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Publisher: Oxford University Press   (Total: 406 journals)

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Showing 1 - 200 of 406 Journals sorted alphabetically
ACS Symposium Series     Full-text available via subscription   (SJR: 0.189, CiteScore: 0)
Acta Biochimica et Biophysica Sinica     Hybrid Journal   (Followers: 5, SJR: 0.79, CiteScore: 2)
Adaptation     Hybrid Journal   (Followers: 9, SJR: 0.143, CiteScore: 0)
Advances in Nutrition     Hybrid Journal   (Followers: 53, SJR: 2.196, CiteScore: 5)
Aesthetic Surgery J.     Hybrid Journal   (Followers: 6, SJR: 1.434, CiteScore: 1)
Aesthetic Surgery J. Open Forum     Open Access  
African Affairs     Hybrid Journal   (Followers: 66, SJR: 1.869, CiteScore: 2)
Age and Ageing     Hybrid Journal   (Followers: 90, SJR: 1.989, CiteScore: 4)
Alcohol and Alcoholism     Hybrid Journal   (Followers: 19, SJR: 1.376, CiteScore: 3)
American Entomologist     Full-text available via subscription   (Followers: 8)
American Historical Review     Hybrid Journal   (Followers: 169, SJR: 0.467, CiteScore: 1)
American J. of Agricultural Economics     Hybrid Journal   (Followers: 44, SJR: 2.113, CiteScore: 3)
American J. of Clinical Nutrition     Hybrid Journal   (Followers: 178, SJR: 3.438, CiteScore: 6)
American J. of Epidemiology     Hybrid Journal   (Followers: 197, SJR: 2.713, CiteScore: 3)
American J. of Health-System Pharmacy     Full-text available via subscription   (Followers: 52, SJR: 0.595, CiteScore: 1)
American J. of Hypertension     Hybrid Journal   (Followers: 25, SJR: 1.322, CiteScore: 3)
American J. of Jurisprudence     Hybrid Journal   (Followers: 19, SJR: 0.281, CiteScore: 1)
American J. of Legal History     Full-text available via subscription   (Followers: 9, SJR: 0.116, CiteScore: 0)
American Law and Economics Review     Hybrid Journal   (Followers: 27, SJR: 1.053, CiteScore: 1)
American Literary History     Hybrid Journal   (Followers: 16, SJR: 0.391, CiteScore: 0)
Analysis     Hybrid Journal   (Followers: 22, SJR: 1.038, CiteScore: 1)
Animal Frontiers     Hybrid Journal   (Followers: 1)
Annals of Behavioral Medicine     Hybrid Journal   (Followers: 16, SJR: 1.423, CiteScore: 3)
Annals of Botany     Hybrid Journal   (Followers: 38, SJR: 1.721, CiteScore: 4)
Annals of Oncology     Hybrid Journal   (Followers: 56, SJR: 5.599, CiteScore: 9)
Annals of the Entomological Society of America     Full-text available via subscription   (Followers: 10, SJR: 0.722, CiteScore: 1)
Annals of Work Exposures and Health     Hybrid Journal   (Followers: 34, SJR: 0.728, CiteScore: 2)
Antibody Therapeutics     Open Access  
AoB Plants     Open Access   (Followers: 4, SJR: 1.28, CiteScore: 3)
Applied Economic Perspectives and Policy     Hybrid Journal   (Followers: 17, SJR: 0.858, CiteScore: 2)
Applied Linguistics     Hybrid Journal   (Followers: 59, SJR: 2.987, CiteScore: 3)
Applied Mathematics Research eXpress     Hybrid Journal   (Followers: 1, SJR: 1.241, CiteScore: 1)
Arbitration Intl.     Full-text available via subscription   (Followers: 21)
Arbitration Law Reports and Review     Hybrid Journal   (Followers: 14)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 30, SJR: 0.731, CiteScore: 2)
Aristotelian Society Supplementary Volume     Hybrid Journal   (Followers: 3)
Arthropod Management Tests     Hybrid Journal   (Followers: 2)
Astronomy & Geophysics     Hybrid Journal   (Followers: 44, SJR: 0.146, CiteScore: 0)
Behavioral Ecology     Hybrid Journal   (Followers: 52, SJR: 1.871, CiteScore: 3)
Bioinformatics     Hybrid Journal   (Followers: 338, SJR: 6.14, CiteScore: 8)
Biology Methods and Protocols     Hybrid Journal  
Biology of Reproduction     Full-text available via subscription   (Followers: 9, SJR: 1.446, CiteScore: 3)
Biometrika     Hybrid Journal   (Followers: 20, SJR: 3.485, CiteScore: 2)
BioScience     Hybrid Journal   (Followers: 29, SJR: 2.754, CiteScore: 4)
Bioscience Horizons : The National Undergraduate Research J.     Open Access   (Followers: 1, SJR: 0.146, CiteScore: 0)
Biostatistics     Hybrid Journal   (Followers: 17, SJR: 1.553, CiteScore: 2)
BJA : British J. of Anaesthesia     Hybrid Journal   (Followers: 185, SJR: 2.115, CiteScore: 3)
BJA Education     Hybrid Journal   (Followers: 65)
Brain     Hybrid Journal   (Followers: 68, SJR: 5.858, CiteScore: 7)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 50, SJR: 2.505, CiteScore: 5)
Briefings in Functional Genomics     Hybrid Journal   (Followers: 3, SJR: 2.15, CiteScore: 3)
British J. for the Philosophy of Science     Hybrid Journal   (Followers: 36, SJR: 2.161, CiteScore: 2)
British J. of Aesthetics     Hybrid Journal   (Followers: 25, SJR: 0.508, CiteScore: 1)
British J. of Criminology     Hybrid Journal   (Followers: 604, SJR: 1.828, CiteScore: 3)
British J. of Social Work     Hybrid Journal   (Followers: 86, SJR: 1.019, CiteScore: 2)
British Medical Bulletin     Hybrid Journal   (Followers: 6, SJR: 1.355, CiteScore: 3)
British Yearbook of Intl. Law     Hybrid Journal   (Followers: 34)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 4, SJR: 1.376, CiteScore: 1)
Cambridge J. of Economics     Hybrid Journal   (Followers: 70, SJR: 0.764, CiteScore: 2)
Cambridge J. of Regions, Economy and Society     Hybrid Journal   (Followers: 12, SJR: 2.438, CiteScore: 4)
Cambridge Quarterly     Hybrid Journal   (Followers: 10, SJR: 0.104, CiteScore: 0)
Capital Markets Law J.     Hybrid Journal   (Followers: 2, SJR: 0.222, CiteScore: 0)
Carcinogenesis     Hybrid Journal   (Followers: 2, SJR: 2.135, CiteScore: 5)
Cardiovascular Research     Hybrid Journal   (Followers: 14, SJR: 3.002, CiteScore: 5)
Cerebral Cortex     Hybrid Journal   (Followers: 48, SJR: 3.892, CiteScore: 6)
CESifo Economic Studies     Hybrid Journal   (Followers: 22, SJR: 0.483, CiteScore: 1)
Chemical Senses     Hybrid Journal   (Followers: 1, SJR: 1.42, CiteScore: 3)
Children and Schools     Hybrid Journal   (Followers: 6, SJR: 0.246, CiteScore: 0)
Chinese J. of Comparative Law     Hybrid Journal   (Followers: 5, SJR: 0.412, CiteScore: 0)
Chinese J. of Intl. Law     Hybrid Journal   (Followers: 22, SJR: 0.329, CiteScore: 0)
Chinese J. of Intl. Politics     Hybrid Journal   (Followers: 10, SJR: 1.392, CiteScore: 2)
Christian Bioethics: Non-Ecumenical Studies in Medical Morality     Hybrid Journal   (Followers: 10, SJR: 0.183, CiteScore: 0)
Classical Receptions J.     Hybrid Journal   (Followers: 27, SJR: 0.123, CiteScore: 0)
Clean Energy     Open Access   (Followers: 1)
Clinical Infectious Diseases     Hybrid Journal   (Followers: 69, SJR: 5.051, CiteScore: 5)
Communication Theory     Hybrid Journal   (Followers: 24, SJR: 2.424, CiteScore: 3)
Communication, Culture & Critique     Hybrid Journal   (Followers: 27, SJR: 0.222, CiteScore: 1)
Community Development J.     Hybrid Journal   (Followers: 27, SJR: 0.268, CiteScore: 1)
Computer J.     Hybrid Journal   (Followers: 9, SJR: 0.319, CiteScore: 1)
Conservation Physiology     Open Access   (Followers: 3, SJR: 1.818, CiteScore: 3)
Contemporary Women's Writing     Hybrid Journal   (Followers: 9, SJR: 0.121, CiteScore: 0)
Contributions to Political Economy     Hybrid Journal   (Followers: 6, SJR: 0.906, CiteScore: 1)
Critical Values     Full-text available via subscription  
Current Developments in Nutrition     Open Access   (Followers: 2)
Current Legal Problems     Hybrid Journal   (Followers: 29)
Current Zoology     Full-text available via subscription   (Followers: 3, SJR: 1.164, CiteScore: 2)
Database : The J. of Biological Databases and Curation     Open Access   (Followers: 9, SJR: 1.791, CiteScore: 3)
Digital Scholarship in the Humanities     Hybrid Journal   (Followers: 14, SJR: 0.259, CiteScore: 1)
Diplomatic History     Hybrid Journal   (Followers: 21, SJR: 0.45, CiteScore: 1)
DNA Research     Open Access   (Followers: 5, SJR: 2.866, CiteScore: 6)
Dynamics and Statistics of the Climate System     Open Access   (Followers: 4)
Early Music     Hybrid Journal   (Followers: 17, SJR: 0.139, CiteScore: 0)
Econometrics J.     Hybrid Journal   (Followers: 32, SJR: 2.926, CiteScore: 1)
Economic J.     Hybrid Journal   (Followers: 113, SJR: 5.161, CiteScore: 3)
Economic Policy     Hybrid Journal   (Followers: 46, SJR: 3.584, CiteScore: 3)
ELT J.     Hybrid Journal   (Followers: 24, SJR: 0.942, CiteScore: 1)
English Historical Review     Hybrid Journal   (Followers: 56, SJR: 0.612, CiteScore: 1)
English: J. of the English Association     Hybrid Journal   (Followers: 17, SJR: 0.1, CiteScore: 0)
