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Cardiac surgery, coronary, valve, cabg, mitral, aortic,

Tyler Wallen, Andreas Habertheuer, Joseph E Bavaria, Chad Hughes, Vinay Badhwar, Jeff Jacobs, Babatunde Yerokun, Dylan Thibault, Karianna Milewski, Nimesh Desai, Wilson Szeto, Lars Svensson, Prashanth Vallabhajosyula
BACKGROUND: Unlike coronary artery bypass, aortic and mitral valve procedures, there is no predictive risk model for aortic root replacement procedures. As a first step towards development of a risk model, we analyzed the Society of Thoracic Surgeons (STS) database to determine factors predictive of mortality and morbidity in patients undergoing elective aortic root replacement (ARR). METHODS: STS database was queried (7/2011-6/2016) for elective ARR with following exclusion criteria: urgent/ salvage cases, endocarditis, redo cardiac surgery, circulatory arrest, and aortic arch surgery...
January 24, 2019: Annals of Thoracic Surgery
Paweł Czub, Andrzej Cacko, Monika Gawałko, Emanuel Tataj, Jakub Poliński, Kacper Pawlik, Romuald Cichoń, Piotr Hendzel
Nowadays, both the European System for Cardiac Operative Risk Evaluation (EuroSCORE) logistic (ESL) and EuroSCORE II (ESII) models are used worldwide in predicting in-hospital mortality after cardiac operation. However, these scales are based on different populations and represent different medical approaches. The aim of the study was to assess the effectiveness of the ESL and the ESII risk scores in predicting in-hospital death and prolonged hospitalization in intensive care unit (ICU) after coronary artery bypass grafting (CABG), aortic valve replacement (AVR), and mitral valve replacement (MVR) by comparison of an estimated risk and a real-life observation at a reference cardiac surgery unit...
December 2018: Medicine (Baltimore)
Nassir M Thalji, Simon Maltais, Richard C Daly, Kevin L Greason, Hartzell V Schaff, Shannon M Dunlay, John M Stulak
BACKGROUND: Despite suggestions that severe left ventricle dysfunction may warrant selection of durable mechanical circulatory support over conventional surgery, comparative studies are lacking due to incomplete characterization of patients at highest risk after conventional surgery. We sought to define subsets of patients with severe left ventricle dysfunction who are at greatest mortality risk following conventional cardiac surgery. METHODS: We studied 892 patients aged ≥ 18 years who underwent conventional coronary or valve surgery from 1993 to 2014, with preoperative ejection fraction ≤ 25%...
October 2018: Journal of Thoracic and Cardiovascular Surgery
Alessandro Leone, Daniela Fortuna, Davide Gabbieri, Francesco Nicolini, Giovanni Andrea Contini, Florio Pigini, Claudio Zussa, Rossana De Palma, Roberto Di Bartolomeo, Davide Pacini
AIMS: Triple valve surgery (TVS) may still be considered a challenge in cardiac surgery, and is still associated with a not negligible mortality and morbidity. This study analyzed retrospectively patients' data from RERIC (Registro Regionale degli Interventi Cardiochirurgici) registry, to evaluate early and mid-term results of TVS. METHODS: From April 2002 to December 2013, data from n = 44 211 cardiac surgical procedures were collected from six Cardiac Surgery Departments (RERIC)...
July 2018: Journal of Cardiovascular Medicine
David M Shahian, Jeffrey P Jacobs, Vinay Badhwar, Paul A Kurlansky, Anthony P Furnary, Joseph C Cleveland, Kevin W Lobdell, Christina Vassileva, Moritz C Wyler von Ballmoos, Vinod H Thourani, J Scott Rankin, James R Edgerton, Richard S D'Agostino, Nimesh D Desai, Liqi Feng, Xia He, Sean M O'Brien
BACKGROUND: The last published version of The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) risk models were developed in 2008 based on patient data from 2002 to 2006 and have been periodically recalibrated. In response to evolving changes in patient characteristics, risk profiles, surgical practice, and outcomes, the STS has now developed a set of entirely new risk models for adult cardiac surgery. METHODS: New models were estimated for isolated coronary artery bypass grafting surgery (CABG [n = 439,092]), isolated aortic or mitral valve surgery (n = 150,150), and combined valve plus CABG procedures (n = 81,588)...
