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Publisher: Oxford University Press   (Total: 370 journals)

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Showing 1 - 200 of 370 Journals sorted alphabetically
Acta Biochimica et Biophysica Sinica     Hybrid Journal   (Followers: 6, SJR: 0.881, h-index: 38)
Adaptation     Hybrid Journal   (Followers: 9, SJR: 0.111, h-index: 4)
Aesthetic Surgery J.     Hybrid Journal   (Followers: 6, SJR: 1.538, h-index: 35)
African Affairs     Hybrid Journal   (Followers: 59, SJR: 1.512, h-index: 46)
Age and Ageing     Hybrid Journal   (Followers: 85, SJR: 1.611, h-index: 107)
Alcohol and Alcoholism     Hybrid Journal   (Followers: 17, SJR: 0.935, h-index: 80)
American Entomologist     Full-text available via subscription   (Followers: 6)
American Historical Review     Hybrid Journal   (Followers: 142, SJR: 0.652, h-index: 43)
American J. of Agricultural Economics     Hybrid Journal   (Followers: 40, SJR: 1.441, h-index: 77)
American J. of Epidemiology     Hybrid Journal   (Followers: 173, SJR: 3.047, h-index: 201)
American J. of Hypertension     Hybrid Journal   (Followers: 25, SJR: 1.397, h-index: 111)
American J. of Jurisprudence     Hybrid Journal   (Followers: 18)
American J. of Legal History     Full-text available via subscription   (Followers: 6, SJR: 0.151, h-index: 7)
American Law and Economics Review     Hybrid Journal   (Followers: 25, SJR: 0.824, h-index: 23)
American Literary History     Hybrid Journal   (Followers: 12, SJR: 0.185, h-index: 22)
Analysis     Hybrid Journal   (Followers: 23)
Annals of Botany     Hybrid Journal   (Followers: 36, SJR: 1.912, h-index: 124)
Annals of Occupational Hygiene     Hybrid Journal   (Followers: 28, SJR: 0.837, h-index: 57)
Annals of Oncology     Hybrid Journal   (Followers: 49, SJR: 4.362, h-index: 173)
Annals of the Entomological Society of America     Full-text available via subscription   (Followers: 8, SJR: 0.642, h-index: 53)
Annals of Work Exposures and Health     Hybrid Journal  
AoB Plants     Open Access   (Followers: 4, SJR: 0.78, h-index: 10)
Applied Economic Perspectives and Policy     Hybrid Journal   (Followers: 19, SJR: 0.884, h-index: 31)
Applied Linguistics     Hybrid Journal   (Followers: 51, SJR: 1.749, h-index: 63)
Applied Mathematics Research eXpress     Hybrid Journal   (Followers: 1, SJR: 0.779, h-index: 11)
Arbitration Intl.     Full-text available via subscription   (Followers: 20)
Arbitration Law Reports and Review     Hybrid Journal   (Followers: 13)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 26, SJR: 0.96, h-index: 71)
Aristotelian Society Supplementary Volume     Hybrid Journal   (Followers: 2, SJR: 0.102, h-index: 20)
Arthropod Management Tests     Hybrid Journal   (Followers: 2)
Astronomy & Geophysics     Hybrid Journal   (Followers: 45, SJR: 0.144, h-index: 15)
Behavioral Ecology     Hybrid Journal   (Followers: 51, SJR: 1.698, h-index: 92)
Bioinformatics     Hybrid Journal   (Followers: 308, SJR: 4.643, h-index: 271)
Biology Methods and Protocols     Hybrid Journal  
Biology of Reproduction     Full-text available via subscription   (Followers: 9, SJR: 1.646, h-index: 149)
Biometrika     Hybrid Journal   (Followers: 19, SJR: 2.801, h-index: 90)
BioScience     Hybrid Journal   (Followers: 30, SJR: 2.374, h-index: 154)
Bioscience Horizons : The National Undergraduate Research J.     Open Access   (Followers: 1, SJR: 0.213, h-index: 9)
Biostatistics     Hybrid Journal   (Followers: 16, SJR: 1.955, h-index: 55)
BJA : British J. of Anaesthesia     Hybrid Journal   (Followers: 155, SJR: 2.314, h-index: 133)
BJA Education     Hybrid Journal   (Followers: 65, SJR: 0.272, h-index: 20)
Brain     Hybrid Journal   (Followers: 61, SJR: 6.097, h-index: 264)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 44, SJR: 4.086, h-index: 73)
Briefings in Functional Genomics     Hybrid Journal   (Followers: 4, SJR: 1.771, h-index: 50)
British J. for the Philosophy of Science     Hybrid Journal   (Followers: 36, SJR: 1.267, h-index: 38)
British J. of Aesthetics     Hybrid Journal   (Followers: 26, SJR: 0.217, h-index: 18)
British J. of Criminology     Hybrid Journal   (Followers: 541, SJR: 1.373, h-index: 62)
British J. of Social Work     Hybrid Journal   (Followers: 85, SJR: 0.771, h-index: 53)
British Medical Bulletin     Hybrid Journal   (Followers: 7, SJR: 1.391, h-index: 84)
British Yearbook of Intl. Law     Hybrid Journal   (Followers: 27)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 3, SJR: 1.474, h-index: 31)
Cambridge J. of Economics     Hybrid Journal   (Followers: 58, SJR: 0.957, h-index: 59)
Cambridge J. of Regions, Economy and Society     Hybrid Journal   (Followers: 11, SJR: 1.067, h-index: 22)
Cambridge Quarterly     Hybrid Journal   (Followers: 11, SJR: 0.1, h-index: 7)
Capital Markets Law J.     Hybrid Journal   (Followers: 1)
Carcinogenesis     Hybrid Journal   (Followers: 2, SJR: 2.439, h-index: 167)
Cardiovascular Research     Hybrid Journal   (Followers: 12, SJR: 2.897, h-index: 175)
Cerebral Cortex     Hybrid Journal   (Followers: 42, SJR: 4.827, h-index: 192)
CESifo Economic Studies     Hybrid Journal   (Followers: 16, SJR: 0.501, h-index: 19)
Chemical Senses     Hybrid Journal   (Followers: 1, SJR: 1.436, h-index: 76)
Children and Schools     Hybrid Journal   (Followers: 6, SJR: 0.211, h-index: 18)
Chinese J. of Comparative Law     Hybrid Journal   (Followers: 3)
Chinese J. of Intl. Law     Hybrid Journal   (Followers: 21, SJR: 0.737, h-index: 11)
Chinese J. of Intl. Politics     Hybrid Journal   (Followers: 9, SJR: 1.238, h-index: 15)
Christian Bioethics: Non-Ecumenical Studies in Medical Morality     Hybrid Journal   (Followers: 11, SJR: 0.191, h-index: 8)
Classical Receptions J.     Hybrid Journal   (Followers: 24, SJR: 0.1, h-index: 3)
Clinical Infectious Diseases     Hybrid Journal   (Followers: 59, SJR: 4.742, h-index: 261)
Clinical Kidney J.     Open Access   (Followers: 4, SJR: 0.338, h-index: 19)
Community Development J.     Hybrid Journal   (Followers: 24, SJR: 0.47, h-index: 28)
Computer J.     Hybrid Journal   (Followers: 7, SJR: 0.371, h-index: 47)
Conservation Physiology     Open Access   (Followers: 2)
Contemporary Women's Writing     Hybrid Journal   (Followers: 11, SJR: 0.111, h-index: 3)
Contributions to Political Economy     Hybrid Journal   (Followers: 5, SJR: 0.313, h-index: 10)
Critical Values     Full-text available via subscription  
Current Legal Problems     Hybrid Journal   (Followers: 26)
Current Zoology     Full-text available via subscription   (Followers: 1, SJR: 0.999, h-index: 20)
Database : The J. of Biological Databases and Curation     Open Access   (Followers: 11, SJR: 1.068, h-index: 24)
Digital Scholarship in the Humanities     Hybrid Journal   (Followers: 13)
Diplomatic History     Hybrid Journal   (Followers: 19, SJR: 0.296, h-index: 22)
DNA Research     Open Access   (Followers: 4, SJR: 2.42, h-index: 77)
Dynamics and Statistics of the Climate System     Open Access   (Followers: 3)
Early Music     Hybrid Journal   (Followers: 15, SJR: 0.124, h-index: 11)
Economic Policy     Hybrid Journal   (Followers: 38, SJR: 2.052, h-index: 52)
ELT J.     Hybrid Journal   (Followers: 25, SJR: 1.26, h-index: 23)
English Historical Review     Hybrid Journal   (Followers: 51, SJR: 0.311, h-index: 10)
English: J. of the English Association     Hybrid Journal   (Followers: 13, SJR: 0.144, h-index: 3)
Environmental Entomology     Full-text available via subscription   (Followers: 11, SJR: 0.791, h-index: 66)
Environmental Epigenetics     Open Access   (Followers: 1)
Environmental History     Hybrid Journal   (Followers: 28, SJR: 0.197, h-index: 25)
EP-Europace     Hybrid Journal   (Followers: 2, SJR: 2.201, h-index: 71)
Epidemiologic Reviews     Hybrid Journal   (Followers: 10, SJR: 3.917, h-index: 81)
ESHRE Monographs     Hybrid Journal  
Essays in Criticism     Hybrid Journal   (Followers: 16, SJR: 0.1, h-index: 6)
European Heart J.     Hybrid Journal   (Followers: 50, SJR: 6.997, h-index: 227)
European Heart J. - Cardiovascular Imaging     Hybrid Journal   (Followers: 8, SJR: 2.044, h-index: 58)
European Heart J. - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 1)
European Heart J. - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart J. Supplements     Hybrid Journal   (Followers: 7, SJR: 0.152, h-index: 31)
European J. of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 8, SJR: 1.568, h-index: 104)
European J. of Intl. Law     Hybrid Journal   (Followers: 163, SJR: 0.722, h-index: 38)