Environmental Entomology     Full-text available via subscription   (Followers: 11, SJR: 0.818, CiteScore: 2)
Environmental Epigenetics     Open Access   (Followers: 2)
Environmental History     Hybrid Journal   (Followers: 26, SJR: 0.408, CiteScore: 1)
EP-Europace     Hybrid Journal   (Followers: 3, SJR: 2.748, CiteScore: 4)
Epidemiologic Reviews     Hybrid Journal   (Followers: 9, SJR: 4.505, CiteScore: 8)
ESHRE Monographs     Hybrid Journal  
Essays in Criticism     Hybrid Journal   (Followers: 19, SJR: 0.113, CiteScore: 0)
European Heart J.     Hybrid Journal   (Followers: 66, SJR: 9.315, CiteScore: 9)
European Heart J. - Cardiovascular Imaging     Hybrid Journal   (Followers: 10, SJR: 3.625, CiteScore: 3)
European Heart J. - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 2)
European Heart J. - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart J. : Case Reports     Open Access  
European Heart J. Supplements     Hybrid Journal   (Followers: 8, SJR: 0.223, CiteScore: 0)
European J. of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9, SJR: 1.681, CiteScore: 2)
European J. of Intl. Law     Hybrid Journal   (Followers: 200, SJR: 0.694, CiteScore: 1)
European J. of Orthodontics     Hybrid Journal   (Followers: 5, SJR: 1.279, CiteScore: 2)
European J. of Public Health     Hybrid Journal   (Followers: 20, SJR: 1.36, CiteScore: 2)
European Review of Agricultural Economics     Hybrid Journal   (Followers: 10, SJR: 1.172, CiteScore: 2)
European Review of Economic History     Hybrid Journal   (Followers: 30, SJR: 0.702, CiteScore: 1)
European Sociological Review     Hybrid Journal   (Followers: 43, SJR: 2.728, CiteScore: 3)
Evolution, Medicine, and Public Health     Open Access   (Followers: 12)
Family Practice     Hybrid Journal   (Followers: 16, SJR: 1.018, CiteScore: 2)
Fems Microbiology Ecology     Hybrid Journal   (Followers: 16, SJR: 1.492, CiteScore: 4)
Fems Microbiology Letters     Hybrid Journal   (Followers: 28, SJR: 0.79, CiteScore: 2)
Fems Microbiology Reviews     Hybrid Journal   (Followers: 32, SJR: 7.063, CiteScore: 13)
Fems Yeast Research     Hybrid Journal   (Followers: 13, SJR: 1.308, CiteScore: 3)
Food Quality and Safety     Open Access   (Followers: 1)
Foreign Policy Analysis     Hybrid Journal   (Followers: 24, SJR: 1.425, CiteScore: 1)
Forest Science     Hybrid Journal   (Followers: 8, SJR: 0.89, CiteScore: 2)
Forestry: An Intl. J. of Forest Research     Hybrid Journal   (Followers: 16, SJR: 1.133, CiteScore: 3)
Forum for Modern Language Studies     Hybrid Journal   (Followers: 6, SJR: 0.104, CiteScore: 0)
French History     Hybrid Journal   (Followers: 33, SJR: 0.118, CiteScore: 0)
French Studies     Hybrid Journal   (Followers: 21, SJR: 0.148, CiteScore: 0)
French Studies Bulletin     Hybrid Journal   (Followers: 10, SJR: 0.152, CiteScore: 0)
Gastroenterology Report     Open Access   (Followers: 2)
Genome Biology and Evolution     Open Access   (Followers: 16, SJR: 2.578, CiteScore: 4)
Geophysical J. Intl.     Hybrid Journal   (Followers: 39, SJR: 1.506, CiteScore: 3)
German History     Hybrid Journal   (Followers: 23, SJR: 0.161, CiteScore: 0)
GigaScience     Open Access   (Followers: 5, SJR: 5.022, CiteScore: 7)
Global Summitry     Hybrid Journal   (Followers: 1)
Glycobiology     Hybrid Journal   (Followers: 13, SJR: 1.493, CiteScore: 3)
Health and Social Work     Hybrid Journal   (Followers: 57, SJR: 0.388, CiteScore: 1)
Health Education Research     Hybrid Journal   (Followers: 16, SJR: 0.854, CiteScore: 2)
Health Policy and Planning     Hybrid Journal   (Followers: 24, SJR: 1.512, CiteScore: 2)
Health Promotion Intl.     Hybrid Journal   (Followers: 22, SJR: 0.812, CiteScore: 2)
History Workshop J.     Hybrid Journal   (Followers: 33, SJR: 1.278, CiteScore: 1)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 28, SJR: 0.105, CiteScore: 0)
Human Communication Research     Hybrid Journal   (Followers: 15, SJR: 2.146, CiteScore: 3)
Human Molecular Genetics     Hybrid Journal   (Followers: 9, SJR: 3.555, CiteScore: 5)
Human Reproduction     Hybrid Journal   (Followers: 72, SJR: 2.643, CiteScore: 5)
Human Reproduction Open     Open Access   (Followers: 1)
Human Reproduction Update     Hybrid Journal   (Followers: 20, SJR: 5.317, CiteScore: 10)
Human Rights Law Review     Hybrid Journal   (Followers: 62, SJR: 0.756, CiteScore: 1)
ICES J. of Marine Science: J. du Conseil     Hybrid Journal   (Followers: 58, SJR: 1.591, CiteScore: 3)
ICSID Review : Foreign Investment Law J.     Hybrid Journal   (Followers: 10)
ILAR J.     Hybrid Journal   (Followers: 2, SJR: 1.732, CiteScore: 4)
IMA J. of Applied Mathematics     Hybrid Journal   (SJR: 0.679, CiteScore: 1)
IMA J. of Management Mathematics     Hybrid Journal   (SJR: 0.538, CiteScore: 1)
IMA J. of Mathematical Control and Information     Hybrid Journal   (Followers: 2, SJR: 0.496, CiteScore: 1)
IMA J. of Numerical Analysis - advance access     Hybrid Journal   (SJR: 1.987, CiteScore: 2)
Industrial and Corporate Change     Hybrid Journal   (Followers: 9, SJR: 1.792, CiteScore: 2)
Industrial Law J.     Hybrid Journal   (Followers: 39, SJR: 0.249, CiteScore: 1)
Inflammatory Bowel Diseases     Hybrid Journal   (Followers: 47, SJR: 2.511, CiteScore: 4)
Information and Inference     Free  
Innovation in Aging     Open Access  
Integrative and Comparative Biology     Hybrid Journal   (Followers: 9, SJR: 1.319, CiteScore: 2)
Integrative Biology     Full-text available via subscription   (Followers: 6, SJR: 1.36, CiteScore: 3)
Integrative Organismal Biology     Open Access  
Interacting with Computers     Hybrid Journal   (Followers: 11, SJR: 0.292, CiteScore: 1)
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7, SJR: 0.762, CiteScore: 1)
Intl. Affairs     Hybrid Journal   (Followers: 66, SJR: 1.505, CiteScore: 3)
Intl. Data Privacy Law     Hybrid Journal   (Followers: 26)
Intl. Health     Hybrid Journal   (Followers: 6, SJR: 0.851, CiteScore: 2)
Intl. Immunology     Hybrid Journal   (Followers: 3, SJR: 2.167, CiteScore: 4)
Intl. J. for Quality in Health Care     Hybrid Journal   (Followers: 36, SJR: 1.348, CiteScore: 2)
Intl. J. of Constitutional Law     Hybrid Journal   (Followers: 64, SJR: 0.601, CiteScore: 1)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 245, SJR: 3.969, CiteScore: 5)
Intl. J. of Law and Information Technology     Hybrid Journal   (Followers: 5, SJR: 0.202, CiteScore: 1)
Intl. J. of Law, Policy and the Family     Hybrid Journal   (Followers: 28, SJR: 0.223, CiteScore: 1)
Intl. J. of Lexicography     Hybrid Journal   (Followers: 10, SJR: 0.285, CiteScore: 1)
Intl. J. of Low-Carbon Technologies     Open Access   (Followers: 1, SJR: 0.403, CiteScore: 1)
Intl. J. of Neuropsychopharmacology     Open Access   (Followers: 3, SJR: 1.808, CiteScore: 4)
Intl. J. of Public Opinion Research     Hybrid Journal   (Followers: 11, SJR: 1.545, CiteScore: 1)
Intl. J. of Refugee Law     Hybrid Journal   (Followers: 38, SJR: 0.389, CiteScore: 1)
Intl. J. of Transitional Justice     Hybrid Journal   (Followers: 11, SJR: 0.724, CiteScore: 2)
Intl. Mathematics Research Notices     Hybrid Journal   (Followers: 1, SJR: 2.168, CiteScore: 1)
Intl. Political Sociology     Hybrid Journal   (Followers: 40, SJR: 1.465, CiteScore: 3)
Intl. Relations of the Asia-Pacific     Hybrid Journal   (Followers: 23, SJR: 0.401, CiteScore: 1)
Intl. Studies Perspectives     Hybrid Journal   (Followers: 9, SJR: 0.983, CiteScore: 1)
Intl. Studies Quarterly     Hybrid Journal   (Followers: 49, SJR: 2.581, CiteScore: 2)
Intl. Studies Review     Hybrid Journal   (Followers: 25, SJR: 1.201, CiteScore: 1)
ISLE: Interdisciplinary Studies in Literature and Environment     Hybrid Journal   (Followers: 2, SJR: 0.15, CiteScore: 0)
ITNOW     Hybrid Journal   (Followers: 1, SJR: 0.103, CiteScore: 0)
J. of African Economies     Hybrid Journal   (Followers: 17, SJR: 0.533, CiteScore: 1)
J. of American History     Hybrid Journal   (Followers: 46, SJR: 0.297, CiteScore: 1)
J. of Analytical Toxicology     Hybrid Journal   (Followers: 14, SJR: 1.065, CiteScore: 2)
J. of Antimicrobial Chemotherapy     Hybrid Journal   (Followers: 15, SJR: 2.419, CiteScore: 4)
J. of Antitrust Enforcement     Hybrid Journal   (Followers: 1)
J. of Applied Poultry Research     Hybrid Journal   (Followers: 5, SJR: 0.585, CiteScore: 1)
J. of Biochemistry     Hybrid Journal   (Followers: 41, SJR: 1.226, CiteScore: 2)
J. of Breast Imaging     Full-text available via subscription  
J. of Burn Care & Research     Hybrid Journal   (Followers: 10, SJR: 0.768, CiteScore: 2)

