelastometric (EXTEM) component of the (preoperative) ROTEM® test: patients with MCF <50 mm (n = 16) and those with MCF ≥50 mm (n = 44)...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#19
Amarja Sachin Nagre, Nagesh P Jambures
Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652271/prophylactic-preoperative-levosimendan-for-off-pump-coronary-artery-bypass-grafting-in-patients-with-left-ventricular-dysfunction-single-centered-randomized-prospective-study
#20
Pushkar Mahendra Desai, Manjula S Sarkar, Sanjeeta R Umbarkar
Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients. Aim and Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery...
April 2018: Annals of Cardiac Anaesthesia
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