European J. of Orthodontics     Hybrid Journal   (Followers: 4, SJR: 1.09, h-index: 60)
European J. of Public Health     Hybrid Journal   (Followers: 22, SJR: 1.284, h-index: 64)
European Review of Agricultural Economics     Hybrid Journal   (Followers: 11, SJR: 1.549, h-index: 42)
European Review of Economic History     Hybrid Journal   (Followers: 28, SJR: 0.628, h-index: 24)
European Sociological Review     Hybrid Journal   (Followers: 41, SJR: 2.061, h-index: 53)
Evolution, Medicine, and Public Health     Open Access   (Followers: 11)
Family Practice     Hybrid Journal   (Followers: 11, SJR: 1.048, h-index: 77)
Fems Microbiology Ecology     Hybrid Journal   (Followers: 9, SJR: 1.687, h-index: 115)
Fems Microbiology Letters     Hybrid Journal   (Followers: 21, SJR: 1.126, h-index: 118)
Fems Microbiology Reviews     Hybrid Journal   (Followers: 26, SJR: 7.587, h-index: 150)
Fems Yeast Research     Hybrid Journal   (Followers: 13, SJR: 1.213, h-index: 66)
Foreign Policy Analysis     Hybrid Journal   (Followers: 22, SJR: 0.859, h-index: 10)
Forestry: An Intl. J. of Forest Research     Hybrid Journal   (Followers: 16, SJR: 0.903, h-index: 44)
Forum for Modern Language Studies     Hybrid Journal   (Followers: 6, SJR: 0.108, h-index: 6)
French History     Hybrid Journal   (Followers: 32, SJR: 0.123, h-index: 10)
French Studies     Hybrid Journal   (Followers: 20, SJR: 0.119, h-index: 7)
French Studies Bulletin     Hybrid Journal   (Followers: 10, SJR: 0.102, h-index: 3)
Gastroenterology Report     Open Access   (Followers: 2)
Genome Biology and Evolution     Open Access   (Followers: 11, SJR: 3.22, h-index: 39)
Geophysical J. Intl.     Hybrid Journal   (Followers: 34, SJR: 1.839, h-index: 119)
German History     Hybrid Journal   (Followers: 26, SJR: 0.437, h-index: 13)
GigaScience     Open Access   (Followers: 3)
Global Summitry     Hybrid Journal  
Glycobiology     Hybrid Journal   (Followers: 14, SJR: 1.692, h-index: 101)
Health and Social Work     Hybrid Journal   (Followers: 49, SJR: 0.505, h-index: 40)
Health Education Research     Hybrid Journal   (Followers: 12, SJR: 0.814, h-index: 80)
Health Policy and Planning     Hybrid Journal   (Followers: 20, SJR: 1.628, h-index: 66)
Health Promotion Intl.     Hybrid Journal   (Followers: 21, SJR: 0.664, h-index: 60)
History Workshop J.     Hybrid Journal   (Followers: 27, SJR: 0.313, h-index: 20)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 26, SJR: 0.115, h-index: 13)
Human Molecular Genetics     Hybrid Journal   (Followers: 9, SJR: 4.288, h-index: 233)
Human Reproduction     Hybrid Journal   (Followers: 79, SJR: 2.271, h-index: 179)
Human Reproduction Update     Hybrid Journal   (Followers: 17, SJR: 4.678, h-index: 128)
Human Rights Law Review     Hybrid Journal   (Followers: 60, SJR: 0.7, h-index: 21)
ICES J. of Marine Science: J. du Conseil     Hybrid Journal   (Followers: 54, SJR: 1.233, h-index: 88)
ICSID Review     Hybrid Journal   (Followers: 11)
ILAR J.     Hybrid Journal   (Followers: 1, SJR: 1.099, h-index: 51)
IMA J. of Applied Mathematics     Hybrid Journal   (SJR: 0.329, h-index: 26)
IMA J. of Management Mathematics     Hybrid Journal   (Followers: 2, SJR: 0.351, h-index: 20)
IMA J. of Mathematical Control and Information     Hybrid Journal   (Followers: 2, SJR: 0.661, h-index: 28)
IMA J. of Numerical Analysis - advance access     Hybrid Journal   (SJR: 2.032, h-index: 44)
Industrial and Corporate Change     Hybrid Journal   (Followers: 8, SJR: 1.37, h-index: 81)
Industrial Law J.     Hybrid Journal   (Followers: 32, SJR: 0.184, h-index: 15)
Information and Inference     Free  
Integrative and Comparative Biology     Hybrid Journal   (Followers: 8, SJR: 1.911, h-index: 90)
Interacting with Computers     Hybrid Journal   (Followers: 10, SJR: 0.529, h-index: 59)
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 5, SJR: 0.743, h-index: 35)
Intl. Affairs     Hybrid Journal   (Followers: 52, SJR: 1.264, h-index: 53)
Intl. Data Privacy Law     Hybrid Journal   (Followers: 29)
Intl. Health     Hybrid Journal   (Followers: 5, SJR: 0.835, h-index: 15)
Intl. Immunology     Hybrid Journal   (Followers: 3, SJR: 1.613, h-index: 111)
Intl. J. for Quality in Health Care     Hybrid Journal   (Followers: 33, SJR: 1.593, h-index: 69)
Intl. J. of Constitutional Law     Hybrid Journal   (Followers: 60, SJR: 0.613, h-index: 19)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 155, SJR: 4.381, h-index: 145)
Intl. J. of Law and Information Technology     Hybrid Journal   (Followers: 4, SJR: 0.247, h-index: 8)
Intl. J. of Law, Policy and the Family     Hybrid Journal   (Followers: 29, SJR: 0.307, h-index: 15)
Intl. J. of Lexicography     Hybrid Journal   (Followers: 8, SJR: 0.404, h-index: 18)
Intl. J. of Low-Carbon Technologies     Open Access   (Followers: 1, SJR: 0.457, h-index: 12)
Intl. J. of Neuropsychopharmacology     Open Access   (Followers: 3, SJR: 1.69, h-index: 79)
Intl. J. of Public Opinion Research     Hybrid Journal   (Followers: 9, SJR: 0.906, h-index: 33)
Intl. J. of Refugee Law     Hybrid Journal   (Followers: 34, SJR: 0.231, h-index: 21)
Intl. J. of Transitional Justice     Hybrid Journal   (Followers: 13, SJR: 0.833, h-index: 12)
Intl. Mathematics Research Notices     Hybrid Journal   (Followers: 1, SJR: 2.052, h-index: 42)
Intl. Political Sociology     Hybrid Journal   (Followers: 31, SJR: 1.339, h-index: 19)
Intl. Relations of the Asia-Pacific     Hybrid Journal   (Followers: 18, SJR: 0.539, h-index: 17)
Intl. Studies Perspectives     Hybrid Journal   (Followers: 7, SJR: 0.998, h-index: 28)
Intl. Studies Quarterly     Hybrid Journal   (Followers: 39, SJR: 2.184, h-index: 68)
Intl. Studies Review     Hybrid Journal   (Followers: 18, SJR: 0.783, h-index: 38)
ISLE: Interdisciplinary Studies in Literature and Environment     Hybrid Journal   (Followers: 1, SJR: 0.155, h-index: 4)
ITNOW     Hybrid Journal   (Followers: 2, SJR: 0.102, h-index: 4)
J. of African Economies     Hybrid Journal   (Followers: 15, SJR: 0.647, h-index: 30)
J. of American History     Hybrid Journal   (Followers: 44, SJR: 0.286, h-index: 34)
J. of Analytical Toxicology     Hybrid Journal   (Followers: 13, SJR: 1.038, h-index: 60)
J. of Antimicrobial Chemotherapy     Hybrid Journal   (Followers: 13, SJR: 2.157, h-index: 149)
J. of Antitrust Enforcement     Hybrid Journal   (Followers: 1)
J. of Applied Poultry Research     Hybrid Journal   (Followers: 3, SJR: 0.563, h-index: 43)
J. of Biochemistry     Hybrid Journal   (Followers: 43, SJR: 1.341, h-index: 96)
J. of Chromatographic Science     Hybrid Journal   (Followers: 17, SJR: 0.448, h-index: 42)
J. of Church and State     Hybrid Journal   (Followers: 11, SJR: 0.167, h-index: 11)
J. of Competition Law and Economics     Hybrid Journal   (Followers: 36, SJR: 0.442, h-index: 16)
J. of Complex Networks     Hybrid Journal   (Followers: 1, SJR: 1.165, h-index: 5)
J. of Conflict and Security Law     Hybrid Journal   (Followers: 12, SJR: 0.196, h-index: 15)
J. of Consumer Research     Full-text available via subscription   (Followers: 43, SJR: 4.896, h-index: 121)
J. of Crohn's and Colitis     Hybrid Journal   (Followers: 10, SJR: 1.543, h-index: 37)
J. of Cybersecurity     Hybrid Journal   (Followers: 3)
J. of Deaf Studies and Deaf Education     Hybrid Journal   (Followers: 9, SJR: 0.69, h-index: 36)
J. of Design History     Hybrid Journal   (Followers: 16, SJR: 0.166, h-index: 14)
J. of Economic Entomology     Full-text available via subscription   (Followers: 6, SJR: 0.894, h-index: 76)
J. of Economic Geography     Hybrid Journal   (Followers: 24, SJR: 2.909, h-index: 69)
J. of Environmental Law     Hybrid Journal   (Followers: 24, SJR: 0.457, h-index: 20)
J. of European Competition Law & Practice     Hybrid Journal   (Followers: 20)
J. of Experimental Botany     Hybrid Journal   (Followers: 14, SJR: 2.798, h-index: 163)
J. of Financial Econometrics     Hybrid Journal   (Followers: 23, SJR: 1.314, h-index: 27)
J. of Global Security Studies     Hybrid Journal   (Followers: 3)
J. of Heredity     Hybrid Journal   (Followers: 4, SJR: 1.024, h-index: 76)
J. of Hindu Studies     Hybrid Journal   (Followers: 7, SJR: 0.186, h-index: 3)
J. of Hip Preservation Surgery     Open Access  
J. of Human Rights Practice     Hybrid Journal   (Followers: 20, SJR: 0.399, h-index: 10)
J. of Infectious Diseases     Hybrid Journal   (Followers: 39, SJR: 4, h-index: 209)
J. of Insect Science     Open Access   (Followers: 8, SJR: 0.388, h-index: 31)

