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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   (Followers: 1, 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: 54, 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: 89, SJR: 1.989, CiteScore: 4)
Alcohol and Alcoholism     Hybrid Journal   (Followers: 18, SJR: 1.376, CiteScore: 3)
American Entomologist     Full-text available via subscription   (Followers: 8)
American Historical Review     Hybrid Journal   (Followers: 177, 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: 182, SJR: 3.438, CiteScore: 6)
American J. of Epidemiology     Hybrid Journal   (Followers: 195, SJR: 2.713, CiteScore: 3)
American J. of Health-System Pharmacy     Full-text available via subscription   (Followers: 54, SJR: 0.595, CiteScore: 1)
American J. of Hypertension     Hybrid Journal   (Followers: 26, 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: 28, SJR: 1.053, CiteScore: 1)
American Literary History     Hybrid Journal   (Followers: 17, SJR: 0.391, CiteScore: 0)
Analysis     Hybrid Journal   (Followers: 23, 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: 55, SJR: 5.599, CiteScore: 9)
Annals of the Entomological Society of America     Full-text available via subscription   (Followers: 11, 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: 60, 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: 53, SJR: 1.871, CiteScore: 3)
Bioinformatics     Hybrid Journal   (Followers: 345, SJR: 6.14, CiteScore: 8)
Biology Methods and Protocols     Hybrid Journal  
Biology of Reproduction     Full-text available via subscription   (Followers: 10, 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: 2, 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: 67)
Brain     Hybrid Journal   (Followers: 70, SJR: 5.858, CiteScore: 7)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 49, 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: 38, 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: 603, SJR: 1.828, CiteScore: 3)
British J. of Social Work     Hybrid Journal   (Followers: 88, 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: 35)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 4, SJR: 1.376, CiteScore: 1)
Cambridge J. of Economics     Hybrid Journal   (Followers: 71, 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: 51, SJR: 3.892, CiteScore: 6)
CESifo Economic Studies     Hybrid Journal   (Followers: 23, 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: 23, 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: 25, SJR: 2.424, CiteScore: 3)
Communication, Culture & Critique     Hybrid Journal   (Followers: 28, 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: 3)
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: 116, SJR: 5.161, CiteScore: 3)
Economic Policy     Hybrid Journal   (Followers: 48, 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: 203, 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: 19, 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: 15, 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: 33, SJR: 7.063, CiteScore: 13)
Fems Yeast Research     Hybrid Journal   (Followers: 14, 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: 34, 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: 3)
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: 6, 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: 15, 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: 75, SJR: 2.643, CiteScore: 5)
Human Reproduction Open     Open Access   (Followers: 1)
Human Reproduction Update     Hybrid Journal   (Followers: 21, SJR: 5.317, CiteScore: 10)
Human Rights Law Review     Hybrid Journal   (Followers: 64, 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: 11)
ILAR J.     Hybrid Journal   (Followers: 3, 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: 10, SJR: 1.792, CiteScore: 2)
Industrial Law J.     Hybrid Journal   (Followers: 41, 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: 68, 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: 65, SJR: 0.601, CiteScore: 1)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 255, 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: 39, 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: 24, SJR: 0.401, CiteScore: 1)
Intl. Studies Perspectives     Hybrid Journal   (Followers: 9, SJR: 0.983, CiteScore: 1)
Intl. Studies Quarterly     Hybrid Journal   (Followers: 50, 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   (Followers: 1)
J. of Burn Care & Research     Hybrid Journal   (Followers: 11, 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]
  • Single-centre first experience with transapical transcatheter mitral valve
    • Authors: Dahle G; Helle-Valle T, Beitnes J, et al.
      Pages: 695 - 703
      Abstract: OBJECTIVESTranscatheter mitral valve replacement has recently been introduced as an alternative treatment option for severe mitral regurgitation. We present our single-centre first experience with screening and implantation outcomes.METHODSTwenty-five patients with mitral regurgitation grades 3 and 4 were screened based on study inclusion/exclusion criteria, echocardiography and computed tomography imaging. All patients were evaluated by the centre’s Heart Team, followed by the Tendyne’s internal screening process. Patients who failed the screening criteria were considered for alternative treatments.RESULTSOf the 25 patients screened for transcatheter mitral valve replacement, 14 patients failed screening and 11 patients passed. The patients who failed screening were more often older, were women and were smaller in stature than those who passed screening. The main reason for patients to fail screening changed during the study from large annular dimensions to a small predicted neo-left ventricular outflow tract. Eight of the 11 patients who passed screening were treated using the Tendyne device, and 3 patients required alternate treatments due to urgency including 1 MitraClip procedure and 2 surgical repairs. Of the 14 patients who failed the screening, 5 patients had open surgery (4 patients received mitral valve repair and 1 mitral valve replacement). All 8 patients who underwent the Tendyne procedure were successfully treated without mortality during the observation time.CONCLUSIONSTranscatheter mitral valve replacement is an effective and safe treatment for well-selected patients with symptomatic mitral regurgitation. For patients who fail the screening process, the MitraClip procedure or open surgical valve repair are feasible.
      PubDate: Wed, 02 Jan 2019 00:00:00 GMT
      DOI: 10.1093/icvts/ivy343
      Issue No: Vol. 28, No. 5 (2019)
  • The prognostic impact of obstructive lung disease on survival of never
           smokers with resected non-small-cell lung cancer: a comparison with
    • Authors: Akamine T; Tagawa T, Shimokawa M, et al.
      Pages: 735 - 743
      Abstract: OBJECTIVESThe proportion of never smokers among non-small-cell lung cancer (NSCLC) patients has steadily increased in recent decades, suggesting an urgent need to identify the major underlying causes of disease in this cohort. Chronic obstructive pulmonary disease is a risk factor for lung cancer in both smokers and never smokers. The aim of this study was to investigate the association between obstructive lung disease and survival in never smokers and smokers with NSCLC after complete resection.METHODSWe retrospectively reviewed data from 548 NSCLC patients treated at our institution. The effects of obstructive lung disease on recurrence-free survival and cancer-specific survival following the resection of NSCLC were determined by univariable and multivariable Cox regression analyses.RESULTSAmong the 548 patients analysed, 244 patients (44.5%) were never smokers and 304 patients (55.4%) were current or former smokers. In the never-smoker group, 48 patients (19.7%) had obstructive lung disease, 185 patients (75.8%) were women and 226 patients (92.6%) had adenocarcinoma. Obstructive lung disease was significantly associated with shorter recurrence-free survival (P = 0.006) and cancer-specific survival (P = 0.022) in the never smokers, but not the smokers, on both univariable and multivariable analyses. The associations between obstructive lung disease and prognosis in never smokers remained significant after propensity score matching.CONCLUSIONSObstructive lung disease is an independent prognostic factor for recurrence-free survival and cancer-specific survival in never smokers, but not in smokers, with NSCLC. Based on this finding, further examination is warranted to advance our understanding of the mechanisms associated with NSCLC in never smokers.
