European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Apr 2016
The combined role of sinuses of Valsalva and flow pulsatility improves energy loss of the aortic valve.
Normal aortic valve opening and closing movement is a complex mechanism mainly regulated by the blood flow characteristics and the cyclic modifications of the aortic root. Our previous in vitro observations demonstrated that the presence of the Valsalva sinuses, independently from root compliance, is important in reducing systolic pressure drop across the aortic valve. This in vitro study was designed to ascertain if this effect is dependent on the flow characteristics. ⋯ These findings (i) confirm the hypothesis that the sinuses of Valsalva play a key role in optimizing the aortic haemodynamics during systole, minimizing energy losses; (ii) suggest that the sinuses of Valsalva are needed because of the complex nature of blood flow during ejection.
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Eur J Cardiothorac Surg · Apr 2016
Hemiarch replacement with concomitant antegrade stent grafting of the descending thoracic aorta versus total arch replacement for treatment of acute DeBakey I aortic dissection with arch tear†.
For acute DeBakey I aortic dissection with arch tear, conventional distal reconstruction entails total arch replacement (TAR). Some surgeons at our institution have utilized an alternative reconstructive strategy-primary arch tear repair and transverse hemiarch reconstruction (THR) with concomitant antegrade thoracic endovascular aortic repair (TEVAR). We assessed early and mid-term outcomes comparing these two surgical strategies for arch tear management. ⋯ In treating DeBakey I aortic dissection with arch tear, hemiarch replacement with primary tear repair and concomitant TEVAR is a safe alternative to conventional TAR, with improved distal aortic remodelling.
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Eur J Cardiothorac Surg · Apr 2016
Clinical TrialMeasurement of preoperative lobar lung function with computed tomography ventilation imaging: progress towards rapid stratification of lung cancer lobectomy patients with abnormal lung function.
In lung cancer preoperative evaluation, functional lung imaging is commonly used to assess lobar function. Computed tomography ventilation (CT-V) imaging is an emerging lung function imaging modality. We compared CT-V imaging assessment of lobar function and its prediction of postoperative lung function to that achieved by (i) positron emission tomography ventilation (PET-V) imaging and (ii) the standard anatomical segment counting (ASC) method. We hypothesized (i) that CT-V and PET-V have similar relative lobar function and (ii) that functional imaging and anatomic assessment (ASC) yield different predicted postoperative (ppo) lung function and therefore could change clinical management. ⋯ The assessment of lobar function from CT-V imaging correlated strongly with PET-V imaging, but had low correlations with ASC. CT-V imaging may be a useful alternative method in preoperative evaluation for lung cancer patients.
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Eur J Cardiothorac Surg · Apr 2016
Sleep apnoea is a risk factor for acute kidney injury after coronary artery bypass grafting.
Acute kidney injury (AKI) is a common complication in patients who undergo coronary artery bypass grafting (CABG). Sleep apnoea is associated with sympathetic activation, inflammatory reaction and plaque burden. The possible status of sleep apnoea as a risk factor for AKI after CABG has not been studied. ⋯ Sleep apnoea is prevalent and is associated with AKI after CABG. The data presented here provide the first insights into the potential of treating sleep apnoea to attenuate the risk of AKI after CABG.
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Eur J Cardiothorac Surg · Apr 2016
Surgical ventricular restoration plus mitral valve repair in patients with ischaemic heart failure: risk factors for early and mid-term outcomes†.
To assess the early and mid-term outcomes and related predictors in a consecutive series of patients who underwent surgical ventricular restoration (SVR) combined with additional mitral valve (MV) repair. ⋯ MV repair combined with SVR is a complex and challenging procedure that can be performed with acceptable early and mid-term results. Interestingly, angina features predict both early and late outcome, with unstable angina at the time of surgery being a predictor of poor early outcome and the absence of angina at surgery, a predictor of favourable outcome at mid-term follow-up.