Subjects -> MEDICAL SCIENCES (Total: 8669 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (218 journals)
    - ANAESTHESIOLOGY (120 journals)
    - CARDIOVASCULAR DISEASES (338 journals)
    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (21 journals)
    - COMMUNICABLE DISEASES, EPIDEMIOLOGY (235 journals)
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    - HEMATOLOGY (157 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (176 journals)
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    - SURGERY (406 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (155 journals)

CARDIOVASCULAR DISEASES (338 journals)                  1 2 | Last

Showing 1 - 200 of 338 Journals sorted alphabetically
Acta Angiologica     Open Access   (Followers: 5)
Acta Cardiologica     Hybrid Journal   (Followers: 2)
Acute Cardiac Care     Hybrid Journal   (Followers: 8)
Adipositas - Ursachen, Folgeerkrankungen, Therapie     Hybrid Journal  
AJP Heart and Circulatory Physiology     Hybrid Journal   (Followers: 12)
Aktuelle Kardiologie     Hybrid Journal   (Followers: 1)
American Heart Journal     Hybrid Journal   (Followers: 60)
American Journal of Cardiology     Hybrid Journal   (Followers: 68)
American Journal of Cardiovascular Drugs     Hybrid Journal   (Followers: 18)
American Journal of Hypertension     Hybrid Journal   (Followers: 29)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
Anatolian Journal of Cardiology     Open Access   (Followers: 6)
Angiología     Full-text available via subscription  
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)
Angiology     Hybrid Journal   (Followers: 3)
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (Followers: 1)
Annals of Circulation     Open Access   (Followers: 2)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 12)
AORTA     Open Access  
Archives of Cardiovascular Diseases     Full-text available via subscription   (Followers: 6)
Archives of Cardiovascular Diseases Supplements     Full-text available via subscription   (Followers: 4)
Archives of Cardiovascular Imaging     Open Access   (Followers: 2)
Archivos de cardiología de México     Open Access   (Followers: 1)
Argentine Journal of Cardiology (English edition)     Open Access   (Followers: 2)
Arquivos Brasileiros de Cardiologia     Open Access   (Followers: 2)
Arrhythmia & Electrophysiology Review     Open Access   (Followers: 1)
Arteriosclerosis, Thrombosis and Vascular Biology     Full-text available via subscription   (Followers: 33)
Artery Research     Hybrid Journal   (Followers: 5)
ARYA Atherosclerosis     Open Access  
ASAIO Journal     Hybrid Journal   (Followers: 4)
ASEAN Heart Journal     Open Access   (Followers: 3)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2)
Aswan Heart Centre Science & Practice Services     Open Access   (Followers: 1)
Atherosclerosis : X     Open Access  
Bangladesh Heart Journal     Open Access   (Followers: 3)
Basic Research in Cardiology     Hybrid Journal   (Followers: 9)
BMC Cardiovascular Disorders     Open Access   (Followers: 22)
Brain Circulation     Open Access   (Followers: 1)
British Journal of Cardiology     Full-text available via subscription   (Followers: 18)
Canadian Journal of Cardiology     Hybrid Journal   (Followers: 18)
Cardiac Cath Lab Director     Full-text available via subscription  
Cardiac Electrophysiology Review     Hybrid Journal   (Followers: 2)
Cardiac Failure Review     Open Access   (Followers: 2)
Cardiocore     Full-text available via subscription   (Followers: 1)
Cardiogenetics     Open Access   (Followers: 3)
Cardiology     Full-text available via subscription   (Followers: 20)
Cardiology and Angiology: An International Journal     Open Access   (Followers: 1)
Cardiology and Therapy     Open Access   (Followers: 11)
Cardiology Clinics     Full-text available via subscription   (Followers: 14)
Cardiology in Review     Hybrid Journal   (Followers: 9)
Cardiology in the Young     Hybrid Journal   (Followers: 35)
Cardiology Journal     Open Access   (Followers: 6)
Cardiology Plus     Open Access   (Followers: 1)
Cardiology Research     Open Access   (Followers: 15)
Cardiology Research and Practice     Open Access   (Followers: 11)
Cardiopulmonary Physical Therapy Journal     Hybrid Journal   (Followers: 9)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Cardiothoracic Surgeon     Open Access   (Followers: 1)
CardioVasc     Full-text available via subscription   (Followers: 1)
Cardiovascular & Haematological Disorders - Drug Targets     Hybrid Journal   (Followers: 1)
Cardiovascular & Hematological Agents in Medicinal Chemistry     Hybrid Journal   (Followers: 2)
CardioVascular and Interventional Radiology     Hybrid Journal   (Followers: 15)
Cardiovascular and Thoracic Open     Open Access  
Cardiovascular Diabetology     Open Access   (Followers: 10)
Cardiovascular Drugs and Therapy     Hybrid Journal   (Followers: 14)
Cardiovascular Endocrinology & Metabolism     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering and Technology     Hybrid Journal   (Followers: 1)
Cardiovascular Intervention and Therapeutics     Hybrid Journal   (Followers: 5)
Cardiovascular Journal     Open Access   (Followers: 6)
Cardiovascular Journal of Africa     Full-text available via subscription   (Followers: 5)
Cardiovascular Journal of South Africa     Full-text available via subscription   (Followers: 2)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Cardiovascular Pathology     Hybrid Journal   (Followers: 4)
Cardiovascular Regenerative Medicine     Open Access  
Cardiovascular Research     Hybrid Journal   (Followers: 16)
Cardiovascular Revascularization Medicine     Hybrid Journal   (Followers: 1)
Cardiovascular System     Open Access  
Cardiovascular Therapeutics     Open Access   (Followers: 1)
Cardiovascular Toxicology     Hybrid Journal   (Followers: 6)
Cardiovascular Ultrasound     Open Access   (Followers: 5)
Case Reports in Cardiology     Open Access   (Followers: 7)
Catheterization and Cardiovascular Interventions     Hybrid Journal   (Followers: 3)
Cerebrovascular Diseases     Full-text available via subscription   (Followers: 3)
Cerebrovascular Diseases Extra     Open Access  
Chest     Full-text available via subscription   (Followers: 103)
Choroby Serca i Naczyń     Open Access   (Followers: 1)
Circulation     Hybrid Journal   (Followers: 267)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 15)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 19)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 11)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 16)
Circulation : Heart Failure     Hybrid Journal   (Followers: 26)
Circulation Research     Hybrid Journal   (Followers: 35)
Cirugía Cardiovascular     Open Access  
