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Publisher: Oxford University Press   (Total: 396 journals)

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Showing 1 - 200 of 396 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: 8, SJR: 0.143, CiteScore: 0)
Advances in Nutrition     Hybrid Journal   (Followers: 44, SJR: 2.196, CiteScore: 5)
Aesthetic Surgery J.     Hybrid Journal   (Followers: 6, SJR: 1.434, CiteScore: 1)
African Affairs     Hybrid Journal   (Followers: 63, SJR: 1.869, CiteScore: 2)
Age and Ageing     Hybrid Journal   (Followers: 88, 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: 6)
American Historical Review     Hybrid Journal   (Followers: 147, SJR: 0.467, CiteScore: 1)
American J. of Agricultural Economics     Hybrid Journal   (Followers: 40, SJR: 2.113, CiteScore: 3)
American J. of Clinical Nutrition     Hybrid Journal   (Followers: 144, SJR: 3.438, CiteScore: 6)
American J. of Epidemiology     Hybrid Journal   (Followers: 166, SJR: 2.713, CiteScore: 3)
American J. of Hypertension     Hybrid Journal   (Followers: 25, SJR: 1.322, CiteScore: 3)
American J. of Jurisprudence     Hybrid Journal   (Followers: 18, SJR: 0.281, CiteScore: 1)
American J. of Legal History     Full-text available via subscription   (Followers: 8, 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: 15, SJR: 0.391, CiteScore: 0)
Analysis     Hybrid Journal   (Followers: 21, SJR: 1.038, CiteScore: 1)
Animal Frontiers     Hybrid Journal  
Annals of Behavioral Medicine     Hybrid Journal   (Followers: 14, SJR: 1.423, CiteScore: 3)
Annals of Botany     Hybrid Journal   (Followers: 35, SJR: 1.721, CiteScore: 4)
Annals of Oncology     Hybrid Journal   (Followers: 42, SJR: 5.599, CiteScore: 9)
Annals of the Entomological Society of America     Full-text available via subscription   (Followers: 9, SJR: 0.722, CiteScore: 1)
Annals of Work Exposures and Health     Hybrid Journal   (Followers: 33, SJR: 0.728, CiteScore: 2)
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: 56, 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: 20)
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: 42, SJR: 0.146, CiteScore: 0)
Behavioral Ecology     Hybrid Journal   (Followers: 52, SJR: 1.871, CiteScore: 3)
Bioinformatics     Hybrid Journal   (Followers: 294, 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: 30, 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: 162, SJR: 2.115, CiteScore: 3)
BJA Education     Hybrid Journal   (Followers: 64)
Brain     Hybrid Journal   (Followers: 68, SJR: 5.858, CiteScore: 7)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 48, 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: 34, SJR: 2.161, CiteScore: 2)
British J. of Aesthetics     Hybrid Journal   (Followers: 26, SJR: 0.508, CiteScore: 1)
British J. of Criminology     Hybrid Journal   (Followers: 578, SJR: 1.828, CiteScore: 3)
British J. of Social Work     Hybrid Journal   (Followers: 87, SJR: 1.019, CiteScore: 2)
British Medical Bulletin     Hybrid Journal   (Followers: 7, SJR: 1.355, CiteScore: 3)
British Yearbook of Intl. Law     Hybrid Journal   (Followers: 31)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 4, SJR: 1.376, CiteScore: 1)
Cambridge J. of Economics     Hybrid Journal   (Followers: 61, SJR: 0.764, CiteScore: 2)
Cambridge J. of Regions, Economy and Society     Hybrid Journal   (Followers: 10, SJR: 2.438, CiteScore: 4)
Cambridge Quarterly     Hybrid Journal   (Followers: 9, 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: 45, SJR: 3.892, CiteScore: 6)
CESifo Economic Studies     Hybrid Journal   (Followers: 17, SJR: 0.483, CiteScore: 1)
Chemical Senses     Hybrid Journal   (Followers: 1, SJR: 1.42, CiteScore: 3)
Children and Schools     Hybrid Journal   (Followers: 5, SJR: 0.246, CiteScore: 0)
Chinese J. of Comparative Law     Hybrid Journal   (Followers: 4, 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: 9, 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: 25, SJR: 0.123, CiteScore: 0)
Clean Energy     Open Access   (Followers: 1)
Clinical Infectious Diseases     Hybrid Journal   (Followers: 64, SJR: 5.051, CiteScore: 5)
Clinical Kidney J.     Open Access   (Followers: 3, SJR: 1.163, CiteScore: 2)
Communication Theory     Hybrid Journal   (Followers: 21, SJR: 2.424, CiteScore: 3)
Communication, Culture & Critique     Hybrid Journal   (Followers: 26, 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: 2, 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: 5, SJR: 0.906, CiteScore: 1)
Critical Values     Full-text available via subscription  
Current Developments in Nutrition     Open Access  
Current Legal Problems     Hybrid Journal   (Followers: 27)
Current Zoology     Full-text available via subscription   (Followers: 2, SJR: 1.164, CiteScore: 2)
Database : The J. of Biological Databases and Curation     Open Access   (Followers: 8, SJR: 1.791, CiteScore: 3)
Digital Scholarship in the Humanities     Hybrid Journal   (Followers: 13, SJR: 0.259, CiteScore: 1)
Diplomatic History     Hybrid Journal   (Followers: 20, 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: 3)
Early Music     Hybrid Journal   (Followers: 15, SJR: 0.139, CiteScore: 0)
Economic Policy     Hybrid Journal   (Followers: 39, SJR: 3.584, CiteScore: 3)
ELT J.     Hybrid Journal   (Followers: 24, SJR: 0.942, CiteScore: 1)
English Historical Review     Hybrid Journal   (Followers: 51, SJR: 0.612, CiteScore: 1)
English: J. of the English Association     Hybrid Journal   (Followers: 14, SJR: 0.1, CiteScore: 0)
Environmental Entomology     Full-text available via subscription   (Followers: 11, SJR: 0.818, CiteScore: 2)
Environmental Epigenetics     Open Access   (Followers: 3)
Environmental History     Hybrid Journal   (Followers: 27, SJR: 0.408, CiteScore: 1)
EP-Europace     Hybrid Journal   (Followers: 2, 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: 16, SJR: 0.113, CiteScore: 0)
European Heart J.     Hybrid Journal   (Followers: 57, SJR: 9.315, CiteScore: 9)
European Heart J. - Cardiovascular Imaging     Hybrid Journal   (Followers: 9, SJR: 3.625, CiteScore: 3)
European Heart J. - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 1)
European Heart J. - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart J. : 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: 178, SJR: 0.694, CiteScore: 1)
European J. of Orthodontics     Hybrid Journal   (Followers: 4, 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: 28, SJR: 0.702, CiteScore: 1)
European Sociological Review     Hybrid Journal   (Followers: 40, SJR: 2.728, CiteScore: 3)
Evolution, Medicine, and Public Health     Open Access   (Followers: 10)
Family Practice     Hybrid Journal   (Followers: 14, SJR: 1.018, CiteScore: 2)
Fems Microbiology Ecology     Hybrid Journal   (Followers: 11, SJR: 1.492, CiteScore: 4)
Fems Microbiology Letters     Hybrid Journal   (Followers: 23, SJR: 0.79, CiteScore: 2)
Fems Microbiology Reviews     Hybrid Journal   (Followers: 29, 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: 23, SJR: 1.425, CiteScore: 1)
Forest Science     Hybrid Journal   (Followers: 7, 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: 32, SJR: 0.118, CiteScore: 0)
French Studies     Hybrid Journal   (Followers: 20, 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: 12, SJR: 2.578, CiteScore: 4)
Geophysical J. Intl.     Hybrid Journal   (Followers: 35, SJR: 1.506, CiteScore: 3)
German History     Hybrid Journal   (Followers: 22, SJR: 0.161, CiteScore: 0)
GigaScience     Open Access   (Followers: 3, SJR: 5.022, CiteScore: 7)
Global Summitry     Hybrid Journal   (Followers: 1)
Glycobiology     Hybrid Journal   (Followers: 14, SJR: 1.493, CiteScore: 3)
Health and Social Work     Hybrid Journal   (Followers: 56, SJR: 0.388, CiteScore: 1)
Health Education Research     Hybrid Journal   (Followers: 14, 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: 29, SJR: 1.278, CiteScore: 1)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 26, SJR: 0.105, CiteScore: 0)
Human Communication Research     Hybrid Journal   (Followers: 13, SJR: 2.146, CiteScore: 3)
Human Molecular Genetics     Hybrid Journal   (Followers: 8, SJR: 3.555, CiteScore: 5)
Human Reproduction     Hybrid Journal   (Followers: 71, SJR: 2.643, CiteScore: 5)
Human Reproduction Open     Open Access  
Human Reproduction Update     Hybrid Journal   (Followers: 19, SJR: 5.317, CiteScore: 10)
Human Rights Law Review     Hybrid Journal   (Followers: 60, SJR: 0.756, CiteScore: 1)
ICES J. of Marine Science: J. du Conseil     Hybrid Journal   (Followers: 50, SJR: 1.591, CiteScore: 3)
ICSID Review     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: 10, SJR: 1.792, CiteScore: 2)
Industrial Law J.     Hybrid Journal   (Followers: 35, SJR: 0.249, CiteScore: 1)
Inflammatory Bowel Diseases     Hybrid Journal   (Followers: 43, SJR: 2.511, CiteScore: 4)
Information and Inference     Free  
