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Publisher: Oxford University Press   (Total: 392 journals)

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Showing 1 - 200 of 392 Journals sorted alphabetically
Acta Biochimica et Biophysica Sinica     Hybrid Journal   (Followers: 5, SJR: 0.881, h-index: 38)
Adaptation     Hybrid Journal   (Followers: 8, SJR: 0.111, h-index: 4)
Advances in Nutrition     Hybrid Journal   (Followers: 42, SJR: 2.075, h-index: 36)
Aesthetic Surgery J.     Hybrid Journal   (Followers: 6, SJR: 1.538, h-index: 35)
African Affairs     Hybrid Journal   (Followers: 64, SJR: 1.512, h-index: 46)
Age and Ageing     Hybrid Journal   (Followers: 86, SJR: 1.611, h-index: 107)
Alcohol and Alcoholism     Hybrid Journal   (Followers: 18, SJR: 0.935, h-index: 80)
American Entomologist     Full-text available via subscription   (Followers: 6)
American Historical Review     Hybrid Journal   (Followers: 149, SJR: 0.652, h-index: 43)
American J. of Agricultural Economics     Hybrid Journal   (Followers: 40, SJR: 1.441, h-index: 77)
American J. of Clinical Nutrition     Hybrid Journal   (Followers: 145, SJR: 3.771, h-index: 262)
American J. of Epidemiology     Hybrid Journal   (Followers: 169, SJR: 3.047, h-index: 201)
American J. of Hypertension     Hybrid Journal   (Followers: 25, SJR: 1.397, h-index: 111)
American J. of Jurisprudence     Hybrid Journal   (Followers: 18)
American J. of Legal History     Full-text available via subscription   (Followers: 9, SJR: 0.151, h-index: 7)
American Law and Economics Review     Hybrid Journal   (Followers: 27, SJR: 0.824, h-index: 23)
American Literary History     Hybrid Journal   (Followers: 15, SJR: 0.185, h-index: 22)
Analysis     Hybrid Journal   (Followers: 21)
Animal Frontiers     Hybrid Journal  
Annals of Behavioral Medicine     Hybrid Journal   (Followers: 14, SJR: 2.112, h-index: 98)
Annals of Botany     Hybrid Journal   (Followers: 35, SJR: 1.912, h-index: 124)
Annals of Oncology     Hybrid Journal   (Followers: 47, SJR: 4.362, h-index: 173)
Annals of the Entomological Society of America     Full-text available via subscription   (Followers: 8, SJR: 0.642, h-index: 53)
Annals of Work Exposures and Health     Hybrid Journal   (Followers: 29, SJR: 0.837, h-index: 57)
AoB Plants     Open Access   (Followers: 4, SJR: 0.78, h-index: 10)
Applied Economic Perspectives and Policy     Hybrid Journal   (Followers: 16, SJR: 0.884, h-index: 31)
Applied Linguistics     Hybrid Journal   (Followers: 55, SJR: 1.749, h-index: 63)
Applied Mathematics Research eXpress     Hybrid Journal   (Followers: 1, SJR: 0.779, h-index: 11)
Arbitration Intl.     Full-text available via subscription   (Followers: 20)
Arbitration Law Reports and Review     Hybrid Journal   (Followers: 14)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 30, SJR: 0.96, h-index: 71)
Aristotelian Society Supplementary Volume     Hybrid Journal   (Followers: 3, SJR: 0.102, h-index: 20)
Arthropod Management Tests     Hybrid Journal   (Followers: 2)
Astronomy & Geophysics     Hybrid Journal   (Followers: 42, SJR: 0.144, h-index: 15)
Behavioral Ecology     Hybrid Journal   (Followers: 51, SJR: 1.698, h-index: 92)
Bioinformatics     Hybrid Journal   (Followers: 289, SJR: 4.643, h-index: 271)
Biology Methods and Protocols     Hybrid Journal  
Biology of Reproduction     Full-text available via subscription   (Followers: 10, SJR: 1.646, h-index: 149)
Biometrika     Hybrid Journal   (Followers: 20, SJR: 2.801, h-index: 90)
BioScience     Hybrid Journal   (Followers: 30, SJR: 2.374, h-index: 154)
Bioscience Horizons : The National Undergraduate Research J.     Open Access   (Followers: 1, SJR: 0.213, h-index: 9)
Biostatistics     Hybrid Journal   (Followers: 17, SJR: 1.955, h-index: 55)
BJA : British J. of Anaesthesia     Hybrid Journal   (Followers: 162, SJR: 2.314, h-index: 133)
BJA Education     Hybrid Journal   (Followers: 64, SJR: 0.272, h-index: 20)
Brain     Hybrid Journal   (Followers: 68, SJR: 6.097, h-index: 264)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 45, SJR: 4.086, h-index: 73)
Briefings in Functional Genomics     Hybrid Journal   (Followers: 3, SJR: 1.771, h-index: 50)
British J. for the Philosophy of Science     Hybrid Journal   (Followers: 33, SJR: 1.267, h-index: 38)
British J. of Aesthetics     Hybrid Journal   (Followers: 26, SJR: 0.217, h-index: 18)
British J. of Criminology     Hybrid Journal   (Followers: 584, SJR: 1.373, h-index: 62)
British J. of Social Work     Hybrid Journal   (Followers: 86, SJR: 0.771, h-index: 53)
British Medical Bulletin     Hybrid Journal   (Followers: 7, SJR: 1.391, h-index: 84)
British Yearbook of Intl. Law     Hybrid Journal   (Followers: 31)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 4, SJR: 1.474, h-index: 31)
Cambridge J. of Economics     Hybrid Journal   (Followers: 61, SJR: 0.957, h-index: 59)
Cambridge J. of Regions, Economy and Society     Hybrid Journal   (Followers: 10, SJR: 1.067, h-index: 22)
Cambridge Quarterly     Hybrid Journal   (Followers: 9, SJR: 0.1, h-index: 7)
Capital Markets Law J.     Hybrid Journal   (Followers: 2)
Carcinogenesis     Hybrid Journal   (Followers: 2, SJR: 2.439, h-index: 167)
Cardiovascular Research     Hybrid Journal   (Followers: 13, SJR: 2.897, h-index: 175)
Cerebral Cortex     Hybrid Journal   (Followers: 45, SJR: 4.827, h-index: 192)
CESifo Economic Studies     Hybrid Journal   (Followers: 17, SJR: 0.501, h-index: 19)
Chemical Senses     Hybrid Journal   (Followers: 1, SJR: 1.436, h-index: 76)
Children and Schools     Hybrid Journal   (Followers: 5, SJR: 0.211, h-index: 18)
Chinese J. of Comparative Law     Hybrid Journal   (Followers: 4)
Chinese J. of Intl. Law     Hybrid Journal   (Followers: 22, SJR: 0.737, h-index: 11)
Chinese J. of Intl. Politics     Hybrid Journal   (Followers: 8, SJR: 1.238, h-index: 15)
Christian Bioethics: Non-Ecumenical Studies in Medical Morality     Hybrid Journal   (Followers: 10, SJR: 0.191, h-index: 8)
Classical Receptions J.     Hybrid Journal   (Followers: 25, SJR: 0.1, h-index: 3)
Clean Energy     Open Access  
Clinical Infectious Diseases     Hybrid Journal   (Followers: 62, SJR: 4.742, h-index: 261)
Clinical Kidney J.     Open Access   (Followers: 3, SJR: 0.338, h-index: 19)
Communication Theory     Hybrid Journal   (Followers: 21, SJR: 2.62, h-index: 53)
Communication, Culture & Critique     Hybrid Journal   (Followers: 25)
Community Development J.     Hybrid Journal   (Followers: 27, SJR: 0.47, h-index: 28)
Computer J.     Hybrid Journal   (Followers: 9, SJR: 0.371, h-index: 47)
Conservation Physiology     Open Access   (Followers: 2)
Contemporary Women's Writing     Hybrid Journal   (Followers: 9, SJR: 0.111, h-index: 3)
Contributions to Political Economy     Hybrid Journal   (Followers: 5, SJR: 0.313, h-index: 10)
Critical Values     Full-text available via subscription  
Current Developments in Nutrition     Open Access  
Current Legal Problems     Hybrid Journal   (Followers: 27)
Current Zoology     Full-text available via subscription   (Followers: 1, SJR: 0.999, h-index: 20)
Database : The J. of Biological Databases and Curation     Open Access   (Followers: 8, SJR: 1.068, h-index: 24)
Digital Scholarship in the Humanities     Hybrid Journal   (Followers: 14)
Diplomatic History     Hybrid Journal   (Followers: 20, SJR: 0.296, h-index: 22)
DNA Research     Open Access   (Followers: 5, SJR: 2.42, h-index: 77)
Dynamics and Statistics of the Climate System     Open Access   (Followers: 3)
Early Music     Hybrid Journal   (Followers: 15, SJR: 0.124, h-index: 11)
Economic Policy     Hybrid Journal   (Followers: 39, SJR: 2.052, h-index: 52)
ELT J.     Hybrid Journal   (Followers: 25, SJR: 1.26, h-index: 23)
English Historical Review     Hybrid Journal   (Followers: 51, SJR: 0.311, h-index: 10)
English: J. of the English Association     Hybrid Journal   (Followers: 14, SJR: 0.144, h-index: 3)
Environmental Entomology     Full-text available via subscription   (Followers: 11, SJR: 0.791, h-index: 66)
Environmental Epigenetics     Open Access   (Followers: 3)
Environmental History     Hybrid Journal   (Followers: 26, SJR: 0.197, h-index: 25)
EP-Europace     Hybrid Journal   (Followers: 2, SJR: 2.201, h-index: 71)
Epidemiologic Reviews     Hybrid Journal   (Followers: 9, SJR: 3.917, h-index: 81)
ESHRE Monographs     Hybrid Journal  
Essays in Criticism     Hybrid Journal   (Followers: 16, SJR: 0.1, h-index: 6)
European Heart J.     Hybrid Journal   (Followers: 54, SJR: 6.997, h-index: 227)
European Heart J. - Cardiovascular Imaging     Hybrid Journal   (Followers: 8, SJR: 2.044, h-index: 58)
European Heart J. - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 1)