Clínica e Investigación en Arteriosclerosis     Full-text available via subscription  
Clínica e Investigación en arteriosclerosis (English Edition)     Hybrid Journal  
Clinical and Experimental Hypertension     Hybrid Journal   (Followers: 3)
Clinical Cardiology     Hybrid Journal   (Followers: 10)
Clinical Hypertension     Open Access   (Followers: 5)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 6)
Clinical Research in Cardiology     Hybrid Journal   (Followers: 5)
Clinical Research in Cardiology Supplements     Hybrid Journal  
Clinical Trials and Regulatory Science in Cardiology     Open Access   (Followers: 4)
Congenital Heart Disease     Hybrid Journal   (Followers: 6)
Congestive Heart Failure     Hybrid Journal   (Followers: 4)
Cor et Vasa     Full-text available via subscription   (Followers: 1)
Coronary Artery Disease     Hybrid Journal   (Followers: 3)
CorSalud     Open Access  
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 5)
Current Cardiology Reports     Hybrid Journal   (Followers: 6)
Current Cardiology Reviews     Hybrid Journal   (Followers: 3)
Current Cardiovascular Imaging Reports     Hybrid Journal   (Followers: 1)
Current Cardiovascular Risk Reports     Hybrid Journal  
Current Heart Failure Reports     Hybrid Journal   (Followers: 5)
Current Hypertension Reports     Hybrid Journal   (Followers: 6)
Current Hypertension Reviews     Hybrid Journal   (Followers: 6)
Current Opinion in Cardiology     Hybrid Journal   (Followers: 13)
Current Problems in Cardiology     Hybrid Journal   (Followers: 3)
Current Research : Cardiology     Full-text available via subscription   (Followers: 1)
Current Treatment Options in Cardiovascular Medicine     Hybrid Journal   (Followers: 1)
Current Vascular Pharmacology     Hybrid Journal   (Followers: 5)
CVIR Endovascular     Open Access   (Followers: 1)
Der Kardiologe     Hybrid Journal   (Followers: 1)
Echo Research and Practice     Open Access   (Followers: 2)
Echocardiography     Hybrid Journal   (Followers: 4)
Egyptian Heart Journal     Open Access   (Followers: 2)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
ESC Heart Failure     Open Access   (Followers: 4)
European Cardiology Review     Open Access   (Followers: 1)
European Heart Journal     Hybrid Journal   (Followers: 67)
European Heart Journal - Cardiovascular Imaging     Hybrid Journal   (Followers: 10)
European Heart Journal - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 2)
European Heart Journal - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart Journal : Acute Cardiovascular Care     Hybrid Journal   (Followers: 1)
European Heart Journal : Case Reports     Open Access   (Followers: 1)
European Heart Journal Supplements     Hybrid Journal   (Followers: 7)
European Journal of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9)
European Journal of Cardio-Thoracic Surgery Supplements     Full-text available via subscription   (Followers: 2)
European Journal of Cardiovascular Nursing     Hybrid Journal   (Followers: 5)
European Journal of Heart Failure     Hybrid Journal   (Followers: 13)
European Journal of Preventive Cardiology.     Hybrid Journal   (Followers: 6)
European Stroke Organisation     Hybrid Journal   (Followers: 3)
Experimental & Translational Stroke Medicine     Open Access   (Followers: 9)
Expert Review of Cardiovascular Therapy     Full-text available via subscription   (Followers: 3)
Folia Cardiologica     Open Access  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontiers in Cardiovascular Medicine     Open Access   (Followers: 1)
Future Cardiology     Hybrid Journal   (Followers: 5)
General Thoracic and Cardiovascular Surgery     Hybrid Journal   (Followers: 3)
Global Cardiology Science and Practice     Open Access   (Followers: 5)
Global Heart     Hybrid Journal   (Followers: 3)
Heart     Hybrid Journal   (Followers: 48)
Heart and Mind     Open Access  
Heart and Vessels     Hybrid Journal  
Heart Failure Clinics     Full-text available via subscription   (Followers: 2)
Heart Failure Reviews     Hybrid Journal   (Followers: 3)
Heart India     Open Access   (Followers: 2)
Heart International     Full-text available via subscription  
Heart Rhythm     Hybrid Journal   (Followers: 11)
Heart Views     Open Access   (Followers: 2)
HeartRhythm Case Reports     Open Access  
Hellenic Journal of Cardiology     Open Access   (Followers: 1)
Herz     Hybrid Journal   (Followers: 2)
High Blood Pressure & Cardiovascular Prevention     Full-text available via subscription   (Followers: 2)
Hypertension     Full-text available via subscription   (Followers: 23)
Hypertension     Open Access   (Followers: 2)
Hypertension in Pregnancy     Hybrid Journal   (Followers: 9)
Hypertension Research     Hybrid Journal   (Followers: 4)
Ibrahim Cardiac Medical Journal     Open Access  
IJC Heart & Vessels     Open Access   (Followers: 1)
IJC Heart & Vasculature     Open Access   (Followers: 1)
IJC Metabolic & Endocrine     Open Access   (Followers: 1)
Indian Heart Journal     Open Access   (Followers: 5)
Indian Journal of Cardiovascular Disease in Women WINCARS     Open Access  
Indian Journal of Thoracic and Cardiovascular Surgery     Hybrid Journal  
Indian Pacing and Electrophysiology Journal     Open Access   (Followers: 1)
Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery     Hybrid Journal   (Followers: 1)
Insuficiencia Cardíaca     Open Access  
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7)
International Cardiovascular Forum Journal     Open Access  
International Journal of Angiology     Hybrid Journal   (Followers: 2)
International Journal of Cardiology     Hybrid Journal   (Followers: 17)
International Journal of Cardiology Hypertension     Open Access   (Followers: 1)
International Journal of Cardiovascular and Cerebrovascular Disease     Open Access   (Followers: 3)
International Journal of Cardiovascular Imaging     Hybrid Journal   (Followers: 2)
International Journal of Cardiovascular Research     Hybrid Journal   (Followers: 6)
International Journal of Heart Rhythm     Open Access  
International Journal of Hypertension     Open Access   (Followers: 8)
International Journal of Hyperthermia     Open Access  
International Journal of Stroke     Hybrid Journal   (Followers: 32)
International Journal of the Cardiovascular Academy     Open Access  
Interventional Cardiology Clinics     Full-text available via subscription   (Followers: 2)
Interventional Cardiology Review     Open Access  
JACC : Basic to Translational Science     Open Access   (Followers: 5)
JACC : Cardiovascular Imaging     Hybrid Journal   (Followers: 18)
JACC : Cardiovascular Interventions     Hybrid Journal   (Followers: 19)
JACC : Heart Failure     Full-text available via subscription   (Followers: 14)
JAMA Cardiology     Hybrid Journal   (Followers: 30)