      PubDate: Wed, 02 Jan 2019 00:00:00 GMT
      DOI: 10.1093/icvts/ivy329
      Issue No: Vol. 28, No. 5 (2019)
  • Effect of inferior pulmonary ligament division on residual lung volume and
           function after a right upper lobectomy
    • Authors: Kim D; Moon D, Kim H, et al.
      Pages: 760 - 766
      Abstract: OBJECTIVESThe requirement to divide an inferior pulmonary ligament (IPL) during an upper lobectomy has not been standardized. We evaluated the influence of the division of an IPL after a lobectomy of the right upper lobe.METHODSWe evaluated 52 patients with lung cancer who underwent a video-assisted thoracoscopic lobectomy of the right upper lobe at Asan Medical Center between January 2011 and April 2014. These cases were stratified by division of the IPL or not, i.e. a preservation group (group P, n = 21) and a division group (group D, n = 31). The angle between the bronchus intermedius and the right middle lobe bronchus and the lung volume were measured using computed tomography. The results of the pulmonary function tests and the prevalence of complications were also reviewed.RESULTSThe prevalences of atelectasis (P = 0.538), dead space (P = 0.084) and pleural effusion (P = 0.538) were not statistically different. The postoperative volumetric change of the right middle lobe (group P, −27 ± 97 ml; group D, −29 ± 111 ml; P = 0.950) and of the right lower lobe (group P, 397 ± 293 ml; group D, 335 ± 294 ml; P = 0.459) did not show statistical differences. The change in the bronchial angle was not statistically different between the groups (group P, −26.3 ± 13.7°; group D, −26.7 ± 13.6°; P = 0.930). The patients in group D experienced a greater loss in forced vital capacity than those in group P (group P, −0.16 ± 0.26 l; group D, −0.42 ± 0.33 l; P = 0.007), but the loss in the forced expiratory volume in 1 s was not significant (P = 0.328).CONCLUSIONSAn IPL division does not produce significant differences in lung volume, bronchial angle change or prevalence of complications other than loss of forced vital capacity.
      PubDate: Fri, 04 Jan 2019 00:00:00 GMT
      DOI: 10.1093/icvts/ivy344
      Issue No: Vol. 28, No. 5 (2019)
  • Mechanical stress alters the expression of calcification-related genes in
           vascular interstitial and endothelial cells
    • Authors: Rutkovskiy A; Lund M, Siamansour T, et al.
      Pages: 803 - 811
      Abstract: OBJECTIVESVascular wall calcification is a major pathophysiological component of atherosclerotic disease with many similarities to osteogenesis. Mechanical stress of the vascular wall may theoretically contribute to the proliferative processes by endothelial and interstitial cells. The aim of the study was to investigate the effect of mechanical stress on the expression of some calcification-related genes in primary human endothelial and interstitial cells, and how endothelial cells may stimulate the fibroblast and smooth muscle cells.METHODSHuman umbilical vein endothelial and interstitial cells were subjected to cyclic stretch using a FlexCell® bioreactor, and interstitial cells were also subjected to tensile strain in cultures embedded in 3-dimensional collagen gels. The medium from endothelial cells was used to stimulate the gel-cultured interstitial cells, or the endothelium was sown directly on top. For comparison, human endothelial and smooth muscle cells were isolated from aortic wall fragments of patients with and without the aortic aneurysm. The expression of genes was measured using quantitative PCR.RESULTSFour hours of cyclic stretch applied to cultured endothelial cells upregulated the mRNA expression of bone morphogenetic protein 2 (BMP-2), a major procalcific growth factor. When applied to a 3-dimensional culture of vascular interstitial cells, the medium from prestretched endothelial cells decreased the expression of BMP-2 and periostin mRNA in the fibroblasts. The static tension in gel-cultured interstitial cells upregulated BMP-2 mRNA expression. The addition of endothelial cells on the top of this culture also reduced mRNA of anticalcific genes, periostin and osteopontin. Similar changes were observed in smooth muscle cells from human aortic aneurysms compared to cells from the healthy aorta. Aortic aneurysm endothelial cells also showed an increased expression of BMP-2 mRNA.CONCLUSIONSEndothelial cells respond to mechanical stress by upregulation of pro-osteogenic factor BMP-2 mRNA and modulate the expression of other osteogenic factors in vascular interstitial cells. Endothelial cells may, thus, contribute to vascular calcification when exposed to mechanical stress.
      PubDate: Wed, 02 Jan 2019 00:00:00 GMT
      DOI: 10.1093/icvts/ivy339
      Issue No: Vol. 28, No. 5 (2019)
  • Corrigendum to ‘Long-term outcome following repair of acute type A
           aortic dissection after previous cardiac surgery’ [Interact CardioVasc
           Thorac Surg 2011;13:386–391]
    • Authors: Modi A; Vohra H, Kaarne M, et al.
      Pages: 830 - 830
      Abstract: The authors regret that errors have appeared in the published version of this article.
      PubDate: Fri, 26 Apr 2019 00:00:00 GMT
      DOI: 10.1093/icvts/ivz100
      Issue No: Vol. 28, No. 5 (2019)
  • Discontinuation of dual antiplatelet therapy and bleeding in intensive
           care in patients undergoing urgent coronary artery bypass grafting: a
           retrospective analysis
    • Authors: Vuilliomenet T; Gebhard C, Bizzozero C, et al.