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Journal Cover Interactive CardioVascular and Thoracic Surgery
  [SJR: 0.743]   [H-I: 35]   [5 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1569-9293 - ISSN (Online) 1569-9285
   Published by Oxford University Press Homepage  [370 journals]
  • A new technique to implant a transcatheter inflatable, fully
           repositionable prosthesis in aortic stenosis with severe asymmetric
           calcification†
    • Authors: Bushnaq H; Raspé C, Öner A, et al.
      Pages: 679 - 682
      Abstract: OBJECTIVESIn contrast to stented transcatheter aortic valves, the Direct Flow Medical (DFM) valve is a stentless bovine aortic bioprosthesis mounted in a non-metallic inflatable frame. Hence, severe asymmetric annular calcification may result in residually elevated transaortic pressure gradients after DFM implantation. We present a novel intraprocedural dilatation (IDIL) technique for successful implantation of the DFM valve in the presence of complex annular calcification.METHODSBetween January 2014 and May 2015, 55 patients underwent DFM valve-based transcatheter aortic valve implantation at our institution. Of these, 5 patients required an IDIL technique due to a residual intraoperative transaortic pressure mean gradient above 15 mmHg. The mean patient age was 73 ± 8.2 years; the mean logistic EuroSCORE was 24.5 ± 8.2% and the mean Society of Thoracic Surgeons score was 6.3 ± 4.3%.RESULTSThe IDIL technique immediately attenuated transvalvular mean pressure gradients from 20 ± 2 mmHg to 6 ± 1 mmHg. The results remained stable during the 30-day observation period at 10 ± 3 mmHg. Minimal paravalvular aortic regurgitation (trace) was detected in 2 patients. No in-hospital deaths were observed.CONCLUSIONSThe IDIL technique facilitates safe DFM valve implantation in patients with complex asymmetric annular calcification without adverse side effects on valve structure or performance in short-term follow-up.
      PubDate: 2017-08-01
      DOI: 10.1093/icvts/ivx197
      Issue No: Vol. 25, No. 5 (2017)
       
  • Primary leiomyosarcoma of inferior vena cava adjacent to hepatic veins:
           complete off-pump resection and inferior vena cava graft reconstruction
           with application of external skin surface cooling
    • Authors: Malyshev M; Zotov S, Malyshev A, et al.
      Pages: 683 - 686
      Abstract: OBJECTIVESResection of a leiomyosarcoma of the inferior vena cava (IVC) requires venovenous bypass, especially if IVC clamping above the hepatic veins is planned. This report describes the application of external skin surface cooling for off-pump resection of a primary IVC leiomyosarcoma adjacent to the hepatic veins with graft IVC reconstruction in conditions of suprahepatic caval clamping and uninterrupted Pringle’s manoeuvre.METHODSA 62-year-old woman presented with IVC leiomyosarcoma adjacent to the hepatic veins. After anaesthesia induction, the patient’s head, neck, abdomen, chest, thighs and shanks were covered by polyethylene bags containing granulated ice. The ice bag was also placed between the internal surfaces of the thighs. After 108 min, the target oesophageal temperature (29°C) was achieved, all bags were removed, except the bags that were used for temperature control during the operation located on head, neck and between internal surfaces of the thighs. Off-pump resection of the tumour was performed in conditions of suprahepatic IVC and portal triad clamping via median laparotomy.RESULTSIVC clamping was accompanied by arterial hypotension of 55–65 mmHg well-tolerating in the hypothermic background for 69 min. The simultaneous application of an uninterrupted Pringle’s manoeuvre was accompanied by low levels of transaminases and bilirubin. There was no local relapse of the tumour or metastases over a 6-month follow-up.CONCLUSIONSExternal skin surface cooling in cases demanding IVC clamping above the hepatic veins and Pringle’s manoeuvre allows avoiding venovenous bypass. This method is safe, cost effective, easily performed and may be used in clinical cases involving systemic arterial hypotension.
      PubDate: 2017-05-19
      DOI: 10.1093/icvts/ivx133
      Issue No: Vol. 25, No. 5 (2017)
       
  • Additional veno-venous gas exchange as a problem-solving strategy for an
           oxygenator not transferring oxygen in paediatric cardiopulmonary bypass
           †
    • Authors: Boettcher W; Sinzobahamvya N, Dehmel F, et al.
      Pages: 687 - 689
      Abstract: OBJECTIVESOxygenator failure during cardiopulmonary bypass constitutes a life-threatening event, especially when perfusion is conducted under normothermia. An alternative solution to emergency oxygenator changeover is described.METHODSA supplementary oxygenator is added in the venous line without interrupting perfusion. De-airing is achieved through the cardiotomy reservoir. Oxygen supply is adapted to ensure physiologic partial oxygen pressure.RESULTSOn 5 occasions in the past 4 years, Capiox Baby FX 05 oxygenator (n = 4) and Capiox FX15 (n = 1) failed to exchange blood gases after bypass run ranging from 290 min to 563 min. Hypoxia ensued with partial oxygen pressure values of 49–79 mmHg with a fraction of inspired oxygen of 1. An additional veno-venous Terumo Capiox FX 05 oxygenator immediately improved oxygenation with resulting partial oxygen pressure increasing to at least 291 mmHg.CONCLUSIONSAn additional veno-venous oxygenator effectively corrects failing oxygenator during cardiopulmonary bypass. The method does not require circulation arrest. It does not carry the risk of air embolism. It can be carried out without any help from a second perfusionist or member of operation team.
      PubDate: 2017-06-20
      DOI: 10.1093/icvts/ivx192
      Issue No: Vol. 25, No. 5 (2017)
       
  • Epidermal growth factor receptor mutation status is strongly associated
           with smoking status in patients undergoing surgical resection for lung
           adenocarcinoma
    • Authors: Matsumura Y; Owada Y, Inoue T, et al.
      Pages: 690 - 695
      Abstract: OBJECTIVESThe purpose of this analysis was to examine the relationship between epidermal growth factor receptor (EGFR) mutation status and clinicopathological factors in a cohort of patients who underwent surgical resections for lung adenocarcinoma.METHODSFrom the patients who underwent surgical resections for primary lung cancers between 2005 and 2012, 371 consecutive adenocarcinoma patients were enrolled in this study, and their tumours were analysed for EGFR mutations. We examined the clinicopathological factors of all enrolled patients, including age, sex, pathological stage and smoking status and tested for associations with EGFR mutation status.RESULTSAmong the 371 enrolled patients, 195 (52%) patients had EGFR mutations. There were significantly more women, never smokers and tumours of lower grade histology in the EGFR mutation group than in the wild-type group (P < 0.001 each). However, other factors, such as pathological stage and World Health Organization classification, were not significantly associated with mutation status. Multivariable analysis showed that age, smoking history and histological grade were independently associated with EGFR mutations (P = 0.026, P < 0.001 and P < 0.001, respectively), but sex was not. Regarding smoking status, especially, frequency of EGFR mutation decreased, as smoking index increased. On the other hand, sex and smoking cessation (whether the patients were former or current smokers) were not significantly associated with EGFR mutation status.CONCLUSIONSIn our cohort of patients who underwent surgical resection for lung adenocarcinoma, EGFR mutation status was strongly associated with smoking status, especially smoking index.
      PubDate: 2017-07-19
      DOI: 10.1093/icvts/ivx207
      Issue No: Vol. 25, No. 5 (2017)
       
  • Extended pleurectomy decortication for malignant pleural mesothelioma in
           the elderly: the need for an inclusive yet selective approach †
    • Authors: Sharkey A; Bilancia R, Tenconi S, et al.
      Pages: 696 - 702
      Abstract: OBJECTIVESThe median age at diagnosis of patients with pleural mesothelioma in the UK is 73 years. Recent series have shown the feasibility of extended pleurectomy decortication in the elderly, but with continuing debate about the efficacy of this treatment, we reviewed our experience to identify more detailed selection criteria.METHODSWe reviewed prospectively collected data on all patients from 1999 to 2016 undergoing extended pleurectomy decortication. We compared clinical and pathological outcomes and survival data from patients 70 years and older (≥70 years) with those younger than 70 years (<70 years).RESULTSEighty-two of the 300 (27.3%) patients were ≥70 years of age at the time of surgery. More patients in the elderly group required intensive care postoperatively (6.2 vs 16.7%, P = 0.01) and developed atrial fibrillation (14.4 vs 24.4%, P = 0.05). There was no intergroup difference in length of hospital stay or in in-hospital, 30-day or 90-day mortality. Elderly patients were less likely to receive neoadjuvant (<70 years 21.2%, ≥70 years 11.0%; P = 0.045) or adjuvant chemotherapy (<70 years 45.4%, ≥70 years 29.3%; P = 0.04). Median overall survival was similar: <70 years 14.0 months, ≥70 years 10.3 months; P = 0.29. However, in node-positive patients, survival was poorer in the elderly (13.0 vs 9.1 months, P = 0.05), particularly in those with non-epithelioid tumours (3.8 vs 6.7 months, P = 0.04). On multivariable analysis, age was not a significant prognostic factor, although lack of adjuvant therapy (P = 0.001) and admission to the intensive care unit (P < 0.001) remained poor prognostic factors.CONCLUSIONSAlthough age in isolation should not be an exclusion criterion for extended pleurectomy decortication for mesothelioma, in the elderly, a more rigorous preoperative evaluation of nodal disease and an additional assessment of fitness for adjuvant chemotherapy are recommended.
      PubDate: 2017-07-21
      DOI: 10.1093/icvts/ivx221
      Issue No: Vol. 25, No. 5 (2017)
       