        1 2 | Last

Similar Journals
Journal Cover
Interactive CardioVascular and Thoracic Surgery
Journal Prestige (SJR): 0.762
Citation Impact (citeScore): 1
Number of Followers: 7  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1569-9293 - ISSN (Online) 1569-9285
Published by Oxford University Press Homepage  [412 journals]
  • Association of previous cardiac surgery with outcomes in left ventricular
           assist device patients
    • Authors: Ayers B; Wood K, McNitt S, et al.
      Pages: 1 - 8
      Abstract: AbstractOBJECTIVESHistory of prior cardiac surgery has traditionally been considered a risk factor for subsequent cardiac procedures. The aim of this study was to investigate the outcomes of patients implanted with a left ventricular assist device via redo sternotomy.METHODSProspectively collected data were reviewed for all patients implanted with a continuous-flow left ventricular assist device at a single institution from December 2006 through June 2018. Patients were separated into 2 cohorts: those with a history of prior cardiac surgery (redo sternotomy) and those undergoing primary sternotomy at the time of left ventricular assist device implantation. The primary outcome was overall survival.RESULTSOf the 321 patients included in the study, 77 (24%) were implanted via redo sternotomy and 244 (76%) via primary sternotomy. The redo sternotomy cohort was generally older (59 ± 10 vs 57 ± 12 years, P = 0.050) and had a higher incidence of ischaemic disease (70% vs 49%, P = 0.002). The Kaplan–Meier survival analysis demonstrated that overall survival was not significantly different between the redo sternotomy and primary sternotomy groups (6-month survival: 86% vs 92%; 5-year survival: 53% vs 51%; log-rank P = 0.590 for overall difference during follow-up). The propensity score analysis consistently showed that redo sternotomy was not significantly associated with mortality risk (hazard ratio 1.19, 95% confidence interval 0.73–1.93; P = 0.488). Redo sternotomy patients were more likely to require rehospitalization during their first year postoperatively (P = 0.020) and spent less time out of the hospital during the first year (P = 0.046).CONCLUSIONSThe redo sternotomy cohort represents a more technically challenging patient population, but overall survival similar to that of primary sternotomy patients can be achieved.
      PubDate: Sat, 04 Apr 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa055
      Issue No: Vol. 31, No. 1 (2020)
       