European Heart J. - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart J. Supplements     Hybrid Journal   (Followers: 7, SJR: 0.152, h-index: 31)
European J. of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9, SJR: 1.568, h-index: 104)
European J. of Intl. Law     Hybrid Journal   (Followers: 172, SJR: 0.722, h-index: 38)
European J. of Orthodontics     Hybrid Journal   (Followers: 4, SJR: 1.09, h-index: 60)
European J. of Public Health     Hybrid Journal   (Followers: 20, SJR: 1.284, h-index: 64)
European Review of Agricultural Economics     Hybrid Journal   (Followers: 10, SJR: 1.549, h-index: 42)
European Review of Economic History     Hybrid Journal   (Followers: 28, SJR: 0.628, h-index: 24)
European Sociological Review     Hybrid Journal   (Followers: 40, SJR: 2.061, h-index: 53)
Evolution, Medicine, and Public Health     Open Access   (Followers: 10)
Family Practice     Hybrid Journal   (Followers: 14, SJR: 1.048, h-index: 77)
Fems Microbiology Ecology     Hybrid Journal   (Followers: 10, SJR: 1.687, h-index: 115)
Fems Microbiology Letters     Hybrid Journal   (Followers: 22, SJR: 1.126, h-index: 118)
Fems Microbiology Reviews     Hybrid Journal   (Followers: 27, SJR: 7.587, h-index: 150)
Fems Yeast Research     Hybrid Journal   (Followers: 14, SJR: 1.213, h-index: 66)
Food Quality and Safety     Open Access  
Foreign Policy Analysis     Hybrid Journal   (Followers: 23, SJR: 0.859, h-index: 10)
Forest Science     Hybrid Journal   (Followers: 4, SJR: 0.872, h-index: 59)
Forestry: An Intl. J. of Forest Research     Hybrid Journal   (Followers: 16, SJR: 0.903, h-index: 44)
Forum for Modern Language Studies     Hybrid Journal   (Followers: 6, SJR: 0.108, h-index: 6)
French History     Hybrid Journal   (Followers: 32, SJR: 0.123, h-index: 10)
French Studies     Hybrid Journal   (Followers: 20, SJR: 0.119, h-index: 7)
French Studies Bulletin     Hybrid Journal   (Followers: 10, SJR: 0.102, h-index: 3)
Gastroenterology Report     Open Access   (Followers: 2)
Genome Biology and Evolution     Open Access   (Followers: 12, SJR: 3.22, h-index: 39)
Geophysical J. Intl.     Hybrid Journal   (Followers: 35, SJR: 1.839, h-index: 119)
German History     Hybrid Journal   (Followers: 22, SJR: 0.437, h-index: 13)
GigaScience     Open Access   (Followers: 3)
Global Summitry     Hybrid Journal   (Followers: 1)
Glycobiology     Hybrid Journal   (Followers: 14, SJR: 1.692, h-index: 101)
Health and Social Work     Hybrid Journal   (Followers: 55, SJR: 0.505, h-index: 40)
Health Education Research     Hybrid Journal   (Followers: 13, SJR: 0.814, h-index: 80)
Health Policy and Planning     Hybrid Journal   (Followers: 24, SJR: 1.628, h-index: 66)
Health Promotion Intl.     Hybrid Journal   (Followers: 21, SJR: 0.664, h-index: 60)
History Workshop J.     Hybrid Journal   (Followers: 29, SJR: 0.313, h-index: 20)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 26, SJR: 0.115, h-index: 13)
Human Communication Research     Hybrid Journal   (Followers: 13, SJR: 2.199, h-index: 61)
Human Molecular Genetics     Hybrid Journal   (Followers: 8, SJR: 4.288, h-index: 233)
Human Reproduction     Hybrid Journal   (Followers: 72, SJR: 2.271, h-index: 179)
Human Reproduction Update     Hybrid Journal   (Followers: 17, SJR: 4.678, h-index: 128)
Human Rights Law Review     Hybrid Journal   (Followers: 60, SJR: 0.7, h-index: 21)
ICES J. of Marine Science: J. du Conseil     Hybrid Journal   (Followers: 51, SJR: 1.233, h-index: 88)
ICSID Review     Hybrid Journal   (Followers: 12)
ILAR J.     Hybrid Journal   (Followers: 2, SJR: 1.099, h-index: 51)
IMA J. of Applied Mathematics     Hybrid Journal   (SJR: 0.329, h-index: 26)
IMA J. of Management Mathematics     Hybrid Journal   (SJR: 0.351, h-index: 20)
IMA J. of Mathematical Control and Information     Hybrid Journal   (Followers: 2, SJR: 0.661, h-index: 28)
IMA J. of Numerical Analysis - advance access     Hybrid Journal   (SJR: 2.032, h-index: 44)
Industrial and Corporate Change     Hybrid Journal   (Followers: 10, SJR: 1.37, h-index: 81)
Industrial Law J.     Hybrid Journal   (Followers: 34, SJR: 0.184, h-index: 15)
Inflammatory Bowel Diseases     Hybrid Journal   (Followers: 42, SJR: 1.994, h-index: 107)
Information and Inference     Free  
Integrative and Comparative Biology     Hybrid Journal   (Followers: 7, SJR: 1.911, h-index: 90)
Interacting with Computers     Hybrid Journal   (Followers: 10, SJR: 0.529, h-index: 59)
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 6, SJR: 0.743, h-index: 35)
Intl. Affairs     Hybrid Journal   (Followers: 56, SJR: 1.264, h-index: 53)
Intl. Data Privacy Law     Hybrid Journal   (Followers: 31)
Intl. Health     Hybrid Journal   (Followers: 5, SJR: 0.835, h-index: 15)
Intl. Immunology     Hybrid Journal   (Followers: 3, SJR: 1.613, h-index: 111)
Intl. J. for Quality in Health Care     Hybrid Journal   (Followers: 34, SJR: 1.593, h-index: 69)
Intl. J. of Constitutional Law     Hybrid Journal   (Followers: 64, SJR: 0.613, h-index: 19)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 195, SJR: 4.381, h-index: 145)
Intl. J. of Law and Information Technology     Hybrid Journal   (Followers: 5, SJR: 0.247, h-index: 8)
Intl. J. of Law, Policy and the Family     Hybrid Journal   (Followers: 30, SJR: 0.307, h-index: 15)
Intl. J. of Lexicography     Hybrid Journal   (Followers: 10, SJR: 0.404, h-index: 18)
Intl. J. of Low-Carbon Technologies     Open Access   (Followers: 1, SJR: 0.457, h-index: 12)
Intl. J. of Neuropsychopharmacology     Open Access   (Followers: 3, SJR: 1.69, h-index: 79)
Intl. J. of Public Opinion Research     Hybrid Journal   (Followers: 9, SJR: 0.906, h-index: 33)
Intl. J. of Refugee Law     Hybrid Journal   (Followers: 35, SJR: 0.231, h-index: 21)
Intl. J. of Transitional Justice     Hybrid Journal   (Followers: 12, SJR: 0.833, h-index: 12)
Intl. Mathematics Research Notices     Hybrid Journal   (Followers: 1, SJR: 2.052, h-index: 42)
Intl. Political Sociology     Hybrid Journal   (Followers: 36, SJR: 1.339, h-index: 19)
Intl. Relations of the Asia-Pacific     Hybrid Journal   (Followers: 22, SJR: 0.539, h-index: 17)
Intl. Studies Perspectives     Hybrid Journal   (Followers: 9, SJR: 0.998, h-index: 28)
Intl. Studies Quarterly     Hybrid Journal   (Followers: 44, SJR: 2.184, h-index: 68)
Intl. Studies Review     Hybrid Journal   (Followers: 20, SJR: 0.783, h-index: 38)
ISLE: Interdisciplinary Studies in Literature and Environment     Hybrid Journal   (Followers: 1, SJR: 0.155, h-index: 4)
ITNOW     Hybrid Journal   (Followers: 1, SJR: 0.102, h-index: 4)
J. of African Economies     Hybrid Journal   (Followers: 14, SJR: 0.647, h-index: 30)
J. of American History     Hybrid Journal   (Followers: 45, SJR: 0.286, h-index: 34)
J. of Analytical Toxicology     Hybrid Journal   (Followers: 14, SJR: 1.038, h-index: 60)
J. of Antimicrobial Chemotherapy     Hybrid Journal   (Followers: 14, SJR: 2.157, h-index: 149)
J. of Antitrust Enforcement     Hybrid Journal   (Followers: 1)
J. of Applied Poultry Research     Hybrid Journal   (Followers: 4, SJR: 0.563, h-index: 43)
J. of Biochemistry     Hybrid Journal   (Followers: 41, SJR: 1.341, h-index: 96)
J. of Burn Care & Research     Hybrid Journal   (Followers: 9, SJR: 0.713, h-index: 57)
J. of Chromatographic Science     Hybrid Journal   (Followers: 18, SJR: 0.448, h-index: 42)
J. of Church and State     Hybrid Journal   (Followers: 11, SJR: 0.167, h-index: 11)
J. of Communication     Hybrid Journal   (Followers: 50, SJR: 3.327, h-index: 82)
J. of Competition Law and Economics     Hybrid Journal   (Followers: 35, SJR: 0.442, h-index: 16)
J. of Complex Networks     Hybrid Journal   (Followers: 2, SJR: 1.165, h-index: 5)
J. of Computer-Mediated Communication     Open Access   (Followers: 26, SJR: 2.878, h-index: 80)
J. of Conflict and Security Law     Hybrid Journal   (Followers: 13, SJR: 0.196, h-index: 15)
J. of Consumer Research     Full-text available via subscription   (Followers: 41, SJR: 4.896, h-index: 121)
J. of Crohn's and Colitis     Hybrid Journal   (Followers: 9, SJR: 1.543, h-index: 37)
J. of Cybersecurity     Hybrid Journal   (Followers: 3)
J. of Deaf Studies and Deaf Education     Hybrid Journal   (Followers: 8, SJR: 0.69, h-index: 36)

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Journal Cover European Journal of Cardio-Thoracic Surgery
  [SJR: 1.568]   [H-I: 104]   [9 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1010-7940 - ISSN (Online) 1873-734X
   Published by Oxford University Press Homepage  [392 journals]
  • Extracorporeal life support in thoracic surgery
    • Authors: Reeb J; Olland A, Massard G, et al.