  • Usefulness of near-infrared angiography for identifying the intersegmental
           plane and vascular supply during video-assisted thoracoscopic
           segmentectomy †
    • Authors: Guigard S; Triponez F, Bédat B, et al.
      Pages: 703 - 709
      Abstract: OBJECTIVESSegmentectomy by video-assisted thoracoscopic surgery (VATS) permits anatomical resection for diagnosis and treatment of small lung nodules but requires that intersegmental planes and segmental vessels be identified accurately. Near-infrared angiography with systemic injection of indocyanine green (ICG) can precisely identify the intersegmental plane. The purpose of this study was to confirm the usefulness of ICG angiography during VATS segmentectomy.METHODSWe retrospectively reviewed the records of 22 consecutive patients who underwent VATS segmentectomy performed with near-infrared angiography between November 2014 and October 2015. Segments were localized and anatomical vascular supply was identified on preoperative computed tomography scans. VATS segmentectomy was performed using an anterior approach with 2 ports and 1 non-spreading minithoracotomy, with ICG injected systemically after arterial ligation.RESULTSVATS was feasible for all 22 segmentectomies, and in all patients, the intersegmental plane was identified accurately by ICG angiography. This angiography method was also useful in patients whose anatomical vascular segmentation was difficult to identify and, in a few patients, to assess the distribution of an artery before sectioning, to determine the vascular supply of the remaining lung and to distinguish between segmental and intersegmental veins. The postoperative course was uneventful for 18 patients and complicated for 2 patients who had prolonged air leak (10 and 15 days) with pneumonia, 1 patient with gastroparesis and 1 with colonic ileus. The drain was removed before the 3rd postoperative day in all but 2 patients, and the mean hospital stay was 5.4 ± 4.5 days. Anatomopathological examination indicated that 4 benign lesions and 18 primary lung cancers were completely removed, including 14 that were Stage IA, 2 Stage IIA and 2 Stage IIIA.CONCLUSIONSIndocyanine green angiography provides technical support for identifying the intersegmental plane and the vasculature during VATS segmentectomy. It contributes to the quality of diagnostic and therapeutic excisions of small nodules that are often not visible and not palpable during VATS.
      PubDate: 2017-09-06
      DOI: 10.1093/icvts/ivx225
      Issue No: Vol. 25, No. 5 (2017)
       
  • Cytomegalovirus infection in living-donor and cadaveric lung
           transplantations †
    • Authors: Ohata K; Chen-Yoshikawa TF, Takahashi K, et al.
      Pages: 710 - 715
      Abstract: OBJECTIVESCytomegalovirus (CMV) infection remains a major cause of morbidity after lung transplantation. Some studies have reported prognostic factors for the postoperative development of CMV infection in cadaveric lung transplantation (CLT), but no research has been performed in living-donor lobar lung transplantation (LDLLT). Therefore, we analysed the possible risk factors of post-transplant CMV infection and the differences between LDLLT and CLT.METHODSThe development of CMV disease and viraemia in 110 patients undergoing lung transplantation at Kyoto University Hospital in 2008–2015 were retrospectively assessed. The prognostic factors in the development of CMV infection and the differences between LDLLT and CLT were analysed.RESULTSAmong 110 patients, 58 LDLLTs and 52 CLTs were performed. The 3-year freedom rates from CMV disease and viraemia were 92.0% and 58.5%, respectively. There was no difference in the development of CMV infection between LDLLT and CLT (disease: 94.6% vs 91.0%, P = 0.58 and viraemia: 59.3% vs 57.2%, P = 0.76). In preoperative anti-CMV immunoglobulin status, R−D+ recipients (recipient: negative, donor: positive) and R–D– recipients (recipient: negative, donor: negative) tended to have higher and lower cumulative incidences, respectively, of CMV infection (disease: P = 0.34 and viraemia: P = 0.24) than that with R+ recipients (recipient: seropositive). Significantly lower cumulative incidence of CMV viraemia was observed in patients receiving 12-month prophylactic medication (70.6% vs 36.8%, P < 0.001). Twenty-eight patients (25.5%) had early cessation of anti-CMV prophylaxis due to toxicity; however, the extended prophylaxis duration did not increase the incidence of early cessation (P = 0.88). These trends were seen in both LDLLT and CLT.CONCLUSIONSWe found that there was no difference in the development of CMV infection between LDLLT and CLT. Twelve-month prophylaxis protocol provides beneficial effect without increased toxicity also in LDLLT.
      PubDate: 2017-08-07
      DOI: 10.1093/icvts/ivx226
      Issue No: Vol. 25, No. 5 (2017)
       
  • Evaluation of patients who underwent resympathectomy for treatment of
           primary hyperhidrosis
    • Authors: de Campos J; Lembrança L, Fukuda J, et al.
      Pages: 716 - 719
      Abstract: OBJECTIVESVideo thoracoscopic sympathectomy is the recommended surgical treatment for primary hyperhidrosis and has a high success rate. Despite this high success rate, some patients are unresponsive and eventually need a resympathectomy. Few studies have previously analysed exclusively the results of these resympathectomies in patients with primary hyperhidrosis. None of the studies have objectively evaluated the degree of response to surgery or the improvement in quality of life after resympathectomies.METHODSThis is a retrospective study, evaluating 15 patients from an initial group of 2300 patients who underwent resympathectomy after failure of the primary surgical treatment. We evaluated sympathectomy levels of resection, technical difficulties, surgical complications preoperative quality of life, response to treatment and quality-of-life improvement 30 days after each surgery.RESULTSRegarding gender, 11 (73.3%) patients were women. The average age was 23.2 with SD of 5.17 years, and the mean body mass index was 20.9 (SD 2.12). Ten patients had major complaints about their hands (66%) and 5 (33%) patients about their forearms. A high degree of response to sympathectomy occurred in 73% of patients. In 11 of these patients, the improvement in quality of life was considered high, 3 showed a mild improvement and 1 did not improve. No major complications occurred; the presence of adhesions was reported in 11 patients and pleural drainage was necessary in 4 patients.CONCLUSIONSResympathectomy is an effective procedure, and it improves the quality of life in patients with primary hyperhidrosis who failed after the first surgery.
      PubDate: 2017-07-31
      DOI: 10.1093/icvts/ivx235
      Issue No: Vol. 25, No. 5 (2017)
       
  • Early- and mid-term aortic remodelling after the frozen elephant trunk
           technique for retrograde type A acute aortic dissection using the new
           Japanese J Graft open stent graft
    • Authors: Yamane Y; Uchida N, Mochizuki S, et al.
      Pages: 720 - 726
      Abstract: OBJECTIVESWe previously performed the frozen elephant trunk (FET) technique for acute type A aortic dissection to try to improve the long-term prognosis. In this study, we report the mid-term results of the FET technique for treating retrograde type A acute aortic dissection using a new device, the J Graft open stent graft (JOSG).METHODSBetween January 2008 and December 2015, 24 patients (mean age: 59.3 ± 13.9 years) underwent total arch replacement with the FET technique using the JOSG for retrograde type A acute aortic dissection. All patients had at least 1 year of follow-up imaging.RESULTSThe average outer diameter of the JOSG was 28 ± 2.8 mm (range: 25–35 mm). The average position of the distal edge of the JOSG was Th 6.6 ± 1.1. The cumulative survival rate at 1 year was 91.6%. Postoperative computed tomography 1 year after surgery showed that complete thrombosis was present in all patients at the level of the distal edge of the stent graft and the aortic valve. At the diaphragmatic level, complete thrombosis was seen in 14 (70%) patients, the false lumen was patent in most patients (90%) at the superior mesenteric artery level.CONCLUSIONSThe use of the FET technique with the JOSG for retrograde type A acute aortic dissection provides good outcomes. With the proper use of the JOSG, it is possible to expand the true lumen and eliminate antegrade false-lumen flow, resulting in good aortic remodelling. Furthermore, there should be obliteration of the false lumen from the stent graft to the aortic valve, and this might reduce long-term complications.
      PubDate: 2017-06-09
      DOI: 10.1093/icvts/ivx144
      Issue No: Vol. 25, No. 5 (2017)
       