  • Failure to achieve a satisfactory cardiac outcome after isolated coronary
           surgery in low-risk patients
    • Authors: Rubino A; Nicolini F, Tauriainen T, et al.
      Pages: 9 - 15
      Abstract: AbstractOBJECTIVESThis study aims to investigate the incidence and determinants of major early adverse events in low-risk patients undergoing isolated coronary artery bypass grafting (CABG).METHODSThe multicentre E-CABG registry included 7352 consecutive patients who underwent isolated CABG from January 2015 to December 2016. Patients with an European System for Cardiac Operative Risk Evaluation (EuroSCORE) II of <2% and without any major comorbidity were the subjects of the present analysis.RESULTSOut of 2397 low-risk patients, 11 (0.46%) died during the index hospitalization or within 30 days from surgery. Five deaths were cardiac related, 4 of which were secondary to technical failures. We estimated that 8 out of 11 deaths were potentially preventable. Logistic regression model identified porcelain aorta [odds ratio (OR) 34.3, 95% confidence interval (CI) 1.3–346.3] and E-CABG bleeding grades 2–3 (OR 30.2, 95% CI 8.3–112.9) as independent predictors of hospital death.CONCLUSIONSMortality and major complications, although infrequently, do occur even in low-risk patients undergoing CABG. Identification of modifiable causes of postoperative adverse events may be useful to develop preventative strategies to improve the quality of care of patients undergoing cardiac surgery.Clinical Trial RegistrationNCT02319083 (https://clinicaltrials.gov/ct2/show/NCT02319083).
      PubDate: Sat, 23 May 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa062
      Issue No: Vol. 31, No. 1 (2020)
       
  • Predictive value of great saphenous vein mapping prior to
           endoscopic harvesting in coronary artery bypass surgery
    • Authors: Akca F; Lam K, Verberkmoes N, et al.
      Pages: 16 - 19
      Abstract: AbstractOBJECTIVESThe use of endoscopic vein harvesting in patients undergoing coronary artery bypass grafting is increasing, often using bedside mapping. However, data on the predictive value of great saphenous vein (GSV) mapping are scarce. This study assessed whether preoperative mapping could predict final conduit diameter.METHODSA prospective registry was created that included 251 patients. Saphenous vein mapping was performed prior to endoscopic vein harvesting at 3 predetermined sites. After harvesting and preparing the GSV, the outer diameters were measured. Appropriate graft size was defined as an outer diameter between 3 and 6 mm.RESULTSA total of 753 GSV segments were analysed. The average mapping diameter was 3.2 ± 0.7 mm. The harvested GSV had a mean diameter of 4.7 ± 0.8 mm. Mapping diameters were significantly positively correlated with actual GSV diameters (correlation coefficient, 0.47; P < 0.001). If the preoperative mapping diameters were between 1.5 and 5 mm, 96.6% of the GSVs had suitable dimensions after endoscopic vein harvesting.CONCLUSIONSPreoperative bedside mapping moderately predicts final GSV size after endoscopic harvesting but could not detect unsuitable vein segments. However, the majority of endoscopically harvested GSVs had diameters suitable to be used as coronary bypass grafts.
      PubDate: Fri, 01 May 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa063
      Issue No: Vol. 31, No. 1 (2020)
       
  • Preoperative determination of artificial chordae tendineae length by
           transoesophageal echocardiography in totally endoscopic mitral valve
           repair
    • Authors: Pitsis A; Tsotsolis N, Theofilogiannakos E, et al.
      Pages: 20 - 27
      Abstract: AbstractOBJECTIVESArtificial chordae tendineae are widely used for surgical repair in patients with mitral regurgitation due to floppy mitral valve/mitral valve prolapse. Expanded polytetrafluoroethylene has been used to construct these artificial chordae; however, the determination of the optimal length of the chordae prior to surgery has been an issue. For this reason, such a method was developed and the results of its use are presented.METHODSForty-seven consecutive patients with significant mitral regurgitation due to floppy mitral valve/mitral valve prolapse who underwent totally endoscopic mitral valve surgery were studied. The chordae length was predetermined using transoesophageal echocardiography. The length between the top of the fibrous body of the papillary muscle and the coaptation line of the 2 leaflets of the mitral valve was measured and used to define the length of the chordae to be used for repair. Then under stereoscopic vision, a total endoscopic mitral valve repair was performed.RESULTSThe predicted mean length of chordal loops was 19.76 ± 0.71 mm (median 20, range 16–28) and the actual mean length of chordal loops used was 19.68 ± 0.74 mm (median 20, range 16–26) demonstrating an excellent correlation between the two (r = 0.959). The mean number of chordae loops used per patient was 5.12 ± 0.62 (median 4, range 2–12). All patients at the time of discharge had no or trivial mitral regurgitation on transoesophageal echocardiography.CONCLUSIONSThe chordae length used for mitral valve repair can be determined prior to surgery using transoesophageal echocardiography with a high degree of accuracy. Further, total endoscopic repair in this group of patients provides excellent results. For these reasons, it is expected that this method will replace most traditional approaches to cardiac surgeries in the years to come.
      PubDate: Wed, 01 Apr 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa046
      Issue No: Vol. 31, No. 1 (2020)
       