      Pages: 489 - 494
      Abstract: Extracorporeal life support Extracorporeal membrane oxygenation Thoracic surgery Lung transplantation Acute respiratory distress syndrome Novalung lung assist device Pumpless interventional lung assist device Cardiothoracic surgery
      PubDate: Wed, 10 Jan 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx477
      Issue No: Vol. 53, No. 3 (2018)
  • In memory of Francis Fontan 1929–2018
    • Authors: Turina M.
      Pages: 693 - 693
      PubDate: Tue, 20 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy043
      Issue No: Vol. 53, No. 3 (2018)
  • Retraction to ‘Functional results after chest wall stabilization with a
           new screwless fixation device’ [Eur J Cardiothorac Surg
    • Authors: Wiese M; Kawel-Boehm N, de la Santa P, et al.
      Pages: 695 - 695
      Abstract: This article has been retracted at the request of the authors following concerns raised by the Ethics Committee subsequent to an audit at the University Hospital Basel. The audit performed in 2016 revealed that some informed consents were missing.
      PubDate: Tue, 01 May 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy048
      Issue No: Vol. 53, No. 3 (2018)
  • Spotlight on recently published ICVTS articles
    • Pages: 696 - 696
      PubDate: Tue, 20 Feb 2018 00:00:00 GMT
      DOI: 10.1093/ejcts/ezy047
      Issue No: Vol. 53, No. 3 (2018)
  • Comparative performance of transcatheter aortic valve-in-valve
           implantation versus conventional surgical redo aortic valve replacement in
           patients with degenerated aortic valve bioprostheses: systematic review
           and meta-analysis
    • Authors: Gozdek M; Raffa G, Suwalski P, et al.
      Pages: 495 - 504
      Abstract: SummaryThe objective of this report was to directly compare, by means of a systematic review and meta-analysis, redo surgical aortic valve replacement (re-sAVR) with valve-in-valve transcatheter aortic valve implantation (ViV TAVI) for patients with failed degenerated aortic bioprostheses. Multiple databases were screened for all available reports comparing ViV TAVI with re-sAVR in patients with failing degenerated aortic bioprostheses. The primary outcome was all-cause mortality determined from the longest available survival data. Five observational studies (n = 342) were included in the meta-analysis; patients in the ViV TAVI group were older and had a higher baseline risk compared to those in the re-sAVR group. Although there was no statistical difference in procedural mortality [risk ratio (RR) 0.74, 95% confidence interval (CI) 0.18–2.97; P = 0.67], 30-day mortality (RR 1.29, 95% CI 0.44–3.78; P = 0.64) and cardiovascular mortality (RR 0.91, 95% CI 0.30–2.70; P = 0.86) at a mean follow-up period of 18 months, cumulative survival analysis favoured surgery with borderline statistical significance (ViV TAVI versus re-sAVR: hazard ratio 1.91, 95% CI 1.03–3.57; P = 0.039). ViV TAVI was associated with a significantly lower rate of permanent pacemaker implantations (RR 0.37, 95% CI 0.20–0.68; P = 0.002) and shorter intensive care unit (P < 0.001) and hospital stays (P = 0.020). In contrast, re-sAVR offered superior echocardiographic outcomes: lower incidence of patient–prosthesis mismatch (P = 0.008), fewer paravalvular leaks (P = 0.023) and lower mean postoperative aortic valve gradients in the prespecified analysis (P = 0.017). The ViV TAVI approach is a safe and feasible alternative to re-sAVR that may offer an effective, less invasive treatment for patients with failed surgical aortic valve bioprostheses who are inoperable or at high risk. Re-sAVR should remain the standard of care, particularly in the low-risk population, because it offers superior haemodynamic outcomes with low mortality rates.
      PubDate: Wed, 04 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx347
      Issue No: Vol. 53, No. 3 (2017)
  • To fly as a pilot after cardiac surgery
    • Authors: Syburra T; Nicol E, Mitchell S, et al.
      Pages: 505 - 511
      Abstract: SummaryAircrew are responsible for safe and reliable aircraft operations. Cardiovascular disease accounts for 50% of all pilot licences declined or withdrawn for medical reasons in Western Europe and is the most common cases of sudden incapacitation in flight. Aircrew retirement age is increasing (up to age 65) in a growing number of airlines and the burden of subclinical, but potentially significant, coronary atherosclerosis is unknown in qualified pilots above age 40. Safety considerations are paramount in aviation medicine, and the most dreaded cardiovascular complications are thromboembolic events and rhythm disturbances due to their potential for sudden incapacitation. In aviation, the current consensus risk threshold for an acceptable level of controlled risk of acute incapacitation is 1% (for dual pilot commercial operations), a percentage calculated using engineering principles to ensure the incidence of a fatal air accident is no greater than 1 per 107 h of flying. This is known as the ‘1% safety rule’. To fly as a pilot after cardiac surgery is possible; however, special attention to perioperative planning is mandatory. Choice of procedure is crucial for license renewal. Licensing restrictions are likely to apply and the postoperative follow-up requires a tight scheduling. The cardiac surgeon should always liaise and communicate with the pilot’s aviation medicine examiner prior to and following cardiac surgery.
      PubDate: Fri, 13 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx346
      Issue No: Vol. 53, No. 3 (2017)
  • Infrared intraoperative fluorescence imaging using indocyanine green in
           thoracic surgery
    • Authors: Okusanya O; Hess N, Luketich J, et al.
      Pages: 512 - 518
      Abstract: SummaryThoracic surgery faces many unique challenges that require innovative solutions. The increase in utilization of minimally invasive practices, poor overall cancer survival and significant morbidity of key operations remain key obstacles to overcome. Intraoperative fluorescence imaging is a process by which fluorescent dyes and imaging systems are used as adjuncts for surgeons in the operating room. Other surgical subspecialists have shown that intraoperative fluorescence imaging can be applied as a practical adjunct to their practices. Thoracic surgeons over the last 15 years have also used intraoperative fluorescence imaging for sentinel lymph node mapping, lung mapping, oesophageal conduit vascular perfusion and lung nodule identification. This review describes some of the key studies that demonstrate the applications of intraoperative near-infrared fluorescence imaging.
      PubDate: Wed, 27 Sep 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx352
      Issue No: Vol. 53, No. 3 (2017)
  • Aortic events and reoperations after elective arch surgery: incidence,
           surgical strategies and outcomes†
    • Authors: Luehr M; Peterss S, Zierer A, et al.
      Pages: 519 - 524
      Abstract: OBJECTIVESThe true incidence of aortic events (AEs) and reoperations (REDO) following elective total aortic arch replacement remains unknown. The aim of this study was to review the incidence of AEs and surgical REDO, and its respective outcomes after 1232 elective arch repairs at 11 European aortic centres.METHODSRetrospective chart review (in the absence of prospective data collection) was performed for statistical analysis. Follow-up was conducted during routine clinical examination or in a telephone interview with patients and/or their respective physicians.RESULTSOne hundred fifty-five (12.6%) patients were identified (median follow-up time 48.7 months). The recorded AEs comprised aortic dilatation (62.6%), rupture (15.5%), endoleak (11%), false aneurysm (3.9%), dissection (3.2%), infection (2.6%) and others (1.3%). REDO (open/endovascular) were performed in 85.8% of patients (n = 133). Intraoperative and in-hospital mortality in the REDO patients were 7.5% and 17.3%, respectively. Postoperative neurological complications comprised paraplegia (6.0%) and stroke (1.5%). Survival rates after REDO at 1, 3 and 5 years were 81.2%, 79.0% and 76.7%, respectively. Univariate analysis identified ‘rupture’ and ‘diameter progression’, ‘older age at REDO’ and the REDO strategies ‘frozen elephant trunk’ and ‘no elephant trunk’ as predictors of increased in-hospital mortality. Multivariate analysis identified ‘older age at REDO’ (P = 0.008) as the only independent risk factor for in-hospital mortality.CONCLUSIONSAEs after elective arch surgery are not irrelevant and mostly involve the distal aspects of the adjoining aorta. In accordance with the underlying pathology, open or endovascular REDO may be performed with an acceptable outcome. Preparation of an adequate proximal landing zone at the time of primary arch surgery is advisable.