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Similar Journals
Journal Cover
Interactive CardioVascular and Thoracic Surgery
Journal Prestige (SJR): 0.762
Citation Impact (citeScore): 1
Number of Followers: 7  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1569-9293 - ISSN (Online) 1569-9285
Published by Oxford University Press Homepage  [406 journals]
  • Interactive CardioVascular and Thoracic Surgery – 2018 Reviewers
    • Pages: 659 - 664
      Abstract: On behalf of EACTS and the EBCP, the Editor-in-Chief wishes to thank the following colleagues who have voluntarily given their valued time and effort to reviewing papers for ICVTS in 2018.
      PubDate: Mon, 25 Mar 2019 00:00:00 GMT
      DOI: 10.1093/icvts/ivz078
      Issue No: Vol. 28, No. 4 (2019)
       
  • Durability of pulmonary homografts for reconstruction of the right
           ventricular outflow tract: how relevant are donor-related factors'
    • Authors: Dekens E; Van Damme E, Jashari R, et al.
      Pages: 503 - 509
      Abstract: OBJECTIVESOur goal was to evaluate the influence of donor-related factors on the durability of pulmonary homografts (PHGs) for right ventricular outflow tract reconstruction of congenital heart defects.METHODSBetween 1990 and 2016, 223 PHGs were used in 197 patients for right ventricular outflow tract reconstruction. Long-term durability was investigated in relation to patient- and disease-specific as well as to donor-related factors, based on the PHG replacement rate. To minimize the effect of outgrowth, a subgroup analysis was performed on patients with PHG size >22 mm, as the discriminant cut-off identified by the classification tree method.RESULTSDuring a median follow-up of 8.5 years [interquartile range (IQR) 12.3], 47 (21%) PHGs were explanted within a mean interval of 9.5 ± 5.3 years, resulting in a freedom from PHG replacement of 82 ± 6% at 10 years. The risk factors for PHG explantation determined by univariable analysis were predominantly patient-related, including younger age (P = 0.003), extra-anatomic implantation (P = 0.006), bicuspidalization (P = 0.002) and younger donor age (P = 0.032). PHG size [hazard ratio (HR) 0.80, 95% confidence interval 0.73–0.88; P < 0.001] was the only independent determinant in multivariable analysis. The subgroup analysis comprised 119 PHG >22 mm, implanted at a median age of 15 years (IQR 7). A significant beneficial effect of ABO matching on the explantation rate was only identified with univariable analysis (HR 0.24, 95% confidence interval 0.12–4.68; P = 0.010).CONCLUSIONSCryopreserved PHGs provide a durable substitute for right ventricular outflow tract reconstruction in congenital heart disease. PHG size at the time of implantation remains the principal determinant of PHG explantation during late follow-up. However, once an adult-sized homograft is required, matching for ABO blood group compatibility between host and donor might help to improve homograft durability.
      PubDate: Fri, 23 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy316
      Issue No: Vol. 28, No. 4 (2018)
       
  • Fluid accumulation in the staged Fontan procedure: the impact of colloid
           osmotic pressures
    • Authors: Indrebø M; Berg A, Holmstrøm H, et al.
      Pages: 510 - 517
      Abstract: OBJECTIVESDespite Fontan surgery showing improved results, fluid accumulation and oedema formation with pleural effusion are major challenges. Transcapillary fluid balance is dependent on hydrostatic and colloid osmotic pressure (COP) gradients; however, the COP values are not known for Fontan patients. The aim of this study was to evaluate the COP of plasma (COPp) and interstitial fluid (COPi) in children undergoing bidirectional cavopulmonary connection and total cavopulmonary connection.METHODSThis study was designed as a prospective, observational study. Thirty-nine children (age 3 months–4.9 years) undergoing either bidirectional cavopulmonary connection or total cavopulmonary connection procedures were included. Blood samples and interstitial fluid were obtained prior to, during and after the preoperative cardiac catheterization and surgery with the use of cardiopulmonary bypass (CPB). Interstitial fluid was harvested using the wick method when the patient was under general anaesthesia. Plasma and interstitial fluid were measured by a colloid osmometer. Baseline values were compared with data from healthy controls.RESULTSBaseline COPp was 20.6 ± 2.8 and 22.0 ± 3.2 mmHg and COPi was 11.3 ± 2.6 and 12.5 ± 3.5 mmHg in the bidirectional cavopulmonary connection group and the total cavopulmonary connection group, respectively. These values were significantly lower than in healthy controls. The COPp was slightly reduced throughout both procedures and normalized after surgery. The COPi increased slightly during the use of CPB and significantly decreased after surgery, resulting in an increased COP gradient and was correlated to pleural effusion.CONCLUSIONSFluid accumulation seen after Fontan surgery is associated with changes in COPs, determinants for fluid filtration and lymphatic flow.ClinicalTrials.gov IdentifierNCT 02306057: https://clinicaltrials.gov/ct2/results'cond=&term=NCT+02306057.
      PubDate: Fri, 26 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy298
      Issue No: Vol. 28, No. 4 (2018)
       