  • Excellent long-term results with minimally invasive edge-to-edge repair in
           myxomatous degenerative mitral valve regurgitation
    • Authors: Belluschi I; Lapenna E, Blasio A, et al.
      Pages: 28 - 34
      Abstract: AbstractOBJECTIVESPrevious series of minimally invasive mitral valve repairs showed excellent results at up to 10 years of follow-up. The goal of this study was to assess the long-term durability beyond 10 years of the edge-to-edge repair for myxomatous degeneration performed through a minimally invasive approach.METHODSNinety-seven consecutive patients (mean age 35 ± 9 years; left ventricular ejection fraction 63 ± 6%) with severe myxomatous mitral regurgitation (MR) underwent mitral valve repair through a right minithoracotomy between 1999 and 2006. MR was due to lesions involving the posterior leaflet (7.2% of patients), anterior leaflet (12.4%) and both leaflets (80.4%).RESULTSNo hospital deaths occurred. At hospital discharge all patients had no or trivial MR. Follow-up was 100% complete (median 15.5 years; interquartile range 13.6–17.0, max 19.3 years). The 16-year overall survival rate was 95.9 ± 2.02% [95% confidence interval (CI) 89.39–98.43]. At 16 years, the cumulative incidence function of cardiac death, with non-cardiac death as a competing risk, was 3.1 ± 1.75 (95% CI 0.83–8.02). Only 3 patients (4.1%) had redo operations for recurrent severe MR. At 16 years, the cumulative incidence functions of reoperation for and recurrence of MR ≥3+, with death as a competing risk, were 3.1 ± 1.76% (95% CI 0.83–8.02) and 5.6 ± 2.47% (95% CI 2.06–11.83), respectively. No predictors of recurrence of MR ≥3+ were identified. At the last follow-up, moderate MR (2+/4+) was detected in 17 patients (17.5%); most of the patients were in New York Heart Association functional class I–II (97%) and in sinus rhythm (90%).CONCLUSIONSMinimally invasive mitral valve edge-to-edge repair through a right minithoracotomy for myxomatous degeneration appears to be an effective and durable approach even in the long-term follow-up (up to 19 years).
      PubDate: Sat, 28 Mar 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa048
      Issue No: Vol. 31, No. 1 (2020)
       
  • Re-repair after previous mitral valve reconstruction: handle with care!
    • Authors: Trumello C; Giambuzzi I, Del Forno B, et al.
      Pages: 35 - 41
      Abstract: AbstractOBJECTIVESPatients with recurrent mitral regurgitation after surgical repair are currently treated with a re-repair procedure or valve replacement. The aim of this study was to compare outcomes of our series of patients who underwent re-repair versus replacement in this setting.METHODSFrom 2003 to 2017, a total of 79 patients with recurrent mitral regurgitation underwent re-repair, group A (39), or replacement, group B (40). Mean follow-up was 7.4 ± 3.27 years (max 14.4). Inverse Probability of Treatment Weighting was used to create comparable distributions of the covariates; the Kaplan–Meier method was used for survival and competing risk analysis for time to cardiac death, time to recurrence of MR ≥3+ and MR ≥2+.RESULTSA re-repair was possible in 49.4% of patients (39/79). At hospital discharge, residual MR ≥2+ was present in 5 patients in group A, and none in group B (P < 0.001). The paired overall survival at 8 years was 100% in the re-repair group and 96.5 ± 2.34% in the replacement group (P = 0.069). The cumulative incidence function of cardiac death, with non-cardiac death as competitive event, at 8 years was 0% in group A and 3.5 ± 2.34% in group B (P = 0.077). The cumulative incidence function of MR ≥3+ at 8 years was 29.2 ± 8.81% in group A and 0% in group B (P < 0.001).CONCLUSIONSRecurrent significant mitral regurgitation after re-repair is not rare already at 8 years, but the survival tends to be worse after replacement. This finding calls for a very selective approach in pursuing a re-repair only when the intraoperative findings and the immediate results are very reassuring as far as long-term durability is concerned.
      PubDate: Thu, 16 Apr 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa057
      Issue No: Vol. 31, No. 1 (2020)
       