      PubDate: Thu, 09 Nov 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx378
      Issue No: Vol. 53, No. 3 (2017)
  • The frozen elephant trunk technique for the treatment of acute complicated
           Type B aortic dissection
    • Authors: Kreibich M; Berger T, Morlock J, et al.
      Pages: 525 - 530
      Abstract: OBJECTIVESOur goal was to report our preliminary results in patients with acute complicated Type B aortic dissection without a suitable landing zone for primary thoracic endovascular aortic repair who were treated with the frozen elephant trunk (FET) technique.METHODSWithin a 25-month period, 14 patients with acute complicated Type B aortic dissection underwent surgical repair using the FET technique. The reasons to perform the FET procedure were an ectatic ascending aorta/arch in 6 patients and the lack of an adequate landing zone in 8 patients.RESULTSNo deaths were observed. A non-disabling stroke occurred in 2 patients. Symptomatic spinal cord injury was not observed. The closure of the primary entry tear was successfully achieved in all patients. In 3 patients, a secondary distal thoracic endovascular aortic repair extension was performed during the same hospital stay. The median follow-up period was 6 ± 5 months.CONCLUSIONSThe FET technique is an attractive method for the repair of acute complicated Type B aortic dissection without a suitable landing zone for primary thoracic endovascular aortic repair. It should be considered as an alternative in patients who are at high risk for retrograde Type A aortic dissection, in patients with an unfavourable anatomy or in patients with connective tissue disease.
      PubDate: Wed, 02 Aug 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx281
      Issue No: Vol. 53, No. 3 (2017)
  • Impact of arch reobstruction and early hypertension on late hypertension
           after coarctation repair†
    • Authors: Lee M; Allen S, Koleff J, et al.
      Pages: 531 - 537
      Abstract: OBJECTIVESLate hypertension after coarctation repair is associated with high mortality, but its risk factors remain unclear. This study aims to determine early and late postoperative risk factors for late hypertension after coarctation repair.METHODSA cross-sectional study including transthoracic echocardiogram and 24-h blood pressure (BP) monitoring was performed in 144 patients aged ≥10 years with previous coarctation repair. Median age at repair was 39 days (interquartile range 0–3 years). Early postoperative hypertension was evaluated by calculating the mean of BP measurements taken on the same day before hospital discharge or the need for antihypertensives prior to discharge. Multivariable analyses were performed to adjust for gender, surgical age, and follow-up age.RESULTSAfter a mean follow-up period of 22 ± 7 years, 59% (84/142) of patients were hypertensive: 58% (82/142) on 24-h BP monitoring and 1% (2/142) on antihypertensives. Early postoperative hypertension was present in 58% (73/126): 39% (49/126) on BP measurements and 19% (24/126) on antihypertensives. Early and late arch reobstruction (transthoracic echocardiogram peak gradient ≥25 mmHg) was present in 37% (23/62) and 23% (33/144), respectively. On multivariable logistic analysis, early postoperative hypertension and maximum descending arch velocity on echocardiography were associated with late hypertension on 24-h BP monitoring (odds ratio 2.21, 95% confidence interval 1.05–4.66, P = 0.04; and odds ratio 2.28, 95% confidence interval 1.08–4.81, P = 0.03; respectively).CONCLUSIONSThere is a high prevalence of late hypertension after coarctation repair. Arch reobstruction may be a major determinant of late hypertension. Early postoperative hypertension may identify very early in life those at risk of developing late hypertension.
      PubDate: Mon, 23 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx360
      Issue No: Vol. 53, No. 3 (2017)
  • Clinical long-term outcome of septal myectomy for obstructive hypertrophic
           cardiomyopathy in infants
    • Authors: Schleihauf J; Cleuziou J, Pabst von Ohain J, et al.
      Pages: 538 - 544
      Abstract: OBJECTIVESSurgical septal myectomy is performed to relieve left ventricular outflow tract narrowing in severe drug-refractory obstructive hypertrophic cardiomyopathy. The objective of this study was to assess the perioperative and long-term clinical outcome of this procedure performed during infancy.METHODSClinical, transthoracic echocardiographic, electrocardiographic, 24-h Holter, cardiopulmonary exercise test and genetic data were extracted by medical record review. A subset of patients underwent additional prospective detailed clinical evaluation including cardiac magnetic resonance imaging with contrast.RESULTSSurgery was performed in 23 paediatric patients between 1978 and 2015 at the German Heart Centre Munich. Twelve patients had undergone surgery during infancy (≤ 1 year) (Group A), 11 between 1 and 18 years of age (Group B). The underlying genetic diagnosis was Noonan syndrome spectrum and non-syndromic hypertrophic cardiomyopathy. As compared to Group B, patients in Group A showed more concomitant cardiac procedures and received more homologous transfusions. One perioperative death occurred in Group A, and none in Group B. Two patients in Group A but no patient in Group B required redo septal myectomy. The long-term clinical outcome was similar between the 2 groups. One patient in Group B required cardioverter–defibrillator/pacemaker implantation for higher degree atrioventricular block and none in Group A. There was no evidence of differences in myocardial fibrosis between groups on long-term follow-up magnetic resonance imaging.CONCLUSIONSSurgical septal myectomy can be performed safely during infancy with favourable perioperative and long-term clinical outcome but with a trend towards a higher reoperation rate later in life.
      PubDate: Fri, 27 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx369
      Issue No: Vol. 53, No. 3 (2017)
  • Transinnominate approach for transcatheter aortic valve replacement:
           single-centre experience of minimally invasive alternative access
    • Authors: Pirelli L; Scheinerman J, Brinster D, et al.
      Pages: 545 - 551
      Abstract: OBJECTIVESIliofemoral arteries have been the preferred access for transcatheter aortic valve replacement (TAVR). When these arteries are too small, calcified or tortuous, an alternative access must be considered. Transinnominate (TI) access is an extrathoracic approach that does not require manipulation of major neurovascular structures or the apex. The aim of this study is to evaluate the efficacy and safety of TI TAVR as an alternative access in patients with severe aortic stenosis not amenable to a transfemoral approach.METHODSThirteen patients with severe aortic stenosis underwent TI TAVR between February 2016 and January 2017 at our institution. The average Society of Thoracic Surgeons (STS) score was 7.7 ± 4.5%. Eight patients had previous surgical revascularization, 7 of which involved the left thoracic artery. All patients underwent preoperative computed tomography angiography that revealed significant atheromatous and calcific disease of the iliofemoral vessels and/or the descending aorta. The innominate artery was found to be of appropriate calibre (>10 mm), free of plaque and easy to access via surgical incision. Fusion multimodality imaging was utilized in all cases to guide the procedure.RESULTSThe innominate artery was accessed via a 2-inch right parasternal supraclavicular incision. Nine self-expandable valves and 4 balloon-expandable valves were implanted. Procedural success occurred in all cases without intraprocedural and in-hospital mortality. No neurological deficits or vascular complications were recorded; postoperative bleeding was trivial. Ten patients were discharged on Day 3 and 3 patients who required PPM on Day 5.CONCLUSIONSTI approach represents a safe, reproducible and minimally invasive hybrid technique for TAVR in high-risk patients. In our early experience, surgical trauma and perioperative complications are minimal with rapid patient recovery.
      PubDate: Wed, 18 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx361
      Issue No: Vol. 53, No. 3 (2017)
  • Trends in practice and outcomes from 2011 to 2015 for surgical aortic
           valve replacement: an update from the German Aortic Valve Registry on
           42 776 patients
    • Authors: Fujita B; Ensminger S, Bauer T, et al.
      Pages: 552 - 559
      Abstract: OBJECTIVES:Surgical aortic valve replacement (sAVR) is coming under close scrutiny with the recent upswing in the use of less invasive approaches. The aim of this analysis was to identify current trends in patient selection, procedural characteristics and outcomes after sAVR in Germany.METHODS:We analysed data from 42 776 patients included in the German Aortic Valve Registry who underwent sAVR with and without coronary artery bypass surgery (CABG) between 2011 and 2015. Baseline, procedural and short-term outcome parameters were analysed.RESULTS:Of all registered patients, 26 618 (62.2%) underwent isolated sAVR and 16 158 (37.8%) sAVR + CABG. The median age was 72 years, and the median Society of Thoracic Surgeons Predicted Risk of Mortality (STS PROM) was 2.3%. From 2011 to 2015, there was a decline in STS PROM (2.4–2.2%, P < 0.001) and a decline in risk factors, such as pulmonary hypertension (9.1–3.2%, P < 0.001), occlusive arterial disease (19.6–17.7%, P = 0.003), mitral regurgitation ≥2° (10.6–7.6%, P < 0.001) and New York Heart Association Class III/IV (65.3–59.2%, P < 0.001). In-hospital mortality was 2.3%, 1.3% had disabling stroke, 0.4% residual aortic regurgitation ≥2°, and the incidence of new-onset pacemaker/implantable cardioverter–defibrillator implantation was 3.9%. There was an increase in the use of biological valves in patients <65 years (50.1–65.7%, P < 0.001), and the proportion of rapid deployment valves increased significantly (1.5–8.4%, P < 0.001) over the investigated time period.CONCLUSIONS:Both isolated sAVR as well as sAVR + CABG resulted in excellent in-hospital outcomes based on >42 000 patients treated between 2011 and 2015. The implementation of alternative treatment strategies has resulted in palpable changes in patient and device selection.
