Maya R Chilbert, Sara Salah, Brian Kersten, Lindsay Nitsche, Nicole Castoro, Awad El-Ashry
BACKGROUND: Evidence surrounding P2Y12 platelet reactivity units (PRU) impact on bleeding outcomes in patients undergoing coronary artery bypass is varied. This study sought to assess whether on-pump CABG procedures result in increased bleeding in patients with high compared to low PRUs. METHODS: This retrospective cohort study compared those with a PRU level ≤237 (low PRU group) to >237 (high PRU group). The primary outcome assessed massive or severe bleeding in accordance with universal definition of perioperative bleeding criteria...
March 23, 2023: Journal of Cardiovascular Surgery
Edward C Oh, Natalie D Sridharan, Efthymios D Avgerinos
Asymptomatic carotid stenosis has been shown to be associated with progressive neurocognitive decline, but the effects of carotid endarterectomy (CEA) on this are not well defined. Due to the wide heterogeneity of studies and lack of standardization in cognitive function tests and study design, there is mounting scientific evidence to support the notion that CEA is effective in reversing or slowing neurocognitive decline; however, definitive conclusions are difficult to make. Further, while the association between ACS and cognitive decline has been well document, a direct etiological role has not been established...
March 10, 2023: Journal of Cardiovascular Surgery
Roy Zuidema, Martina Bastianon, Jorge M Mena Vera, Sara DI Gregorio, Gaddiel Mozzetta, Jean-Paul Pm de Vries, Richte C Schuurmann, Giovanni Pratesi
BACKGROUND: The GORE EXCLUDER Conformable Endoprosthesis with active control (CEXC) was developed to treat challenging aortic neck anatomy. This study investigated the clinical results and changes in endograft (ap)position during follow-up. METHODS: Patients treated with the CEXC between 2018 and 2022 were included in this prospective single-center study. Computed tomography angiography (CTA) follow-up was grouped into three categories: 0 to 6 (FU1), 7 to 18 (FU2), and 19 to 30 (FU3) months...
March 10, 2023: Journal of Cardiovascular Surgery
Claire VAN DER Riet, Richte C Schuurmann, Simone N Schuurmann, Ingeborg K Koopmans, Debora A Werson, Ignace F Tielliu, Reinoud P Bokkers, Jean-Paul Pm de Vries
BACKGROUND: Fenestrated endovascular aortic aneurysm repair (FEVAR) is used in pararenal abdominal aortic aneurysms to achieve a durable proximal seal. This study investigated the mid-term course of the proximal fenestrated stent graft (FSG) sealing zone on the first and latest available post-FEVAR computed tomographic angiography (CTA) scan in a single-center series. METHODS: In 61 elective FEVAR patients, the shortest length of circumferential apposition between the FSG and the aortic wall (shortest apposition length [SAL]) was retrospectively assessed on the first and last available postoperative CTA scans...
March 10, 2023: Journal of Cardiovascular Surgery
Maria-Annette Kooijman, Richte Cl Schuurmann, Rogier Hj Kropman, Nada Y Elzefzaf, Jan Wille, Ignace Fj Tielliu, George A Antoniou, Jean-Paul Pm de Vries
BACKGROUND: Literature is scarce on the course of iliac endograft limb apposition after endovascular aortic aneurysm repair (EVAR), which is why this study was conducted. METHODS: A retrospective observational imaging study was performed to measure iliac apposition of endograft limbs on the first post-EVAR computed tomography angiography (CTA) scan and on the latest available follow-up CTA scan. With center lumen line reconstructions and CT-applied dedicated software, the shortest apposition length (SAL) of the endograft limbs was assessed as well as the distance between the end of the fabric and the proximal border of the internal iliac artery or the endograft-internal artery distance (EID)...
March 10, 2023: Journal of Cardiovascular Surgery
Takuya Haraguchi, Tsujimoto Masanaga, Tsutomu Fujita, Ryo Otake, Daisuke Hachinohe, Umihiko Kaneko, Yoshifumi Kashima, Katsuhiko Sato
BACKGROUND: The Misago iliac stent has not been compared with other stents. This study aimed to evaluate the 2-year clinical outcomes between the Misago stent and other self-expandable nitinol stents for symptomatic chronic aortoiliac disease. METHODS: This retrospective, single-center observational study enrolled 138 patients (180 limbs; Rutherford classification, between categories 2 and 6) treated with a Misago stent (N.=41) or self-expandable nitinol stent (N...