  • Safety and efficacy of digital chest drainage units compared to
           conventional chest drainage units in cardiac surgery
    • Authors: Saha S; Hofmann S, Jebran A, et al.
      Pages: 42 - 47
      Abstract: AbstractOBJECTIVESThe use of digital chest drainage units (CDUs) has become increasingly common in thoracic surgery due to several advantages. However, in cardiac surgery, its use is still limited in favour of conventional analogue CDUs. In order to investigate the potential benefit of digital CDUs in cardiac surgery, we compared the safety and efficacy of both systems in patients undergoing cardiac surgery at our centre.METHODSWe retrospectively investigated 265 consecutive patients who underwent cardiac surgery at our institution between June 2017 and October 2017. These patients were divided into 2 groups: patients with analogue (A, n = 65) and digital CDUs (D, n = 200). Postoperative outcome was analysed and compared between both groups. In addition, the ‘user experience’ was evaluated by means of a questionnaire.RESULTSThe median age of the cohort was 70 years (P = 0.167), 25.3% of patients were female (P = 0.414). There were no differences in terms of re-explorative surgery or use of blood products. Nor was there a difference in the overall amount of fluid collected. However, during the first 6 h, more fluid was collected by the digital CDUs. The overall rate of technical failure was 0.4%. We observed a significantly higher rate of clotting in the tubing system of the digital CDUs (P = 0.042). Concerning the user experience, the digital CDUs were associated with a more favourable ease of use on the regular wards (P < 0.001). With regard to the overall user experience, the digital CDUs outperformed the analogue systems (P = 0.002).CONCLUSIONSDigital CDUs can be safely and effectively applied in patients after cardiac surgery. Due to the improved patient mobility and simplified chest tube management, the use of digital CDUs may be advantageous for patients after cardiac surgery. However, the issue of clotting of the tubing systems should be addressed by further technical improvements.
      PubDate: Mon, 06 Apr 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa049
      Issue No: Vol. 31, No. 1 (2020)
       
  • The impact of cardiopulmonary bypass management on outcome: a propensity
           matched comparison between minimally invasive and conventional valve
           surgery
    • Authors: Vandewiele K; De Somer F, Vandenheuvel M, et al.
      Pages: 48 - 55
      Abstract: AbstractOBJECTIVESResearch concerning cardiopulmonary bypass (CPB) management during minimally invasive cardiac surgery (MICS) is scarce. We investigated the effect of CPB parameters such as pump flow, haemoglobin concentration and oxygen delivery on clinical outcome and renal function in a propensity matched comparison between MICS and median sternotomy (MS) for atrioventricular valve surgery.METHODSA total of 356 patients undergoing MICS or MS for atrioventricular valve surgery between 2006 and 2017 were analysed retrospectively. Propensity score analysis matched 90 patients in the MS group with 143 in the MICS group. Logistic regression analysis was performed to investigate independent predictors of cardiac surgery-associated acute kidney injury in patients having MICS.RESULTSIn MICS, CPB (142.9 ± 39.4 vs 101.0 ± 38.3 min; P < 0.001) and aortic cross-clamp duration (89.9 ± 30.6 vs 63.5 ± 23.0 min; P < 0.001) were significantly prolonged although no differences in clinical outcomes were detected. The pump flow index was lower [2.2 ± 0.2 vs 2.4 ± 0.1 l⋅(min⋅m2)−1; P < 0.001] whereas intraoperative haemoglobin levels were higher (9.25 ± 1.1 vs 8.8 ± 1.2; P = 0.004) and the nadir oxygen delivery was lower [260.8 ± 43.5 vs 273.7 ± 43.7 ml⋅(min⋅m2)−1; P = 0.029] during MICS. Regression analysis revealed that the nadir haemoglobin concentration during CPB was the sole independent predictor of cardiac surgery-associated acute kidney injury (odds ratio 0.67, 95% confidence interval 0.46–0.96; P = 0.029) in MICS but not in MS.CONCLUSIONSSpecific cannulation-related issues lead to CPB management during MICS being confronted with flow restrictions because an average pump flow index ≤2.2 l/min/m2 is achieved in 40% of patients who have MICS compared to those who have a conventional MS. This study showed that increasing the haemoglobin level might be helpful to reduce the incidence of cardiac surgery-associated acute kidney injury after minimally invasive mitral valve surgery.
      PubDate: Fri, 03 Apr 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa052
      Issue No: Vol. 31, No. 1 (2020)
       
  • Is aortic valve replacement with a minimally invasive extracorporeal
           circuit a contemporary option for octogenarians'
    • Authors: El-Essawi A; Follis M, Brouwer R, et al.
      Pages: 56 - 62
      Abstract: AbstractOBJECTIVESMinimally invasive extracorporeal circuits have been introduced to cardiac surgery in an attempt to reduce the negative effects of cardiopulmonary bypass on patient outcome. On the other hand, transcatheter aortic valve replacement (TAVR) provides an excellent option to replace the aortic valve without the need for cardiopulmonary bypass. Several studies have compared TAVR to surgical aortic valve replacement (SAVR) but none have utilized a minimally invasive extracorporeal circuit.METHODSWe retrospectively analysed the results of both procedures among octogenarians operated in our department from 2003 to 2016. Excluded were patients with an active endocarditis, a history of previous cardiac surgery, as well as those who had a minimally invasive surgical approach. This yielded 81 and 142 octogenarians in the SAVR and TAVR groups, respectively. To compensate for a lack of randomization, we performed a propensity score analysis, which yielded 68 patient pairs for the final analysis.RESULTSThe 30-day postoperative mortality was lower in the SAVR group (1.5% vs 5.9%) but not statistically significant (P  = 0.4). In contrast, the incidence of postoperative atrial fibrillation was lower in the TAVR group (13% vs 29%) but also non-significant (P  = 0.2). Finally, the incidence of paravalvular leakage was in favour of the SAVR group (2.9% vs 52%; P  = 0.001) while the transfusion requirement was significantly lower in the TAVR group (29% vs 72%; P < 0.001).CONCLUSIONSSAVR utilizing a minimally invasive extracorporeal circuit improves the quality of patient care and can offer an alternative to TAVR in octogenarians.
      PubDate: Sat, 23 May 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa066
      Issue No: Vol. 31, No. 1 (2020)
       