      PubDate: Mon, 27 Nov 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx408
      Issue No: Vol. 53, No. 3 (2017)
  • Should the dilated ascending aorta be repaired at the time of bicuspid
           aortic valve replacement'†
    • Authors: Kaneko T; Shekar P, Ivkovic V, et al.
      Pages: 560 - 568
      Abstract: OBJECTIVESBicuspid aortic valve (BAV) is the most common congenital valvular abnormality and frequently presents with accelerated calcific aortic valve disease, requiring aortic valve replacement (AVR) and thoracic aortic aneurysm and dissection. Supporting evidence for Association Guidelines of aortic dimensions for aortic resection is sparse. We sought to determine whether concurrent repair of dilated or aneurysmal aortic disease during AVR in patients with BAV substantially improves morbidity and mortality outcomes.METHODSMortality and reoperation outcomes of 1301 adults with BAV and dilated aorta undergoing AVR-only surgery were compared to patients undergoing AVR with aortic resection (AVR-AR) using Cox proportional hazards modelling and patient matching.RESULTSClinically important differences in patient characteristics, aortic valve function and aortic dimensions were identified between cohorts. Event rates were low, with rates of reoperation and death within 1 year of only 1.8% and 5.4%, respectively, and no aortic dissection observed during follow-up. There were no significant differences in reoperation or mortality outcomes between the AVR-only and AVR-AR cohorts. Age, aortic dimension or a combination thereof was not associated with better or worse outcomes after each AVR-AR compared with AVR.CONCLUSIONSWe conclude AVR-only and AVR-AR surgery have low morbidity and mortality and have utility over a wide range of age and aortic sizes. Our results do not provide support for the 45-mm aortic dimension recommended in the current guidelines for aortic resection while performing AVR or any other specific dimension.
      PubDate: Tue, 14 Nov 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx387
      Issue No: Vol. 53, No. 3 (2017)
  • Aortic valve replacement improves survival in severe aortic stenosis with
           gradient–area mismatch
    • Authors: Mo Y; Van Camp G, Di Gioia G, et al.
      Pages: 569 - 575
      Abstract: OBJECTIVESTo investigate whether and in which patients with catheter-derived low pressure gradient (PG, <40 mmHg) severe (aortic valve area ≤ 1 cm2) aortic stenosis and preserved left ventricular ejection fraction, early aortic valve replacement (AVR) might improve survival.METHODSWe investigated a total of 506 consecutive patients (age 75 ± 9 years, 58% men) with either moderate aortic stenosis (MAS) or severe aortic stenosis (SAS) and preserved left ventricular ejection fraction (≥50%) as defined at catheterization. Propensity score matching was used to select matched pairs of patients with and without AVR in each group. A 100% complete follow-up of all cause death was obtained after a median of 6.6 years (interquartile range 3.4–8.8 years).RESULTSThere were 62 (12%) patients with MAS, 119 (24%) patients with SAS and low (<40 mmHg) PG and 325 (64%) patients with SAS and high PG. Significantly less patients with MAS and low-gradient SAS underwent AVR compared to patients with high gradient SAS (58% vs 60% vs 83%, P < 0.001). In propensity score-matched patients, AVR was independently associated with a decrease in all-cause mortality in all groups (P < 0.05) regardless of the PG, stroke volume or aortic valve area.CONCLUSIONSThe present data indicate a that AVR improves survival in SAS regardless of the gradient and flow. This advocates an ‘early-AVR’ rather than a ‘watchful waiting’ strategy.
      PubDate: Fri, 13 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx362
      Issue No: Vol. 53, No. 3 (2017)
  • Surgical treatment for isolated mitral valve endocarditis: a 16-year
           single-centre experience
    • Authors: Perrotta S; Fröjd V, Lepore V, et al.
      Pages: 576 - 581
      Abstract: OBJECTIVES:Despite progress in management, mitral valve endocarditis (MVE) is still a life-threatening disease. We report our experience in surgical treatment of infective isolated MVE.METHODS:A total of 140 operations in 128 patients for MVE performed between January 2000 and December 2015 were included in a retrospective study. There were 109 (78%) operations for native and 31 (22%) operations for prosthetic valve endocarditis. Preoperative and postoperative characteristics and mortality of patients were registered. Cox regression identified factors associated with mortality. Mean follow-up period was 68 months (range 1–168 months) and 100% complete.RESULTS:There were 13 deaths within 30 days after the 140 operations (9%). Severe perioperative complications occurred in 59 (42%) operations. Overall cumulative survival was 73% ± 4 at 5 years and 62 ± 5% at 10 years after the first operation. Age, diabetes, EuroSCORE II and perivalvular abscess were independent predictors for long-term mortality. Valve repair was performed in 76 (54%) operations and replacement in 64 (46%) operations. Thirty-day mortality for repair was 1%, and 5-year and 10-year cumulative survival was 86 ± 4% and 77 ± 6%, respectively. In the replacement group the 30-day mortality was 19% and cumulative survival at 5 years and 10 years was 55 ± 7% and 41 ± 8%, respectively. Postoperative complications occurred in 21% and 67%, respectively, after operations for repair and replacement. Ten (8%) patients had 12 reoperations for recurrent endocarditis.CONCLUSIONS:MVE requiring surgical treatment is a challenging disease with high hospital mortality after valve replacement. Mitral valve repair can be performed in suitable endocarditis patients with excellent results. Age, diabetes and EuroSCORE were independently associated with mortality in a multivariable model.
      PubDate: Mon, 27 Nov 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx416
      Issue No: Vol. 53, No. 3 (2017)
  • Does septal thickness influence outcome of myectomy for hypertrophic
           obstructive cardiomyopathy'†
    • Authors: Nguyen A; Schaff H, Nishimura R, et al.
      Pages: 582 - 589
      Abstract: OBJECTIVES:Patients with hypertrophic obstructive cardiomyopathy and basal septal thickness <18 mm are often considered unsuitable candidates for myectomy. Mitral valve (MV) replacement is frequently performed instead. We aimed to determine whether septal thickness affects outcomes and adequacy of myectomy.METHODS:Clinical and echocardiographic data were reviewed for 1486 consecutive adult patients with hypertrophic obstructive cardiomyopathy who underwent transaortic septal myectomy from January 2005 through December 2014. Comparisons between patients, grouped by septal thickness (<18 mm, n = 369; 18–21 mm, n = 612 and >21 mm, n = 505), were performed with the Kruskal–Wallis and the Pearson χ2 tests and semiparametric analysis of covariance.RESULTS:Median group ages were 57, 57 and 54 years (P = 0.007); men comprised 50.4%, 56.7% and 62.0%, respectively (P = 0.003). Intrinsic MV disease was present in 5.9%, 5.2% and 4.6%, respectively (P = 0.80). All patients underwent transaortic septal myectomy. Additional mitral procedures were performed in 7.6%, 7.8% and 8.1%, respectively (P = 0.90). Reasons for MV surgery included intrinsic MV disease (66.7%), residual mitral regurgitation (30.8%) and residual gradient (2.6%). All groups had postoperative gradient relief (median reduction: 51, 54 and 50 mmHg; P = 0.11). Ventricular septal defect occurred in 4 patients (0.3%), and risk did not differ by group (P = 0.24).CONCLUSIONS:Adequate relief of left ventricular outflow tract obstruction can be achieved via transaortic septal myectomy without concomitant MV procedures when septal thickness is < 18 mm, and the risk of ventricular septal defect is minimal. Concomitant MV repair/replacement should be reserved for patients with intrinsic MV disease or inadequate relief of mitral regurgitation/left ventricular outflow tract obstruction following adequate extended septal myectomy.
      PubDate: Wed, 22 Nov 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx398
      Issue No: Vol. 53, No. 3 (2017)
  • Extracorporeal membrane oxygenation support for right ventricular failure
           after left ventricular assist device implantation†
    • Authors: Riebandt J; Haberl T, Wiedemann D, et al.
      Pages: 590 - 595
      Abstract: OBJECTIVESRight ventricular (RV) failure complicating left ventricular assist device implantation is associated with increased mortality. Despite a lack of supporting evidence, venoarterial extracorporeal membrane oxygenation (ECMO) support is increasingly being used as an alternative to traditional temporary RV support. We report our institutional experience with ECMO-facilitated RV support after left ventricular assist device implantation.METHODSWe retrospectively reviewed the concept of temporary ECMO support for perioperative RV failure in 32 consecutive left ventricular assist device (mean age 52 ± 14 years; male 84.4%; ischaemic cardiomyopathy 40.6%; INTERMACS Level I 71.8%; INTERMACS Level II 6.3%; INTERMACS Level III 12.5%; INTERMACS Level IV–VII 9.4%; HeartWare ventricular assist device 75%; HeartMate II: 25%) from May 2009 to April 2014. The study end points were RV recovery during ECMO support, mortality and causes of death.RESULTSTwenty-nine (90.6%) patients were successfully weaned from ECMO support after RV recovery. Three (9.4%) patients expired during ECMO support. ECMO support improved RV function and haemodynamic parameters (central venous pressure 13 mmHg vs 10 mmHg, P < 0.01; mean pulmonary artery pressure 28 mmHg vs 21 mmHg, P < 0.01; cardiac output 5.1 l/min vs 5.9 l/min, P = 0.09) over a median period of 3 (range 1–15) days. Thirty-day and in-hospital mortality were 18.8% and 25%, respectively. One-year survival was 75%, causes of death were multiorgan dysfunction syndrome (50%), sepsis (25%), haemorrhagic stroke (12.5%) and ischaemic stroke (12.5%). Causes of death during ECMO support were ischaemic stroke, sepsis and multiorgan dysfunction syndrome.CONCLUSIONSTemporary ECMO-facilitated RV support is associated with good long-term outcomes and high rates of RV recovery.