March 10, 2023: Journal of Cardiovascular Surgery
Kosmas I Paraskevas, Dimitri P Mikhailidis, Francesco Spinelli, Gianluca Faggioli, Luca Saba, Mauro Silvestrini, Alexei Svetlikov, Francesco Stilo, Rodolfo Pini, Piotr Myrcha, Vincenzo DI Lazzaro, Pier L Antignani, Pavel Poredos, Gaetano Lanza
INTRODUCTION: The aim of this review was to assess the evidence supporting an association between asymptomatic carotid stenosis (ACS) with impaired cognitive function due to chronic cerebral hypoperfusion and/or silent cerebral embolization. EVIDENCE ACQUISITION: PubMed/Medline, Embase and the Cochrane databases were searched up to December 1, 2022 to identify studies focusing on the association between ACS and cognitive function, as well as the mechanisms involved...
February 15, 2023: Journal of Cardiovascular Surgery
Pedro J Neves, Emily A Malgor, Mahmood Kabeil, Marcone L Sobreira, Rafael D Malgor
Atherectomy as an endovascular modality to treat peripheral arterial disease has gained traction over the past 10 years. Unlike most other available technologies, atherectomy works by physically debulking atherosclerotic plaque via a variety of mechanisms being the femoropopliteal segment the most targeted one. The aims of this review were to detail the types of atherectomy available, existing evidence available for atherectomy use in the femoropopliteal segment as compared to other interventions, critical appraisal of its current use and the possible influences on its indication...
February 10, 2023: Journal of Cardiovascular Surgery
George Galyfos, Alexandros Chamzin, Nikolaos Intzes, Georgia Matthaiou, Spilios Spiliotopoulos, Dimosthenis Sotirakis, Frangeska Sigala, Konstantinos Filis
Acute limb ischemia (ALI) is an emergency situation requiring rapid diagnosis and treatment. Although the traditional treating strategy for ALI includes open surgery, novel endovascular techniques have been introduced during the last decade. Additionally, many new cases of ALI have been reported due to infection by the SARS-CoV-2 virus. The aim of this study was to present an updated overview of characteristics, diagnosis, and current treating strategies of patients with ALI.
February 10, 2023: Journal of Cardiovascular Surgery
Daniela Mazzaccaro, Paolo Righini, Matteo Giannetta, Alfredo Modafferi, Giovanni Malacrida, Valentina Milani, Federico Ambrogi, Giovanni Nano
INTRODUCTION: The aim of this study was to perform a systematic review about the clinical and technical aspects of late open conversion for failed endovascular aortic repair (EVAR) of abdominal aortic aneurysms (AAA), and to investigate if the need for suprarenal aortic cross clamping, graft infection, urgent procedures, endoleaks and aortic rupture were associated with an increase of 30-days (perioperative) mortality. EVIDENCE ACQUISITION: A literature search was conducted on PubMed using the words "open conversion endovascular" on December 29th , 2021...
February 10, 2023: Journal of Cardiovascular Surgery
Amine Fikani, Martin Beaufigeau, Justine Vignon, Benoit Cosset, Ahmad Hayek, Fadi Farhat
BACKGROUND: Ventricular septal rupture (VSR) is an uncommon but life-threatening complication of acute myocardial infarction. Extra corporeal life support (ECLS) use in the preoperative setting allows hemodynamic stabilization for a delayed surgery. We aimed to assess the role of ECLS in the preoperative period of post infarction VSR surgery. METHODS: We retrospectively analyzed all consecutive patients operated for VSR between January 2007 and August 2019. We assessed baseline characteristics, pre and post-operative clinical status and the use of ECLS in the peri-operative period...
February 9, 2023: Journal of Cardiovascular Surgery
Ali F Aburahma
The type of closure after carotid endarterectomy (CEA), whether with patching primary closure or eversion resulting optimal results, remains somewhat controversial. We conducted a PubMed literature review search comparing CEA with patching versus CEA with primary closure versus eversion CEA over the past four decades with emphasis on randomized controlled trials and systematic/meta-analysis and large single center or multicenter studies. The data showed that routine carotid patching can be recommended over primary closure (level 1 evidence); however, CEA with primary closure can be used for large internal carotid arteries (ICAs)>6 mm...
February 6, 2023: Journal of Cardiovascular Surgery
Eduard Charchyan, Denis Breshenkov, Yuriy Belov
BACKGROUND: The aim of this study was to assess predictors of technical complexity of minimally invasive aortic root repairs (MIARR) performed through J-shaped mini-sternotomies in patients with aortic root aneurysm. METHODS: This study included 49 patients with aortic root aneurysm who underwent MIARR via an upper median J-shaped mini-sternotomy between January 2017 and April 2020. Preoperative high-resolution computed tomographic images synchronised with electrocardiography were mandatory for inclusion...