  • Treat bronchopleural fistula after right lower lobectomy by extra right
           middle lobectomy—a neglected approach
    • Authors: Wang Y; Zhuang W.
      Pages: 63 - 70
      Abstract: AbstractOBJECTIVESBronchopleural fistula (BPF) after right lower lobectomy (RLL), although uncommon, is associated with high mortality rates. This study was aimed at evaluating the therapeutic effect of extra right middle lobectomy (ERML) in the management of BPF after RLL.METHODSWe investigated 12 consecutive patients who were treated at our hospital for BPF occurring after RLL. The diagnosis of BPF was established by bronchoscopy in all cases and BPFs were treated by ERML. All patients were followed up for at least 1 year after ERML to assess treatment outcomes.RESULTSThe severity of infection and malnutrition after BPF was different for different patients. All patients agreed to undergo ERML. The procedure was uneventful in all cases, and there were no cases of perioperative complications or death. The median duration of hospitalization after ERML was 10.5 (range 6–21) days. Postoperative pathological examination showed the presence of hyperaemia and oedema in the BPF stump, and inflammatory cell infiltration in the stroma. The fresh stump of the bronchus intermedius was well structured. Patients were followed up for a median duration of 27 (range 12–41) months. The BPFs were successfully treated in all patients, and a new BPF did not develop in the new fresh stump in any of the cases.CONCLUSIONSERML aimed at creating a fresh stump for quick healing could be alternative for treating BPF after RLL.
      PubDate: Tue, 07 Apr 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa050
      Issue No: Vol. 31, No. 1 (2020)
       
  • Surgical treatment of pulmonary sequestration in adults and children:
           long-term results
    • Authors: Trabalza Marinucci B; Maurizi G, Vanni C, et al.
      Pages: 71 - 77
      Abstract: AbstractOBJECTIVESFew experiences comparing paediatric and adult patients treated for pulmonary sequestration (PS) have been reported. Surgical treatment is considered the best choice, but the time of surgery is still controversial. We present our experience in this setting, comparing characteristics, histological results and outcome of paediatric and adult patients undergoing PS resection.METHODSBetween 1998 and 2017, a total of 74 patients underwent lobectomy or sublobar resection for PS. Sixty patients were children (group A: ≤16 years old) and 14 were adults (group B: >16 years old). Preoperative diagnosis was radiological. PS was intralobar (42 cases) and extralobar (32 cases). The operation was a muscle-sparing lateral thoracotomy or video-assisted thoracoscopic surgery. Preoperative characteristics, histological results and short-/long-term results of the 2 groups were retrospectively analysed and compared.RESULTSThirty-seven percent of the patients in group A presented with respiratory symptoms and 79% in group B (P = 0.44). Most symptomatic patients were treated with a lobectomy. In group A, 2 patients (3%) had a malignant transformation of the lesion. Patients with a prenatal diagnosis treated after the age of 1 year became more symptomatic than those operated on before the age of 1 year (57% vs 23%; P = 0.08). No differences were found in postoperative complications. Long-term stable remission of respiratory symptoms was obtained in 91% of patients in group A and 100% in group B. Adulthood (P = 0.03) and the association with congenital cystic adenomatoid malformation (P = 0.03) were negative prognostic factors for the development of respiratory symptoms.CONCLUSIONSSurgical treatment of PS is safe and feasible. Despite the small number of patients included, study results indicated that an early operation during childhood may prevent the subsequent development of respiratory symptoms. Surgical treatment is also recommended to prevent the rare transformation into malignancy.
      PubDate: Thu, 16 Apr 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa054
      Issue No: Vol. 31, No. 1 (2020)
       