  • Clinical standard for valve area after common atrioventricular valve
           plasty for a single ventricle
    • Authors: Kido T; Kawata H, Iwai S, et al.
      Pages: 727 - 733
      Abstract: OBJECTIVESTo determine a clinical standard for post-repair common atrioventricular valve orifice area based on mid- to long-term valve function in patients with a functional single ventricle.METHODSThe medical records of 19 single-ventricle patients who underwent common atrioventricular valve plasty from July 1988 to January 2013 were retrospectively reviewed. Bivalvation valvuloplasty was performed in 7 patients with relatively hypoplastic leaflets. The relationship between the orifice area of the repaired common atrioventricular valve measured intraoperatively and valve function and ventricular volume in the early postoperative period (median, 9.5 months) and at mid- to long-term follow-up (median, 4 years) were analysed.RESULTSPost-repair valve area was significantly positively correlated with valve regurgitation severity in the early postoperative period (P = 0.001, r = 0.69) and at mid- to long-term follow-up (P = 0.02, r = 0.57). Patients who did not undergo bivalvation had favourable valve function at mid- to long-term follow-up and in the early postoperative period when the post-repair valve area was 96–136% of the normal mitral valve area. Bivalvation patients had significantly more valve regurgitation in the early postoperative period than patients without bivalvation, despite equivalent repaired valve area (P = 0.02).CONCLUSIONSThe post-repair orifice area of the common atrioventricular valve is significantly related to postoperative valve function. The clinical standard of post-repair valve orifice area might be 96–136% of the normal mitral valve area in patients undergoing repair without bivalvation. Patients undergoing bivalvation require greater reduction to obtain favourable mid- to long-term valve function.
      PubDate: 2017-05-31
      DOI: 10.1093/icvts/ivx156
      Issue No: Vol. 25, No. 5 (2017)
       
  • Mid-term outcomes of congenital mitral valve surgery: Shone’s syndrome
           is a risk factor for death and reintervention †
    • Authors: Sughimoto K; Konstantinov IE, d’Udekem Y, et al.
      Pages: 734 - 739
      Abstract: OBJECTIVESTo study the recent trends and outcomes of congenital mitral valve surgery in children.METHODSFrom 2008 to 2014, 84 procedures in 66 consecutive patients (41 procedures in 31 patients with mitral stenosis and 43 procedures in 35 patients with mitral regurgitation) were retrospectively evaluated. The mean age at surgery was 4.3 ± 5.4 years, and 27 patients (41%) were neonates or infants.RESULTSSeven (11%) patients died during the follow-up period of 3.2 ± 2.3 years and 5 (71%) were <1 year. Ten mitral valve replacements were performed in 8 patients, including 1 pulmonary valve homograft, 3 Contegra conduits of 12 mm thickness in the intra-annular position and 6 mechanical valves. Shone’s syndrome, dysplastic valve, a need for valve replacement and age <1 year were the risk factors for death or reoperation in a univariable analysis, while in a multivariable analysis of all patients, valve replacement and age <1 year remained as risk factors. In a multivariable analysis of 27 patients aged <1 year, mitral valve dysplasia was a significant risk factor for reoperation or death. The 5-year rate of freedom from death or reoperation in neonates or infants was 55% and that in patients aged >1 year was 88% (P = 0.003).CONCLUSIONSAn age of <1 year, mitral valve dysplasia and a need for mitral valve replacement were associated with a higher incidence of death or reoperation. Primary mitral valve replacement or univentricular strategy may have to be considered for symptomatic neonates with Shone’s syndrome.
      PubDate: 2017-08-07
      DOI: 10.1093/icvts/ivx211
      Issue No: Vol. 25, No. 5 (2017)
       
  • Aortopulmonary window: results of repair beyond infancy †
    • Authors: Talwar S; Siddharth B, Gupta S, et al.
      Pages: 740 - 744
      Abstract: OBJECTIVESTo study the anatomic and haemodynamic data and results of surgery in patients undergoing surgical repair of aortopulmonary window beyond infancy.METHODSBetween July 2005 and December 2015, 23 patients, older than 1 year undergoing surgery for aortopulmonary window were analysed retrospectively. Postoperative clinical and echocardiography follow-up were performed.RESULTSMedian age and weight at repair was 4 years (range 14 months–12 years) and 12 kg (range 3.5–22 kg), respectively. Fifteen patients had Richardson’s Type I, 6 patients had Type II and 2 patients had Type III aortopulmonary window. Six patients had associated defects. Baseline mean systolic pulmonary artery pressure was 101 ± 14.9 mmHg (range 80–130, median 100 mmHg) and pulmonary vascular resistance index was 9.6 ± 5.9 (median 7.7 Wood units/m2, range 3.7–23.5 Wood units/m2). Patch repair of aortopulmonary window was performed using the sandwich method (transwindow) (n = 15), transaortic (n = 3) and transpulmonary artery (n = 2) approaches; 2 patients underwent double ligation and 1 underwent division and suturing. Two patients underwent valved patch closure of aortopulmonary window and 1 patient underwent valved patch closure of associated ventricular septal defect. There were 2 in-hospital deaths: one due to intractable pulmonary hypertension and the other due to low cardiac output. Mean follow-up was 36 months (range 2–119 months). Eighteen patients were in NYHA Class I at last follow-up. There were no late deaths or reoperation.CONCLUSIONSSurgery can be safely undertaken beyond infancy in carefully selected patients of aortopulmonary window with acceptable early and mid-term outcomes.
      PubDate: 2017-06-13
      DOI: 10.1093/icvts/ivx158
      Issue No: Vol. 25, No. 5 (2017)
       
  • Bilateral bidirectional Glenn: outcome of off-pump technique
    • Authors: El Midany AH; Mostafa EA, Mansour SA, et al.
      Pages: 745 - 749
      Abstract: OBJECTIVESOff-pump bilateral bidirectional Glenn (b-BDG) poses a surgical challenge and may add complexity to the postoperative outcome especially regarding uniformity of the anastomosis and central pulmonary artery growth. Herein, we report early- and mid-term outcomes after off-pump b-BDG without using superior vena cava decompression techniques.METHODSNinety-seven consecutive patients, between 2009 and 2014, were included in this prospective study. All patients had complete pre- and postoperative clinical and detailed neurological assessments. Diagnosis and follow-up were done by echocardiography and cardiac catheterization for assessment of pulmonary artery anatomically and haemodynamically. Median follow-up period was 3.5 years. Perioperative variables, clinical outcome, morbidity, mortality and follow-up data were recorded.RESULTSHypoplastic right ventricle was present in 52 cases (53.6%) and hypoplastic left ventricle was present in 45 cases (46.4%). Mean superior vena cava pressure on clamping was 21.49 ± 3.04 mmHg. Mean total clamping time was 23.11 ± 3.44 min. Mean oxygen saturation increased from preoperative 69.22 ± 6.01% to 83.66 ± 3.97% after b-BDG construction (P-value ≤ 0.0001). The Nakata index increased from 288.47 ± 28.66 mm2/m2 to 303.64 ± 26.85mm2/m2 on follow-up (P-value ≤ 0.05). In-hospital mortality was 4 patients (4.1%) due to low-cardiac output. There were chylothorax in 9 patients (9.3%) and convulsions in 4 patients (4.1%) who were treated conservatively.CONCLUSIONSOff-pump b-BDG can be conducted safely, with a uniform anastomosis that allows a good central pulmonary artery growth for subsequent Fontan completion. Moreover, avoiding the use of cardiopulmonary bypass is more economic and less hazardous.
      PubDate: 2017-06-13
      DOI: 10.1093/icvts/ivx168
      Issue No: Vol. 25, No. 5 (2017)
       
  • A biomechanical study of 4 different sternum closure techniques under
           different deformation modes
    • Authors: Orhan S; Ozyazicioglu M, Colak A.
      Pages: 750 - 756
      Abstract: OBJECTIVESThis study experimentally compares the efficiency of the 4 most preferred sternal closure tehniques, in 3 different deformation modes of the chest.METHODSPolyurethane sternum models fixed by conventional wiring, steel band, ZipFix band and figure-8 wiring are tested statically under lateral distraction, longitudinal shear and torsional deformation modes. As a result, load-deformation curves are obtained. The closure efficiency of the techniques is then compared with respect to allowable load (corresponding to 2 mm displacement), rigidity, rupture load and rupture displacement. A comparison in terms of cost and ease of application has also been presented.RESULTSThe highest allowable load and rigidity values in simple tension and longitudinal shear are obtained by the steel and ZipFix band techniques, respectively. In torsion mode, the highest allowable load is provided by the ZipFix band and the highest rigidty is attained by the steel band technique. The highest rupture loads under simple tension, longitudinal shear and torsion modes are observed in ZipFix, steel band and conventional wiring, respectively. Steel band closure provides the least rupture displacement in simple tension as well as torsion, whereas ZipFix bands give the smallest rupture displacements in longitudinal shear. However, in every loading mode there were no statistically significant differences in allowable load, rigidity and rupture load values between the closure methods, and only rupture displacement values were statistically different for each method.CONCLUSIONSOur results showed that conventional wiring is the most advantageous closing method when compared to the others.
      PubDate: 2017-06-15
      DOI: 10.1093/icvts/ivx175
      Issue No: Vol. 25, No. 5 (2017)
       