  • Siewert type I and II oesophageal adenocarcinoma: sensitivity/specificity
           of computed tomography, positron emission tomography and endoscopic
           ultrasound for assessment of lymph node metastases in groups of thoracic
           and abdominal lymph node stations
    • Authors: Lopci E; Kauppi J, Lugaresi M, et al.
      Pages: 518 - 525
      Abstract: OBJECTIVESIn Siewert type I/II oesophageal adenocarcinoma, the sensitivity and specificity of computed tomography (CT), positron emission tomography (PET)-CT and endoscopic ultrasound (EUS) for assessment of the N descriptor in defined groups of lymph nodes were investigated.METHODSCT, PET/CT, EUS images and the pathological data of 101 oesophageal adenocarcinomas submitted to primary resection were compared. The lymph nodes were identified as (a) right paratracheal/subcarinal/pulmonary ligament; (b) paraoesophageal; (c) paracardial; (d) left gastric artery, lesser curvature; (e) coeliac trunk, hepatic/splenic artery.RESULTSOf the 2451 lymph nodes identified, 273 (11.1%) were histologically positive. Overall sensitivity, specificity and negative and positive predictive value for detection of lymph nodes metastatic were respectively: CT sensitivity 39%, specificity 86%, negative 58% and positive 74% predictive value; PET/CT sensitivity 30%, specificity 98%, negative 58% and positive 93% predictive value; EUS sensitivity 50%, specificity 81%, negative 72% and positive 62% predictive value. The sensitivity of CT, PET/CT and EUS in the thoracic nodal groups (a) and (b) was, respectively, 58.3%, 7.1% and 87.5% and 33.3%, 20% and 80%. Sensitivity was below 47% for all tests in the abdominal nodal groups. In contrast, specificity (88.6–100%) was super imposable in all nodal groups. The strength of agreement among the 3 imaging techniques was poor (kappa < 0.30) for the thoracic anatomical groups of interest: (a) lower paratracheal/subcarinal/pulmonary ligament and (b) paraoesophageal; it was moderate/good (kappa >0.30) for the abdominal N groups of interest: c, d and e.CONCLUSIONSThe diagnostic performance of CT, PET and EUS for assessing the N descriptor in the paracardial and abdominal stations close to the primary tumour is not satisfactory. EUS can efficiently assess the presence/absence of nodal metastases in the thoracic stations.Clinical trial registrationClinicalTrials.gov number: NCT03529968
      PubDate: Tue, 27 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy314
      Issue No: Vol. 28, No. 4 (2018)
       
  • A systematic review and meta-analysis of robotic versus open and
           video-assisted thoracoscopic surgery approaches for lobectomy
    • Authors: O’Sullivan K; Kreaden U, Hebert A, et al.
      Pages: 526 - 534
      Abstract: OBJECTIVESA number of meta-analytical and database studies have sought to compare open, video-assisted thoracoscopic surgery (VATS) and robotic operative approaches to lobectomy, often with conflicting results. Our objective was to perform a comprehensive review of these meta-analytical and database studies published to date.METHODSA systematic review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines using the PubMed and Scopus databases. Primary outcome was short-term mortality, and secondary outcomes were operative time, blood loss or transfusion rate, hospital stay, conversions, lymph node yield and complications. Meta-analyses of the primary and secondary outcomes were performed.RESULTSRobotic lobectomy is a valid alternative to the VATS approach and is superior to the open approach with respect to complications [OR 0.67, 95% CI 0.58–0.76, P  < 0.00001] and duration of hospital stay (WMD −1.4, 95% CI −1.96–0.85, P < 0.00001). It is inferior to both VATS and open with respect to operative duration (robotic vs. VATS; WMD 4.98, 95% CI 2.61–7.36, P < 0.001, robotic vs. open WMD 65.56, 95% CI 53.66–77.46, P < 0.00001). Robotic approach is superior with respect to 30-day mortality compared to VATS (OR 0.61, 95% CI 0.45–0.83, P = 0.001 and open approaches (OR 0.53, 95% CI 0.33–0.85, P = 0.008).CONCLUSIONSThis is the largest published systematic review and meta-analysis to date qualifying the robotic lobectomy as a reasonable alternative to VATS and open surgery. Short-term survival is superior in the robotic cohorts. No definitive conclusions on long-term outcomes can be drawn until a randomized controlled trial comparing approaches is conducted.
      PubDate: Tue, 27 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy315
      Issue No: Vol. 28, No. 4 (2018)
       
  • Aspirin for patients undergoing major lung resections: hazardous or
           harmless'†
    • Authors: Stamenovic D; Schneider T, Messerschmidt A.
      Pages: 535 - 541
      Abstract: OBJECTIVESAcetylsalicylic acid (ASA, aspirin) is a medication widely used for primary and secondary prevention of cardiovascular diseases, which are the leading cause of morbidity and mortality worldwide. Whether aspirin should be continued or paused in the perioperative period remains controversial, especially in thoracic surgical settings.METHODSA single-centred retrospective study comprised 486 patients. Of these, 329 patients did not use aspirin (group ASA-0) and 157 did (group ASA-1) during the perioperative period after anatomical lung resection at our hospital from January 2013 to December 2016. Major outcome measures were the amount of blood loss during the operation and during the first 5 days postoperatively (per Mercuriali’s formula), as well as the amount and proportion of the blood transfusion (packed red cells) received. The need for reoperation due to a postoperative haemothorax and/or bleeding was recorded. The groups were also compared according to their rates of morbidity and mortality. Inferential statistical methods with bootstrap analysis using 1000 samples and the Mersenne Twister, a random number generator, were used.RESULTSThere were no significant differences between the 2 groups in intraoperative bleeding [ASA-0M = 418.69 ml, standard deviation (SD) ± 364.87; ASA-1M = 399.8 ml, SD ± 323.84; P = 0.58] or in total blood loss according to Mercuriali’s formula (ASA-0M = 1111.62 ml, SD ± 816.69; ASA-1M = 1115.08 ml, SD ± 682.12; P = 0.95). A total of 104 patients received transfusions up to postoperative day 5: 71 patients in the ASA-0 group received 151 blood transfusions, whereas 33 patients in the ASA-1 group received 65 blood transfusions (P = 0.66). The indication for reoperation due to bleeding (ASA-1 = 3, ASA-0 = 4; P = 0.69) was similar between the groups. There was a trend towards higher rates of postoperative complications in the ASA-1 group (risk ratio (RR) = 1.28; P = 0.055); neither cardiovascular complications nor deaths were more frequent in either of the 2 groups (P = 0.73).CONCLUSIONSPatients taking aspirin therapy and undergoing anatomical lung resection seem not to be at any disadvantage regarding bleeding. However, a trend towards a higher rate of postoperative complications indicates a basically increased risk for operations due to comorbidities in these patients.
      PubDate: Sat, 20 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy255
      Issue No: Vol. 28, No. 4 (2018)
       