      PubDate: Mon, 16 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx349
      Issue No: Vol. 53, No. 3 (2017)
  • Previous lung volume reduction surgery does not negatively affect survival
           after lung transplantation†
    • Authors: Inci I; Iskender I, Ehrsam J, et al.
      Pages: 596 - 602
      Abstract: OBJECTIVESLung volume reduction surgery (LVRS) and lung transplantation (LTx) are the treatments of choice in selected patients with end-stage emphysema. Recently, the history of LVRS has been questioned due to reduced post-transplant survival. We aim to address this question by reviewing our experience, which is the largest single-centre series of LVRS followed by LTx.METHODSWe reviewed our prospectively recorded database in patients with emphysema undergoing LTx between 1993 and 2014. Preoperative workup and postoperative outcomes were compared according to previous LVRS status. The Kaplan–Meier test was used for survival analysis and compared with a log-rank test.RESULTSOne hundred and seventeen patients (66 men; mean age 56 ± 7 years) underwent LTx during the study period, 52 of whom had previous LVRS (LVRS + LTx). The mean time from LVRS to LTx was 45 ± 31 months. Patients were slightly older and had extensive smoking history in the LVRS + LTx group. Overall, in-hospital mortality was 10%, which did not differ significantly regardless of the history of LVRS (P = 0.8). The median survival for the LTx-only and LVRS + LTx groups was 86 [95% confidence interval (CI) 56–116] and 107 (95% CI 77–137) months, respectively (P = 0.6).CONCLUSIONSPrevious LVRS does not negatively affect short-term and long-term outcomes following LTx in patients with end-stage emphysema. The history of LVRS should not preclude the candidacy for LTx. Considering the limited number of donors available, the LVRS option should be kept in mind for the postponement of LTx in carefully selected patients.
      PubDate: Fri, 08 Sep 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx318
      Issue No: Vol. 53, No. 3 (2017)
  • Use of taurolidine in lung transplantation for cystic fibrosis and impact
           on bacterial colonization†
    • Authors: Zeriouh M; Sabashnikov A, Patil N, et al.
      Pages: 603 - 609
      Abstract: OBJECTIVESThe presence of bacterial colonization that causes chronic pulmonary infections in cystic fibrosis (CF) patients remains a key issue before lung transplantation. We sought to assess the impact of intraoperative taurolidine lavage on bacterial colonization and long-term outcomes following lung transplantation in CF patients.METHODSBetween 2007 and 2013, 114 CF patients underwent lung transplantation at our institute, and taurolidine 2% bronchial lavage was applied in a substantial proportion of patients (n = 42). A detailed analysis of donor and recipient bacterial colonization status in treatment and control groups and their impact on outcome was performed.RESULTSThe proportion of recipients colonized with Pseudomonas aeruginosa was lower in the taurolidine group at 3 months (P < 0.001) and at 1 year (P = 0.053) postoperatively, despite no differences before transplant (P = 1.000). Moreover, a complete eradication of Burkholderia cepacia and Stenotrophomonas maltophilias colonizations could be achieved in the taurolidine group, whereas in the non-taurolidine group, persistent B. cepacia and S. maltophilias colonizations were observed. Early outcome in the taurolidine group was superior regarding fraction of expired volume in 1 s at 3 and 6 months after surgery with 74.5 ± 14.6 vs 60.4 ± 17.5 (P < 0.001) and 80.6 ± 16.9 vs 67.2 ± 19.4 (P = 0.005) percent of predicted values, respectively. In terms of long-term overall survival (P = 0.277) and freedom from bronchiolitis obliterans syndrome (P = 0.979), both groups were comparable.CONCLUSIONSTaurolidine might be associated with a reduced proportion of CF patients colonized with multiresistant pathogens, particularly with P. aeruginosa. Long-term results should be further assessed in larger multicentre trials.
      PubDate: Wed, 18 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx359
      Issue No: Vol. 53, No. 3 (2017)
  • Outcome of long-term complications after permanent metallic left bronchial
           stenting in children†
    • Authors: Serio P; Nenna R, Di Maurizio M, et al.
      Pages: 610 - 617
      Abstract: OBJECTIVESWe describe the way we treated 7 children with critical long-term complications after metallic balloon-expandable stenting in the left mainstem bronchus.METHODSEndoscopic follow-up included a first bronchoscopy 3 weeks after stenting, then monthly for 3 months, every 4–6 months up to 1 year and at scheduled times to calibrate stent diameter up to final calibration. When major complications occurred, patients underwent chest computed tomographic angiography.RESULTSIn 1 of the 7 children (median age 2.8 years), metallic left bronchial stenting served as a bridge to surgery. After a median 4-year follow-up, all 7 children experienced recurrent stent ovalizations with stent breakage in 3 and erosion in 1. In 4 children, computed tomographic angiography showed abundant peribronchial fibrous tissue, in 2 left mediastinal rotation and in 1 displacement along the left bronchus after pulmonary re-expansion as the cause of stent-related complication. Of the 7 children, 6 underwent surgery (5 posterior aortopexy and 1 section of the ligamentum arteriosus) and 3 required nitinol stents placement within the metallic ones. One patient completed the follow-up, and 1 patient was lost to follow-up. All 5 remaining children still have permanent bronchial stents in place, patent and re-epithelialized after a median 10.5-year follow-up. There were no deaths.CONCLUSIONSSatisfactory anatomical relationships when children have stents placed in the left mainstem bronchus alone do not guarantee the final success. Several mechanisms intervene to cause critical stent-related complications in children during growth. Permanent metallic stents should be used carefully, and only in selected patients.
      PubDate: Wed, 08 Nov 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx374
      Issue No: Vol. 53, No. 3 (2017)
  • Bilateral cavitary multidrug- or extensively drug-resistant tuberculosis:
           role of surgery†
    • Authors: Marfina G; Vladimirov K, Avetisian A, et al.
      Pages: 618 - 624
      Abstract: OBJECTIVESCavitary disease and bilateral lesions are among the risk factors for poor outcome of pulmonary tuberculosis (TB). Our aim was to explore the value and limits of surgery in patients with advanced TB.METHODSA retrospective study of 57 consecutive patients who underwent thoracic surgery for culture-positive bilateral cavitary pulmonary TB was performed. Forty-four (77.2%) patients were men and 13 (22.8%) patients were women; their ages were in the range of 18–61 years. Twenty-two (38.6%) patients had multidrug-resistant (MDR) TB and 35 (61.4%) patients had extensively drug-resistant (XDR) TB confirmed with cultures. On admission, 49 (86.0%) patients had sputum smear microscopy positive for acid-fast bacilli. The main indication for surgery was treatment failure manifested as contagious persisting cavities despite best available therapy. The surgical procedures included combinations of pulmonary resections of different levels, selective thoracoplasties and/or endobronchial valve treatment. The operations were performed consecutively, starting with the most affected side. TB therapy preceded the operation for a minimum of 6 months and was continued after the operation on the basis of the patient’s susceptibility to drugs for Mycobacterium tuberculosis.RESULTSWe performed 121 operations: 42 in 22 patients with MDR TB (1.9 operations per patient) and 79 procedures in 35 patients with XDR TB (2.3 operations per patient). No deaths occurred in the 1st year. Two late deaths followed, 1 unrelated to and 1 due to TB progression. Ten major complications (1 complication per patient) developed: main bronchus stump fistula (n = 4), prolonged air leak (n = 3), respiratory failure (n = 2) and wound seroma (n = 1). At the 1-month follow-up visit, sputum smear conversion was observed in 11 (68.8%) patients with MDR and in 15 (45.5%) patients with XDR TB. At the late (20–36 months) follow-up visit, culture negativity was achieved in 21 (95.5%) patients with MDR TB and in 23 (65.7%) patients with XDR TB (P = 0.015).CONCLUSIONSThoracic surgery may significantly improve patients’ outcomes and even result in a cure in a good portion of patients with bilateral cavitary MDR and XDR TB and should be considered as the essential element of multimodality treatment for MDR and XDR TB, even in patients with bilateral cavitary disease and borderline respiratory reserves.
      PubDate: Tue, 10 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx350
      Issue No: Vol. 53, No. 3 (2017)
  • Pulmonary metastasectomy for thyroid cancer as salvage therapy for
           radioactive iodine-refractory metastases†
    • Authors: Moneke I; Kaifi J, Kloeser R, et al.