  • Transaortic transcatheter aortic valve implantation using SAPIEN XT or
           SAPIEN 3 valves in the ROUTE registry †
    • Authors: Romano M; Frank D, Cocchieri R, et al.
      Pages: 757 - 764
      Abstract: OBJECTIVESTransaortic (TAo) access for transcatheter aortic valve implantation (TAVI) is an alternative to the conventional transfemoral or transapical routes. Data comparing the characteristics and outcomes of TAo-TAVI using the SAPIEN XT and SAPIEN 3 heart valves are scarce. The objective of the current analysis was to provide such information.METHODSROUTE is an international, prospective, observational registry. Patients with severe calcific aortic stenosis scheduled for TAo-TAVI with an Edwards SAPIEN XT or a SAPIEN 3 heart valve were consecutively enrolled at 22 centres across Europe between February 2013 and February 2015. Periprocedural, in-hospital and 30-day complication rates were assessed.RESULTSOf the 301 patients included, 126 (41.9%) received a SAPIEN 3 and 175 (58.1%) a SAPIEN XT. The SAPIEN 3 was associated with shorter procedure time (101 ± 35 vs 111 ± 40 min; P = 0.031) and a lower quantity of contrast agent used (87 ± 43 vs 112 ± 50 ml; P < 0.001). Balloon dilation was performed less often before (68.0% vs 78.3%; P = 0.045) and after implantation (13.6% vs 30.1%; P = 0.001). No statistically significant differences between the valve types were documented for overall (4.1% SAPIEN 3 vs 7.6% SAPIEN XT; P = 0.21), TAVI-related (0.8% vs 4.7%; P = 0.084) and cardiovascular mortality (2.4% vs 5.9%; P = 0.158). Major vascular complications were less frequent (0.8% vs 5.3%; P = 0.049), and there was a lower rate of moderate-to-severe paravalvular regurgitation (0.8% vs 5.1%; P = 0.050) in the SAPIEN 3 group.CONCLUSIONSBoth the SAPIEN XT and SAPIEN 3 were safely implanted via the TAo route, though the SAPIEN 3 may be associated with a higher procedural success rate and improved prognosis.ClinicalTrials.gov IdentifierNCT01991431.
      PubDate: 2017-06-05
      DOI: 10.1093/icvts/ivx159
      Issue No: Vol. 25, No. 5 (2017)
       
  • Impact of the Haga Braincare Strategy on the burden of haemodynamic and
           embolic strokes related to cardiac surgery
    • Authors: Duynstee F; Keunen RM, van Sonderen A, et al.
      Pages: 765 - 771
      Abstract: OBJECTIVESThis study prospectively evaluates the impact of the Haga Braincare Strategy (HBS) on the occurrence of haemodynamic and embolic stroke in a cohort of patients who underwent coronay artery bypass grafting (CABG), valve replacement of a combination of both types of surgery between 2012 and 2015 at the Haga Teaching Hospitals.METHODSThe HBS is a dual strategy based on a preoperative vascular work-up of the cerebral circulation by transcranial Doppler and a perioperative monitoring of the cerebral circulation by cerebral oximetry. Duplex of the carotid arteries and/or computed tomography angiography prior to surgery was performed in high-risk patients. Patients with severe carotid artery stenosis were scheduled for carotid angioplasty prior to surgery or waived from surgery.RESULTSA total of 1065 patients were included. Poor cerebral haemodynamics were identified by transcranial Doppler in 2.1% of patients (n = 22). Based on the HBS, 3 patients were waived from surgery, 4 received preoperative carotid angioplasty followed by cardiac surgery and the remaining patients were operated while being monitored with bilateral cerebral oximetry sensors. In all, 2.2% of the study group experienced a stroke (n = 23), of which none were classified as haemodynamic. Most of the remaining presumed embolic strokes showed a minor to moderate stroke severity.CONCLUSIONSIn this single-centre prospective follow-up study, surveillance of cerebral perfusion by the HBS eliminated the occurrence of haemodynamic stroke while most of the residual strokes had a good to favourable prognosis.
      PubDate: 2017-06-15
      DOI: 10.1093/icvts/ivx171
      Issue No: Vol. 25, No. 5 (2017)
       
  • Is delayed surgical revascularization in acute myocardial infarction
           useful or dangerous' New insights into an old problem
    • Authors: Grieshaber P; Roth P, Oster L, et al.
      Pages: 772 - 779
      Abstract: OBJECTIVESHaemodynamically stable patients admitted for coronary artery bypass grafting in acute myocardial infarction often undergo delayed surgery in order to avoid the risks of emergency surgery. However, initially stable patients undergoing delayed surgery may develop low cardiac output syndrome (LCOS) during the waiting period, which might be a major drawback of this strategy. We aim to define risk factors and clinical consequences of LCOS during the waiting period.METHODSA total of 530 consecutive patients with acute myocardial infarction (33% non-ST-segment elevation myocardial infarction and 67% ST-segment-elevation myocardial infarction) underwent isolated coronary artery bypass grafting between 2008 and 2013. Outcomes after either immediate (<48 h after onset of symptoms) or delayed (>48 h after onset of symptoms) therapy were compared. Predictors of preoperative development of LCOS were identified using multivariate regression analysis.RESULTSOf the 327 patients undergoing delayed therapy, 39 (12%) developed preoperative LCOS, resulting in increased mortality compared with patients who remained stable (21 vs 7.6%, P < 0.001). Immediate therapy resulted in similar mortality compared with delayed therapy (6.4 vs 7.6%; P = 0.68) and better 7-year survival (70 vs 55%; P < 0.001). Predictors of developing LCOS were reduced left ventricular function (odds ratio 4.4), renal impairment (odds ratio 3.0), acute pulmonary infection (odds ratio 3.4) and the extent of troponin elevation at admission (odds ratio 1.01 per increase by 1 µg/l).CONCLUSIONSIn patients with acute myocardial infarction undergoing delayed coronary artery bypass grafting, preoperative LCOS is a relevant and dangerous condition that can be avoided by operating immediately or by carefully selecting patients to be delayed according to the risk parameters identified preoperatively.
      PubDate: 2017-06-20
      DOI: 10.1093/icvts/ivx188
      Issue No: Vol. 25, No. 5 (2017)
       
  • Preoperative SYNTAX score to assess the late outcomes after coronary
           endarterectomy for the diffusely diseased left anterior descending artery
           †
    • Authors: Nishigawa K; Fukui T, Takanashi S.
      Pages: 780 - 784
      Abstract: OBJECTIVESTo evaluate whether the preoperative Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) score was associated with late outcomes of coronary endarterectomy (CE) for the diffusely diseased left anterior descending artery (LAD).METHODSWe retrospectively analysed 205 of 212 patients undergoing CE for the diffusely diseased LAD between September 2004 and May 2016, excluding 2 patients without preoperative angiographic data and 5 redo cases. The mean SYNTAX score was 34.6. Patients were divided into 3 groups according to their SYNTAX score: low (≤22, n = 26), intermediate (23–32, n = 58) and high (≥33, n = 121). The study end-points were cardiac death and major adverse cardiac and cerebrovascular events, defined as all-cause death, cerebrovascular accidents, non-fatal myocardial infarction and repeat revascularization. All CEs involved long arteriotomy and the reconstruction of the endarterectomized LAD using the skeletonized internal thoracic artery.RESULTSPostoperative mortality and morbidity were similar between the groups. The median follow-up period was 5.4 years. We found no significant difference in the cumulative cardiac death-free survival rate at 5 years (91.1% vs 100% vs 98.3%; log-rank, P = 0.196) or major adverse cardiac and cerebrovascular events (61.6% vs 71.5% vs 76.7%; log-rank, P = 0.258) in the low, intermediate and high SYNTAX score groups, respectively. Univariate and multivariate Cox proportional hazard analyses revealed no significant association between the study end-points and individual components of the SYNTAX score for the LAD.CONCLUSIONSThe preoperative SYNTAX score and its individual components for the LAD were not associated with late outcomes following CE for the diffusely diseased LAD.
      PubDate: 2017-06-16
      DOI: 10.1093/icvts/ivx184
      Issue No: Vol. 25, No. 5 (2017)
       
  • A low-cost bioprosthetic semilunar valve for research, disease modelling
           and surgical training applications
    • Authors: Rosa B; Machaidze Z, Shin B, et al.
      Pages: 785 - 792
      Abstract: OBJECTIVESThis paper provides detailed instructions for constructing low-cost bioprosthetic semilunar valves for animal research and clinical training. This work fills an important gap between existing simulator training valves and clinical valves by providing fully functioning designs that can be employed in ex vivo and in vivo experiments and can also be modified to model valvular disease.METHODSValves are constructed in 4 steps consisting of creating a metal frame, covering it with fabric and attaching a suture ring and leaflets. Computer-aided design files are provided for making the frame from wire or by metal 3D printing. The covering fabric and suturing ring are made from materials readily available in a surgical lab, while the leaflets are made from pericardium. The entire fabrication process is described in figures and in a video. To demonstrate disease modelling, design modifications are described for producing paravalvular leaks, and these valves were evaluated in porcine ex vivo (n = 3) and in vivo (n = 6) experiments.RESULTSPorcine ex vivo and acute in vivo experiments demonstrate that the valves can replicate the performance of clinical valves for research and training purposes. Surgical implantation is similar, and echocardiograms are comparable to clinical valves. Furthermore, valve leaflet function was satisfactory during acute in vivo tests with little central regurgitation, while the paravalvular leak modifications consistently produced leaks in the desired locations.CONCLUSIONSThe detailed design procedure presented here, which includes a tutorial video and computer-aided design files, should be of substantial benefit to researchers developing valve disease models and to clinicians developing realistic valve training systems.
      PubDate: 2017-08-02
      DOI: 10.1093/icvts/ivx189
      Issue No: Vol. 25, No. 5 (2017)
       