      Pages: 665 - 673
      Abstract: OBJECTIVESOur goal was to evaluate the impact of the discontinuation times of dual antiplatelet therapy with clopidogrel, prasugrel or ticagrelor on postoperative bleeding rates and the use of blood products in patients undergoing isolated urgent coronary artery bypass grafting (CABG).METHODSWe retrospectively analysed 334 patients with acute coronary syndrome undergoing urgent CABG at the University Hospital Basel. A total of 262 patients continued to take dual antiplatelet therapy during the surgery (72 received clopidogrel; 68, prasugrel; and 122, ticagrelor). They were stratified by the discontinuation time of dual antiplatelet therapy (<24 h, 24–48 h, 48–72 h and >72 h). Seventy-two patients taking acetylsalicylic acid (ASA) as monotherapy served as a comparison group.RESULTSMedian postsurgical bleeding rates were significantly higher with ticagrelor if it was discontinued <24 h [1220 ml, interquartile range (IQR) 978–1520 ml; P < 0.001], 24–48 h (1200 ml, IQR 800–1550 ml; P < 0.001) and 48–72 h (1100 ml, IQR 845–1245 ml; P = 0.036) but not if discontinued >72 h (700 ml, IQR 520–825 ml; P = 0.22) and with prasugrel if discontinued <24 h (1320 ml, IQR 900–1950 ml; P < 0.001) but not if discontinued 24–48 h (1050 ml, IQR 638–1438 ml; P = 0.089) or >72 h (750 ml, IQR 488–1040; P = 0.63) compared to ASA monotherapy (800 ml, IQR 593–1043 ml). The postsurgical use of blood products compared to ASA monotherapy (0, IQR 0–2 units) was significantly higher with ticagrelor and prasugrel if discontinued <24 h (2.5 units, IQR 0–6; P < 0.001 and 2 units, IQR 1–6; P < 0.001, respectively).CONCLUSIONSDiscontinuation of ticagrelor and prasugrel for more than 72 h before urgent CABG was not associated with higher bleeding rates compared to treatment with ASA monotherapy. In contrast, discontinuation for less than 24 h was associated with higher use of blood products. For ticagrelor, this study supports evidence and recent guidelines proposing a shorter discontinuation time of 3 days and raises the question of whether the same could be true for prasugrel.
      PubDate: Thu, 06 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy330
      Issue No: Vol. 28, No. 5 (2018)
  • Right ventricular free wall longitudinal strain and stroke work index for
           predicting right heart failure after left ventricular assist device
    • Authors: Gumus F; Durdu M, Cakici M, et al.
      Pages: 674 - 682
      Abstract: OBJECTIVESRight heart failure (RHF) is an important prognostic factor in continuous-flow left ventricular assist device (LVAD) therapy. We aimed to assess the clinical variables associated with RHF after LVAD implantation and to compare their performance against currently available RHF predictive scoring systems.METHODSThe study cohort comprised 57 patients who underwent LVAD therapy between January 2012 and May 2018 in our centre. The mean age of the patients was 39.9 ± 18.3 years, and 43 (81.1%) of them were men. Thirty-eight patients (66.6%) were in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile I or II. The study cohort was divided into the patients with RHF postoperatively (n = 20, 35.1%) and without RHF (n = 37, 64.9%).RESULTSIndependent predictors for RHF were preoperative right ventricular ejection fraction <25% [odds ratio (OR) 4.68, 95% confidence interval (CI) 1.41–15.5; P = 0.01], right ventricular stroke work index <400 mmHg ml−1 (OR 3.73, 95% CI 1.01–13.7; P = 0.04), right ventricular outflow tract systolic excursion <7 mm (OR 1.55, 95% CI 0.31–0.84; P = 0.002), right ventricular outflow tract fractional shortening <15% (OR 1.62, 95% CI 0.34–0.78; P = 0.02), right ventricular free wall longitudinal strain ≤19% (OR 3.13, 95% CI 1.01–2.43; P = 0.003), right ventricular fractional area change <27% (OR 3.71, 95% CI 1.15–11.9; P = 0.02) and prealbumin <14 mg/dl (OR 3.45, 95% CI 1.07–11.03; P = 0.03). Modest diagnostic performance for RHF was detected in 4 of 7 validated scoring systems with resulting area under the curve values of 0.70 (95% CI 0.55–0.84; P = 0.001) for the Seattle Heart Failure Model; 0.68 (95% CI 0.49–0.81, P = 0.03) for the Fitzpatrick’s; 0.68 (95% CI 0.53–0.83, P = 0.028) for the acute physiology and chronic health evaluation (APACHE) II; and 0.66 (95% CI 0.50–0.82, P = 0.04) for the model for end-stage liver disease scoring systems. However, we found best discrimination performance of the score with a resulting area under the curve value of 0.94 (95% CI 0.55–0.89, P = 0.03) for right ventricular free wall longitudinal strain ≥−15.5% and 0.82 for right ventricular stroke work index <400 mmHg ml−1 m−2 in predicting RHF.CONCLUSIONSRight ventricular free wall longitudinal strain ≥−15.5% and right ventricular stroke work index <400 mmHg ml−1 m−2 were independent predictors of RHF following LVAD implantation. Currently available prediction risk scores had the modest power of accuracy in the low INTERMACS profile Turkish population.
      PubDate: Fri, 14 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy328
      Issue No: Vol. 28, No. 5 (2018)
  • Correlates of haemodynamic flow characteristics of sequential saphenous
           vein grafts in coronary artery bypass grafting
    • Authors: An K; Mei J, Zhu J, et al.