  • Preoperative thoracic muscle area on computed tomography predicts
           long-term survival following pneumonectomy for lung cancer
    • Authors: Troschel F; Kuklinski M, Knoll S, et al.
      Pages: 542 - 549
      Abstract: OBJECTIVESTo assess the prognostic role of thoracic muscle as quantified on preoperative computed tomography (CT) for the estimation of overall survival (OS) following pneumonectomy.METHODSMuscle cross-sectional area (CSA) at the level of the fifth (T5) and eighth (T8) thoracic vertebra was measured on CT scans of consecutive patients with lung cancer prior to pneumonectomy. We stratified patients into high and low muscle groups using the gender-specific median of muscle CSA as separator and estimated associations of muscle CSA and OS using the Kaplan–Meier analysis. Multivariable logistic regression adjusted for body mass index, Charlson comorbidity index (includes age), forced expiratory volume in the first second as a % of predicted, sex, race, smoking status, tumour stage and prior lung cancer treatment was performed.RESULTSA total of 128 patients were included (61.0 ± 10.6 years of age, mean body mass index of 26.9 kg/m2, 55.5% men). The T8 level showed fewer artefacts and strong correlation with the T5 level (Pearson’s rho = 0.904). T8 CSA was therefore used for subsequent analyses. Mean T8 CSA was 118.5 cm2 (median 115.3 cm2) in men and 75.2 cm2 (median 74.0 cm2) in women. During a median follow-up of 23.6 months (interquartile range 39.3), 65 patients (50.8%) died, of whom 41 were in the low muscle group. The Kaplan–Meier analysis showed significantly longer OS in the high muscle group (log-rank P = 0.02). Multivariable analysis showed an independent association of muscle CSA and OS (P = 0.02) with a hazard ratio of 0.80 (confidence interval 0.67–0.98) per 10-cm2 increment.CONCLUSIONSThoracic muscle is independently associated with long-term overall survival following pneumonectomy for lung cancer and may contribute to refined survival estimates in this population.IRB ProtocolProtocol #2017P000650, approved 21 April 2017.
      PubDate: Wed, 10 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy280
      Issue No: Vol. 28, No. 4 (2018)
       
  • Is systematic lymph node dissection mandatory or is sampling adequate in
           patients with stage I non-small-cell lung cancer'
    • Authors: Mitsos S; Panagiotopoulos N, Patrini D, et al.
      Pages: 550 - 554
      Abstract: A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was: Is systematic lymph node dissection (SLND) mandatory or is sampling adequate in stage I non-small-cell lung cancer (NSCLC)' Two hundred and eleven papers were identified, of which 12 papers represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and the results of these papers are tabulated. There are 7 retrospective cohort reviews, 3 meta-analyses and 2 randomized controlled clinical trials (RCTs) to answer the clinical question. Four of the 7 retrospective studies demonstrated that the total number of resected lymph nodes and the number of lymph node stations sampled affected the accuracy of staging in patients with early-stage NSCLC and had an impact on overall survival and disease-free survival. Two RCTs, 1 meta-analysis and 1 cohort study revealed no significant benefit in overall survival and disease-free survival in patients undergoing SLND. One meta-analysis, which contained only 1 RCT, revealed significantly better 3- and 5-year survival with SLND. One further meta-analysis revealed improved survival with SLND in cohort studies but no significant difference in the 4 RCTs included. Two further studies identified specific subgroups of patients in whom LN sampling could be justified and SLND avoided. We conclude that there is no significant difference in the recurrence rate when performing either SLND or LN sampling in patients with stage I NSCLC. While retrospective cohort studies implied survival benefit with SLND, this was not borne out in RCTs and meta-analyses. However, there may be a potential survival benefit for patients who are upstaged by SLND identifying mediastinal nodal involvement.
      PubDate: Tue, 27 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy309
      Issue No: Vol. 28, No. 4 (2018)
       
  • Does the ‘non-intubated’ anaesthetic technique offer any advantage for
           patients undergoing pulmonary lobectomy'
    • Authors: Ali J; Volpi S, Kaul P, et al.
      Pages: 555 - 558
      Abstract: A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was: Do patients undergoing pulmonary lobectomy using the non-intubated anaesthetic technique have superior clinical outcomes' Altogether, 324 papers were found using the reported search, of which 5 represented the best 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. The non-intubated anaesthetic technique can be safely used in patients undergoing video-assisted thoracic surgery lobectomy. Low conversion rates to intubation are reported, and conversion has been safely managed with no associated morbidity or mortality reported. The technique has not been shown to impact on the incidence of postoperative complications. However, studies consistently demonstrate improved postoperative outcomes in terms of recovery from anaesthesia permitting earlier oral intake and mobilization which is associated with a reduced length of hospital stay.
      PubDate: Tue, 27 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy312
      Issue No: Vol. 28, No. 4 (2018)
       
  • Incidental thoracic findings in computed tomography scans before
           transcatheter aortic valve implantation
    • Authors: Markowiak T; Holzamer A, Hilker M, et al.
      Pages: 559 - 565
      Abstract: OBJECTIVESPreoperative computed tomography (CT) scans for transcatheter aortic valve implantation (TAVI) are used routinely. In elderly high-risk patients, incidental radiographic findings are frequently reported. The aim of this study was to investigate the impact of auxiliary findings on the patients’ mid-term survival, which might affect the treatment strategy.METHODSBetween March 2011 and April 2016, all radiological reports of contrast-enhanced CT scans of 976 patients scheduled for TAVI were analysed retrospectively for incidental thoracic findings including solitary pulmonary nodules (SPN) and thoracic lymphadenopathy (LAP). The minimum follow-up period was 1 year after TAVI.RESULTSThe median age of all patients was 79 years; 51.9% (n = 507) were women. Approximately 37% (n = 361) of patients showed 1 of the determined findings. An SPN ≥5 mm was diagnosed in 16.4% (n = 160) of patients. Four of them developed lung cancer and 2 nodules were identified as metastases during follow-up. In addition, 12% (n = 117) of the patients had thoracic LAP. Whereas SPN had no significant effect on the overall survival rate, evidence of LAP turned out to be a statistically significant factor regarding 4-year survival (P = 0.001; hazard ratio 1.66; 95% confidence internal 1.19–2.31).CONCLUSIONSSPN ≥5 mm were detected in 16.4% of patients scheduled for TAVI. Nevertheless, the incidence of lung cancer was low and the effect on survival in this high-risk group of patients was statistically not significant. In contrast, thoracic LAP had a significant negative effect on survival. It needs to be proven if the outcome of this cohort can be enhanced by further diagnostics and therapy.
      PubDate: Tue, 30 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy299
      Issue No: Vol. 28, No. 4 (2018)
       
  • Randomized evaluation of fibrinogen versus placebo in complex
           cardiovascular surgery: post hoc analysis and interpretation of phase III
           results
    • Authors: Rahe-Meyer N; Levy J, Mazer C, et al.
      Pages: 566 - 574
      Abstract: OBJECTIVESIn a multicentre, randomized-controlled, phase III trial in complex cardiovascular surgery (Randomized Evaluation of Fibrinogen vs Placebo in Complex Cardiovascular Surgery: REPLACE), single-dose human fibrinogen concentrate (FCH) was associated with the transfusion of increased allogeneic blood products (ABPs) versus placebo. Post hoc analyses were performed to identify possible reasons for this result.METHODSWe stratified REPLACE results by adherence to the transfusion algorithm, pretreatment fibrinogen level (≤2 g/l vs >2 g/l) and whether patients were among the first 3 treated at their centre.RESULTSPatients whose treatment was adherent with the transfusion algorithm [FCH, n = 47 (60.3%); placebo, n = 57 (77.0%); P = 0.036] received smaller quantities of ABPs than those with non-adherent treatment (P < 0.001). Among treatment-adherent patients with pretreatment plasma fibrinogen ≤2 g/l, greater reduction in 5-min bleeding mass was seen with FCH versus placebo (median −22.5 g vs −15.5 g; P = 0.071). Considering patients with the above conditions and not among the first 3 treated at their centre (FCH, n = 15; placebo, n = 22), FCH was associated with trends towards reduced transfusion of ABPs (median 2.0 vs 4.0 units; P = 0.573) and greater reduction in 5-min bleeding mass (median −21.0 g vs −9.5 g; P = 0.173). Differences from a preceding single-centre phase II study with positive outcomes included more patients with pretreatment fibrinogen >2 g/l and fewer patients undergoing thoracoabdominal aortic aneurysm repair.CONCLUSIONSNone of the patient stratifications provided a clear explanation for the lack of efficacy seen for FCH in the REPLACE trial versus the positive phase II outcomes. However, together, the 3 factors demonstrated trends favouring FCH. Less familiarity with the protocol and procedures and unavoidable differences in the study populations may explain the differences seen between the phase II study and REPLACE.Clinical trial registrationNCT01475669 https://clinicaltrials.gov/ct2/show/NCT01475669; EudraCT trial no: 2011-002685-20.
      PubDate: Tue, 20 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy302
      Issue No: Vol. 28, No. 4 (2018)
       