  • First ex vivo and preliminary sheep model results of the new TRIBIO aortic
           valve bioprosthesis in small aortic annuli
    • Authors: Stock S; Sievers H, Richardt D, et al.
      Pages: 793 - 798
      Abstract: OBJECTIVESSmall aortic annuli are challenging in aortic valve replacement. Prosthesis-patient mismatch, accompanied by high transvalvular gradients and small orifice area, is an often faced problem impairing postoperative outcome. The new TRIBIO bioprosthesis aims to enable enhanced haemodynamics, being increasingly important with decreasing annular size. This study compares ex vivo hydrodynamics of TRIBIO with 2 established bioprostheses in small annuli at different stroke volumes, simulating ‘rest’ and ‘exercise’, and evaluates haemodynamics of TRIBIO in a sheep model.METHODSEx vivo: Porcine aortic roots were hardened with glutaraldehyde, approaching the stiffness of decalcified roots. Each bioprosthesis (TRIBIO, Trifecta™, Perimount® Magna Ease), size 19 mm, was implanted in each aortic root and inserted into a pulse duplicator, determining hydrodynamics and geometric orifice area at different stroke volumes (74, 90, 104 ml). Sheep model: Postoperative transvalvular gradients were assessed after implantation of 19 mm TRIBIO in aortic position.RESULTSEx vivo: Mean transvalvular gradients were lowest in TRIBIO (7.3, 8.7, 10.2 mmHg at 74, 90, 104 ml) with significant difference to Perimount® Magna Ease. Geometric orifice area in TRIBIO was 2.7 cm2 and significantly larger compared to Perimount® Magna Ease and Trifecta™. Opening of TRIBIO was uniform and apparently complete, whereas leaflet’s outward movement was restricted particularly in Perimount® Magna Ease. Sheep model: TRIBIO presented with low transvalvular gradients (δpmean 4.1 ± 2 mmHg, δpmax 7.8 ± 4.6 mmHg), unimpaired leaflet motion and no central or paravalvular leakage.CONCLUSIONSEx vivo, the TRIBIO achieved superior hydrodynamics compared to latest generation bioprostheses. These excellent data are supported by very low transvalvular gradients in a preliminary sheep model.
      PubDate: 2017-06-20
      DOI: 10.1093/icvts/ivx196
      Issue No: Vol. 25, No. 5 (2017)
       
  • Long-term patency of on- and off-pump coronary artery bypass grafting with
           bilateral internal thoracic arteries: the significance of late string sign
           development in the off-pump technique
    • Authors: Hayashi Y; Maekawa A, Sawaki S, et al.
      Pages: 799 - 805
      Abstract: OBJECTIVESThis study aimed to examine the effect of off-pump coronary artery bypass grafting (CABG) in patients who underwent revascularization with bilateral internal thoracic arteries (ITAs).METHODSBetween January 2000 and December 2014, 499 patients underwent isolated CABG with bilateral ITAs for complete revascularization of the left coronary system at our institution. On-pump CABG was performed in 137 patients, and off-pump CABG was performed in 362 patients. We retrospectively compared the clinical outcomes and patency of the ITAs.RESULTSThe off-pump group showed less respiratory failure and required a shorter postoperative stay than the on-pump group. The survival probability, freedom from cardiac events and early graft patency were similar in both groups. Five-year patency of the ITA anastomosed to the left anterior descending artery was significantly greater in the on-pump group than in the off-pump group (98.8% vs 91.2%, P = 0.010). The incidence of string change in the off-pump group was higher than that in the on-pump group (P = 0.017). There was no significant difference between the groups in the 5-year patency of the ITA anastomosed to the left circumflex artery (on-pump group: 93.8%, off-pump group: 91.8%; P = 0.46).CONCLUSIONSThe early graft patency and the late patency of the ITA anastomosed to the left circumflex artery between the groups were similar, implying an equivalent quality of anastomoses. However, the patency of the ITA anastomosed to the left anterior descending artery in the off-pump group showed late deterioration, mainly because of string sign development.
      PubDate: 2017-07-31
      DOI: 10.1093/icvts/ivx214
      Issue No: Vol. 25, No. 5 (2017)
       
  • Reoperation for mitral paravalvular leak: a single-centre experience with
           200 patients†
    • Authors: Said SM; Schaff HV, Greason KL, et al.
      Pages: 806 - 812
      Abstract: OBJECTIVESParavalvular leak (PVL) is a major cause of morbidity and mortality after mitral valve replacement. Risk factors and data on long-term surgical outcomes are lacking.METHODSBetween January 1995 and December 2012, 206 [118 males (57%)] patients underwent reoperation due to mitral PVL. Mean age was 64 ± 11 years. Haemolytic anaemia was present in 85 (41%) patients, while 137 (67%) patients were in New York Heart Association Class III or IV. Baseline creatinine was above 1.5 in 91 (44%) patients, while chronic steroids were used in 14 (7%) patients. Active endocarditis was present in 8 (4%) patients. Device occlusion was attempted in 21 (10%) patients.RESULTSPVL was most common at the aortomitral curtain (82 patients, 40%). Repair was possible in 105 (51%) patients. Early mortality occurred in 11 (5%) patients. Mean follow-up was 5 (maximum 19) years. Overall survival at 1, 5 and 15 years was 83%, 62% and 16%, respectively. Death due to heart failure or cardiogenic shock occurred in 39 patients. Recurrence occurred in 43 (21%) patients and reoperation was required in 19 patients. Multivariate analysis revealed advanced New York Heart Association class (P < 0.0001), active endocarditis (P = 0.013), chronic steroids (P = 0.022), previous coronary artery bypass grafting (P = 0.026), baseline creatinine above 1.5 (P = 0.001), postoperative need for dialysis (P = 0.036) and residual PVL (P < 0.0001) to be predictors of late mortality. Active endocarditis (P = 0.0004) and chronic steroids (P = 0.002) were significant predictors for PVL recurrence. Freedom from reoperation due to PVL recurrence was 89% and 84%, while freedom from late intervention was 94% and 61% at 5 and 15 years, respectively.CONCLUSIONSPVL after mitral valve replacement is associated with increased morbidity and mortality. Re-repair is possible, but recurrent PVL is a risk factor for late mortality, and reoperation should be performed prior to the onset of advanced heart failure.
      PubDate: 2017-07-31
      DOI: 10.1093/icvts/ivx222
      Issue No: Vol. 25, No. 5 (2017)
       
  • Search for genetic factors in bicuspid aortic valve disease: ACTA2
           mutations do not play a major role
    • Authors: Tortora G; Wischmeijer A, Berretta P, et al.
      Pages: 813 - 817
      Abstract: OBJECTIVESMutations in ACTA2 have been reported as a cause of familiar thoracic aortic aneurysm (TAA) with associated bicuspid aortic valve (BAV) in some individuals. Our aim is to investigate the role of ACTA2 mutations in BAV associated with TAA in 20 patients.METHODSWe recruited 20 patients who underwent surgery for BAV and TAA; clinical genetic evaluation and ACTA2 mutation analysis were performed on each patient, along with next-generation sequencing analysis of BAV-related genes. Available first-degree relatives were enrolled and evaluated with echocardiography and clinical genetic examination.RESULTSNo mutations were found in ACTA2 or in BAV-related genes in our probands nor any common clinical signs possibly related to their heart disease. One-third of probands did not have any cardiovascular risk factor. Surgery was required at a young age (mean age 47.2 years) and at relatively small ascending aortic diameters (mean size 49.7 mm). In 77 first-degree relatives, 1 new diagnosis of TAA requiring surgery was made and 8 previous BAV/TAA diagnoses (9/77 = 11.7%) were confirmed. The phenotype BAV ± TAA segregated in 25% of our families.CONCLUSIONSAlthough based on a small cohort, our results seemed to justify the conclusion that ACTA2 did not play a significant role in the pathogenesis of BAV aortopathy. The underlying genetic factors of this condition remain elusive and both large association studies and exome or genome sequencing could represent promising tools to unravel its pathogenesis. Aortic resection of TAA at elective surgery in these patients should be recommended as well as echocardiography in their first-degree relatives.
      PubDate: 2017-07-27
      DOI: 10.1093/icvts/ivx242
      Issue No: Vol. 25, No. 5 (2017)
       
  • Is ministernotomy superior to right anterior minithoracotomy in minimally
           invasive aortic valve replacement'
    • Authors: Balmforth D; Harky A, Lall K, et al.
      Pages: 818 - 821
      Abstract: A best evidence topic was constructed according to a structured protocol. The question addressed was whether, in patients undergoing minimally invasive aortic valve replacement (AVR), right anterior thoracotomy (RT) or mini-sternotomy (MS) was superior in terms of postoperative outcome' A total of 840 publications were found using the reported search. Of these, 6 represented the best available evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. In all, except 1 study, the primary outcome was early mortality, ranging from in-hospital mortality to 90 days postoperatively. The remaining study was a cost–benefit analysis. Four studies were non-randomized observational studies, one of which was multicentre. Two were meta-analyses of studies comparing minithoracotomy or MS with conventional sternotomy for AVR, rather than direct comparisons of the 2 minimal access techniques. We conclude that there is a lack of high-quality evidence comparing RT and MS for minimally invasive AVR, with no randomized controlled trials to date. The available evidence shows no difference in early mortality between RT and MS for surgical AVR. In studies that directly compared RT and MS, RT was found to be associated with reduced length of hospital stay, despite longer cardiopulmonary bypass times and cross-clamp times. One study reported groin complications (10.8%) with the RT group, where peripheral cannulation was used, while the other 5 studies did not comment on groin complications associated with peripheral cannulation. In the only cost–benefit analysis, RT was found to carry considerably more cost than MS over and above conventional AVR.
      PubDate: 2017-08-01
      DOI: 10.1093/icvts/ivx241
      Issue No: Vol. 25, No. 5 (2017)
       
  • The safe volume threshold for chest drain removal following pulmonary
           resection
    • Authors: Yap K; Soon J, Ong B, et al.
      Pages: 822 - 826
      Abstract: A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was ‘In patients undergoing pulmonary resection, is there a safe drainage volume threshold for chest drain removal'’ Altogether 1054 papers were found, of which 5 papers represented the best evidence. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Chest drainage threshold, where used, ranged from 250 to 500 ml/day. Both randomized controlled trials showed no significant difference in reintervention rates with a higher chest drainage volume threshold. Four studies that performed analysis on other complications showed no statistical significant difference with a higher chest drainage volume threshold. Four studies evaluating length of hospital stay showed reduced or no difference in the length of stay with a higher chest drainage volume threshold. Two cohort studies reported the mortality rate of 0–0.01% with a higher chest drainage volume threshold. We conclude that early chest drain removal after pulmonary resection, accepting a higher chest drainage volume threshold of 250–500 ml/day is safe, and may result in shorter hospital stay without increasing reintervention, morbidity or mortality.
      PubDate: 2017-06-01
      DOI: 10.1093/icvts/ivx161
      Issue No: Vol. 25, No. 5 (2017)
       