      Pages: 683 - 688
      Abstract: OBJECTIVESA sequential bypass technique has been widely used in the saphenous vein grafts (SVGs) during coronary artery bypass grafting (CABG) surgery. The aim of the present study was to investigate the correlates of haemodynamic flow characteristics of sequential SVGs using transit-time flow measurement.METHODSFrom January 2013 to December 2016, 235 patients underwent isolated CABG using 1 aortosequential SVG to non-left anterior descending targets and the left internal mammary artery to the left anterior descending coronary artery. Among them, 212 patients have completed computed tomography angiography at 1-year follow-up and were included in the present study. The intraoperative flow rate and pulsatility index (PI) of sequential SVGs were assessed with transit-time flow measurement. The univariable and multivariable stepwise linear regression analyses of the possible correlating variables, including distal-end coronary artery (DECA) characteristics, were performed.RESULTSFor sequential SVGs, the mean proximal flow rate was 45.8 ± 19.2 ml/min, and the mean PI was 3.17 ± 1.00. We assessed the following correlates for proximal flow rate and PI: patient characteristics and DECA characteristics. Independent correlates of proximal flow rate were triple sequential SVG (by 21.0 ± 2.5 ml/min; P < 0.001), the DECA with more severe proximal stenosis (3.6 ± 1.3 ml/min per 10% increase; P = 0.007) and the DECA with larger diameter (≥1.5 mm) (by 4.8 ± 2.3 ml/min; P = 0.038). For PI, independent correlate was triple sequential SVG (by −0.55 ± 0.15; P < 0.001), and the DECA with larger diameter (≥1.5 mm) showed a strong trend (P = 0.069). The flow rate plotted against the logarithmic transformation of PI showed a significant inverse relationship in the linear regression analysis (P < 0.001). At 1-year follow-up, the patency of the proximal segment (between the aorta and the first side-to-side anastomosis) was 99.5% (211 of 212).CONCLUSIONSTriple sequential SVG, the DECA with a larger diameter and more severe proximal stenosis were associated with higher proximal flow rate, whereas triple sequential SVG was associated with lower PI. These findings provide new data on flow characteristics and may guide subsequent studies towards improving sequential SVG patency.
      PubDate: Mon, 17 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy335
      Issue No: Vol. 28, No. 5 (2018)
  • A novel trileaflet mechanical heart valve: first in vitro results
    • Authors: Schubert K; Schaller T, Stojenthin E, et al.
      Pages: 689 - 694
      Abstract: OBJECTIVESHeart valve prostheses are the therapy of choice for patients with severe heart valve diseases. Two types of prostheses that can be implanted in patients are available: biological and mechanical. Though mechanical heart valves have some disadvantages like necessity of life-long anticoagulation, biological heart valve prostheses often necessitate reinterventions due to limited durability. Therefore, a new trileaflet mechanical heart valve was developed, featuring hinges in the systolic flow with the aim of function and thrombogenicity.METHODSWe first compared the new trileaflet mechanical heart valve to conventional bileaflet heart valves (St. Jude Medical and On-X valves) in vitro. Haemodynamic measurements were performed in a pulse duplicator system, and clot formation was examined with an implemented method using enzyme-activated milk as the test medium.RESULTSHaemodynamic measurements showed the largest effective orifice areas and smallest pressure gradients for the trileaflet prosthesis compared to the bileaflet valve. Opening and closing characteristics of the trileaflet valve and of the St. Jude Medical valve were comparable. Clotting tests depicted only minor isolated deposits for the new trileaflet valve whereas the bileaflet valves showed distinct clots in the area of the hinge in all experiments.CONCLUSIONSHaemodynamic and clotting tests showed improvements for the new trileaflet valve compared to common bileaflet valves. The off-wall systolic position of the hinges, which eluded adverse flow areas, was a major advantage of the new valve.
      PubDate: Mon, 24 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy337
      Issue No: Vol. 28, No. 5 (2018)
  • Efficacy and safety of transvenous lead extraction in 108 consecutive
           patients: a single-centre experience
    • Authors: Monsefi N; Waraich H, Vamos M, et al.
      Pages: 704 - 708
      Abstract: OBJECTIVESThe number of cardiac implantable electronic devices is growing worldwide because they play a relevant role in improving the survival rate in patients with specific heart diseases. Cardiac implantable electronic devices complications including infection, dysfunction or venous stenosis increase the need for the least traumatic way to explant leads. Our goal was to report the successes and procedural complication rates of transvenous lead extraction (TLE) in a consecutive series of patients.METHODSFrom 2010 to 2016, 108 patients underwent TLE of 227 leads due to endocarditis (n = 21; 19%), pocket infection (n = 58; 54%) or lead dysfunction (n = 29; 27%). In 98% (n = 106) of the patients, laser-assisted lead extraction was performed. In 2% (n = 2) of the patients, the application of a solitary locking stylet was sufficient. The patient mean age was 68 ± 14 years; 25% of the patients had previous cardiac surgery. TLE was performed a mean of 9 ± 6 years after the implantation of the existing device.RESULTSComplete procedural success (removal of all lead material from the vascular space) was achieved in 98.7% (n = 224), and clinical success (achievement of all clinical goals associated with the indication for lead removal and absence of major complications) was achieved in 98% (n = 106). In 2 patients the procedure failed due to a vascular tear requiring a thoracotomy. In 1 patient, complete lead extraction was not possible due to heavy calcification (coronary-sinus lead). The 30-day mortality rate was 3.7% (n = 4); the patients died of multiorgan failure (n = 1), cardiac failure (n = 1) and septicaemia (n = 2). The procedure-related major complication rate was 2% (n = 2).CONCLUSIONSLaser-assisted TLE seems to be a safe and effective procedure with an acceptable complication rate.
      PubDate: Fri, 28 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy351
      Issue No: Vol. 28, No. 5 (2018)
  • Postoperative platelet function is associated with severe bleeding in
           ticagrelor-treated patients
    • Authors: Björklund E; Hansson E, Romlin B, et al.
      Pages: 709 - 715
      Abstract: OBJECTIVESPreoperative testing of platelet function predicts bleeding risk in cardiac surgery patients treated with dual antiplatelet therapy, but the value of postoperative platelet function testing, reflecting both preoperative antiplatelet therapy and perioperative changes in platelet function, has not been evaluated.METHODSSeventy-four patients with acute coronary syndrome treated with acetylsalicylic acid and ticagrelor within 5 days before cardiac surgery were included in a prospective observational study. Platelet aggregation induced by adenosine diphosphate, arachidonic acid and thrombin receptor-activating peptide was assessed with multiple electrode impedance aggregometry immediately before surgery and 2 h after weaning off cardiopulmonary bypass. Receiver operating characteristic curves were used to determine any association between platelet aggregation and severe bleeding according to the universal definition of perioperative bleeding in adult cardiac surgery.RESULTSSevere bleeding occurred in 25 of 74 patients (34%). Preoperative and postoperative adenosine diphosphate-induced platelet aggregations were associated with bleeding, with comparable areas under the receiver operating characteristic curve [0.77 (95% confidence interval 0.65–0.89) vs 0.75 (0.62–0.87)]. Postoperative arachidonic acid- and thrombin receptor-activating peptide-induced aggregation had markedly smaller areas under the curve. There were significant correlations between preoperative and postoperative platelet aggregation induced by adenosine diphosphate (r2 = 0.77, P <  0.001), arachidonic acid (r2 = 0.24, P  <  0.001) and thrombin receptor-activating peptide (r2 = 0.21, P  < 0.001) but with large interindividual variations.CONCLUSIONSPoor postoperative platelet function was associated with severe bleeding, with accuracy comparable to that of preoperative platelet function. There was a correlation between preoperative and postoperative platelet function, but the predictability in an individual patient was limited.