Integrative and Comparative Biology     Hybrid Journal   (Followers: 7, SJR: 1.319, CiteScore: 2)
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: 58, SJR: 1.505, CiteScore: 3)
Intl. Data Privacy Law     Hybrid Journal   (Followers: 31)
Intl. Health     Hybrid Journal   (Followers: 5, 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: 34, SJR: 1.348, CiteScore: 2)
Intl. J. of Constitutional Law     Hybrid Journal   (Followers: 63, SJR: 0.601, CiteScore: 1)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 212, 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: 31, 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: 9, SJR: 1.545, CiteScore: 1)
Intl. J. of Refugee Law     Hybrid Journal   (Followers: 35, SJR: 0.389, CiteScore: 1)
Intl. J. of Transitional Justice     Hybrid Journal   (Followers: 12, SJR: 0.724, CiteScore: 2)
Intl. Mathematics Research Notices     Hybrid Journal   (Followers: 1, SJR: 2.168, CiteScore: 1)
Intl. Political Sociology     Hybrid Journal   (Followers: 36, 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: 44, SJR: 2.581, CiteScore: 2)
Intl. Studies Review     Hybrid Journal   (Followers: 21, SJR: 1.201, CiteScore: 1)
ISLE: Interdisciplinary Studies in Literature and Environment     Hybrid Journal   (Followers: 1, SJR: 0.15, CiteScore: 0)
ITNOW     Hybrid Journal   (Followers: 1, SJR: 0.103, CiteScore: 0)
J. of African Economies     Hybrid Journal   (Followers: 15, SJR: 0.533, CiteScore: 1)
J. of American History     Hybrid Journal   (Followers: 45, 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: 4, SJR: 0.585, CiteScore: 1)
J. of Biochemistry     Hybrid Journal   (Followers: 42, SJR: 1.226, CiteScore: 2)
J. of Burn Care & Research     Hybrid Journal   (Followers: 9, SJR: 0.768, CiteScore: 2)
J. of Chromatographic Science     Hybrid Journal   (Followers: 18, SJR: 0.36, CiteScore: 1)
J. of Church and State     Hybrid Journal   (Followers: 11, SJR: 0.139, CiteScore: 0)
J. of Communication     Hybrid Journal   (Followers: 50, SJR: 4.411, CiteScore: 5)
J. of Competition Law and Economics     Hybrid Journal   (Followers: 35, SJR: 0.33, CiteScore: 0)
J. of Complex Networks     Hybrid Journal   (Followers: 2, SJR: 1.05, CiteScore: 4)
J. of Computer-Mediated Communication     Open Access   (Followers: 26, SJR: 2.961, CiteScore: 6)
J. of Conflict and Security Law     Hybrid Journal   (Followers: 12, SJR: 0.402, CiteScore: 0)
J. of Consumer Research     Full-text available via subscription   (Followers: 41, SJR: 5.856, CiteScore: 5)

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Journal Cover
European Journal of Cardio-Thoracic Surgery
Journal Prestige (SJR): 1.681
Citation Impact (citeScore): 2
Number of Followers: 9  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1010-7940 - ISSN (Online) 1873-734X
Published by Oxford University Press Homepage  [396 journals]
  • Statistical Primer: developing and validating a risk prediction
    • Authors: Grant S; Collins G, Nashef S.
      Pages: 203 - 208
      Abstract: A risk prediction model is a mathematical equation that uses patient risk factor data to estimate the probability of a patient experiencing a healthcare outcome. Risk prediction models are widely studied in the cardiothoracic surgical literature with most developed using logistic regression. For a risk prediction model to be useful, it must have adequate discrimination, calibration, face validity and clinical usefulness. A basic understanding of the advantages and potential limitations of risk prediction models is vital before applying them in clinical practice. This article provides a brief overview for the clinician on the various issues to be considered when developing or validating a risk prediction model. An example of how to develop a simple model is also included.
      PubDate: Mon, 07 May 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy180
      Issue No: Vol. 54, No. 2 (2018)
  • Statistical primer: a cost–effectiveness analysis†
    • Authors: Antonides C; Cohen D, Osnabrugge R.
      Pages: 209 - 213
      Abstract: Cost–effectiveness analyses (CEAs) of new treatment strategies are increasingly reported. This can be a part of a clinical trial or as a separate study. Governments and healthcare payers frequently require a CEA to decide whether a new treatment strategy will be reimbursed. CEA is a framework to assess the effectiveness and costs of a new treatment strategy (e.g. a drug or intervention) when compared with a reference strategy. Effectiveness is often measured in life-years or quality-adjusted life-years, whereas costs consist of direct costs (the costs of the treatment), induced costs (downstream costs and cost offsets) and indirect costs. In this statistical primer, the rationale for assessing the economic consequences of new therapies is explained, followed by the fundamental concepts of CEAs, the different types of CEAs and an introduction to interpretation of CEAs. Finally, a real-world example of a CEA is discussed, comparing cost–effectiveness of transcatheter versus surgical aortic valve replacement in patients with severe aortic stenosis at intermediate surgical risk.
      PubDate: Wed, 02 May 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy187
      Issue No: Vol. 54, No. 2 (2018)
  • A harmonized European training syllabus for thoracic surgery: report from
           the ESTS–ERS task force†
    • Authors: Massard G; Tabin N, Mitchell S, et al.
      Pages: 214 - 220
      Abstract: Training of European thoracic surgeons is subject to huge variations in terms of length of training, content of training and operative experience during training. Harmonization of training outcomes has been approached by creating the European Board of Thoracic Surgery, which has been accredited by the European Union of Medical Specialists (UEMS); however, a clear description of the content of training is lacking. Building on their recognized experience with curriculum building, task forces of the European Respiratory Society and the European Society of Thoracic Surgery agreed on a joint task force on training in thoracic surgery. The goal of this study is to report on the mission statement developed from the UEMS-driven survey, describe the Delphi method and the observed results and present the first large consensus-based syllabus. The working group is currently working on a description of the curriculum and assessment of learning outcomes.
      PubDate: Thu, 24 May 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy206
      Issue No: Vol. 54, No. 2 (2018)
  • Comparison of graft patency following coronary artery bypass grafting in
           the left versus the right coronary artery systems: a systematic review and
    • Authors: Pinho-Gomes A; Azevedo L, Antoniades C, et al.
      Pages: 221 - 228
      Abstract: Although coronary artery bypass grafting has been the standard of care for patients with complex coronary artery disease for over 50 years, the evolution of graft patency over time in the left versus the right coronary systems remains poorly documented. This systematic review and meta-analysis aimed to characterize the evolution of graft patency over time comparing the left (excluding left anterior descending artery) and right coronary systems, with an emphasis on the comparison of venous versus arterial grafts and symptomatic versus asymptomatic patients. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE from inception to August 2016. We also searched clinical trials registers and reference lists of relevant studies. We included randomized clinical trials and observational studies comparing graft patency in the left versus the right coronary systems. Our outcome was graft patency defined as a binary variable according to whether grafts were reported as patent or failed at the time of angiogram. Data collection and analysis were performed according to the methodological recommendations of the Cochrane Collaboration. From a total 2275 papers, 52 studies were included in the qualitative analysis and 48 studies (including 36 006 grafts) in the meta-analysis. There was a 3.3% significant difference between the left-sided and right-sided graft patency, and the difference appeared to increase over time. Furthermore, patency of arterial grafts was higher in the left coronary system, while venous grafts performed similarly irrespective of the coronary circulation. Symptom recurrence also seemed related to a higher failure rate in the right coronary circulation. However, the high degree of heterogeneity precluded drawing definite conclusions. This meta-analysis suggested that graft patency might be better for left-sided vessels and that this difference might be driven by the better performance of arterial grafts in the left coronary system. However, evidence currently available is limited, and further research is warranted to understand whether certain grafts achieve better patency in the right versus the left coronary circulations.