January 26, 2023: Journal of Cardiovascular Surgery
Sébastien Vedani, Didem Haligür, Silvan Jungi, Michel J Bosiers
Calcification represent one the most important predictors of treatment failure of endovascular therapy for peripheral arterial disease, since it restricts wall expansion and acts as a barrier for drug uptake. It also increases complications after PTA like dissection, perforation, and embolization with poor outcomes. Intravascular lithotripsy (IVL) is a novel approach for the treatment of vascular calcifications with the goal to optimize outcome in patients with PAD and heavy calcifications. This review gives an overview of the currently published articles regarding the use of IVL within the vascular field...
January 13, 2023: Journal of Cardiovascular Surgery
Julian F Wagner, Hannes Abfalterer, Cenk Özpeker, Christina Tiller, Christoph Brenner, Juliane Kilo, Michael Grimm, Hanno Ulmer, Elfriede Ruttmann
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is frequently used for emergency support in patients with profound cardiogenic shock (CS) of all etiologies. However, no controlled study investigating ECMO in myocardial infarction (AMI)-induced CS is available. METHODS: Retrospective analysis of patients experiencing AMI induced CS; ECMO therapy vs. non ECMO therapy. A total of 476 patients with AMI-induced CS were investigated. One hundred twenty-seven patients (26...
January 11, 2023: Journal of Cardiovascular Surgery
Bahaa Nasr, Mélanie Carret, Kevin Pluchon, Eric Bezon
BACKGROUND: Endarterectomy with prosthetic patch angioplasty is the preferred treatment for common femoral artery occlusive disease. Eversion endarterectomy was described as a promising alternative. the aim of this study was to compare the eversion endarterectomy and patch angioplasty outcomes for patients with de novo femoral bifurcation atherosclerotic lesions. this study was a single-center, retrospective analysis of prospectively collected registry data, non-randomized cohort. Patients treated by eversion endarterectomy and patch angioplasty for de novo femoral bifurcation atheromatous lesions were evaluated...
January 11, 2023: Journal of Cardiovascular Surgery
Lili Sadri, Eileen Lu, Donald T Baril
Endovascular treatment of peripheral arterial disease has emerged as a minimally-invasive alternative to surgical intervention and has often become the first-line therapy. The patency of these interventions has shown promise but has remained variable depending upon the location, length of lesion and device used for a particular treatment. Specifically, one of the most common locations that is treated with endovascular means for chronic-limb threatening ischemia is the femoropopliteal region. This area of the arterial tree is highly exposed to movements such as flexion, extension, and rotational torque; as such, placing metallic stents can result in kinking and damage to the stent, and subsequently the artery, over time...
January 10, 2023: Journal of Cardiovascular Surgery
Emanuel R Tenorio, Andrea Vacirca, Thomas Mesnard, Titia Sulzer, Aidin Baghbani-Oskouei, Aleem K Mirza, Ying Huang, Gustavo S Oderich
Open surgical repair remains the gold standard for treatment for aortic arch diseases, but these operations can be associated with wide heterogeneity in outcomes and significant morbidity and mortality, particularly in elderly patients with severe comorbidities or those who had prior arch procedures via median sternotomy. Endovascular repair has been introduced as a less invasive alternative to reduce morbidity and mortality associated with open surgical repair. The technique evolved with new device designs using up to three inner branches for incorporation of the supra-aortic trunks...
January 4, 2023: Journal of Cardiovascular Surgery
Günes Dogan, Jasmin S Hanke, Khaldoon Alhumood, Riyad Tarazi, Julia Riebandt, Dominik Wiedemann, Ivan Kneževič, Axel Haverich, Daniel Zimpfer, Jan D Schmitto
BACKGROUND: Total artificial heart (TAH) implantation is a rarely performed procedure. Contrarily, left ventricular assist device (VAD) implantation is rather common in many centers. As transplantation is quantitatively limited cardiac replacement with artificial hearts is a viable alternative in the treatment of severe biventricular heart failure. An alternative to TAH is the implantation of two VADs in a TAH configuration. We hereby present the first multi-center study on 3-months outcomes of patients treated by cardiectomy and placement of two HeartMate 3s in a TAH configuration...
February 2023: Journal of Cardiovascular Surgery
Francesco Squizzato, Andrea Spertino, Franco Grego, Augusto D'Onofrio, Michele Piazza, Michele Antonello
Aortic arch pathologies are commonly treated by open surgery which is still the gold standard. Patients that are unfit for surgery can be effectively treated mini-invasively with novel endovascular endograft specifically designed for the arch. Endovascular technology has remarkably improved in recent years and is a valid alternative option for the treatment of aortic arch. Available endografts on the market include fenestrated and branched (single, double, or triple). Most endograft designed for the aortic arch are custom-made and production time could be limiting...
February 2023: Journal of Cardiovascular Surgery
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