Interactive CardioVascular and Thoracic Surgery

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List of Papers (Total 5,415)

Non-anastomotic rupture of the Valsalva graft 6 years after undergoing the Bentall procedure

A 72-year old man with an unruptured aneurysm of the right sinus of Valsalva and aortic insufficiency underwent aortic root replacement using a valved composite graft created with a 28-mm woven Dacron graft (Gelweave Valsalva™ graft, Vascutek Terumo, Renfrewshire, Scotland) and a 25-mm stented bioprosthetic aortic valve (Carpentier-Edwards PERIMOUNT pericardial bioprosthesis...

Selective, segmental decalcification: a safe alternative to extensive debridement of a severely calcified annulus during repair of mitral regurgitation

Resection of the calcium bar and creation of a more compressible annulus with pericardium are necessary in case of extensive calcification of the mitral valve annulus in patients with advanced myxomatous degenerative disease. Such annular bar calcification is technically challenging and represents a risk factor for death following mitral valve operations, because of atrio...

Totally endoscopic robotic repair of coronary sinus atrial septal defect

Coronary sinus atrial septal defect is a rare congenital cardiac anomaly in adults. Patients with this anomaly are generally treated using conventional sternotomy or thoracotomy incisions. However, robotic surgery can be a feasible alternative in this anomaly. We report an adult patient, who presented with coronary sinus atrial septal defect. A totally endoscopic robotic repair...

An unusual fenestration in single-stage Fontan operation

Fontan operation and importance of fenestration in the treatment of unusual and complex forms of double outlet right ventricle (DORV) are well established. Nonetheless, rarely, the creation of fenestration becomes challenging in complex morphologies. We present one such child with situs solitus, dextrocardia, DORV, hypoplastic right ventricle, large ventricular septal defect...

Does positron emission tomography/computed tomography aid the diagnosis of prosthetic valve infective endocarditis?

A best evidence topic was constructed according to a structured protocol. The question addressed was whether 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) aids the diagnosis of prosthetic valve endocarditis (PVE)? A total of 107 publications were found using the reported search, of which 6 represented the best evidence to answer the clinical...

Cardiac protection with phosphocreatine: a meta-analysis†

Phosphocreatine (PCr) plays an important role in the energy metabolism of the heart and a decrease in its intracellular concentration results in alteration of myocardium energetics and work. We conducted a meta-analysis of all randomized and matched trials that compared PCr with placebo or standard treatment in patients with coronary artery disease or chronic heart failure or in...

Improved cognitive flexibility after aortic valve replacement surgery

OBJECTIVES Aortic valve replacement (AVR) surgery is associated with potential risk to cerebral injury. On the other hand, improved cardiovascular functioning after the surgery may have positive impact on brain health. The aim of this preliminary study was to investigate the impact of AVR surgery on cognition, specifically on higher cognitive control functions, i.e. executive...

Partial replacement of left hemidiaphragm in dogs by either cryopreserved or decellularized heterograft patch†

OBJECTIVES Large diaphragmatic defects are still a challenging issue for reconstruction using either synthetic prosthesis or bioprosthesis. To evaluate the possibility of using diaphragm allograft as a natural bioprosthesis in humans, we conducted a two-group study and compared cryopreserved and decellularized diaphragmatic heterograft patched in a canine model.

Pressure level required during prolonged cerebral perfusion time has no impact on neurological outcome: a propensity score analysis of 800 patients undergoing selective antegrade cerebral perfusion†

OBJECTIVES Operating on the aortic arch is a surgical challenge involving various periods of circulatory arrest. Deep hypothermia is used to protect the brain. Selective antegrade cerebral perfusion (SACP) is employed to protect the brain and enable cerebral ischaemia time to be prolonged. However, there is no standardized SACP protocol. Our centre has performed flow- and...

Early and mid-term results after hybrid total arch repair of DeBakey type I dissection without deep hypothermic circulatory arrest

OBJECTIVES The purpose of this study was to assess the efficacy of the hybrid total arch procedure for the treatment of DeBakey type I dissection by analyzing mid-term results.

Bileaflet mechanical valve replacement: an assessment of outcomes with 30 years of follow-up†

OBJECTIVES Heart valve replacement with a bileaflet mechanical valve is a well-established procedure. However, the long-term results of valve replacement using the bileaflet mechanical valve remain unclear, especially for follow-up periods over 30 years. Additionally, it is important to identify predictors of long-term mortality and valve-related events.