      PubDate: Wed, 28 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy060
      Issue No: Vol. 54, No. 2 (2018)
  • The role of the ground-glass opacity ratio in resected lung adenocarcinoma
    • Authors: Huang T; Lin K, Huang H, et al.
      Pages: 229 - 234
      Abstract: OBJECTIVESThe goal of this study was to investigate the role of the ground-glass opacity (GGO) ratio in lung adenocarcinoma in predicting surgical outcomes.METHODSPatients who underwent surgical resection for pulmonary adenocarcinoma between January 2004 and December 2013 were reviewed. The clinical data, imaging characteristics of nodules, surgical approaches and outcomes were analysed with a mean follow-up of 87 months.RESULTSOf 789 enrolled patients, 267 cases were categorized as having a GGO ratio ≥0.75; 522 cases were categorized as having a GGO ratio <0.75. The gender, tumour differentiation, epidermal growth factor receptor mutation, smoking habits, lymphovascular space invasion, tumour size, maximum standard uptake value and carcinoembryonic antigen levels were significantly different in the 2 groups. In the group with a GGO ratio ≥0.75, 63.3% of the patients underwent sublobar resection (18.8% with a GGO ratio < 0.75, P <0.001). These patients had fewer relapses (2.2% for GGO ratio ≥0.75, 26.8% for GGO ratio <0.75, P < 0.001) and a better 5-year survival rate (95.5% for GGO ratio ≥0.75, 77.4% for GGO ratio <0.75, P < 0.001). None of the patients with a GGO ratio ≥0.75 had lymph node involvement. The multivariable Cox regression analysis revealed that a GGO ratio <0.75 was an independent factor for postoperative relapse with a hazard ratio of 3.96.CONCLUSIONSA GGO ratio ≥0.75 provided a favourable prognostic prediction in patients with resected lung adenocarcinoma. Sublobar resection and lymph node sampling revealed a fair outcome regardless of tumour size. However, anatomical resection is still the standard approach for patients with tumours with a GGO ratio <0.75, size >2 cm.
      PubDate: Mon, 19 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy040
      Issue No: Vol. 54, No. 2 (2018)
  • Solid to ground-glass opacity ratio in lung adenocarcinomas: is it a new
           criterion for limited pulmonary resection'
    • Authors: Batirel H.
      Pages: 235 - 236
      Abstract: Lung adenocarcinomaGround-glass opacity
      PubDate: Thu, 08 Mar 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy090
      Issue No: Vol. 54, No. 2 (2018)
  • Prognostic value of Twist, Snail and E-cadherin expression in pathological
           N0 non-small-cell lung cancer: a retrospective cohort study
    • Authors: Wang G; Ma W, Li Y, et al.
      Pages: 237 - 245
      Abstract: OBJECTIVESLung cancer is the leading cause of cancer-related death worldwide. The 5-year survival rate for patients after curative surgery with pathological N0 non-small-cell lung cancer (NSCLC) is as low as 56%, which is due to recurrence and metastasis. Emerging evidence suggests that epithelial–mesenchymal transition is important for cancer metastasis. Twist and Snail are epithelial–mesenchymal transition regulators that induce metastasis by down-regulating E-cadherin. The aim of this study was to evaluate the prognostic value of Twist, Snail and E-cadherin expression in patients with resectable pathological N0 NSCLC.METHODSThe expression levels of Twist, Snail and E-cadherin in 78 patients with resected pathological N0 NSCLC were assessed using immunohistochemistry. The association between the expression of Twist/Snail/E-cadherin and overall survival (OS) and recurrence-free survival (RFS) was investigated.RESULTSHigh expression of Twist, Snail and E-cadherin was detected in 18%, 21% and 53% of NSCLC samples, respectively. High expression of Twist and Snail and low expression of E-cadherin were associated with worse RFS [hazard ratio (HR) 2.29, 95% confidence interval (CI) 1.07–4.87, P = 0.026; HR 2.54, 95% CI 1.24–5.20, P = 0.008 and HR 2.41, 95% CI 1.23–4.73, P = 0.007, respectively] and worse OS (HR 2.26, 95% CI 1.01–5.04, P = 0.040; HR 2.56, 95% CI 1.20–5.43, P = 0.011 and HR 2.42, 95% CI 1.18–4.95, P = 0.012, respectively). Co-expression of at least 2 markers from the combination of high Twist/high Snail/low E-cadherin expression predicted poor RFS and OS (HR 4.12, 95% CI 2.08–8.16, P < 0.001 and HR 4.28, 95% CI 2.08–8.77, P < 0.001, respectively), and it was an independent predictor of RFS and OS (HR 3.99, 95% CI 1.89–8.44, P < 0.001 and HR 4.16, 95% CI 1.88–9.18, P < 0.001, respectively).CONCLUSIONSCo-expression of at least 2 markers from the combination of high Twist/high Snail/low E-cadherin expression was a significant prognostic predictor in patients with pathological N0 NSCLC.
      PubDate: Mon, 05 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy022
      Issue No: Vol. 54, No. 2 (2018)
  • Bronchopulmonary sequestrations in a paediatric centre: ongoing practices
           and debated management
    • Authors: Khen-Dunlop N; Farmakis K, Berteloot L, et al.
      Pages: 246 - 251
      Abstract: OBJECTIVESBronchopulmonary sequestration (BPS) is the second most common congenital lung malformation, with an estimated incidence ranging from 0.15% to 1.8%. Surgical treatment is elective in patients with symptoms, but the management of asymptomatic patients remains controversial.METHODSWe retrospectively reviewed the medical records of 99 patients treated for BPS in our institution from January 2000 to December 2015. BPS was diagnosed prenatally in 86 (87%) cases. Management throughout this 16-year period was based on 3 interventions: resection by open surgery, resection by thoracoscopy and embolization.RESULTSAmong the 86 patients with a prenatal diagnosis of BPS, 14% had symptoms at birth and 10% had delayed symptoms at a median delay of 8 months (4.5–42 months). For the other 13 patients, symptoms occurred at a median age of 34 months (range 3–96 months). Embolization of the feeding vessel was performed in 46 patients with 6 secondary surgical resections (13%). A total of 59 patients were operated on: 23 cases by open surgery and 36 cases by thoracoscopy. The mean hospitalization stay was significantly longer for open surgery: 4.8 ± 1.3 days vs 4.1 ±1.5 days, respectively (P = 0.03). Differences in hospitalization stay were also found between asymptomatic and symptomatic patients: 3.5 ± 1.2 vs 5.1 ±1.6 days, respectively (P = 0.002). Two of the operated patients died.CONCLUSIONSWhen surgery is chosen, thoracoscopy appears to be a valuable procedure. A better understanding of the natural history of BPS is still needed to define the optimal management and the respective roles of surgery, embolization or non-interventional follow-up.
      PubDate: Wed, 28 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy049
      Issue No: Vol. 54, No. 2 (2018)
  • Mid-term survival outcome of single-port video-assisted thoracoscopic
           anatomical lung resection: a two-centre experience
    • Authors: Wu C; Fernandez R, de la Torre M, et al.
      Pages: 252 - 259
      Abstract: OBJECTIVESSingle-port video-assisted thoracoscopic surgery (SPVATS) anatomical resection has been shown to be a feasible technique for lung cancer patients. Whether SPVATS has equivalent or better oncological outcomes for lung cancer patients remains controversial. The purpose of this study was to evaluate the perioperative and mid-term survival outcomes of SPVATS in 2 different medical centres.METHODSWe retrospectively reviewed patients who underwent SPVATS anatomical resections between January 2014 and February 2017 in Coruña University Hospital’s Minimally Invasive Thoracic Surgery Unit (Spain) and Chang Gung Memorial Hospital (Taiwan). Survival outcomes were assessed by pathological stage according to the American Joint Committee on Cancer (AJCC) 7th and 8th classifications.RESULTSIn total, 307 patients were enrolled in this study. Mean drainage days and postoperative hospital stay were 3.90 ± 2.98 and 5.03 ± 3.34 days. The overall 30-day mortality, 90-day morbidity and mortality rate were 0.7%, 20.1% and 0.7%, respectively. The 2-year disease-free survival and 2-year overall survival of the cohort were 80.6% and 93.4% for 1A, 68.8% and 84.6% for 1B, 51.0% and 66.7% for 2A, 21.6% and 61.1% for 2B, 47.6% and 58.5% for 3A, respectively, following the AJCC 7th classification. By the AJCC 8th classification, these were 92.3% and 100% for 1A1, 73.7% and 91.4% for 1A2, 75.2% and 93.4% for 1A3, 62.1% and 85.9% for 1B, 55.6% and 72.7% for 2A, 47.1% and 64.2% for 2B and 42.1% and 60.3% for 3A.CONCLUSIONSOur preliminary results revealed that SPVATS anatomical resection achieves acceptable 2-year survival outcomes for early-stage lung cancer and is consistent with AJCC 8th staging system 2-year survival data. For advanced stage non-small-cell lung cancer patients, further evaluation is warranted.