  • Minimally invasive mitral valve repair or replacement for degenerative
           mitral regurgitation
    • Authors: Hata M; Zittermann A, Hakim-Meibodi K, et al.
      Pages: 575 - 580
      Abstract: OBJECTIVESThis study describes our experience with minimally invasive mitral valve (MV) repair and chordal-sparing replacement in patients with degenerative MV regurgitation.METHODSBetween February 2009 and October 2015, a total of 960 patients underwent isolated minimally invasive MV repair, whereas 95 patients underwent chordal-sparing MV replacement. We performed a propensity score-matched analysis in 85 pairs to compare overall survival and major adverse cardiac and cerebrovascular event (MACCE) -free survival over an 8-year follow-up period. For sensitivity analyses, in the entire study cohort, we used the multivariable-adjusted Cox regression analysis to assess the overall mortality and MACCE.RESULTSIn the propensity score-matched pairs, the 7-year probability of survival was 76.3% in the repair group and 78.8% in the replacement group (P = 0.60). Similarly, freedom from MACCE at year 7 of follow-up did not differ between the repair and replacement groups (78.6% and 72.3%, respectively; P = 0.48). The corresponding values for 7-year freedom from valve reintervention were 95.6% and 98.8%, respectively (P = 0.31). In the entire study cohort, the multivariable-adjusted hazard ratio (HR) of mortality for the replacement versus the repair group was 1.31 [95% confidence interval (CI) 0.68–2.50; P = 0.42], and the multivariable-adjusted HR of MACCE was 1.03 (95% CI 0.61–1.74; P = 0.91).CONCLUSIONSOur findings suggest that mid-term clinical outcomes do not significantly differ between patients undergoing MV repair or chordal-sparing MV replacement.
      PubDate: Wed, 21 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy305
      Issue No: Vol. 28, No. 4 (2018)
       
  • New postoperative conduction abnormalities after the implantation of a
           rapid-deployment aortic valve prosthesis
    • Authors: Mogilansky C; Balan R, Deutsch C, et al.
      Pages: 581 - 586
      Abstract: OBJECTIVESSutureless and rapid-deployment aortic valves have enlarged the selection of prostheses available for surgical aortic valve replacement. However, the rate of postoperative pacemaker implantation seems to have increased.METHODSIn addition to pacemaker implantation, we were interested in the incidence of new postoperative conduction abnormalities, namely left bundle branch block, right bundle branch block and atrioventricular block III after the implantation of the EDWARDS INTUITY Elite™ sutureless prosthesis. All patients undergoing isolated or concomitant surgical aortic valve replacement between May 2014 and May 2017 were included in the study.RESULTSTwo hundred patients were operated on. Of them, 14 patients dropped out because of concomitant endocardial or epicardial ablation or because of septal myectomy. Three more patients dropped out because the treatment was converted to conventional aortic valve replacement, and 183 patients remained. At the time of discharge from hospital, 38.1% of the 183 patients had new left bundle branch block, 2.5% of patients had new right bundle branch block and 9.6% had atrioventricular block III requiring either a pacemaker or defibrillator. The postoperative mean transvalvular gradient over the prosthesis was 8.4 ± 3.4 mmHg, the occurrence of paravalvular leakage more than trivial was 1% and hospital mortality was 3.3%.CONCLUSIONSThe incidence of new postoperative conduction abnormalities is considerable with the EDWARDS INTUITY Elite rapid-deployment aortic valve prosthesis. We will focus our future research on the follow-up of patients with postoperative left bundle branch block, which was the most frequently observed form of new conduction abnormality.
      PubDate: Thu, 08 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy307
      Issue No: Vol. 28, No. 4 (2018)
       
  • Comparison of cardiac energetics after transcatheter and surgical aortic
           valve replacements
    • Authors: Yamashita Y; Tanoue Y, Sonoda H, et al.
      Pages: 587 - 593
      Abstract: OBJECTIVESThe effect of transcatheter aortic valve replacement (TAVR) on cardiac energetics has not been described. We compared changes in cardiac energetics after TAVR with those after surgical aortic valve replacement (SAVR).METHODSWe retrospectively estimated end-systolic elastance (Ees) and effective arterial elastance (Ea) using blood pressure and left ventricular (LV) volume obtained from echocardiography. LV efficiency [ventriculoarterial coupling (Ea/Ees) and the stroke work to pressure–volume area ratio (SW/PVA)] was calculated. Measurements were taken before, 1 week after and 1 year after bioprosthetic aortic valve replacement (TAVR, n = 56; SAVR, n = 61) in patients with severe aortic stenosis and preserved ejection fraction.RESULTSPatients with TAVR had a lower aortic valve pressure gradient and larger stroke volume 1 week after the procedure than those with SAVR. Ea was more markedly decreased, and LV efficiency was significantly improved 1 week after TAVR (SW/PVA 68.1% ± 8.4% to 72.0% ± 8.5%, P < 0.001), but LV efficiency was unchanged 1 week after SAVR (SW/PVA 70.1% ± 7.4% to 69.1%  ±  8.0%). LV efficiency was improved 1 year after both procedures (SW/PVA 75.5% ± 6.1% in TAVR; 74.7% ± 6.4% in SAVR).CONCLUSIONSTAVR decreases the transvalvular pressure gradient further without deteriorating stroke volume in the early postoperative period, which is accompanied by early improvement in afterload and LV efficiency compared with SAVR. Improvement in LV efficiency at mid-term follow-up is satisfactory after both procedures.
      PubDate: Thu, 25 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy292
      Issue No: Vol. 28, No. 4 (2018)
       
  • Durable left ventricular assist device support as a bridge to heart
           transplant candidacy†
    • Authors: Shaw S; Venkateswaran R, Hogg R, et al.
      Pages: 594 - 601
      Abstract: OBJECTIVESLeft ventricular assist devices are funded in the UK exclusively as a bridge to transplant (BTT). However, patients who potentially could receive a transplant may develop reversible contraindications to transplant. Bridge to candidacy (BTC) has sometimes been controversial, given the uncertain clinical efficacy of BTC and the risk that reimbursement could be denied. We analysed the UK ventricular assist device database to understand how common BTC was and to assess patient survival rates and incidences of transplants.METHODSWe identified BTC implants in patients with pulmonary hypertension, chronic kidney disease and obesity using the UK guidelines for heart transplants.RESULTSA total of 306 of 540 patients had complete data and 157 were identified as BTC (51%). Overall, there was no difference in survival rates between patients designated as BTC and those designated at BTT (71.9 vs 72.9% at 1 year, respectively; P = 0.82). However, the survival rate was lower at all time points in those with an estimated glomerular filtration rate (eGFR) <40 and in patients with a body mass index (BMI) >32 up to 1-year postimplant. There were no significant differences in the incidence of transplant between patients who were BTC and BTT or for any subgroup up to 5 years. However, we noted a diverging trend towards a lower cumulative incidence of transplant for patients with a BMI >32.CONCLUSIONSBTC is common in the UK and appears clinically effective, given that the survival rates and the incidence of transplants were comparable with those for BTT. Patients with a high BMI have a worse survival rate through to 1 year and a trend for a lower incidence of a transplant. Patients with a low eGFR also have a worse survival rate, but a similar proportion received transplants.
      PubDate: Mon, 22 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy288
      Issue No: Vol. 28, No. 4 (2018)
       