      Pages: 625 - 630
      Abstract: OBJECTIVESDistant metastasis arising from thyroid cancer is rare but has been associated with significantly reduced long-term survival, especially when refractory to radioactive iodine ablation. We provide one of the largest studies worldwide reporting the outcome after salvage pulmonary metastasectomy for this entity, aiming to identify prognostic factors and to analyse surgical indication.METHODSWe retrospectively analysed the medical records of 43 patients who had undergone pulmonary metastasectomy for radioactive iodine-refractory thyroid cancer from 1985 to 2016.RESULTSThe median follow-up period was 77 (95% confidence interval 41–113) months. Twenty-three (53%) patients were alive at the time of analysis. The majority of tumours were follicular thyroid cancer by histology, with 23% identified as Hurthle cell subtype. Five- and 10-year disease-specific (DS) survival was 84% and 59%, respectively. Thirty-one (72%) patients underwent R0-resection with a 5- and 10-year DS survival of 100% and 77%, respectively. This was significantly reduced to 62% and 22% (P = 0.013) in case of incomplete resection, respectively. Ten years after R0-metastasectomy, 17 (55%) patients were recurrence-free. Systematic mediastinal lymphadenectomy was performed in 16 (37%) patients and was associated with improved long-term DS survival (10 years 88% vs 46%, P = 0.034). Moreover, a reduction of > 80% in serum thyroglobulin levels post-metastasectomy correlates with better long-term DS survival (10 years 81% vs 36%, P = 0.007).CONCLUSIONSPulmonary metastasectomy is associated with good survival for selected patients with radioactive iodine-refractory metastases of differentiated thyroid cancer, especially if R0-resection can be achieved. Moreover, it is worth considering whether a significant reduction of tumour load, as indicated by thyroglobulin serum levels, seems possible.
      PubDate: Mon, 30 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx367
      Issue No: Vol. 53, No. 3 (2017)
  • The utility of blood neuroendocrine gene transcript measurement in the
           diagnosis of bronchopulmonary neuroendocrine tumours and as a tool to
           evaluate surgical resection and disease progression†
    • Authors: Filosso P; Kidd M, Roffinella M, et al.
      Pages: 631 - 639
      Abstract: OBJECTIVESThe management of bronchopulmonary neuroendocrine tumours (BPNETs) is difficult, since imaging, histology and biomarkers have a limited value in diagnosis, predicting outcome and defining therapeutic efficacy. We evaluated a NET multigene blood test (NETest) to diagnose BPNETs, assess disease status and evaluate surgical resection.METHODS(i) Diagnostic cohort: BP carcinoids (n = 118)—typical carcinoid, n = 67 and atypical carcinoid, n = 51; other lung NEN (large-cell neuroendocrine carcinoma and small-cell lung carcinoma, n = 13); adenocarcinoma, (n = 26); squamous cell carcinoma (n = 23); controls (n = 90) and chronic obstructive pulmonary disease (n = 18). (ii) Surgical cohort, n = 28: BP carcinoids (n = 16: typical carcinoid 12; atypical carcinoid 4); large-cell neuroendocrine carcinoma, n = 3; lung adenocarcinoma, n = 8 and squamous cell carcinoma, n = 1. Blood sampling was performed presurgery and 30 days post-surgery. Transcript levels measured by quantitative polymerase chain reaction were calculated as activity scores (0–100% scale: normal < 14%) and compared with chromogranin A (enzyme-linked immunosorbent assay; normal <109 ng/ml).RESULTSNETest was significantly elevated in carcinoids (48.7 ± 27%) versus controls (6 ± 6%, P < 0.001) with metrics: sensitivity 93%, specificity 89%, positive predictive value 92% and negative predictive value 91%. NETest differentiated progressive disease (73 ± 22%) from stable disease (36 ± 19%, P < 0.001) and R0 resections (10 ± 5%, P < 0.001, area under the curve: 0.98). Levels in chronic obstructive pulmonary disease and lung cancers were 18–24% while elevated in small-cell lung carcinoma/large-cell neuroendocrine carcinoma (59 ± 10%). In BPNETs on postoperative Day 30, NETest decreased by 60% (P < 0.001). Chromogranin A was elevated in only 40% of carcinoids and not altered by surgery.CONCLUSIONSBlood NET gene levels accurately identified BPNETs (100%) and differentiated these from controls, benign and malignant lung disease. Progressive disease could be identified and surgical resection verified. Chromogranin A had no clinical utility. Monitoring NET transcript levels in blood will facilitate management by detecting residual tumour and identifying progressive disease.
      PubDate: Mon, 13 Nov 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx386
      Issue No: Vol. 53, No. 3 (2017)
  • Differences in postoperative changes in pulmonary functions following
           segmentectomy compared with lobectomy
    • Authors: Nomori H; Shiraishi A, Cong Y, et al.
      Pages: 640 - 647
      Abstract: OBJECTIVESTo clarify differences in postoperative changes in systemic and regional pulmonary functions between segmentectomy and lobectomy in patients with lung cancer, we compared the 2 procedures using lung perfusion scintigraphy with a fusion image of single-photon emission computed tomography and computed tomography.METHODSThis study is a retrospective matched cohort study of consecutively acquired data. Pulmonary function tests and perfusion single-photon emission computed tomography/computed tomography were conducted before surgery and 6 months after surgery to measure changes in forced expiratory volume in 1 s of a whole lung, contralateral lung and a lobe. After exactly matching the site of the resected lobe between the 2 procedures, propensity scores for age, sex, smoking status and pulmonary function were used to match them.RESULTSOf the 184 patients treated with segmentectomy and the 208 patients treated with lobectomy between 2013 and 2016, 103 patients were selected from each group after the matching. Whole lung function was significantly more preserved after segmentectomy than after lobectomy (P < 0.001). Segmentectomy preserved the function of the operated lobe with 48 ± 21% of the preoperative function. The function of the ipsilateral non-operated lobe increased after segmentectomy (P = 0.003) but not after lobectomy (P = 0.97). Contralateral lung function increased after both procedures (P < 0.001).CONCLUSIONSOur data suggest that segmentectomy preserved whole lung function better than lobectomy, because it not only preserved the lobe but also increased the function of the ipsilateral non-operated lobe. Lobectomy did not result in an increase of ipsilateral non-operated lobe function. Contralateral lung function increased after both procedures. The postoperative increase in regional functions could be the result of compensatory lung growth.
      PubDate: Wed, 18 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx357
      Issue No: Vol. 53, No. 3 (2017)
  • Short-term and mid-term survival in bronchial sleeve resection by robotic
           system versus thoracotomy for centrally located lung cancer
    • Authors: Gu C; Pan X, Chen Y, et al.
      Pages: 648 - 655
      Abstract: OBJECTIVESThe aim of this study was to compare the short-term and mid-term results of patients with centrally located lung cancer who underwent bronchial sleeve resection by robotic system or thoracotomy.METHODSFrom September 2014 to September 2015, 103 patients, including 17 robotic and 86 open cases, were included in our study. All the clinicopathological data, operative details and follow-up information were investigated.RESULTSThere were no intraoperative deaths. The mean console time was 113.59 min. The operative time for robotic surgery (155.06 ± 44.75 min), even in our initial cases, was comparable to that for thoracotomy (150.30 ± 47.84 min, P = 0.71). The 30-day mortality rate in the robotic and thoracotomy groups was 1 (6%) patient and 2 (2%) patients, respectively, with no significant difference (P = 0.43). A total of 4 (24%) patients in the robotic group and 22 (26%) patients in the thoracotomy group experienced postoperative complications (P = 0.86). In multivariable analysis, tumour size and postoperative radiotherapy were significant predictors of relapse-free survival, whereas only the intensive care unit stay was a significant predictor of overall survival. There was no significant difference in relapse-free survival (log-rank P = 0.16) and overall survival (log-rank P = 0.59) between the 2 groups.CONCLUSIONSRobotic surgery for bronchial sleeve resection is safe and feasible and has similar oncological outcomes compared with open procedures. But long-term survival still needs to be investigated.
      PubDate: Wed, 27 Sep 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx355
      Issue No: Vol. 53, No. 3 (2017)
  • Risk and benefit of neoadjuvant therapy among patients undergoing
           resection for non-small-cell lung cancer†
    • Authors: Yendamuri S; Groman A, Miller A, et al.
      Pages: 656 - 663
      Abstract: OBJECTIVES:Neoadjuvant therapy has emerged as a favoured treatment paradigm for patients with clinical N2 disease undergoing surgical resection for non-small-cell lung cancer. It is unclear whether such a treatment paradigm affects perioperative outcomes. We sought to examine the National Cancer Database (NCDB) to assess the impact of neoadjuvant therapy on perioperative outcomes and long-term survival in these patients.METHODS:All patients with a history of non-small-cell lung cancer undergoing anatomical resection between 2004 and 2014 were included. Thirty-day and 90-day mortality of all patients having neoadjuvant therapy versus those who did not were compared. In addition, the impact of neoadjuvant therapy on the overall survival of patients with clinical N2 disease was examined.RESULTS:Of the 134 428 selected patients, 9896 (7.4%) patients had neoadjuvant chemotherapy. Patients undergoing neoadjuvant therapy had a higher 30-day (3% vs 2.6%; P < 0.01) and 90-day mortality (6.5% vs 4.9%; P < 0.01). This association remained after adjusting for covariates. Among patients with clinical N2 disease (n = 10 139), 42.3%, 35.3% and 22.4% of patients had neoadjuvant, adjuvant and no chemotherapy, respectively. Univariable, multivariable and propensity score-weighted analyses indicated no difference in survival between patients receiving neoadjuvant and adjuvant chemotherapy.CONCLUSIONS:Neoadjuvant therapy may adversely affect perioperative outcomes without providing a survival advantage compared with adjuvant therapy in clinical N2 stage patients. Randomized controlled trials need to be conducted to examine this issue further.
      PubDate: Wed, 13 Dec 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx406
      Issue No: Vol. 53, No. 3 (2017)
  • A dose–response study of glutamate supplementation in isolated, perfused
           rat hearts undergoing ischaemia and cold cardioplegia
    • Authors: Kimose H; Randsbæk F, Christensen T, et al.