      PubDate: Sat, 03 Mar 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy067
      Issue No: Vol. 54, No. 2 (2018)
  • The balance between short-term and long-term outcomes of bilateral
           internal thoracic artery skeletonization in coronary artery bypass
           surgery: a propensity-matched cohort study†
    • Authors: Ngu J; Guo M, Glineur D, et al.
      Pages: 260 - 266
      Abstract: OBJECTIVESThere is growing interest in the use of bilateral internal thoracic arteries (BITAs) for myocardial revascularization. This study sought to compare the balance between early benefits and long-term outcomes of skeletonized or non-skeletonized conduits and to determine whether differences in outcomes are affected by other patient risk factors.METHODSBITAs were used in 1504 cases with either SK or NSK conduits. Propensity matching was completed using 22 covariates identifying 441 pairs of patients. The primary outcomes are the sternal wound infection in the short term and the composite outcome of all-cause mortality, myocardial infarction, revascularization and congestive heart failure. Outcomes were assessed using paired analysis techniques and Cox proportional hazards regression models stratified using the matched pairs.RESULTSIncidences of in-hospital mortality and perioperative myocardial infarction were similar in both groups. There were fewer sternal wound infections in the SK group (5.4 vs 9.1%, P = 0.033). Homogeneity testing of the relative risk estimates confirmed that there was a protective effect of skeletonization in men that was not demonstrated in women (P = 0.020). SK had a protective effect in diabetics not seen in non-diabetics (P = 0.048). The composite outcome of all-cause mortality, myocardial infarction, revascularization and congestive heart failure at a median of 5.6 years was comparable in both groups (hazard ratio 0.81, 95% confidence interval 0.57–1.15).CONCLUSIONSkeletonization results in better perioperative outcomes and comparable cardiac outcomes in patients undergoing BITA with the greatest benefit in men and patients with chronic obstructive pulmonary disease.
      PubDate: Tue, 13 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy025
      Issue No: Vol. 54, No. 2 (2018)
  • Predictors and outcome of conversion to cardiac surgery during
           transcatheter aortic valve implantation
    • Authors: Arsalan M; Kim W, Van Linden A, et al.
      Pages: 267 - 272
      Abstract: OBJECTIVESDue to increasing clinical experience with transcatheter aortic valve implantation (TAVI) procedures, sophisticated imaging and advanced device technology, TAVI complication rates are low; however, patients requiring conversion to surgery are confronted with an increased mortality risk. In this retrospective study, we evaluated the predictors for conversion and the outcomes of these patients.METHODSWe analysed the records of all patients undergoing TAVI in our centre from 2011 to 2016 and focused on cases that required conversion to sternotomy. We investigated reasons and risk factors for conversion as well as 30-day and 1-year outcomes.RESULTSDuring the study period, 32 (2.1%) of 1775 patients undergoing TAVI required immediate conversion to sternotomy. Annular rupture (5 of 32; 16%), device embolization (9 of 32; 28%) and pericardial tamponade (15 of 32; 47%) were the most common reasons for conversion. Usage of a self-expandable valve showed to be the only predictor for conversion (odds ratio 0.38, 95% confidence interval 0.16–0.90; P = 0.03). Survival at 30 days and 1 year was 56% and 41%, respectively. Patients who survived 30 days after conversion showed higher preoperative ejection fraction, shorter duration of surgery and shorter perfusion time.CONCLUSIONSIn this high-volume, single-centre experience, conversion to sternotomy during TAVI occurred in about 2%, with annular rupture, device embolization and pericardial tamponade being the most common causes. Complications requiring conversion showed to be unpredictable. However, in view of these life-threatening complications, the 30-day survival rate exceeding 50% emphasizes the importance of an experienced and well-attuned heart team providing immediate access to surgical bailout procedures.
      PubDate: Thu, 01 Mar 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy034
      Issue No: Vol. 54, No. 2 (2018)
  • Learning curve analysis of transapical NeoChord mitral valve repair†
    • Authors: Colli A; Bagozzi L, Banchelli F, et al.
      Pages: 273 - 280
      Abstract: OBJECTIVESTransapical off-pump mitral valve intervention with neochordae implantation is a novel, minimally invasive procedure for treatment of degenerative mitral valve regurgitation. The aim of this study was to apply control charts (CUSUM curves) to monitor the performance of NeoChord repair during the initial phase of its adoption.METHODSThe first 112 consecutive patients who underwent NeoChord repair at our institution between November 2013 and March 2016 were included in the analysis. Mitral Valve Academic Research Consortium criteria for 1-year patient success was utilized to determine failed procedures. Control charts had predetermined acceptable and unacceptable failure rates of 5% and 15%, respectively.RESULTSThe actual incidence of 1-year-patient failure was 11% (12 of 112 cases), with a cluster of failures within the first 20 cases. The CUSUM analysis demonstrated an initial learning curve; however, the upper boundary (alarm line) was never crossed. The reassurance line was first crossed after 40 procedures and performance remained stable after 49 procedures.CONCLUSIONSNeoChord repair is a safe procedure, and the results are maintained through the 1-year follow-up. A relative high number of implants were required to overcome the learning curve at our institution due to the concurrent development of patient selection criteria and the technical refinement of the procedure. Future studies are needed to assess the evolution of the learning curve after the wide adoption of the procedure across European and North American centres.
      PubDate: Wed, 21 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy046
      Issue No: Vol. 54, No. 2 (2018)
  • Randomized trial of the Carpentier–Edwards supra-annular prosthesis
           versus the Medtronic Mosaic aortic prosthesis: 10-year results†
    • Authors: Zibdeh O; Bugg I, Patel S, et al.
      Pages: 281 - 287
      Abstract: OBJECTIVESWe performed a prospective randomized study comparing the clinical performance of the Carpentier–Edwards supra-annular valve (CE-SAV) (Edwards Lifesciences, Irvine, CA, USA) and the newer Mosaic (Medtronic Corporation, Minneapolis, MN, USA) porcine bioprostheses in the aortic position over a 10-year period.METHODSBetween January 2001 and March 2005, 394 patients undergoing bioprosthetic aortic valve replacement were randomized to receive either the CE-SAV (n = 191) or the Mosaic (n = 203) prosthesis. The preoperative demographics, EuroSCORE and intraoperative characteristics concerning cardiopulmonary bypass of the 2 groups were comparable. All patients were followed annually for 10 years.RESULTSThere were 77 (40.3%) deaths in the CE-SAV group and 93 (45.8%) deaths in the Mosaic group. The 10-year survival rate in the 2 groups was 59.7% and 54.2%, respectively (P = 0.27). There were no statistically significant differences between the 2 groups in terms of structural valve deterioration (P = 0.08), endocarditis (P = 0.95), thromboembolism (P = 0.06) and major bleeds (P = 0.09). However, the incidence of paravalvular leaks and valve-related reoperations were higher in the Mosaic group, with 5 leaks and 6 reoperations when compared to none in the CE-SAV group, (P = 0.02) and (P = 0.01) respectively.CONCLUSIONSAt 10 years after implantation, freedom from reoperation was greater in the CE-SAV group with no incidences of paravalvular leaks. There were no other statistically significant differences between CE-SAV and Mosaic aortic prostheses.Clinical trial ID 1301 (NCT03346044).
      PubDate: Thu, 01 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx512
      Issue No: Vol. 54, No. 2 (2018)
  • Reasons for conversion and adverse intraoperative events in Endoscopic
           Port Access™ atrioventricular valve surgery and minimally invasive
           aortic valve surgery†
    • Authors: van der Merwe J; Van Praet F, Stockman B, et al.