      PubDate: Sat, 22 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy336
      Issue No: Vol. 28, No. 5 (2018)
  • Can postoperative massage therapy reduce pain and anxiety in cardiac
           surgery patients'
    • Authors: Grafton-Clarke C; Grace L, Roberts N, et al.
      Pages: 716 - 721
      Abstract: A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was, ‘In patients undergoing cardiac surgery, is postoperative massage therapy effective in reducing pain, anxiety and physiological parameters'’ Altogether, 287 papers were found using the reported search, of which 7 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. The specific therapy protocols widely varied between studies, with differences in frequency, specific timing in the postoperative period, techniques used and experience of therapy provider. These variations limit the generalization and transferability of the conclusions. The effect of massage therapy on anxiety levels was reported in 5 studies. All but one demonstrated a significant improvement in anxiety. Pain was also reported in 5 studies, with significant improvement demonstrated in 4 studies. Importantly, a number of these studies failed to report on analgesic requirements nor demonstrate a reduction in opioid requirements, thus limiting the validity of the drawn conclusions. There is significant heterogeneity in randomized trials reporting on the effects of massage therapy. Although there is evidence to suggest that massage therapy reduces pain and anxiety following cardiac surgery, there are often caveats to the conclusions drawn with other studies reporting no significant difference. Therefore, in light of this, it would not be logical to recommend massage therapy as an effective therapy. There is no current evidence to suggest that massage therapy improves physiological parameters, including the onset of atrial fibrillation postoperatively.
      PubDate: Sat, 01 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy310
      Issue No: Vol. 28, No. 5 (2018)
  • Music therapy following cardiac surgery—is it an effective method to
           reduce pain and anxiety'
    • Authors: Grafton-Clarke C; Grace L, Harky A.
      Pages: 722 - 727
      Abstract: A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: In patients undergoing cardiac surgery, is postoperative music therapy effective in reducing pain and anxiety' Altogether, 153 papers were found using the reported search method, of which 7 represented the best evidence to answer the clinical question. Six of the included studies were randomized trials, with 1 further non-randomized trial. The specific music protocols utilized widely varied, ranging from 1 short session on day 1 postoperatively to multiple sessions per day over a 72-h period. Most therapies involved music of a relaxing type, typically between 50 and 60 dB. All 7 studies reported on pain, with 4 demonstrating significant differences in pain score; however, 3 of these were not associated with reduction in analgesia requirements. Five studies reported on anxiety, with 2 demonstrating a statistically significant improvement in levels of anxiety. These results need to be contextualized by the small number of participants within each study and the heterogeneity in the therapy protocols utilized. The current best available evidence fails to support the benefits of music therapy as an effective non-pharmacological option in reducing pain and anxiety following open-heart surgery. While there is scarce evidence demonstrating efficacy, the current literature contains very small-sample-sized studies in utilizing music therapy protocols which in turn have wide range of variability in terms of duration, frequency, timing in the postoperative period and specific choice of music utilized in each protocol.
      PubDate: Sat, 01 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy311
      Issue No: Vol. 28, No. 5 (2018)
  • An aggregate score to stratify the technical complexity of video-assisted
           thoracoscopic lobectomy
    • Authors: Miyazaki T; Imperatori A, Jimenez M, et al.
      Pages: 728 - 734
      Abstract: OBJECTIVESThe purpose of this study was to develop a score to predict the complexity of video-assisted thoracoscopic surgery (VATS) lobectomies preoperatively.METHODSOne hundred and thirty-nine consecutive patients undergoing VATS lobectomy operated on by a single surgeon as the first operator were included. Complex operations were defined as: operation time >180 min (corresponding to the 75th percentile) or a conversion to thoracotomy. Several patient-related baseline and radiological variables were tested for a possible association with surgical complexity by logistic regression analysis. An aggregate score was created by weighing the regression estimates of the significant predictors. Patients were then grouped in classes of risk according to their scores. Finally, the score was validated in an external population of 154 VATS lobectomy patients.RESULTSTwenty-nine VATS lobectomies (21%) were classified as complex. The following variables were found to be significantly associated with a complex operation and were used to calculate the risk score in each patient (1 point each): male (P = 0.006), presence of thick pleura (P = 0.003), presence of emphysema (P = 0.001), enlarged hilar nodes (P = 0.003). Patients were grouped in 4 classes showing an incremental incidence of complex operations (P < 0.0001): score 0, 7.4%; score 1, 18%; score 2, 27%; score >2, 67%. In the external validation set, the score confirmed its association with the incidence of complex operations (P < 0.001): score 0, 7.3%; score 1, 10%; score 2, 16%; score >2 50%.CONCLUSIONSThe complexity score appeared to be reproducible in an external setting and can be used to preoperatively identify appropriate candidates for VATS lobectomies to improve the efficiency and safety of the training phase.
      PubDate: Thu, 29 Nov 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy319
      Issue No: Vol. 28, No. 5 (2018)
  • Nonintubated surgical biopsy of undetermined interstitial lung disease: a
           multicentre outcome analysis
    • Authors: Pompeo E; Rogliani P, Atinkaya C, et al.