May 2018: Annals of Thoracic Surgery
Sean M O'Brien, Liqi Feng, Xia He, Ying Xian, Jeffrey P Jacobs, Vinay Badhwar, Paul A Kurlansky, Anthony P Furnary, Joseph C Cleveland, Kevin W Lobdell, Christina Vassileva, Moritz C Wyler von Ballmoos, Vinod H Thourani, J Scott Rankin, James R Edgerton, Richard S D'Agostino, Nimesh D Desai, Fred H Edwards, David M Shahian
BACKGROUND: The Society of Thoracic Surgeons (STS) uses statistical models to create risk-adjusted performance metrics for Adult Cardiac Surgery Database (ACSD) participants. Because of temporal changes in patient characteristics and outcomes, evolution of surgical practice, and additional risk factors available in recent ACSD versions, completely new risk models have been developed. METHODS: Using July 2011 to June 2014 ACSD data, risk models were developed for operative mortality, stroke, renal failure, prolonged ventilation, mediastinitis/deep sternal wound infection, reoperation, major morbidity or mortality composite, prolonged postoperative length of stay, and short postoperative length of stay among patients who underwent isolated coronary artery bypass grafting surgery (n = 439,092), aortic or mitral valve surgery (n = 150,150), or combined valve plus coronary artery bypass grafting surgery (n = 81,588)...
May 2018: Annals of Thoracic Surgery
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)...
July 1, 2018: Interactive Cardiovascular and Thoracic Surgery
Sang-Bae Ko
Although perioperative stroke is uncommon during low-risk non-vascular surgery, if it occurs, it can negatively impact recovery from the surgery and functional outcome. Based on the Society for Neuroscience in Anesthesiology and Critical Care Consensus Statement, perioperative stroke includes intraoperative stroke, as well as postoperative stroke developing within 30 days after surgery. Factors related to perioperative stroke include age, sex, a history of stroke or transient ischemic attack, cardiac surgery (aortic surgery, mitral valve surgery, or coronary artery bypass graft surgery), and neurosurgery (external carotid-internal carotid bypass surgery, carotid endarterectomy, or aneurysm clipping)...
February 2018: Korean Journal of Anesthesiology
Lily E Johnston, Emily A Downs, Robert Hawkins, Mohammed 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 rates 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 replacement (AVR), or isolated mitral valve replacement (MVR) procedures from 2008 to 2015 in a multi-institutional Society of Thoracic Surgeons (STS) database were used to generate observed-to-expected (O/E) ratios for morbidity and death...
June 2018: Annals of Thoracic Surgery
Daniel J Friedman, Jonathan P Piccini, Tongrong Wang, Jiayin Zheng, S Chris Malaisrie, David R Holmes, Rakesh M Suri, Michael J Mack, Vinay Badhwar, Jeffrey P Jacobs, Jeffrey G Gaca, Shein-Chung Chow, Eric D Peterson, J Matthew Brennan
Importance: The left atrial appendage is a key site of thrombus formation in atrial fibrillation (AF) and can be occluded or removed at the time of cardiac surgery. There is limited evidence regarding the effectiveness of surgical left atrial appendage occlusion (S-LAAO) for reducing the risk of thromboembolism. Objective: To evaluate the association of S-LAAO vs no receipt of S-LAAO with the risk of thromboembolism among older patients undergoing cardiac surgery...
January 23, 2018: JAMA: the Journal of the American Medical Association
Rashad Zayat, Andreas Goetzenich, Ju-Yeon Lee, HeeJung Kang, So-Hyun Jansen-Park, Thomas Schmitz-Rode, Giulia Musetti, Heike Schnoering, Rüdiger Autschbach, Nima Hatam, Ali Aljalloud
Background: Bedside non-invasive techniques, such as radial artery tonometry, to estimate hemodynamic parameters have gained increased relevance as an attractive alternative and efficient method to measure hemodynamics in outpatient departments. For our pilot study, we sought to compare cardiac output (CO), and stroke volume (SV) estimated from a radial artery tonometry blood pressure pulse analyzer (BPPA) (DMP-Life, DAEYOMEDI Co., Gyeonggi-do, South Korea) to pulsed-wave Doppler (PWD) echocardiography derived parameters...
2017: PeerJ
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)...
April 2018: Heart, Lung & Circulation
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
Praleene Sivapalan, Anne Caroline Bäck, Sisse Rye Ostrowski, Hanne Berg Ravn, Pär Ingemar Johansson
Managing haemostasis in patients undergoing cardiopulmonary bypass (CPB) surgery remains a challenge. There is no established laboratory test to predict transfusion requirements in cardiac surgery. We investigated whether preoperative Thromboelastography (TEG) with Platelet Mapping Assay (PMA) or Multiple Electrode Aggrometry (MEA) could predict transfusion requirements in patients undergoing elective coronary artery bypass grafting (CABG) or combined CABG with aortic or mitral valve replacement. We prospectively investigated 199 patients undergoing elective CABG or combined procedures...
September 2017: Scandinavian Journal of Clinical and Laboratory Investigation
Li Poa, Miguel Puig, Pablo Zubiate, Edward Ranzenbach, Miller Shari-Knutson, Christina Poa, Hyunah Poa
Background: Atrial Fibrillation is known to account for one third of all the strokes caused in the US in the population above the age of 70. Patients treated with the surgical Cox MAZE operation have been shown to have a 150 fold decrease in the incidence of stroke over an 18 year period. However, the original Cox MAZE although extremely successful in treating atrial fibrillation and decreasing the incidence of strokes was not performed widely because of complexity and invasiveness of the procedure. A variety of alternative energy based curative ablation strategies are now available for more minimally invasive therapeutic management of atrial fibrillation (AF)...