  • Changing clinical profiles and in-hospital outcomes of octogenarians
           undergoing cardiac surgery over 18 years: a single-centre experience†
    • Authors: Habib A; Hussain A, Jarvis M, et al.
      Pages: 602 - 606
      Abstract: OBJECTIVESWith an ageing population, increasing numbers of octogenarians are undergoing high-risk cardiac surgery. We examine the changing characteristics and in-hospital outcomes for octogenarians over an 18-year period.METHODSClinical data from our prospective database for all octogenarians who had cardiac surgery from March 1999 through May 2016 were reviewed. We examined trends, risk profiles and in-hospital outcomes over 3 eras, namely early (1999–2004), middle (2005–2010) and late (2011–2016). A multivariable analysis was performed to identify independent predictors for adverse outcomes.RESULTSThere were 1022 patients aged 80–94 years in our study cohort. The octogenarian population increased progressively from early to late eras (4.5%, n = 255 vs 7.1%, n = 321 vs 9.3%, n = 446), as the average logistic EuroSCORE predicted mortality (9% vs 9.7% vs 10.1%, P < 0.01). On the contrary, observed mortality declined substantially (9.4% vs 7.8% vs 4.7%, P = 0.04) over this period. While cardiac morbidity and respiratory comorbidities were more prevalent in the late era, chronic renal failure was more frequent in the early era. Over time, more procedures were performed electively (P = 0.05). Common operations across all eras were coronary artery bypass grafting (CABG), aortic valve replacement and CABG + aortic valve replacement. Emergency operation [odds ratio (OR) 4.96, 95% confidence interval (CI) 1.51–16.35; P < 0.01], poor ejection fraction (OR 3.38, 95% CI 1.80–6.32; P < 0.01) and bypass time (OR 1.01, 95% CI 1.00–1.02; P < 0.01) were predictors of in-hospital mortality. The late era of surgery (OR 0.41, 95% CI 0.23–0.73; P < 0.01) was associated with reduced mortality risk.CONCLUSIONSThe operative outcome in this growing surgical population is steadily improving despite the increasing prevalence of comorbidities, and surgery should be performed electively as much as possible.
      PubDate: Thu, 08 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy293
      Issue No: Vol. 28, No. 4 (2018)
       
  • Male patients with diabetes undergoing coronary artery bypass grafting
           have increased major adverse cerebral and cardiovascular events
    • Authors: Liu X; Zhang W, Wang L, et al.
      Pages: 607 - 612
      Abstract: OBJECTIVESThe role of body mass index (BMI) in the prognosis of patients with diabetes undergoing coronary artery bypass grafting (CABG) has been of great interest for a long time. However, the precise relationship between BMI and major adverse cerebral and cardiovascular events (MACCEs) in these patients is still unclear. The goal of this study was to investigate the outcome of patients with diabetes with different BMIs undergoing CABG and the results from the 5-year follow-up.METHODSThis study included 771 patients with diabetes undergoing CABG from 1 January 2003 to 31 December 2009. They were classified based on the Chinese standard for BMI as follows: underweight: <18.5 kg/m2; normal weight: 18.5–23.9 kg/m2; overweight: 24–27.9 kg/m2; and obese: >28 kg/m2. Short-term outcomes and 5-year MACCEs were compared among various BMI groups after surgery.RESULTSObese and overweight patients with diabetes tended to be younger than normal weight patients [57 years (49–64) vs 62 years (54–68) and 64 years (59–69); P < 0.001]. There were fewer male patients (25.20% vs 17.78% and 16.54%, P = 0.041). More smokers were in the 2 groups (38.8% vs 51.55% and 57.14%, P < 0.001). Glucose concentration was highest in the overweight group [6.40 (5.40–7.80) vs 6.96 (5.69–8.22) and 6.80 (5.90–8.40); P = 0.041)]. Cox regression analysis of the 5-year follow-up data indicated that various BMI groups were not associated with significant differences in 5-year MACCEs; however, male sex was the risk factor for MACCEs (hazard ratio 1.83, 95% confidence interval 1.11–3.04; P = 0.019).CONCLUSIONSThe BMI of the patients with diabetes undergoing CABG had no effect on MACCEs. Male sex was the risk factor in these patients.
      PubDate: Mon, 15 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy287
      Issue No: Vol. 28, No. 4 (2018)
       
  • Do patients who require re-exploration for bleeding have inferior outcomes
           following cardiac surgery'
    • Authors: Ali J; Wallwork K, Moorjani N.
      Pages: 613 - 618
      Abstract: A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Do patients who require return to theatre (RTT) for bleeding have inferior outcomes following cardiac surgery' Altogether, 598 papers were found using the reported search, of which 8 represented the best 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 summary, patients who bleed following cardiac surgery and then RTT have increased mortality and experience greater morbidity, including neurological, respiratory and renal complications, which result in increased length of intensive care unit stay and hospital stay. It is not easy to dissect the relative contribution of the blood loss and consequent haemodynamic instability, the RTT and the increased blood product consumption to the inferior outcomes observed, as there is evidence that each is important. However, several studies have demonstrated RTT to be an independent predictor of morbidity and mortality, even when controlling for amount of transfusion. Patients who bleed and RTT beyond 12 h postoperatively appear to have the poorest outcomes, suggesting that the decision to RTT should not be delayed if there are concerns over significant bleeding, to ensure the best patient outcomes.
      PubDate: Mon, 15 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy285
      Issue No: Vol. 28, No. 4 (2018)
       
  • Sandro Botticelli’s Madonna of the Pomegranate: the hidden cardiac
           anatomy
    • Authors: Lazzeri D; Al-Mousawi A, Nicoli F.
      Pages: 619 - 621
      Abstract: Sandro Botticelli was one of the most renowned artists of the 15th century. He was based in Florence during the flourishing of the Renaissance, a time when anatomical knowledge of ancient times was reclaimed through cadaveric dissection. This report proposes that such knowledge enabled Botticelli to enhance the iconography of his masterpieces, Madonna of the Pomegranate, by incorporating a concealed image of the heart and cardiac anatomy within it.
      PubDate: Thu, 29 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy321
      Issue No: Vol. 28, No. 4 (2018)
       
  • Anatomical variations of the aortic arch branches in a sample of Chinese
           cadavers: embryological basis and literature review
    • Authors: Qiu Y; Wu X, Zhuang Z, et al.
      Pages: 622 - 628
      Abstract: OBJECTIVESThe aim of this study is to determine the incidence and explore the types of aortic arch branch variations found in our cadavers. METHODSThe types and incidence of aortic branch variations in 120 cadavers were analysed after careful dissection.RESULTSOne hundred and six of 120 cadavers had normal aortic arch branches and gave rise to usual branches, namely the brachiocephalic trunk, the left common carotid artery and the left subclavian artery. The remaining 14 cadavers had 2 basic types of branch variations, thus accounting for an incidence of 11.67%. A total of 9 aortic arches emitted 4 branches; the brachiocephalic trunk, the left common carotid artery, the left vertebral artery and the left subclavian artery (incidence 7.5%). The second subgroup of 5 cadavers also emitted 4 aortic branches: the right common carotid artery, the left common carotid artery, the left subclavian artery and the right subclavian artery (incidence 4.16%). In this group, the right subclavian artery sprung as a distal branch of the aortic arch (descending), thus making a vascular ring that takes a superoposterior course round the back of the trachea and the oesophagus to reach the right side. There was a single cadaver, different from the other 4 aortic branches of the second group which had a common origin for the common carotid arteries, while the left subclavian artery and distally placed right subclavian artery were present. We did not observe any Kommerell’s aortic diverticula.CONCLUSIONSThe variations of aortic arch branching are complex and diverse due to varied possible alterations in the embryological processes. There is an imperative need for further research on these variations to elucidate the possible relationships with clinical diagnostic or surgical events.
      PubDate: Thu, 15 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy296
      Issue No: Vol. 28, No. 4 (2018)
       
  • Morphological predictor of remodelling of the descending thoracic aortic
           false lumen that remains patent after repair of acute type A dissection
    • Authors: Watanabe T; Ito T, Sato H, et al.
      Pages: 629 - 634
      Abstract: OBJECTIVESSome patients achieve complete recovery through false lumen remodelling in the descending aorta after surgery for acute type A aortic dissection. Our goal was to investigate the relationship between false lumen remodelling during later postoperative stages and quantitative analysis of the true lumen shape during the early postoperative stages.METHODSWe examined 88 surgical patients between January 2007 and December 2016. Three points of the descending aorta were assessed from the 6th (T6), the 9th (T9) and the 11th (T11) vertebral levels. The shape of the true lumen was evaluated during the early postoperative stages, and false lumen remodelling 1 year after surgery was the end point. The parameters obtained by evaluating the shape of the true lumen comprised the first principal component analysis using elliptic Fourier analysis, the minor diameter ratio and the ratio of the area of the true lumen to that of the descending aorta, and the number of contact points on the true lumen wall during the early stages.RESULTSUsing univariate analysis, we detected significant differences in the first principal components, the minor diameter ratio, the area ratio and the number of contact points at each thoracic vertebral level (P < 0.05). The cut-off value of the minor diameter ratio was 0.55, and the area ratio was 0.48 as determined by analysis of the receiver operating characteristic. Multivariable logistic analysis indicated that the first principal component was the most significant predictor from the proximal to the middle descending aorta.CONCLUSIONSQuantitative evaluation of shape of the true lumen in the early postoperative stages after surgery for acute type A dissection can serve as a viable predictor for false lumen remodelling in later stages. Furthermore, the first principal component could serve as a more astute predictor than other quantitative parameters according to multivariate analysis.
      PubDate: Thu, 25 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy284
      Issue No: Vol. 28, No. 4 (2018)
       