      Pages: 288 - 293
      Abstract: OBJECTIVESThis study reports the factors that contribute to sternotomy conversions (SCs) and adverse intraoperative events in minimally invasive aortic valve surgery (MI-AVS) and minimally invasive Endoscopic Port Access™ atrioventricular valve surgery (MI-PAS).METHODSIn total, 3780 consecutive patients with either aortic valve disease or atrioventricular valve disease underwent minimally invasive valve surgery (MIVS) at our institution between 1 February 1997 and 31 March 2016. MI-AVS was performed in 908 patients (mean age 69.2 ± 11.3 years, 45.2% women, 6.2% redo cardiac surgery) and MI-PAS in 2872 patients (mean age 64.1 ± 13.3 years, 46.7% women, 12.2% redo cardiac surgery).RESULTSA cumulative total of 4415 MIVS procedures (MI-AVS = 908, MI-PAS = 3507) included 1537 valve replacements (MI-AVS = 896, MI-PAS = 641) and 2878 isolated or combined valve repairs (MI-AVS = 12, MI-PAS = 2866). SC was required in 3.0% (n = 114 of 3780) of MIVS patients, which occurred in 3.1% (n = 28 of 908) of MI-AVS patients and 3.0% (n = 86 of 2872) of MI-PAS patients, respectively. Reasons for SC in MI-AVS included inadequate visualization (n = 4, 0.4%) and arterial cannulation difficulty (n = 7, 0.8%). For MI-PAS, SC was required in 54 (2.5%) isolated mitral valve procedures (n = 2183). Factors that contributed to SC in MI-PAS included lung adhesions (n = 35, 1.2%), inadequate visualization (n = 2, 0.1%), ventricular bleeding (n = 3, 0.1%) and atrioventricular dehiscence (n = 5, 0.2%). Neurological deficit occurred in 1 (0.1%) and 3 (3.5%) MI-AVS and MI-PAS conversions, respectively. No operative or 30-day mortalities were observed in MI-AVS conversions (n = 28). The 30-day mortality associated with SC in MI-PAS (n = 86) was 10.5% (n = 9).CONCLUSIONSMIVS is increasingly being recognized as the ‘gold-standard’ for surgical valve interventions in the context of rapidly expanding catheter-based technology and increasing patient expectations. Surgeons need to be aware of factors that contribute to SC and adverse intraoperative outcomes to ensure that patients enjoy the maximum potential benefit of MIVS and to apply effective risk reduction strategies that encourage safer and sustainable MIVS programmes.
      PubDate: Wed, 14 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy027
      Issue No: Vol. 54, No. 2 (2018)
  • Effect of new-onset atrial fibrillation on cause-specific late mortality
           after coronary artery bypass grafting surgery†
    • Authors: Schwann T; Al-Shaar L, Engoren M, et al.
      Pages: 294 - 301
      Abstract: OBJECTIVESPostoperative atrial fibrillation (POAF) is a common complication after coronary artery bypass grafting. Although transient, POAF is linked to increased late mortality. We hypothesized that POAF increases late cerebrovascular (CeV) and composite cerebrovascular/cardiovascular/vascular (CV* = CeV + CV + Other-V) but not non-cardiovascular (Non-CV) mortality.METHODSWe analysed 8807 non-salvage coronary artery bypass grafting patients (1994–2011). Fifteen-year and time-segmented (early, 0–1 year; intermediate, 1–6 years and late, 6–15 years) all-cause and cause-specific mortality were compared for POAF versus No-POAF patients. Corresponding POAF versus No-POAF adjusted hazard ratios [AHRs (95% confidence interval, CI)] were derived using the competing risk Cox regression.RESULTSPOAF occurred in 1992 (23%) patients. Complications other than POAF occurred in 1875 (21%) patients but were more frequent among POAF patients (31% vs 18%; P < 0.001). Overall mean follow-up was 9 ± 4 years. POAF patients had a higher 15-year unadjusted mortality (53% vs 39%; P < 0.001) and were consequently associated with higher adjusted all-cause [AHR (95% CI) = 1.23 (1.14–1.33)] and composite cardiovascular [CV*: AHR (95% CI) = 1.15 (1.02–1.30)] mortality. The trends towards a higher 15-year CeV [AHR (95% CI) = 1.34 (0.94–1.91)] and Non-CV [AHR (95% CI) = 1.12 (0.99–1.26)] mortality were not significant. Time-segmented analyses showed that (i) POAF increased all-cause mortality early, and this persisted in the intermediate and late periods and (ii) CeV [AHR (95% CI) = 2.14 (1.14–4.04)] and CV* [AHR (95% CI) = 1.31 (1.06–1.62)] mortality rates were increased in the intermediate but not in the early or late periods. Non-CV mortality was similar in POAF and No-POAF for all time intervals. These findings were corroborated in propensity-matched sub-cohorts and in sensitivity analyses in patients free of any other complication.CONCLUSIONSPOAF is associated with worse long-term survival principally driven by increased intermediate-term cerebrovascular and cardiovascular mortality, while Non-CV mortality was similar.
      PubDate: Wed, 21 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy028
      Issue No: Vol. 54, No. 2 (2018)
  • Bioprosthetic mitral valve replacement in patients aged 65 years or
           younger: long-term outcomes with the Carpentier–Edwards PERIMOUNT
           pericardial valve†
    • Authors: Bourguignon T; Espitalier F, Pantaleon C, et al.
      Pages: 302 - 309
      Abstract: OBJECTIVESMitral valve replacement using a bioprosthesis remains controversial in young patients because data on long-term outcomes are missing. This study evaluated the long-term results of the PERIMOUNT pericardial mitral bioprosthesis in patients aged 65 years or younger.METHODSFrom 1984 to 2010, 148 Carpentier–Edwards PERIMOUNT mitral bioprostheses were implanted in 148 patients aged 65 years or younger. Baseline clinical, perioperative and follow-up data were recorded prospectively. Structural valve deterioration (SVD) was defined by strict echocardiographic assessment.RESULTSThe mean follow-up period was 8.6 ± 5.5 years, for a total of 1269 valve-years. Operative mortality rate was 2.0%. Fifty-one late deaths occurred (linearized rate 4.0% per valve-year). Actuarial survival rates averaged 70 ± 4%, 53 ± 6% and 31 ± 7% after 10, 15 and 20 years of follow-up, respectively. Actuarial freedom from SVD at 10, 15 and 20 years was 78 ± 5%, 47 ± 7% and 19 ± 7%, respectively. Reoperation was associated with no operative mortality. Actuarial freedom from reoperation due to SVD at 10, 15 and 20 years was 82 ± 4%, 50 ± 6% and 25 ± 8%, respectively. Competing risk analysis demonstrated an actual risk of explantation secondary to SVD at 20 years of 44 ± 5%. Expected valve durability was 14.2 years for this age group.CONCLUSIONSIn the selected patients aged 65 years or younger undergoing mitral valve replacement with a pericardial bioprosthesis, the expected valve durability was 14.2 years. Reoperation for SVD was associated with a low risk of mortality.
      PubDate: Mon, 12 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy029
      Issue No: Vol. 54, No. 2 (2018)
  • Prognosis of adult obstructive hypertrophic cardiomyopathy patients with
           different morphological types after surgical myectomy†
    • Authors: Tang B; Song Y, Cui H, et al.
      Pages: 310 - 317
      Abstract: OBJECTIVESThis study aims to assess the impact of morphological type on the prognosis of obstructive hypertrophic cardiomyopathy patients who underwent myectomy.METHODSWe recruited 469 obstructive hypertrophic cardiomyopathy patients refractory to medicinal treatment who have undergone surgical myectomy at a nationwide referral centre. All patients were divided into 3 groups based on the morphological classification of left ventricular hypertrophy and were followed up by telephone every year. The primary end-points were sudden cardiac death, aborted sudden cardiac death and death due to heart failure or stroke. The secondary end-points were non-fatal cardiovascular events.RESULTSTypical hypertrophy limited to the basal septum, hypertrophy of the whole ventricular septum and hypertrophy that involved the whole left ventricle were presented in 248 (52.9%), 141 (30.1%) and 80 (17.0%) patients, respectively. During the follow-up of 2.5 ± 1.4 years after myectomy, 10 (2.1%) and 43 (9.2%) patients met the primary end-point and secondary end-points, respectively. The maximal thickness of the ventricular septum, the left ventricular mass and the presence of extensive late gadolinium enhancement were lower in patients with hypertrophy limited to the basal septum than in other patients. Patients with the basal septum hypertrophy showed better survival after myectomy compared with other patients. For the secondary and composite end-points, there was no significant difference between the 3 groups.CONCLUSIONSPatients with hypertrophy limited to the basal septum represented a special clinical subtype of obstructive hypertrophic cardiomyopathy showing better clinical outcomes, while diffuse hypertrophy of the ventricular septum and free wall indicated lower survival after surgical myectomy.
      PubDate: Mon, 12 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy037
      Issue No: Vol. 54, No. 2 (2018)
  • In situ tissue regeneration using a warp-knitted fabric in the canine
           aorta and inferior vena cava†
    • Authors: Nemoto S; Konishi H, Shimada R, et al.