Benefits and medium-term outcome of the Sorin Pericarbon Freedom stentless aortic prosthesis in cases of acute bacterial endocarditis†

OBJECTIVES The aim of this study is to evaluate the ease of use and the advantages of Sorin Pericarbon Freedom (SPF) stentless valve in cases of acute bacterial endocarditis and to check the intermediate-term results after the implant of SPF with respect to resistance to infection, valve deterioration and durability.

A prospective comparison of mid-term outcomes in patients treated with heart transplantation with advanced age donors versus left ventricular assist device implantation

OBJECTIVES In Europe, the age of heart donors is constantly increasing. Ageing of heart donors limits the probability of success of heart transplantation (HTx). The aim of this study is to compare the outcome of patients with advanced heart failure (HF) treated with a continuous-flow left ventricular assist device (CF-LVAD) with indication as bridge to transplantation (BTT) or...

Recipient age impact on outcome after cardiac transplantation: should it still be considered in organ allocation?†

OBJECTIVES Improvement of clinical results in heart transplantation (HTx) has favoured the expansion of indication criteria towards aged population. The impact of increasing recipient age is controversial and, owing to donor shortage, the debate still remains whether HTx is justified for older patients. We analysed age as a prognostic factor at long-term after HTx and if it...

Spread through air spaces is a predictive factor of recurrence and a prognostic factor in stage I lung adenocarcinoma†

OBJECTIVES Spread through air spaces (STAS) is considered a prognosticator related to local recurrence. We assessed the prognostic impact of spread through air spaces and local recurrence in stage I lung adenocarcinoma.

Prognostic value of body mass index and change in body weight in postoperative outcomes of lung cancer surgery

OBJECTIVES Nutritional status is associated with an effect on oncological outcomes. However, the effect of nutritional status on postoperative survival in lung cancer has not been well studied. We retrospectively analysed and evaluated the effect of preoperative body mass index (BMI) and changes in body weight on postoperative outcomes of lung cancer surgery.

Clinical results of bronchial stump coverage using free pericardial fat pad

OBJECTIVES Bronchial fistula is a severe complication after thoracic surgery. Although many methods of coverage using various autologous tissues including pedicled pericardial fat pad have been reported to be useful for the prevention of bronchial fistula, the ideal roles of these approaches and the coverage techniques yielding the best results still remain unclear. The clinical...

Influence of stapling the intersegmental planes on lung volume and function after segmentectomy

OBJECTIVES Dividing the intersegmental planes with a stapler during pulmonary segmentectomy leads to volume loss in the remnant segment. The aim of this study was to assess the influence of segment division methods on preserved lung volume and pulmonary function after segmentectomy.

Measuring changes in chest wall motion after lung resection using structured light plethysmography: a feasibility study†

OBJECTIVES We describe the use of structured light plethysmography (SLP)—a novel, non-contact, light-based technique for measuring tidal breathing—among a cohort of patients undergoing lung resection. In this feasibility study, we examined whether changes in chest wall motion or in asynchrony between regions of the thoraco–abdominal wall could be identified after surgery.

Comparison between Caprini and Padua risk assessment models for hospitalized medical patients at risk for venous thromboembolism: a retrospective study

OBJECTIVES This study aimed to evaluate the validity of the risk assessment model (RAM) of Caprini and Padua in identifying venous thromboembolism (VTE) among hospitalized medical patients.

Association of nadir oxygen delivery on cardiopulmonary bypass with serum glial fibrillary acid protein levels in paediatric heart surgery patients

OBJECTIVES Protecting the brain during cardiac surgery is a major challenge. We evaluated associations between nadir oxygen delivery (DO2) during paediatric cardiac surgery and a biomarker of brain injury, glial fibrillary acidic protein (GFAP).

Repair of adult aortic coarctation by resection and interposition grafting

OBJECTIVES Aortic coarctation presenting during adult life most frequently represents cases of re-coarctation, following previous transcatheter or surgical therapy, or missed cases of native coarctation. In the area of evolving endovascular therapy, we believe that there is still a place for durable open repair by means of resection and interposition grafting. We, therefore...

Computational haemodynamic analysis of left pulmonary artery angulation effects on pulmonary blood flow

OBJECTIVES To study the effect of the angulation between the left pulmonary artery (LPA) and the main pulmonary artery on pulmonary haemodynamics.