      Pages: 744 - 750
      Abstract: OBJECTIVESNonintubated surgical biopsy (NISB) of interstitial lung disease (ILD) has shown promise in unicentre reports as a reliable method to achieve pathological diagnosis with low morbidity. The aim of this study was to investigate for the first time early outcomes of NISB of ILD using a multicentre retrospective analysis.METHODSSeven European and extra-European institutions participated in the study. Overall, 112 procedures were included. The mean age was 60 ± 12 years (65 men and 47 women). Preoperative total lung capacity and diffusion capacity of carbon monoxide were 74 ± 16% predicted and 57 ± 18% predicted, respectively. Forty-five patients had 1 or more associated comorbidities. NISB of ILD were performed under spontaneous ventilation by intercostal block (n = 84) or epidural anaesthesia (n = 28) with (n = 58) or without (n = 54) sedation and by thoracoscopic surgery (n = 88) or minithoracotomy (n = 24).RESULTSMean anaesthesia time, operative time and global time spent in the operating room were 31 ± 31 min, 29 ± 15 min and 89 ± 156 min, respectively. Feasibility was scored as excellent, good, satisfactory or unsatisfactory requiring conversion to general anaesthesia with intubation in 92, 12, 2 and 6 instances, respectively. There were no deaths. Morbidity was 7.1% and included prolonged air leaks in 4 patients and pneumonia, atelectasis, anaemia and gastric bleeding in 1 patient each. A precise pathological diagnosis was achieved in 108 patients (96%). The mean hospital stay was 2.5 ± 2.7 days. Comparisons of results achieved in the largest single-centre series (group A, 60 patients operated on) versus those resulting from the sum of the patients operated on in the other centres (group B, 52 patients operated on) showed no differences in feasibility (P = 0.10) and morbidity (P = 0.10) whereas hospital stay was shorter in group A (1.3 ± 0.5 days vs 3.9 ± 3.4 days, P < 0.001).CONCLUSIONSResults of this multicentre study confirm the satisfactory feasibility of NISB of ILD in 82% of patients with no deaths and a low morbidity rate. Intergroup comparisons indicated that the hospital stay was shorter in group A whereas there were no differences in feasibility and morbidity rates.
      PubDate: Sat, 01 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy320
      Issue No: Vol. 28, No. 5 (2018)
  • Visual analysis versus quantitative CT analysis of interlobar fissure
           integrity in selecting emphysematous patients for endobronchial valve
    • Authors: Fiorelli A; Poggi C, Anile M, et al.
      Pages: 751 - 759
      Abstract: OBJECTIVESThe aim of this study is to compare the accuracy of the standard visual scoring of computed tomography (CT) scans with a cloud-based quantitative CT analysis that uses the StratX software, to measure collateral ventilation and, thus, predict lobar atelectasis after valve treatment. METHODSThis is a retrospective, multicentre study of patients who had previously undergone valve treatment for severe heterogeneous emphysema and whose required fissure integrity ≥90% had been qualitatively scored by visual assessment of CT scans. For this study, all preprocedural CT scans were retrospectively analysed using the StratX software to provide quantitative scores of fissure integrity. The diagnostic accuracies of the visual and quantitative scores for predicting a target lobe volume reduction (TLVR) of ≥350 ml were calculated and statistically compared, as this level of volume reduction can be achieved only with sound fissure integrity. The clinical outcome of TLVR was also evaluated according to the minimal clinically important difference criteria. RESULTSEighty-three patients were included in the analysis. Of them, 65 of 83 (78%) patients presented with TLVR ≥350 ml. Visual scoring correctly identified the absence of collateral ventilation in 65 of 83 (78%) cases but failed in 18 of 83 (22%) cases. Of these 18 patients, quantitative analysis showed that 16 of 18 (89%) patients did not present completeness of the fissure. The diagnostic accuracy of the quantitative analysis was better than that of the visual analysis (96.4% vs 78.3%; P = 0.0003). Only patients having TLVR ≥350 ml met or exceeded the minimal clinically important difference criteria.CONCLUSIONSThe quantitative analysis using the StratX software contributed a more objective and efficient evaluation of collateral ventilation that would have improved the selection of emphysematous patients for endobronchial valve treatment in the study population.
      PubDate: Fri, 28 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy340
      Issue No: Vol. 28, No. 5 (2018)
  • Significant parameters in the evaluation of donor lungs in single-lung
           cellular ex vivo lung perfusion
    • Authors: Niikawa H; Okamoto T, Ayyat K, et al.
      Pages: 767 - 774
      Abstract: OBJECTIVESTypically, single-lung ex vivo lung perfusion (SL-EVLP) is preferred when there is concern of contamination from the opposite lung. However, a comprehensive assessment of the SL-EVLP has not been completed. The purpose of this study is to compare the physiological parameters of SL-EVLP and double-lung EVLP (DL-EVLP) in the assessment of transplant suitability.METHODSSeven pairs of rejected donor lungs were perfused in cellular EVLP, with a tidal volume of 6 ml/kg ideal body weight and a perfusion flow of 70 ml/kg/min. The transplant suitability of each side was judged in the DL-EVLP. Subsequently, the tidal volume and flow were reduced by half. The right SL-EVLP was maintained for 10 min by clamping the left main pulmonary artery and the bronchus. Similarly, left SL-EVLP was performed. The physiological parameters were compared between SL-EVLP and DL-EVLP.RESULTSPO2/FiO2 ratio was significantly lower in SL-EVLP than in DL-EVLP [182.5 (127.5–309.5) vs 311.5 (257.5–377.0) mmHg, P < 0.001]. There was a significant correlation with a higher shunt fraction and PCO2 in the pulmonary vein in SL-EVLP when compared to DL-EVLP. There was no difference in peak inspiratory and plateau pressures between SL-EVLP and DL-EVLP. Suitable lungs (n = 6) were associated with better PO2/FiO2 ratios and lower airway pressures than non-suitable lungs (n = 8).CONCLUSIONSIn SL-EVLP, peak inspiratory and plateau pressures have clinical utility in the assessment of the transplant suitability. It is important that PO2/FiO2 ratio in SL-EVLP is appreciably lower than that in DL-EVLP. This discrepancy should be considered in the evaluation of the transplant suitability in SL-EVLP.
      PubDate: Thu, 06 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy327
      Issue No: Vol. 28, No. 5 (2018)
  • Novel surgical strategy for complicated pulmonary stenosis using
           haemodynamic analysis based on a virtual operation with numerical flow
    • Authors: Miyaji K; Miyazaki S, Itatani K, et al.