      Pages: 318 - 327
      Abstract: OBJECTIVESMaterials used in paediatric cardiac surgery have drawbacks of deterioration, calcification and pseudointimal proliferation resulting in haemodynamic disturbance. The aim of this study was to investigate whether these drawbacks can be overcome by in situ tissue regeneration using a newly developed synthetic hybrid fabric (SHF).METHODSThe SHF is an expandable, warp-knitted fabric composed of a combination of biodegradable [poly-l-lactic acid (PLLA)] and non-biodegradable (polyethylene terephthalate) yarns. The fabric is coated with cross-linked gelatin. Mechanical properties of the SHF were compared with those of 2 commercial products: expanded polytetrafluoroethylene sheet and glutaraldehyde-treated bovine pericardium. An oval-shaped defect created in the canine descending aorta or inferior vena cava was filled with the SHF patch. After 2 weeks and 1, 3, 6 and 12 (or 24 in the inferior vena cava) months, the patch was removed for histological examination and evaluation of the remaining PLLA.RESULTSThe SHF exhibited satisfactory tensile and suture retention strength for surgical implantation similar to or better than the 2 commercial products. Tissue regeneration was induced with multilayered smooth muscle cells and collagen fibres on both sides of the patch, along with a mature endothelial layer and tissue connections containing vasa vasorum across the patch in the aorta and inferior vena cava. Inflammatory reactions were minimal, and no calcium deposition occurred. The molecular weight of PLLA was reduced to half at 12 months after implantation.CONCLUSIONSThe SHF may solve the drawbacks of the existing products. Further studies of the expandability of the SHF patch after degradation of PLLA are warranted.
      PubDate: Wed, 14 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy045
      Issue No: Vol. 54, No. 2 (2018)
  • Five-year experience using the Lung Allocation Score: the Munich Lung
           Transplant Group
    • Authors: Schuba B; Scheklinski M, von Dossow V, et al.
      Pages: 328 - 333
      Abstract: OBJECTIVESThe Lung Allocation Score (LAS) was implemented in Germany on 10 December 2011 after demonstrating favourable outcomes in the USA since its introduction in 2005. There are only limited and short-term data on the effect of the LAS on lung transplantation programmes in Germany. The purpose of this study was to analyse our 5-year single-centre experience with the LAS within the influential area of the Eurotransplant Foundation (ET).METHODSAfter implementation of the LAS until December 2016, 294 patients underwent a single-lung transplantation or a bilateral sequential lung transplantation for end-stage lung disease at our centre. Patients were divided into 4 groups according to their primary diagnosis. The Kaplan–Meier analyses of survival probabilities were performed to compare types of transplant procedures, underlying diagnoses and the LASs at the time of transplantation. Waitlist characteristics, transplant procedures and up to 5-year post-transplant outcomes were analysed.RESULTSThe proportion of lung transplants performed for interstitial lung disease increased over time from 27% in 2012 to 54% in 2016 (P = 0.056). At the same time, the proportion of patients with chronic obstructive pulmonary disease undergoing lung transplantation declined over the 5-year period, i.e. from 29% in 2011 to 19% in 2016 (P = 0.029). Overall waiting times of transplanted patients were approximately 200 days and did not markedly change over time. There was an increasing proportion of chronic obstructive pulmonary disease patients on the waitlist from 41% in 2011 to 51% in 2016 (P = 0.51). Outcomes were independent of the underlying disease entity or the LAS. Bilateral sequential lung transplantation was associated with a better long-term survival probability when compared with a single-lung transplantation (P < 0.001).CONCLUSIONSOur centre-specific 5-year experience confirms previous findings demonstrating that the LAS is a well-established tool for the selection of lung transplant candidates, respecting urgency and prognostic transplant benefit in a disease-specific manner. However, the LAS did not shorten overall waiting times in transplanted patients. Further long-term and multicentre data with respect to differential transplant centre activities have to be gathered for further evaluation.
      PubDate: Thu, 15 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy035
      Issue No: Vol. 54, No. 2 (2018)
  • Extracorporeal membrane oxygenation as a bridge to lung transplantation
           may not impact overall mortality risk after transplantation: results from
           a 7-year single-centre experience†
    • Authors: Ius F; Natanov R, Salman J, et al.
      Pages: 334 - 340
      Abstract: OBJECTIVESExtracorporeal membrane oxygenation (ECMO) has an important role in bridging patients to lung transplantation. In this study, we present our experience with pretransplant ECMO during the last 7 years and investigate its impact on graft outcomes.METHODSRecords of all lung-transplanted patients at our institution between January 2010 and April 2017 were retrospectively reviewed. Graft survival was compared between patients who required pretransplant ECMO (pre-Tx ECMO+) and patients who did not (pre-Tx ECMO−). Risk factors for in-hospital mortality and graft survival were identified using a binary logistic regression and the Cox regression analyses, respectively.RESULTSAmong the 917 patients transplanted during the study period, 68 (7%) required ECMO as a bridge to transplantation [awake strategy, n = 57 (84%) patients]. Median bridging time was 9 days. Among pre-Tx ECMO+ patients, the need for haemodialysis at any point during bridging emerged as an independent risk factor for in-hospital mortality (odds ratio 7.79, 95% confidence interval 1.21–50.24; P = 0.031). Although in-hospital mortality was significantly higher in pre-Tx ECMO+ versus pre-Tx ECMO− patients (15% vs 5%, P = 0.003), overall graft survival did not differ between groups (79% vs 90% and 61% vs 68% at 1 and 5 years, respectively, P = 0.13). Pretransplant ECMO did not emerge as a risk factor for graft survival in the multivariable analysis.CONCLUSIONSIf applied in selected patients in a high-volume centre, pretransplant ECMO as a bridge to transplantation results in impaired, but still high in-hospital, survival and does not impact graft survival.
      PubDate: Mon, 12 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy036
      Issue No: Vol. 54, No. 2 (2018)
  • Central versus peripheral cannulation of extracorporeal membrane
           oxygenation support during double lung transplant for pulmonary
    • Authors: Glorion M; Mercier O, Mitilian D, et al.
      Pages: 341 - 347
      Abstract: OBJECTIVESExtracorporeal membrane oxygenation (ECMO) has become the standard of cardiopulmonary support during a sequential double lung transplant for pulmonary hypertension. Whether central or peripheral cannulation is the best strategy for these patients remains unknown. Our goal was to determine which is the best strategy by comparing 2 populations of patients.METHODSWe performed a single-centre retrospective study based on an institutional prospective lung transplant database.RESULTSBetween January 2011 and November 2016, 103 patients underwent double lung transplant for pulmonary hypertension. We compared 54 patients who had central ECMO (cECMO group) to 49 patients who had peripheral ECMO (pECMO group). The pECMO group had significantly more bridged patients who received emergency transplants (31% vs 6%, P = 0.001). The incidence of Grade 3 primary graft dysfunction requiring ECMO (14% vs 11%, P = not significant) and of in-hospital mortality (11% vs 14%, P = not significant) was similar between the groups. Groin infections (16% vs 4%, P = 0.031), deep vein thrombosis (27% vs 11%, P = 0.044) and lower limb ischaemia (12% vs 2%, P = 0.031) occurred significantly more often in the pECMO group. The number of chest reopenings for bleeding or infection was similar between the groups. The 3-month, 1-year and 5-year survival rates did not differ between the groups (P = 0.94).CONCLUSIONSCentral or peripheral ECMO produced similar results during double lung transplant for pulmonary hypertension in terms of in-hospital deaths and long-term survival rates. Central ECMO provided satisfactory results without major bleeding provided the patient was weaned from ECMO at the end of the procedure. Despite the rate of groin and lower limb complications, peripheral cannulation remained the preferred solution to bridge the patient to transplant or for postoperative support.
      PubDate: Thu, 08 Mar 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy089
      Issue No: Vol. 54, No. 2 (2018)
  • The impact of the maternal–foetal environment on outcomes of surgery for
           congenital heart disease in neonates†
    • Authors: Gaynor J; Parry S, Moldenhauer J, et al.
