The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
Multicenter StudyTotal aortic arch replacement with frozen elephant trunk technique: Results from two European institutes.
We report on a large series of patients treated at the S. Orsola Hospital, University of Bologna (Bologna, Italy) and Hannover Medical School (Hannover, Germany), with the aim to evaluate the early and midterm results. ⋯ The frozen elephant trunk technique is a treatment option for all complex pathologies of the thoracic aorta. Patients with thoracic aortic aneurysms presented a higher mortality rate, and in patients with acute aortic dissection, the malperfusion syndrome still remains a catastrophic complication. The midterm follow-up showed satisfactory results in terms of survival and freedom from reintervention.
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
Multicenter StudySurvival results in biphasic malignant pleural mesothelioma patients: A multicentric analysis.
The best strategy of care for biphasic malignant pleural mesothelioma (Biph-MPM) is controversial. In this study, a large dataset of Biph-MPM cases was reviewed to identify prognostic factors and to evaluate the role of a multimodal approach, including cancer-directed surgery. ⋯ Despite the overall poor prognosis of biphasic histology, a multimodal approach, including cancer-directed surgery, is associated with improved long-term results in very selected patients with Biph-MPM.
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
Multicenter StudyIntraoperative transit-time flow measurement and high-frequency ultrasound assessment in coronary artery bypass grafting.
We evaluated the influence of transit-time flow measurement with epicardial and epiaortic high-frequency ultrasound in patients undergoing coronary artery bypass grafting procedure. ⋯ Surgical changes related to the aorta, conduits, coronary targets, and anastomosis were made in 25% of patients. This was associated with low operative mortality and low major morbidity. Transit-time flow measurement and high-frequency ultrasound may improve the quality, safety, and efficacy of coronary artery bypass grafting procedures and should be considered as a routine procedural aspect.
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
Preoperative predictors of new-onset prolonged atrial fibrillation after surgical aortic valve replacement.
Patients undergoing surgical aortic valve replacement (SAVR) are at risk of developing prolonged atrial fibrillation (AF) after surgery. Prophylactic interventions such as left atrial appendage amputation (LAAA) and pulmonary vein isolation (PVI) impose cost and operative risk, discouraging routine use. To guide such interventions, we investigated preoperative predictors of AF. ⋯ Older age and left atrial enlargement identify a stratum of patients at high risk of developing prolonged postoperative AF after SAVR. Multicenter, prospective studies should investigate the value of prophylactic interventions such as LAAA, Cox maze, or PVI in these individuals to obviate the consideration of late anticoagulation.
-
J. Thorac. Cardiovasc. Surg. · Apr 2020
Influence of donor brain death duration on outcomes following heart transplantation: A United Network for Organ Sharing Registry analysis.
We hypothesized that an increased duration of donor brain death may worsen survival following orthotopic heart transplantation. ⋯ Longer duration of brain death was not associated with worse survival following heart transplantation. Donors with prolonged interval of brain death should not necessarily be excluded based on brain death period alone.