August 2009: Journal of Atrial Fibrillation
Walter J Gomes, Rita Simone Moreira, Alexandre Cabral Zilli, Luiz Carlos Bettiati, Fernando Augusto Marinho Dos Santos Figueira, Stephanie Steremberg Pires D' Azevedo, Marcelo José Ferreira Soares, Marcio Pimentel Fernandes, Roberto Vito Ardito, Renata Andrea Barberio Bogdan, Valquíria Pelisser Campagnucci, Diana Nakasako, Renato Abdala Karam Kalil, Clarissa Garcia Rodrigues, Anilton Bezerra Rodrigues, Marcelo Matos Cascudo, Fernando Antibas Atik, Elson Borges Lima, Vinicius José da Silva Nina, Renato Albuquerque Heluy, Lisandro Gonçalves Azeredo, Odilon Silva Henrique, José Teles de Mendonça, Katharina Kelly de Oliveira Gama Silva, Marcelo Pandolfo, José Dantas de Lima, Renato Max Faria, Jonas Pereira Dos Santos, Rodrigo Pereira Paez, Guilherme Henrique Biachi Coelho, Sergio Nunes Pereira, Roberta Senger, Enio Buffolo, Guido Marco Caputi, José Amalth do Espírito Santo, Juliana Aparecida Borges de Oliveira, Otavio Berwanger, Alexandre Biasi Cavalcanti, Fabio B Jatene
Objective: To report the early results of the BYPASS project - the Brazilian registrY of adult Patient undergoing cArdiovaScular Surgery - a national, observational, prospective, and longitudinal follow-up registry, aiming to chart a profile of patients undergoing cardiovascular surgery in Brazil, assessing the data harvested from the initial 1,722 patients. Methods: Data collection involved institutions throughout the whole country, comprising 17 centers in 4 regions: Southeast (8), Northeast (5), South (3), and Center-West (1)...
March 2017: Brazilian Journal of Cardiovascular Surgery
Torsten Doenst, Yasin Essa, Khalil Jacoub, Alexandros Moschovas, David Gonzalez-Lopez, Hristo Kirov, Mahmoud Diab, Steffen Bargenda, Gloria Faerber
For the year 2016, more than 20,000 published references can be found in Pubmed when entering the search term "cardiac surgery". Publications last year have helped to more clearly delineate the fields where classic surgery and modern interventional techniques overlap. The field of coronary bypass surgery (partially compared to percutaneous coronary intervention) was enriched by five large prospective randomized trials. The value of CABG for complex coronary disease was reconfirmed and for less complex main stem lesions, PCI was found potentially equal...
November 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Orlando Santana, Rama Krishna, Nisharahmed Kherada, Christos G Mihos
BACKGROUND: The study aim was to evaluate the outcomes of minimally invasive valve surgery, performed via a right anterior thoracotomy approach, in patients with a history of multiple (more than two) prior cardiac surgeries. METHODS: A retrospective review was conducted of all minimally invasive valve operations performed in patients with a prior history of two or more cardiac surgeries, including coronary artery bypass grafting (CABG) and/or valve surgery, at the authors' institution between January 2008 and November 2014...
July 2016: Journal of Heart Valve Disease
Vinay Badhwar, J Scott Rankin, Ralph J Damiano, A Marc Gillinov, Faisal G Bakaeen, James R Edgerton, Jonathan M Philpott, Patrick M McCarthy, Steven F Bolling, Harold G Roberts, Vinod H Thourani, Rakesh M Suri, Richard J Shemin, Scott Firestone, Niv Ad
Surgical ablation for atrial fibrillation (AF) can be performed without additional risk of operative mortality or major morbidity, and is recommended at the time of concomitant mitral operations to restore sinus rhythm. (Class I, Level A) Surgical ablation for AF can be performed without additional operative risk of mortality or major morbidity, and is recommended at the time of concomitant isolated aortic valve replacement, isolated coronary artery bypass graft surgery, and aortic valve replacement plus coronary artery bypass graft operations to restore sinus rhythm...
January 2017: Annals of Thoracic Surgery
Francisco Leyva, Tian Qiu, David McNulty, Felicity Evison, Howard Marshall, Maurizio Gasparini
BACKGROUND: The risk of permanent pacemaker implantation (PPI) after cardiac valve replacement surgery is thought to be highest in the postoperative period. Long-term risks are uncertain. OBJECTIVE: The purpose of this study was to determine rates and timing of PPI after cardiac valve replacement surgery. METHODS: We compared PPI rates of patients undergoing aortic valve replacement (AVR; n = 111,674), mitral valve replacement (MVR; n = 18,402), AVR + MVR (n = 5166), AVR + MVR + tricuspid valve replacement (TVR; n = 114), or coronary artery bypass surgery (CABG) without valve replacement (n = 249,742)...
April 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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