      Pages: 348 - 353
      Abstract: OBJECTIVESPregnancies with congenital heart disease in the foetus have an increased prevalence of pre-eclampsia, small for gestational age and preterm birth, which are evidence of an impaired maternal–foetal environment (MFE).METHODSThe impact of an impaired MFE, defined as pre-eclampsia, small for gestational age or preterm birth, on outcomes after cardiac surgery was evaluated in neonates (n = 135) enrolled in a study evaluating exposure to environmental toxicants and neuro-developmental outcomes.RESULTSThe most common diagnoses were transposition of the great arteries (n = 47) and hypoplastic left heart syndrome (n = 43). Impaired MFE was present in 28 of 135 (21%) subjects, with small for gestational age present in 17 (61%) patients. The presence of an impaired MFE was similar for all diagnoses, except transposition of the great arteries (P < 0.006). Postoperative length of stay was shorter for subjects without an impaired MFE (14 vs 38 days, P < 0.001). Hospital mortality was not significantly different with or without impaired MFE (11.7% vs 2.8%, P = 0.104). However, for the entire cohort, survival at 36 months was greater for those without an impaired MFE (96% vs 68%, P = 0.001). For patients with hypoplastic left heart syndrome, survival was also greater for those without an impaired MFE (90% vs 43%, P = 0.007).CONCLUSIONSAn impaired MFE is common in pregnancies in which the foetus has congenital heart disease. After cardiac surgery in neonates, the presence of an impaired MFE was associated with lower survival at 36 months of age for the entire cohort and for the subgroup with hypoplastic left heart syndrome.
      PubDate: Tue, 13 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy015
      Issue No: Vol. 54, No. 2 (2018)
  • Rapid deployment aortic valve replacement in a minimal access setting:
           intermediate clinical and echocardiographic outcomes†
    • Authors: Schlömicher M; Taghiyev Z, AlJabery Y, et al.
      Pages: 354 - 360
      Abstract: OBJECTIVESTranscatheter procedures have overtaken conventional operations in Germany. Considering that this is a highly competitive field, a rate of 25% for minimal access aortic valve replacement seems to be disappointingly low. One way to promote minimal access techniques is through the systematic use of rapid deployment valves.METHODSA total of 143 patients underwent rapid deployment aortic valve replacement via upper right hemisternotomy between March 2012 and September 2015. All patients were followed up annually. Echocardiographic assessment of the valve was performed after 12 months. The cumulative follow-up time was 275.2 patient-years. The median follow-up time was 1.9 years.RESULTSThe mean age was 76.4 ± 6.2 years, and the mean logistic EuroSCORE was 11.0 ± 4.3%. Early all-cause mortality was 2.8% (n = 4). Actuarial survival after 1 year was 91.6 ±  2.4%, and after 3 years, it was 84.4 ± 3.6%. Mean transprosthetic gradient after 12 months was 10.3 ± 3.8 mmHg. New onset of higher grade paravalvular leakage did not occur during the follow-up period. Perioperatively, higher grade paravalvular leakage (aortic insufficiency  >1+) occurred in 2 cases (1.4%) .CONCLUSIONSRapid deployment aortic valve replacement can be performed safely in a minimal access setting with low complication rates and good haemodynamic results. Therefore, rapid deployment valves are a relevant option in minimal access surgery.
      PubDate: Tue, 06 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy023
      Issue No: Vol. 54, No. 2 (2018)
  • Safety and durability of the biodegradable felt in aortic surgery: a
           propensity score-matched study†
    • Authors: Hosoyama K; Kawamoto S, Watanabe K, et al.
      Pages: 361 - 368
      Abstract: OBJECTIVESSuture line disruption is a serious complication after aortic surgery. We previously reported in a canine model that basic fibroblast growth factor-incorporated biodegradable polyglycolic acid (PGA) felt prevented tissue derangement at the anastomotic site. This study sought to evaluate the safety and durability of this biodegradable felt.METHODSBetween January 2007 and December 2011, 67 patients who consented to undergo aortic surgery with the basic fibroblast growth factor-incorporated PGA felt were enrolled (Group P). As a control, we retrospectively reviewed the charts of 129 patients who underwent aortic surgery using a polytetrafluoroethylene felt during the same registration period (Group N). On the basis of 18 preoperative covariates, 60 well-matched patient pairs were identified using propensity matching, and their clinical indices were compared.RESULTSAmong the matched pairs, in-hospital mortality and postoperative complication rates did not statistically differ between the groups. During a median follow-up of 4.8 years, the rate of anastomotic aneurysm was 1.7% (1 patient) in both groups. The rates of overall survival and freedom from aortic events did not differ between the groups. In total, 65 anastomoses in Group P and 54 anastomoses in Group N were monitored via computed tomography, and the diameters of the juxta-anastomotic sites in Group N were more likely to be increased than those in Group P {dilatation ratio [(post-discharge diameter − predischarge diameter)/predischarge diameter × 100 (%)]: 4.3% ± 0.6% vs 2.5% ± 0.5%, P = 0.01}.CONCLUSIONSThe basic fibroblast growth factor-incorporated PGA felt was as safe and durable as conventional felt for reinforcement in aortic surgery. The attenuation of juxta-anastomotic aortic dilatation by PGA felt reinforcement may provide more beneficial effects on long-term outcomes.
      PubDate: Mon, 05 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy026
      Issue No: Vol. 54, No. 2 (2018)
  • Surgical outcomes of aortic repair via transapical cannulation and the
           adventitial inversion technique for acute Type A aortic dissection†
    • Authors: Shimamura J; Yamamoto S, Oshima S, et al.
      Pages: 369 - 374
      Abstract: OBJECTIVESTo evaluate the surgical outcomes of aortic repair via transapical cannulation and the adventitial inversion technique for acute Type A aortic dissection.METHODSBetween 2008 and 2015, a total of 300 patients with acute Type A aortic dissection underwent emergency surgery, consisting of 271 hemiarch repairs and 29 total aortic arch replacements, using transapical cannulation and the adventitial inversion technique at a distal anastomosis. The mean follow-up periods were 31.7 ± 25.2 months. Overall, 18% (54/300) of the patients were octogenarians, and 21.7% (65/300) had cardiac tamponade; 25% (75/300) had preoperative malperfusion.RESULTSThe in-hospital and 30-day mortality rates were 8.3% (25/300) and 6.7% (20/300), respectively. The 30-day mortality rate was 2.7% (6/225) among patients without preoperative malperfusion and 18.7% (14/75) among patients with malperfusion (P < 0.0001), 7.4% (4/54) among octogenarians and 6.5% (16/246) among patients aged less than 80 years (P = 0.81), and 6.3% (17/271) among patients treated with hemiarch repair and 10.3% (3/29) among patients treated with total aortic arch replacement (P = 0.403). Preoperative malperfusion was an independent predictor of perioperative mortality in a multivariable analysis. During the follow-up period, distal reintervention was performed in 11% (33/300) of the patients. The rates of freedom from reintervention at 1, 3 and 5 years were 95.9%, 88.9% and 80.0%, respectively. The overall survival rates at 1, 3 and 5 years were 88.7%, 86.7% and 82.0%, respectively. The in-hospital mortality rate for elective reintervention was 3.0% (1/33).CONCLUSIONSAortic repair via transapical cannulation and the adventitial inversion technique for acute Type A aortic dissection provides good early and mid-term results. The safety of elective distal reintervention can be guaranteed. To obtain better operative outcomes, effective treatment for cases with malperfusion is mandatory.
      PubDate: Tue, 06 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy014
      Issue No: Vol. 54, No. 2 (2018)
  • True-lumen and false-lumen diameter changes in the downstream aorta after
           frozen elephant trunk implantation
    • Authors: Berger T; Kreibich M, Morlock J, et al.
      Pages: 375 - 381
      Abstract: OBJECTIVESTo evaluate early and mid-term clinical outcomes and to assess the potential of the frozen elephant trunk technique to induce remodelling of downstream aortic segments in acute and chronic thoracic aortic dissections.METHODSOver a 4-year period, 65 patients (48 men, aged 61 ± 12 years) underwent total aortic arch replacement using the frozen elephant trunk technique for acute (n = 31) and chronic (n = 34) thoracic aortic dissections at our institution. We assessed diameter changes at 3 levels: the L1 segment at the stent graft level; the L2 segment at the thoraco-abdominal transition level and the L3 segment at the coeliac trunk level. True-lumen (TL) and false-lumen (FL) diameter changes were assessed at each level.RESULTSFifty-six percent of patients had already undergone previous aortic or cardiac surgery. In-hospital mortality was 6%. Symptomatic spinal cord injury was not observed in this series. During a mean follow-up of 12 ± 12 months, late death was observed in 6% of patients. Aortic reinterventions in downstream aortic segments were performed in 28% at a mean of 394 ± 385 days. TL expansion and FL shrinkage were measured in all segments and were observed at each level. This effect was the most pronounced at the level of the stent graft in patients with chronic aortic dissection, TL diameter increased from 15 ± 17 mm before surgery to 28 ± 2 mm (P = 0.001) after 2 years, and the FL diameter decreased from 40 ± 11 mm before surgery to 32 ± 17 mm (P = 0.026).CONCLUSIONSThe frozen elephant trunk technique is associated with an excellent clinical outcome in a complex cohort of patients, and also effectively induces remodelling in downstream aortic segments in acute and chronic thoracic aortic dissections. The need for secondary interventions in downstream segments, which mainly depends on the extent of the underlying disease process, remains substantial. Further studies are required to assess the long-term outcome of this approach.