  • The role of sartorius muscle flaps in the management of complex groin
           wounds
    • Authors: Katsogridakis E; Pokusevski G, Perricone V.
      Pages: 635 - 637
      Abstract: A best evidence topic in vascular surgery was written according to a structured protocol. The question addressed was whether sartorius muscle flaps (SMF) can be effectively used in the setting of complex groin wounds with exposed prosthetic grafts for graft salvage and limb salvage. The literature review identified 33 articles reporting on the use of SMF for complex vascular wounds. Of these, 7 articles reporting on the use of 539 SMFs were considered the best evidence to answer the clinical question. Indications included surgical site infections with or without wound dehiscence, lymph leaks, graft infection and groin pseudoaneurysms, whereas in 98 of the included 539 cases, the flaps were performed prophylactically. Vacuum-assisted closure systems were used in 25 cases to promote healing. The use of an SMF is associated with low rates of muscle flap and graft complications, whereas outcomes seem to be independent of the presence of occlusive disease in the superficial femoral artery. They can be effectively combined with aggressive debridement strategies and vacuum-assisted closure devices to optimize outcomes. The published literature supports the use of SMF in the management of complex groin wounds following vascular reconstruction and is associated with encouraging flap, limb and graft salvage rates.
      PubDate: Thu, 15 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy300
      Issue No: Vol. 28, No. 4 (2018)
       
  • Late complication of intramural coronary transfer during the arterial
           switch operation
    • Authors: Stoll V; Hudsmith L, Drury N, et al.
      Pages: 638 - 639
      Abstract: Intramural coronary arteries remain a major risk factor and technical challenge of the arterial switch operation for transposition of the great arteries. We report a 27-year-old woman who presented with acute coronary syndrome late after arterial switch with a complex coronary pattern (intramural left and right coronary from sinus 2). Computed tomography demonstrated that the pericardial ‘saddle bag’ used to reconstruct the intramural coronary was compressed between the neoaortic root and the neopulmonary trunk. During surgery, the coronary system was laid open into the neoaorta with patch enlargement, and the patient made an uneventful recovery.
      PubDate: Tue, 30 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy289
      Issue No: Vol. 28, No. 4 (2018)
       
  • Anomalous origin of both the right and left coronary arteries: a singular
           anomaly†
    • Authors: Kostolny M; Kanakis M, Hsia T.
      Pages: 640 - 641
      Abstract: Herein, the case of an 8-year-old male child diagnosed with an extremely rare anatomical presentation of a single origin of both the left and right coronary arteries from the non-coronary sinus is presented. The surgical management is also described.
      PubDate: Mon, 29 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy301
      Issue No: Vol. 28, No. 4 (2018)
       
  • Cryptococcal infective endocarditis in a child with acute lymphocytic
           leukaemia
    • Authors: Kowatari R; Suzuki Y, Daitoku K, et al.
      Pages: 642 - 644
      Abstract: A 4-year-old boy with acute lymphocytic leukaemia presented with left hemiplegia during chemotherapy. Computed tomography revealed cerebral infarction, and an echocardiogram showed vegetation in the right and left ventricles. Despite antifungal therapy, he experienced another stroke; and 9 days after the first stroke, he underwent total extirpation of the vegetative nodules and fragile vegetation. The postoperative course was unremarkable with no recurrence of infective endocarditis. Although a bacterial culture of the vegetation could not identify the presence of any organism, a pathological specimen examination revealed Cryptococcus with a round and mucinous capsule.
      PubDate: Mon, 29 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy291
      Issue No: Vol. 28, No. 4 (2018)
       
  • Giant right atrial aneurysm
    • Authors: Kinsella A; Butany J, Wintersperger B, et al.
      Pages: 645 - 646
      Abstract: Only a handful of congenital aneurysms of the right atrium have been reported in the literature. They are most commonly found in the third decade of life, and the differential diagnosis depends on the patient’s age profile. They are associated with 5% risk of sudden cardiac death. Once diagnosed, they should be surgically removed even in the absence of symptoms.
      PubDate: Wed, 28 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy304
      Issue No: Vol. 28, No. 4 (2018)
       
  • Hybrid treatment of aortic valve regurgitation and right heart failure 22
           years after heterotopic heart transplantation
    • Authors: Smail H; Stock U, Simon A.
      Pages: 647 - 649
      Abstract: Clinical application of heterotopic heart transplantation is no longer pursued. However, a significant number of patients present again with deteriorating function of the native or recipient’s heart. We describe the management of severe native aortic regurgitation and right heart failure in a patient following heterotopic heart transplantation. We performed a percutaneous closure of the insufficient native aortic valve followed by a surgical transposition of the donor’s pulmonary artery from the recipient’s right atrium to the pulmonary artery.
      PubDate: Tue, 30 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy295
      Issue No: Vol. 28, No. 4 (2018)
       
  • Thoracoscopic retrieval of an atrial appendage occlusion device after
           embolization into the left ventricular outflow tract and damaging the
           mitral valve requiring replacement
    • Authors: Yilmaz A; Starinieri P, Antonic M.
      Pages: 650 - 651
      Abstract: Embolization of a percutaneous left atrial appendage occlusion device is a rare, but potentially life-threatening, complication. In this report, we present the case of an embolization of such a device into the left ventricular outflow tract causing extensive damage to the mitral subvalvular apparatus and requiring mitral valve replacement. We also describe the first thoracoscopic removal of such a device from the left ventricular outflow tract.
      PubDate: Tue, 30 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy290
      Issue No: Vol. 28, No. 4 (2018)
       
  • A thoracic venous aneurysm mimicking a chronic expanding haematoma
    • Authors: Tsujimura R; Kojima T, Osaka E, et al.
      Pages: 652 - 654
      Abstract: Thoracic venous aneurysms are rare, and bleeding is possible. A 9-year-old female patient presented with a thoracic wall mass. No blood flow was observed in the mass, and a chronic expanding haematoma was suspected based on the differential diagnosis. However, the venous structure was identified in the wall of the mass on pathological examination, and the diagnosis of the venous aneurysm was thereby established. Because the venous aneurysm contains fresh blood and bleeding can be profuse when such lesions are not properly handled during a surgical procedure, making the visibility of the surgeon poor, the venous aneurysm must be included in the differential diagnosis.
      PubDate: Fri, 23 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy318
      Issue No: Vol. 28, No. 4 (2018)
       
  • Retrograde Stanford type A dissection caused by a multilayer stent graft
           in a patient with chronic type B dissection
    • Authors: Schafigh M; Kohistani Z, Schiller W, et al.
      Pages: 655 - 656
      Abstract: A patient with progressive chronic type B dissection and contraindication for open surgery underwent thoracic endovascular aortic repair using a Cardiatis Multilayer Flow Modulator®. Two weeks after the intervention, the patient experienced a ruptured retrograde type A aortic dissection caused by the stent’s uncovered proximal ends.
      PubDate: Thu, 22 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy313
      Issue No: Vol. 28, No. 4 (2018)
       
  • Blunt abdominal aortic injury may accompany bowel transection
    • Authors: Kao C; Huang T, Chen C, et al.
      Pages: 657 - 658
      Abstract: Blunt abdominal aortic injury is an extremely rare condition. In the past, when blunt abdominal aortic injury was managed with open surgery, intra-abdominal injury was identified more easily, while in the era of endovascular surgery, intra-abdominal injury might potentially be found after vascular reconstruction. We present a case of blunt abdominal aortic injury treated using a parallel graft–stent and simultaneous laparoscopy which revealed an occult bowel perforation.
      PubDate: Sat, 13 Oct 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy286
      Issue No: Vol. 28, No. 4 (2018)
       
 
 
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