      Pages: 775 - 782
      Abstract: OBJECTIVESA novel surgical strategy using haemodynamic analyses based on virtual operations with computational simulations has been introduced for complicated pulmonary stenosis. We evaluated the efficacy of this strategy.METHODSSix patients were enrolled. Before surgery, the optimal pulmonary arteries were constructed based on computational fluid dynamics using 3-dimensional computed tomography. Energy loss (EL, mW) and wall shear stress (WSS, Pa) were calculated. We compared the shapes of preoperative and optimal pulmonary arteries to determine the surgical strategy, including the incision line and the shape of the patch (virtual surgery). EL and WSS were compared between virtual and actual surgeries using flow analysis.RESULTSIn both the virtual and actual surgeries, postoperative EL tended to be lower than the preoperative EL, although there were no significant differences (P = 0.12 and P = 0.17, respectively). The mean WSS in the virtual surgery was significantly reduced from 112 ± 130 Pa to 25 ± 24 Pa (P = 0.028). After the actual surgery, the mean WSS was also significantly reduced to 30 ± 23 Pa (P = 0.047). There were no significant differences in the values for EL and WSS before and after surgery or between virtual and actual surgery (P = 0.94 and P = 0.85, respectively).CONCLUSIONSPulmonary artery plasty, using computational fluid dynamics based on virtual surgery, is an efficient surgical strategy. This novel strategy can easily and successfully provide an optimal pulmonary artery plasty equivalent to that using the conventional approach, which is based on the surgeon’s personal experience and judgement.
      PubDate: Thu, 06 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy326
      Issue No: Vol. 28, No. 5 (2018)
  • Simultaneous operative repair of pectus excavatum and concurrent
           congenital heart defects
    • Authors: Yang G; Deng X, Yang Y, et al.
      Pages: 783 - 788
      Abstract: OBJECTIVESThe aim of this study is to describe an effective surgical strategy for the treatment of children with pectus excavatum (PE) and concurrent congenital heart defect (CHD).METHODSWe retrospectively reviewed the medical records of all children (n = 16) who underwent simultaneous repair of PE with concurrent CHD at the Hunan Children’s Hospital from July 2007 to December 2017. Among them, 7 patients had a simple atrial septal defect (ASD); 4 patients had a simple ventricular septal defect (VSD); 3 patients had both VSD and ASD; 1 patient had VSD, ASD and patent ductus arteriosus; and 1 patient had VSD complicated by pulmonary hypertension. To repair PE, we performed one of the 3 procedures: an open sternal elevation involving freeing the tissue from the posterior sternum and lifting the sternum by wires, a Nuss repair or a repair with a custom-made sternal lifting device. The CHDs were repaired using one of the 3 methods as well: open heart surgery using cardiopulmonary bypass, transcatheter closure under echocardiography or X-ray-guided percutaneous intervention.RESULTSIn all 16 patients, the operations led to satisfactory repair of both conditions without serious complications. All parents and children were satisfied with the postoperative appearance of the chests.CONCLUSIONSBy choosing the correct operative approach based on patient characteristics, simultaneous elective repair of PE and concurrent CHD is safe and effective, avoids the risk of multiple staged operations and achieves satisfactory outcomes.
      PubDate: Tue, 11 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy294
      Issue No: Vol. 28, No. 5 (2018)
  • Long-term results after surgical repair of atrioventricular septal defect
    • Authors: Schleiger A; Miera O, Peters B, et al.
      Pages: 789 - 796
      Abstract: OBJECTIVESWe analysed our 29-year experience of surgical repair of atrioventricular septal defect (AVSD) to define risk factors for mortality and reoperation.METHODSBetween 1988 and 2017, 508 patients received AVSD repair in our institution; 359 patients underwent surgery for complete AVSD, 76 for intermediate AVSD and 73 for partial AVSD. The median age of the patients was 6.1 months (interquartile range 10.3 months), and the median weight was 5.6 kg (interquartile range 3.2 kg). The standard AVSD repair was performed using 2-patch technique (n = 347) and complete cleft closure (n = 496). The results were divided into 2 surgical eras (early era 1986–2004 and late era 2004–2017). Risk factors were analysed to determine the impact of patient age, weight, the presence of trisomy 21 and complex AVSD on mortality and reoperation rate.RESULTSIn-hospital mortality decreased from 10.2% (n = 26) in early surgical era to 1.6% (n = 4) in late surgical era (P < 0.001). Seventy-seven patients required reoperation. Freedom from reoperation was 84.4% after 25 years. The main indication for reoperation was left atrioventricular valve regurgitation (13.8%). The multivariable Cox regression analysis revealed reoperation of the left AV valve, early surgical era, patient age <3.0 months and complex AVSD to be independent risk factors for mortality. Age <3.0 months, complex AVSD and moderate/severe left AV valve regurgitation at discharge predicted reoperation.CONCLUSIONSAVSD repair can be performed with low mortality and reoperation rate. Age <3 months, complex AVSD and moderate/severe regurgitation of the left AV valve at discharge were predictors for reoperation. Reoperation of the left AV valve was the strongest risk factor for mortality.
      PubDate: Sat, 22 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy334
      Issue No: Vol. 28, No. 5 (2018)
  • Accuracy of deployment of the Relay non-bare stent graft in the aortic
    • Authors: Riesterer T; Beyersdorf F, Scheumann J, et al.
      Pages: 797 - 802
      Abstract: OBJECTIVESTo minimize the complications with thoracic endovascular aortic repair (TEVAR), a new stent graft with no bare ends was developed, namely the Relay non-bare stent (NBS). We hypothesized that the new features of the NBS graft would enable highly accurate deployment and fewer complications. The aim of this study was to analyse the quality of the Relay NBS with respect to its landing precision.METHODSRelying on computed tomography angiographs, we evaluated the distance between the stent graft and the target vessel in the proximal landing zone (before and after the intervention as well as the mid-term results). Seventy-eight patients with thoracic aortic pathologies were included. Median computed tomography angiograph follow-up was 16 months.RESULTSThe stent graft was deployable ≤5 mm from the target vessel in 64 (82%) patients; in 14 (18%) of them, the distance to the target vessel was >5 mm. According to the last follow-up computed tomography angiograph, in 35 (55%) patients, the distance to the target vessel was ≤5 mm and in 29 (45%) patients, it was >5 mm. There was no endoleak type Ia immediately after TEVAR or during the follow-up period. A substantial bird beak phenomenon was observed in 3 (4%) and 7 (11%) patients immediately after TEVAR and during the follow-up period, respectively. One patient had a retrograde dissection type A.CONCLUSIONSThe Relay NBS graft can be deployed accurately in the aortic arch in most patients. Retrograde aortic dissection type A seldom occurs after TEVAR using the Relay NBS graft. The distance between the NBS graft and the intended target vessel increases during the follow-up period.