      Pages: 664 - 671
      Abstract: OBJECTIVESSeveral studies have reported superior post-cardioplegic recovery after glutamate supplementation. The optimum dose of glutamate supplementation is unknown. The purpose of this study was to find the optimal protective concentration of glutamate supplementation in a model of ischaemia/cardioplegia and reperfusion.METHODSIsolated rat hearts (n = 77) were perfused with the Krebs–Henseleit buffer. After stabilization, the hearts were subjected to 25 min of normothermic ischaemia followed by a single 3-min infusion of cold (4–6 °C) St. Thomas' Hospital II cardioplegia and 87 min of cardioplegic ischaemic arrest and 60 min of reperfusion. Sodium-l-glutamate was added to the perfusate (control group had zero glutamate) in increasing concentrations (0.01, 0.1, 1, 10, 20, 30 and 100 mM) and given throughout perfusion. Corresponding concentrations were added to the cardioplegic solution. A balloon in the left ventricle inserted via the left atrium measured left ventricular pressures isometrically. Left ventricular developed pressure was calculated. Myocardial exchange of glucose and lactate was measured prior to ischaemia and during reperfusion. Myocardial content of glycogen and glutamate was measured at the end of reperfusion.RESULTSDuring reperfusion left ventricular developed pressure increased (P < 0.0001) in groups supplemented with 0.1, 1.0, 10, 20 and 30 mM glutamate, whereas left ventricular end-diastolic pressure was attenuated (P = 0.008) when compared with the controls. No additional benefit on the continuous data left ventricular developed pressure and left ventricular end-diastolic pressure was observed with glutamate concentrations above 1 mM. Onset of LV pressure rise during the period of ischaemia was delayed by 100 mM of glutamate (P = 0.02). Myocardial content of glutamate was increased in a dose-related manner in Groups 10, 20, 30 and 100 compared with the control hearts (P < 0.0001). Glycogen was increased in the hearts supplemented with 100 mM of glutamate (P = 0.02).CONCLUSIONSEven low concentrations of l-glutamate improved postischaemic and post-cardioplegic heart function and 1 mM seems to be optimal.
      PubDate: Mon, 23 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx368
      Issue No: Vol. 53, No. 3 (2017)
  • Evaluation of changes in cartilage viability in detergent-treated tracheal
           grafts for immunosuppressant-free allotransplantation in dogs
    • Authors: Lu T; Huang Y, Qiao Y, et al.
      Pages: 672 - 679
      Abstract: OBJECTIVESThe first tissue-engineered clinical tracheal transplant prepared using the detergent-enzymatic method resulted in graft stenosis, possibly from detergent-enzymatic method-induced graft non-viability. We reported on the transplantation of de-epithelialized tracheal allografts while maintaining cartilage viability in dogs. No lethal stenosis occurred in allografts. Herein, on the basis of previous experimentation, we assessed cartilage viability in detergent-treated cartilages.METHODSSix canine tracheal grafts were treated with detergent [1% t-octylphenoxypolyethoxyethanol (Triton X-100)] before transplantation. The histoarchitecture was evaluated, and the viable chondrocytes ratio was calculated. Glycosaminoglycan was detected using safranin-O staining. Collagen II was tested using immunohistochemistry.RESULTSThe epithelium was completely removed in 5 grafts. Compared with fresh tracheas, the viable chondrocyte ratio was significantly reduced in the de-epithelialized grafts (100 vs 54.70 ± 8.56%; P < 0.001). Image analysis revealed that the mean optical density of glycosaminoglycan (0.363 ± 0.027 vs 0.307 ± 0.012; P = 0.007) and collagen II (0.115 ± 0.013 vs 0.092 ± 0.011; P = 0.028) was decreased. The observation period ranged from 91 to 792 days. No stenosis occurred in 5 allografts; moderate stenosis developed in 1 allograft during the 4th week after surgery. The chondrocyte nuclei almost completely disappeared. Both glycosaminoglycan (0.307 ± 0.012 vs 0.164 ± 0.104; P = 0.044) and collagen II (0.092 ± 0.011 vs 0.068 ± 0.022; P = 0.022) were significantly degraded.CONCLUSIONSThis study demonstrated successful tracheal transplantation; about 50% of the viable chondrocytes were retained in the cartilage that could prevent development of a lethal stenosis in tracheal grafts.
      PubDate: Wed, 06 Sep 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx317
      Issue No: Vol. 53, No. 3 (2017)
  • Management of foetal circulation by switching to pulsatile perfusion
           during cardiovascular surgery in pregnancy
    • Authors: Masada K; Shimamura K, Kuratani T, et al.
      Pages: 680 - 681
      Abstract: Cardiovascular surgery with cardiopulmonary bypass during pregnancy is associated with high foetal mortality. The foetal heart rate should be monitored, because foetal circulation is rate dependent, and experimental evidence supports the efficacy of pulsatile perfusion. We describe a novel foetal monitoring technique and successful foetal heart rate control by switching non-pulsatile to pulsatile perfusion in a 43-year-old woman with a sinus of Valsalva aneurysm who underwent valve-sparing partial aortic root remodelling at 18 weeks of gestation.
      PubDate: Sat, 02 Sep 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx319
      Issue No: Vol. 53, No. 3 (2017)
  • Spindle cell sarcoma of the mitral valve: a rare indication for mitral
           valve replacement
    • Authors: Massey J; Suvarna S, Krawczyk K, et al.
      Pages: 682 - 683
      Abstract: Primary cardiac tumours are a rare finding and even rarer cause of valvular heart disease. We report a case of cardiac spindle cell sarcoma mimicking mitral valve stenosis and the subsequent operative management.
      PubDate: Tue, 26 Sep 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx339
      Issue No: Vol. 53, No. 3 (2017)
  • Fistula of right internal thoracic artery as a rare cause of chest pain
    • Authors: Harky A; Mohammad H, Garner M, et al.
      Pages: 684 - 685
      Abstract: Variation in the origin of the internal thoracic arteries has been previously described and reported in the literature; however, there has been no report of an anomalous termination of the right internal thoracic artery into the pulmonary vein persisting and presenting in adult life. We report the case of the right internal thoracic artery originating from the first part of subclavian artery but terminating into the right superior pulmonary vein that presented during the third decade of life.
      PubDate: Mon, 11 Sep 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx327
      Issue No: Vol. 53, No. 3 (2017)
  • Robot-assisted ligation of bronchial artery could be an alternative to
    • Authors: Pochulu B; Sarsam O, Peillon C, et al.
      Pages: 686 - 688
      Abstract: A 37-year-old patient presented with a self-limiting episode of moderate haemoptysis. Contrast-enhanced chest computed tomography showed a tortuous and dilated right bronchial artery arising from the descending aorta at the level of T6. Therapeutic angiography was attempted, but in the presence of spinal artery arising from the bronchial artery in question, selective embolization was contraindicated due to risk of spinal cord ischaemia. After a multidisciplinary meeting, it was decided to attempt surgery to ligate this pathological artery. We performed minimally invasive robot-assisted ligation of this pathological artery. The postoperative course was uneventful with good clinical and radiological outcome at 3-month follow-up. A minimally invasive approach provides a real alternative to embolization and could be a therapeutic option.
      PubDate: Mon, 09 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx336
      Issue No: Vol. 53, No. 3 (2017)
  • Intracardiac and pulmonary artery hydatidosis causing thromboembolic
           pulmonary hypertension
    • Authors: Orhan G; Bastopcu M, Aydemir B, et al.
      Pages: 689 - 690
      Abstract: Hydatidosis is a serious parasitic infection in endemic areas. A rare presentation is pulmonary arterial cysts causing thromboembolic pulmonary hypertension. We report the case of a young man who presented with clinical and radiological findings of thromboembolic pulmonary hypertension. The patient was found to have hydatid cysts in both pulmonary arteries and in the right ventricular outflow tract. To remove all cysts without causing rupture, anaphylactic shock or systemic emboli, placing the patient under cardiopulmonary arrest was necessary, and in the case of pulmonary arterial involvement, total circulatory arrest was necessary. The cysts were removed successfully, and the patient survived the operation. The patient is being followed up on albendazole treatment. Myocardial preservation and management of total circulatory arrest are the cornerstones of a successful surgical outcome.
      PubDate: Thu, 07 Sep 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx330
      Issue No: Vol. 53, No. 3 (2017)
  • Intralobar pulmonary sequestration with an aortic aneurysm
    • Authors: Menager J; Mercier O.
      Pages: 691 - 691
      Abstract: Pulmonary sequestrationImagingAneurysm
      PubDate: Wed, 04 Oct 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx356
      Issue No: Vol. 53, No. 3 (2017)
  • An unusual cause of dysphagia
    • Authors: Pfister R; Duss F, Weitsch S, et al.
      Pages: 692 - 692
      Abstract: Pericardial effusionDysphagiaDyspnoea
      PubDate: Thu, 16 Nov 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx366
      Issue No: Vol. 53, No. 3 (2017)
  • Corrigendum to: ‘Clinical long-term outcome of septal myectomy for
           obstructive hypertrophic cardiomyopathy in infants’ [Eur J Cardiothorac
           Surg 2018;53:538--44]†
    • Authors: Schleihauf J; Cleuziou J, Pabst von Ohain J, et al.
      Pages: 694 - 694
      Abstract: A few errors were noticed after publication of this paper.
      PubDate: Sat, 02 Dec 2017 00:00:00 GMT
      DOI: 10.1093/ejcts/ezx441
      Issue No: Vol. 53, No. 3 (2017)
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