      PubDate: Mon, 19 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy031
      Issue No: Vol. 54, No. 2 (2018)
  • Open surgical repair of post-dissection thoraco-abdominal aortic
           aneurysms: early and late outcomes of a single-centre study involving over
           200 patients†
    • Authors: Alfonsi J; Murana G, Smeenk H, et al.
      Pages: 382 - 388
      Abstract: OBJECTIVESChronic, post-dissection thoraco-abdominal aortic aneurysms (TAAAs) are increasingly being treated by (hybrid) endovascular means. Although it is less invasive, thoracic endovascular aortic repair is technically complex with the risk of incomplete aneurysm exclusion, necessitating frequent reinterventions with potentially reduced long-term outcomes. The aim of this study was to evaluate contemporary early and late outcomes after open surgical repair of post-dissection TAAA.METHODSAt our centre, 633 patients underwent open repair for TAAA over a 20-year period (1994–2015), including 217 (34%) patients for post-dissection TAAA, who were included in this analysis. Circulatory support was obtained by either left heart bypass (173 patients, 79.7%), deep hypothermic circulatory arrest (41 patients, 18.9%) or simple aortic cross-clamping in 3 patients. We analysed all relevant perioperative and intraoperative variables with respect to adverse outcomes. Additionally, long-term survival and the need for aortic reinterventions were studied.RESULTSThe mean age was 60.2 ± 11.9 years (men 68.2%). We identified 66 Type I (30.4%), 113 Type II (52.1%), 25 Type III (11.5%), 10 Type IV (4.6%) and 3 Type V (1.4%) TAAAs. Early mortality and spinal cord deficit were 5.9% and 5.5%, respectively. Follow-up was 100% complete (mean 6.0 ± 5.8 years), with long-term survival of 71.4% at 10 years, and freedom from death and reoperation was 68.2% at 10 years.CONCLUSIONSAlthough it is more invasive than current endovascular approaches for post-dissection TAAA, open surgical repair can be performed safely with acceptable rates of morbidity and mortality when it is done in a specialized aortic centre. Long-term survival and freedom from aortic reintervention are excellent and should also be taken into account when evaluating less invasive alternatives.
      PubDate: Fri, 16 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy050
      Issue No: Vol. 54, No. 2 (2018)
  • A computational analysis of different endograft designs for Zone 0 aortic
           arch repair†
    • Authors: van Bakel T; Arthurs C, van Herwaarden J, et al.
      Pages: 389 - 396
      Abstract: OBJECTIVESAortic arch repair remains a major surgical challenge. Multiple manufacturers are developing branched endografts for Zone 0 endovascular repair, extending the armamentarium for minimally invasive treatment of aortic arch pathologies. We hypothesize that the design of the Zone 0 endograft has a significant impact on the postoperative haemodynamic performance, particularly in the cervical arteries. The goal of our study was to compare the postoperative haemodynamic performance of different Zone 0 endograft designs.METHODSPatient-specific, clinically validated, computational fluid dynamics simulations were performed in a 71-year-old woman with a 6.5-cm saccular aortic arch aneurysm. Additionally, 4 endovascular repair scenarios using different endograft designs were created. Haemodynamic performance was evaluated by calculation of postoperative changes in blood flow and platelet activation potential (PLAP) in the cervical arteries.RESULTSPreoperative cervical blood flow and mean PLAP were 1080 ml/min and 151.75, respectively. Cervical blood flow decreased and PLAP increased following endovascular repair in all scenarios. Endografts with 2 antegrade inner branches performed better compared to single-branch endografts. Scenario 3 performed the worst with a decrease in the total cervical blood flow of 4.8%, a decrease in the left hemisphere flow of 6.7% and an increase in the mean PLAP of 74.3%.CONCLUSIONSEndograft design has a significant impact on haemodynamic performance following Zone 0 endovascular repair, potentially affecting cerebral blood flow during follow-up. Our results demonstrate the use of computational modelling for virtual testing of therapeutic interventions and underline the need to monitor the long-term outcomes in this cohort of patients.
      PubDate: Thu, 15 Mar 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy068
      Issue No: Vol. 54, No. 2 (2018)
  • Extended surgery using anterior mediastinal tracheostomy for recurrent
           mediastinal liposarcoma†
    • Authors: Takenaka M; Ichiki Y, Taira A, et al.
      Pages: 397 - 399
      Abstract: Mediastinal liposarcoma is an extremely rare malignancy with a poor prognosis. We report the case of a 73-year-old man who presented with severe respiratory distress. He had previously been diagnosed with mediastinal liposarcoma, which had been treated with extirpation 6 years ago. The histological type was a well-differentiated liposarcoma. Three years ago, he experienced respiratory distress due to postoperative recurrence of mediastinal liposarcoma. To establish an airway, tracheotomy was urgently performed. Tracheal stenosis also developed because the sarcoma progressed to the trachea after tracheostomy. We performed radical resection of the recurrent mediastinal liposarcoma combined with the resection of the laryngopharynx and cervical oesophagus and reconstruction using a free jejunal graft. We then performed anterior mediastinal tracheostomy with a pedicled omental flap. There has been no recurrence in the 3 years since the last operation.
      PubDate: Sat, 03 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy021
      Issue No: Vol. 54, No. 2 (2018)
  • Curative therapy of a hepatitis C infection due to an infected heart
           donor: 5-year outcomes after heart transplantation
    • Authors: Jawad K; Feder S, Barten M, et al.
      Pages: 400 - 401
      Abstract: Heart transplantation is the gold standard therapy for patients diagnosed with end-stage heart failure. Despite the shortage of appropriate donor organs, the transplantation of hepatitis C-infected hearts is disputed. Previous research has shown that long-term results are controversial, and the risk of severe clinical infection should not be underestimated.
      PubDate: Sat, 03 Mar 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy051
      Issue No: Vol. 54, No. 2 (2018)
  • Accelerated acute severe antibody-mediated graft failure related to a Ross
           procedure 17 years earlier†
    • Authors: Andreas M; Freystaetter K, Bernardi M, et al.
      Pages: 402 - 403
      Abstract: A 31-year-old male patient underwent a heart transplantation due to dilated cardiomyopathy. He experienced accelerated acute antibody-mediated rejection despite being negative for human leukocyte antigen antibodies (0% panel-reactive antibodies prior to surgery). Further assessment revealed a common antigen between a homograft implanted 17 years earlier during the Ross procedure and the heart donor. The homograft likely induced specific antibody formation. Interestingly, panel-reactive antibody levels measured 7 years prior to transplantation were 7%. Because of the long time span between the Ross procedure and heart transplantation, no circulating antibodies could be detected in 2015, but reactivation of memory cells might potentially have led to this fulminant rejection episode. For future cases, particular attention should be given to patients with homografts.
      PubDate: Wed, 21 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy052
      Issue No: Vol. 54, No. 2 (2018)
  • Type A aortic dissection with pulmonary hypertension caused by pulmonary
           artery compression and acute mitral regurgitation
    • Authors: Miura S; Iba Y, Yamada A.
      Pages: 404 - 404
      Abstract: Type A aortic dissectionPulmonary artery compressionMitral regurgitationPulmonary hypertension
      PubDate: Wed, 21 Mar 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy085
      Issue No: Vol. 54, No. 2 (2018)
  • A mystery of the myocardial microcirculation during coronary artery bypass
    • Authors: Hellmann M; Piotrowski J, Anisimowicz L, et al.
      Pages: 405 - 405
      Abstract: Myocardial microcirculationCoronary artery bypass graftingLaser DopplerMicrovascular flow monitoring
      PubDate: Fri, 02 Mar 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy107
      Issue No: Vol. 54, No. 2 (2018)
  • Corrigendum to ‘Randomized trial of the Carpentier–Edwards
           supra-annular prosthesis versus the Medtronic Mosaic aortic prosthesis:
           10-year results’ [Eur J Cardiothorac Surg 2018;54:281--7]†
    • Authors: Zibdeh O; Bugg I, Patel S, et al.
      Pages: 406 - 406
      Abstract: The authors noticed after publication of the article online that 4 mitral replacement patients had erroneously been entered into their aortic database. According to them this error can only have occurred at the point when the original CRF was completed on recruitment many years ago. Once that error occurred, the patients were erroneously included into the aortic valve database. The error was thus hidden from view until now, when they were asked by Medtronic to provide serial numbers of the explanted valve prostheses.
      PubDate: Fri, 13 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy238
      Issue No: Vol. 54, No. 2 (2018)
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