European Journal of Cardio-thoracic Surgery

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BACKGROUND: Aortic stenosis or regurgitation in patients with a unicuspid valve morphology require interventions early in life. We have performed either primary valve repair or the Ross procedure. The aim of this study was to compare the mid-term results of repair and pulmonary autograft replacement. METHODS: Between 12/1998 and 04/2022, 345 patients (77% male; mean age 34±9.7 years) underwent treatment of a unicuspid aortic valve. Patients were excluded if they were <18 years (n = 84) or > 54 years (n = 3) at the time of the operation...

OBJECTIVES: The optimal treatment for acute type A aortic dissection (AAAD) with thrombosed false lumen (T-FL) of the ascending aorta remains controversial. This study aimed to the evaluate clinical outcomes of initial medical treatment (IMT) and the effectiveness of thoracic endovascular aortic repair (TEVAR) for AAAD with T-FL. METHODS: We retrospectively analysed 60 AAAD with T-FL patients. Emergent aortic repair was performed in 33 patients and IMT was selected in 27 uncomplicated patients with ascending aortic diameter < 50 mm and ascending T-FL thickness ≤ 10 mm...

OBJECTIVES: Data on prognostic implications of new-onset postoperative atrial fibrillation (POAF) after surgical aortic valve replacement (SAVR) is limited. We sought to explore associations between POAF, early-initiated oral anticoagulation (OAC), and long-term outcome after SAVR and combined SAVR+CABG. METHODS: This is a retrospective, population-based study including all isolated SAVR (n = 7038) and combined SAVR and CABG patients (n = 3854) without a history of preoperative atrial fibrillation in Sweden 2007-2017...

BACKGROUND: Pathophysiology of function tricuspid regurgitation (FTR) is incompletely understood. We set out to comprehensively evaluate geometric and tissue remodeling of the tricuspid valve complex in ovine FTR. METHODS: Twenty adult sheep underwent left thoracotomy and pulmonary artery banding (PAB) to induce right heart pressure overload and FTR. After 8 weeks, 17 surviving animals and 10 healthy controls (CTL) underwent sternotomy, echocardiography, and implantation of sonomicrometry crystals on right ventricle and tricuspid valvular apparatus...

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BACKGROUND: The prevalence and etiology of acute aortic dissection type A in patients ≤30 years is unknown. The aims of this clinical study were to determine the prevalence and potential etiology of acute aortic dissection type A in surgically treated patients ≤30 years and to evaluate the respective postoperative outcomes in this selective group of patients in a large multi-centre study. METHODS: Retrospective data collection was performed at the 16 participating international aortic institutions...

OBJECTIVES: Aortic root abscess can spread to include adjacent cardiac structures, including the central or intervalvular fibrous body and mitral valve. After radical debridement, complex surgical correction is needed. We describe the results of our mitral valve sparing approach. METHODS: Between January 2004 and December 2020, 60 patients underwent operation for infective endocarditis of the aortic root with extension towards the mitral valve at 2 centers in the Netherlands...

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OBJECTIVES: This study aimed to evaluate the outcomes of tricuspid annuloplasty with/without additional edge-to-edge plications in patients with functional tricuspid regurgitation and to clarify the impact of tethering on surgical outcomes. METHODS: This retrospective observational study included patients with moderate or greater functional tricuspid regurgitation who underwent initial tricuspid valve repair between January 2008 and December 2021. The patients were divided into two groups based on whether they had tethering (preoperative tethering area ≥0...

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OBJECTIVES: The impacts of elevated troponin I levels after coronary artery bypass grafting (CABG) on long-term outcomes were investigated. METHODS: A total of 996 patients who underwent elective isolated CABG for stable or unstable angina were enrolled. Patients were divided into higher and lower groups based on 80th percentile postoperative peak troponin I (ppTnI) levels. The relationship between ppTnI and long-term clinical outcomes was analyzed. RESULTS: The median ppTnI was 1...

OBJECTIVE: The role of extracellular matrix collagen biomarkers in chronic thromboembolic pulmonary hypertension is not well known. Our aim is to investigate the matrix metalloproteinase-2 and -9 protein levels in patients with chronic thromboembolic pulmonary hypertension. MATERIALS AND METHODS: This is a prospective and cross-sectional study. Patients with chronic thromboembolic pulmonary hypertension who underwent pulmonary endarterectomy (Group 1) and the control group included patients who underwent lung surgery without pulmonary hypertension (Group 2) between March 2020 and March 2021...

OBJECTIVES: Studies concerning factors associated with long-term outcomes in adult congenital heart disease patients after infective endocarditis are scarce, while infective endocarditis-related mortality in these patients remains a burden. We evaluated the factors associated with long-term survival in adult congenital heart disease patients admitted for infective endocarditis. METHODS: We performed a retrospective single-centre study of all adult congenital heart disease patients admitted for infective endocarditis to a tertiary cardiothoracic centre between 1999 and 2015...

Andexanet alfa was employed to reverse the anticoagulant effect of direct oral anticoagulants in 3 patients who required emergent surgery for repair of type A aortic dissection. Its use was instrumental in securing haemostasis. However, we caution against the administration of Andexanet alfa prior to cardiopulmonary bypass as it can induce heparin resistance and complicate the perioperative monitoring of anticoagulation during CPB.

OBJECTIVE: Previous studies indicated higher long-term mortality after the transfusion of allogeneic red blood cells and newer recommendations emphasize lower transfusion rates. Consequences of transfusion of red blood cells in cardiac surgery are unclear, as later studies focused on transfusion triggers and short-term outcomes and reports on long-term complications after cardiac surgery are few. MATERIAL AND METHODS: The mandatory Western Denmark Heart Registry was used to identify all adult cardiac surgeries performed in four centres from 2000-2019...

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OBJECTIVES: Patients undergoing surgical mitral valve repair for degenerative mitral regurgitation are at risk of even late postoperative atrial fibrillation (AF). Left atrial (LA) functionhas been shown superior to LA volume in evaluating risk of AF in diverse cardiac conditions. We therefore investigated the prognostic value of LA function and volume in predicting mid-to-late postoperative AF after mitral valve repair (>30 days postoperatively). METHODS: We retrospectively identified all patients who underwent mitral valve repair for degenerative mitral regurgitation between 2012-2019 at our institution...

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