  • Spinal cord ischaemia after endovascular aneurysm repair
    • Authors: Natsume K; Shiiya N, Yamashita K, et al.
      Pages: 827 - 829
      Abstract: We report the case of a patient who developed paraparesis 2 days after endovascular aneurysm repair for a right common iliac aneurysm. The patient had undergone thoracic endovascular aortic repair. The left subclavian artery was occluded, but the left internal iliac artery was preserved. The patient fully recovered from the paralysis within 3 months. This case illustrates the importance of collateral blood supply to the spinal cord from the lumbosacral region, especially when other sources are occluded.
      PubDate: 2017-05-12
      DOI: 10.1093/icvts/ivx121
      Issue No: Vol. 25, No. 5 (2017)
       
  • Pulmonary venoplasty with a pericardial conduit in living-donor lobar lung
           retransplantation
    • Authors: Kayawake H; Chen-Yoshikawa TF, Motoyama H, et al.
      Pages: 830 - 831
      Abstract: In living-donor lobar lung transplantation, donor lobectomies must be performed carefully for both donors and recipients. Furthermore, the recipients undergo pneumonectomies rather than lobectomies. Occasionally, anastomosis of the pulmonary vessels is difficult in living-donor lobar lung transplantation because of the limited length of the pulmonary vessels in the graft. This report describes a successful case of pulmonary venoplasty using an autologous pericardial conduit, which was interposed between the superior pulmonary vein of the recipient and the inferior pulmonary vein of the donor in living-donor lobar lung retransplantation. This technique may be required for the success of living-donor lobar lung retransplantation.
      PubDate: 2017-05-12
      DOI: 10.1093/icvts/ivx122
      Issue No: Vol. 25, No. 5 (2017)
       
  • Epicardial cardioverter–defibrillator implantation in a 4-month-old
           infant bridged to heart transplantation
    • Authors: Carro C; Cereda A, Annoni G, et al.
      Pages: 832 - 833
      Abstract: Implantable cardioverter–defibrillator (ICD) is the gold standard therapy for the prevention of sudden cardiac death. Nevertheless, ICD placement in the paediatric population is still limited because of several technical difficulties. Several implantation techniques have been proposed but experience in infants with very low weight and less than 6 months is very limited. We herein describe a case of a minimally invasive ICD epicardial implantation in a 4-month-old infant weighing 5 kg. A diagnosis of arrhythmic cardiomyopathy with left ventricular non-compaction disease with ventricular tachycardia storms, QT prolongation and Wolff–Parkinson–White pattern was made. Antiarrhythmic drugs, radiofrequency ablation and sympathetic denervation were not effective. ICD implantation was successful allowing the infant to survive and bridging to heart transplantation.
      PubDate: 2017-05-16
      DOI: 10.1093/icvts/ivx129
      Issue No: Vol. 25, No. 5 (2017)
       
  • Subxiphoid approach for extracting a giant solitary fibrous tumour of the
           pleura
    • Authors: Hatooka S; Shigematsu Y, Nakanishi M, et al.
      Pages: 834 - 835
      Abstract: We describe a case of resection of a solitary fibrous tumour of the pleura using video-assisted thoracic surgery and removal of the giant tumour using a subxiphoid incision without the need for minithoracotomy. Use of the subxiphoid approach as a retrieval port is simple and feasible.
      PubDate: 2017-05-16
      DOI: 10.1093/icvts/ivx134
      Issue No: Vol. 25, No. 5 (2017)
       
  • Carbon dioxide insufflation and thoracoscopic ultrasonography image of
           pure ground-glass nodule
    • Authors: Uehara H; Yasuda A, Kondo H, et al.
      Pages: 836 - 838
      Abstract: Thoracic surgeons frequently encounter early lung cancer showing a pure ground-glass nodule. Although thoracoscopic wedge resection is used extensively, it cannot be easily located for surgical procedures. Thoracoscopic ultrasonography is a real-time and less invasive technique for small lung lesion localization during thoracoscopic surgery. However, this technique has not been widely adopted because residual air in the lung results in poor ultrasound images. A 64-year-old woman was found to have pure ground-glass nodule. For intraoperative localization, we performed thoracoscopic ultrasonography. To deflate the lung, we insufflated carbon dioxide into the thoracic cavity and maintained an intrathoracic pressure of 10 mmHg for 5 min. We easily achieved complete lung collapse without any complications; pure ground-glass nodule clearly showed as a hyperechoic lesion. We performed thoracoscopic wedge resection with a pathological diagnosis of adenocarcinoma in situ. Carbon dioxide insufflation into the thoracic cavity may be effective for complete lung deflation, which is useful to detect small lung nodules.
      PubDate: 2017-05-29
      DOI: 10.1093/icvts/ivx138
      Issue No: Vol. 25, No. 5 (2017)
       
  • Transcatheter aortic valve implantation for recurrent Valsalva sinus
           re-dissection and severe aortic regurgitation shortly after surgery for
           type-A aortic dissection
    • Authors: Caporali E; Pedrazzini G, Demertzis S, et al.
      Pages: 839 - 841
      Abstract: Delayed aortic regurgitation following Valsalva sinus re-dissection is a well-known complication that can occur at any time after surgery for type-A aortic dissection without root replacement. We describe a case of acute type-A dissection in an 81-year-old lady successfully treated with aortic valve resuspension and ascending aorta replacement with a 28-mm vascular graft. A month later, the patient was readmitted for worsening heart failure and a transthoracic echocardiogram showed severe aortic regurgitation secondary to non-coronary Valsalva sinus re-dissection and non-coronary aortic valve leaflet prolapse also confirmed at computed tomography scan. The patient successfully underwent a transfemoral transcatheter aortic valve implantation with a 29-mm CoreValve Evolut R and concomitant planned extracorporeal membrane oxygenation support.
      PubDate: 2017-05-23
      DOI: 10.1093/icvts/ivx145
      Issue No: Vol. 25, No. 5 (2017)
       
  • A novel method of open reduction and internal fixation of a displaced
           manubrial fracture using distal clavicle locking plates
    • Authors: Miller D; Akhtar M, Fergusson J, et al.
      Pages: 842 - 843
      Abstract: A 52-year-old man sustained a sternal fracture after a blunt traumatic chest injury. He was in severe pain in the intensive care unit, which resulted in difficulty breathing and increased analgesic requirement, and a decision was made to stabilize his manubrial fracture. Orthopaedic and thoracic surgeons jointly performed open reduction and internal fixation of the displaced manubrial fracture using 2 distal clavicle locking plates. This resulted in improvement in patient’s pain and helped with his subsequent recovery and discharge from the hospital. This case report describes a new, safe and effective method of treating this uncommon injury.
      PubDate: 2017-06-20
      DOI: 10.1093/icvts/ivx185
      Issue No: Vol. 25, No. 5 (2017)
       
  • Effect of lifelong antibiotic treatment for aortic arch prosthesis
           infection
    • Authors: Rupprecht L; Grosse J, Hellwig D, et al.
      Pages: 844 - 845
      Abstract: A patient who underwent multiple aortic operations suffered persistent infection of the ascending aorta and arch prosthesis and was finally treated with lifelong antibiotics. An 8-year follow-up with positron emission computed tomography is reported.
      PubDate: 2017-06-20
      DOI: 10.1093/icvts/ivx190
      Issue No: Vol. 25, No. 5 (2017)
       
  • Surgical treatment of an extracranial carotid artery aneurysm in a child
           by an arterial autograft
    • Authors: Gaudry M; Al Farai A, Fouilloux V, et al.
      Pages: 846 - 847
      Abstract: We report a symptomatic aneurysm of the left common carotid artery (LCCA) in a 6-year-old boy. The patient had been diagnosed and treated 3 years earlier for an isolation of the LCCA with a right-sided aortic arch. At the age of 3 years, the LCCA was reimplanted in the ascending aorta. Three years later, the patient developed a voluminous aneurysm of the LCCA complicated by stroke. An arterial graft was used for the carotid reconstruction with good long-term patency and no aneurysm evolution.
      PubDate: 2017-07-04
      DOI: 10.1093/icvts/ivx199
      Issue No: Vol. 25, No. 5 (2017)
       
  • Video-assisted thoracoscopic surgery approach for transmyocardial laser
           revascularization
    • Authors: Bashir MA; Lyle BC, Nasr AS, et al.
      Pages: 848 - 849
      Abstract: Transmyocardial laser revascularization is an established therapy for refractory coronary artery disease. However, utilization of the technology is not as widespread as expected. This is despite the fact that the efficacy of the technology has been established in multiple prospective randomized trials. Furthermore, only about 5% of transmyocardial laser revascularization cases annually are performed in a minimally invasive fashion. We report a case of a female patient treated in a minimally invasive thoracoscopic fashion.
      PubDate: 2017-05-26
      DOI: 10.1093/icvts/ivx146
      Issue No: Vol. 25, No. 5 (2017)
       
  • Spotlight on recently published EJCTS articles
    • Pages: 850 - 850
      PubDate: 2017-10-18
      DOI: 10.1093/icvts/ivx341
      Issue No: Vol. 25, No. 5 (2017)
       
 
 
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