      PubDate: Sat, 22 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy345
      Issue No: Vol. 28, No. 5 (2018)
  • Stem cell secretome attenuates acute rejection in rat lung allotransplant
    • Authors: Pieróg J; Fytianos K, Tamò L, et al.
      Pages: 812 - 818
      Abstract: OBJECTIVESStem cells secrete significant amounts of bioactive factors in their secretome that can be immunosuppressive. We studied the effect of the secretome obtained from bone marrow-derived mesenchymal stem cells (BMSC-sec) in combination with cyclosporine A following acute rejection of lung allografts in the rat.METHODSLung allotransplants were performed from male Brown Norway donor rats to recipient male Fisher 344 rats. Rat BMSC-sec was introduced intratracheally in the recipient every day after the transplant until the day the animal was sacrificed. Group A (n = 5) received control medium and cyclosporine A (2.5 mg/kg body weight intraperitoneally) for 5 days post-transplant and group B (n = 5) received BMSC-sec and cyclosporine A. Blood gas analysis was performed to assess graft function at day 5 only from the graft, and the tissue was sampled for measurement of the wet/dry ratio and histological grading of rejection.RESULTSAll control animals (group A) showed severe signs of rejection. At day 5 grafts in group B showed improved gas exchange (i.e. mean PaO2 mmHg 237.9 ± 130 mmHg vs 24.9 ± 7.8 mmHg in group A). Histological examination according to the International Society of Heart and Lung Transplantation (ISHLT) revealed moderate to severe rejection in all animals in group A (III B) and a significant improvement in group B (I–IIA). The wet/dry ratio was also reduced in group B to 6.19 ± 0.6 compared to 9.36 ± 2 in group A. Furthermore, in vitro T-cell proliferation was reduced after treatment with BMSC-sec for CD 3 cells (69.55 ± 07 vs 73 ± 0.84), for CD 4 (24.95 ± 1.2 vs 27.75 ± 0.21) and for CD 8 cells (3.75 ± 0.2 vs 5.68 ± 0.02).CONCLUSIONSThe BMSC-sec is a promising novel cell-based therapeutic option for acute rejection in a rat lung allograft model.
      PubDate: Sat, 01 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy306
      Issue No: Vol. 28, No. 5 (2018)
  • Q-PULS, a new quasi-physiological pulsatile extracorporeal model to
           simulate heart function
    • Authors: Ostovar R; Hartrumpf M, Kuehnel R, et al.
      Pages: 819 - 825
      Abstract: OBJECTIVESThe invention of new surgical procedures requires testing at different stages including animal models. To facilitate this process, we have developed a computer-controlled extracorporeal circulation system for testing of an explanted porcine heart simulating a variety of physiological parameters. Mitral valve function can be assessed before and after induced valve insufficiency and after valve repair. Accordingly, techniques and instruments can be modified at early stages of prototype development.METHODSIn the diastole, the left atrium is passively filled through the reservoir. The loading pressure of the atrium and flow rates can be widely adjusted. To simulate the systole, a linear motor-driven piston pump promotes volume into the left ventricle and the aorta. An additional circulatory pump compensates for undesired total emptying of the heart chambers. The processor control of the linear pump allows for various settings of flow rate, velocity and even irregular rhythm. Twenty-one isolated porcine hearts were used. The leaflet movement was filmed using a universal serial bus (USB)-probe camera.RESULTSWith 80 mm stroke and 1 m/s speed, a volume of 150 ml can be pumped at a heart rate of up to 73 bpm. Cardiac outputs of up to 10.9 l/min can be achieved. Constant visualization and continuous measurements of the pressure gradients before and after the induction of mitral insufficiency and after repair allowed quantitative verification of repair quality under beating-heart conditions.CONCLUSIONSThis model allows a controllable pulsation, loading and unloading of a porcine heart in a wide range. Thus, the function of the leaflets and repair results can be qualitatively and quantitatively evaluated under quasiphysiological conditions.
      PubDate: Tue, 04 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy317
      Issue No: Vol. 28, No. 5 (2018)
  • Compact coil packing using a steerable microcatheter for a giant
           wide-necked pulmonary artery pseudoaneurysm
    • Authors: Umakoshi N; Arai Y, Sone M, et al.
      Pages: 826 - 827
      Abstract: A 74-year-old man developed a giant wide-necked pulmonary artery pseudoaneurysm. To prevent life-threatening haemoptysis, we performed percutaneous transcatheter coil embolization for the pulmonary artery pseudoaneurysm. To effectively isolate the pseudoaneurysm with the minimal number of coils, we used a steering microcatheter. With intentional folding using the bendable tip of the steerable microcatheter, we achieved compact coil packing for the target vessels, thus avoiding coil deviations and non-target embolization.
      PubDate: Sat, 15 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy332
      Issue No: Vol. 28, No. 5 (2018)
  • Mitral valve replacement with a pulmonary autograft: long-term follow-up
           in an infant
    • Authors: Moreau de Bellaing A; Mathiron A, Lecompte Y, et al.
      Pages: 828 - 829
      Abstract: A 7-month-old boy with a complete atrioventricular septal defect presented with severe left atrioventricular valve regurgitation 4 months after complete repair. As the valve was unsuitable for the repair and the annulus was too small to accommodate a mechanical prosthesis, the modified mitral Ross operation was performed. The long-term outcome was uneventful for 12 years. The mitral Ross procedure is an old-described technique in which classically the pulmonary autograft is encased in a prosthetic conduit preventing any growth potential. On the contrary, the modified technique used in this case shows that the long-term function can be obtained. This procedure may be a valuable option when mitral valve replacement is necessary in infants.
      PubDate: Sat, 01 Dec 2018 00:00:00 GMT
      DOI: 10.1093/icvts/ivy322
      Issue No: Vol. 28, No. 5 (2018)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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