  • Analysis of pneumothorax recurrence risk factors in 843 patients who
           underwent videothoracoscopy for primary spontaneous pneumothorax: results
           of a multicentric study
    • Authors: Cattoni M; Rotolo N, Mastromarino M, et al.
      Pages: 78 - 84
      Abstract: AbstractOBJECTIVESRisk factors for pneumothorax recurrence after videothoracoscopy for primary spontaneous pneumothorax are still being debated. The goal of this study was to assess whether the pleurodesis technique and other variables are possibly associated with the postoperative ipsilateral recurrence of pneumothorax.METHODSWe retrospectively collected data of 1178 consecutive ≤40-year-old patients who underwent videothoracoscopy for primary spontaneous pneumothorax in 9 centres between 2007 and 2017. We excluded patients with hybrid pleurodesis and/or incomplete follow-up, leaving for analysis 843 cases [80% men; median age (interquartile range) 22 (18–28) years]. Univariable and multivariable analyses were performed by logistic regression and tested by Cox regression model to assess factors related to ipsilateral pneumothorax recurrence including age, gender, body mass index, smoking habit, cannabis smoking, respiratory comorbidity, dystrophic severity score, surgical indication, videothoracoscopy port number and side, lung resection, pleurodesis technique and postoperative prolonged air leak (>5 days).RESULTSBlebs/bullae resection was performed in 664 (79%) patients. Pleurodesis was achieved by partial pleurectomy in 228 (27%) cases; by pleural electrocauterization in 176 (21%); by pleural abrasion in 121 (14%); and by talc poudrage in 318 (38%). During a median follow-up period of 70.0 months (95% confidence interval 66.6–73.4), pneumothorax recurred in 79 patients (9.4%); among these, 29 underwent redo surgery; 34, chest drain/talc slurry; and 16, clinicoradiological observation. The only independent risk factor for recurrence was postoperative prolonged air leak (P < 0.001) that was significantly related to blebs/bullae resection (P = 0.03).CONCLUSIONSIn this multicentric series, postoperative ipsilateral pneumothorax recurrence was remarkable and independently related to prolonged postoperative air leak; besides the retrospective study setting, the pleurodesis method did not have an impact on recurrence. To prevent prolonged air leak, blebs/bullae treatment should be accurate and performed only if indicated.
      PubDate: Thu, 30 Apr 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa064
      Issue No: Vol. 31, No. 1 (2020)
       
  • Tumour necrosis factor receptor-associated factors: interacting protein
           with forkhead-associated domain inhibition decreases inflammatory cell
           infiltration and cardiac remodelling after acute myocardial infarction
    • Authors: Jiang Y; Li X, Xu H, et al.
      Pages: 85 - 92
      Abstract: AbstractOBJECTIVESAcute myocardial infarction (AMI) is a leading cause of morbidity and mortality worldwide. Post-AMI cardiac remodelling is closely related to the prognosis of AMI. The excess inflammatory responses could promote cardiac remodelling. Tumour necrosis factor receptor-associated factor-interacting protein with forkhead-associated domain (TIFA) has been identified as a nuclear factor (NF)-κB activator, which plays a key role in the activation of the NF-κB signalling pathway. The goal of this research was to investigate the expression and the underlying mechanism of TIFA in an AMI mouse model.METHODSThe AMI mouse model was induced by ligation of the left coronary artery. TIFA and NF-κB knockdown were established by lentivirus transduction. The expression levels of associated proteins were analysed by a western blot or an enzyme-linked immunosorbent assay. Histological characteristics were evaluated by haematoxylin–eosin staining.RESULTSThe TIFA level was elevated in our AMI mouse model. The production of interleukin-1β and tumour necrosis factor-α increased markedly in the mice with AMI. TIFA knockdown inhibited the infiltration of inflammatory cells, production of pro-inflammatory mediators (interleukin-1β and tumour necrosis factor-α), NF-κB activation and cardiac remodelling (matrix metallopeptidase 9) post-AMI. In addition, NF-κB knockdown could also alleviate cardiac remodelling after AMI.CONCLUSIONSThe preceding results indicated that TIFA inhibition could ameliorate cardiac remodelling after AMI partly through inactivation of NF-κB. This study provides insights into further research of cardiac remodelling and AMI from bench to clinic.
      PubDate: Thu, 07 May 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa060
      Issue No: Vol. 31, No. 1 (2020)
       
  • Does lobar or size-reduced lung transplantation offer satisfactory early
           and late outcomes'
    • Authors: Santos Silva J; Olland A, Massard G, et al.
      Pages: 93 - 97
      Abstract: SummaryA best evidence topic was constructed according to a structured protocol. The question addressed was whether size-reduced or lobar lung transplantation (LLTx) offers the same benefit as classic lung transplantation (LTx). Of the 147 papers found using the reported search, 9 were selected to provide the best evidence. Details of the studies regarding authors, date, journal, country of publication, study type, group studied, relevant outcomes and results are given. All studies reported survival rates of LLTx and most compared it with classical LTx. No statistical differences were reported in medium term and long term. Two of the studies reported a higher incidence of postoperative complications, such as the need for cardiopulmonary bypass, reperfusion oedema or primary graft dysfunction, and longer intubation or intensive care unit stay times. Although the largest study showed a significantly worse 1-year survival in LLTx, a sub-analysis considering patients successfully discharged showed similar outcomes at 1, 3 and 5 years when compared with classic LTx patients. We conclude that LLTx is a valid therapeutic option for recipients with significant donor size mismatch, offering similar outcomes as classical LTx in the medium term and long term.
      PubDate: Fri, 24 Apr 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa051
      Issue No: Vol. 31, No. 1 (2020)
       
  • Survival outcomes of patients with high-grade and poorly differentiated
           thymic neuroendocrine carcinoma
    • Authors: Hamaji M; Omasa M, Nakagawa T, et al.
      Pages: 98 - 101
      Abstract: AbstractHigh-grade and poorly differentiated thymic neuroendocrine carcinoma is the rarest entity in thymic epithelial tumours. The aim of this study is to report survival data in a multi-institutional database in comparison to data in the literature. Retrospective chart review was performed on the basis of our multi-institutional database to identify patients undergoing the resection of poorly differentiated thymic neuroendocrine carcinoma between 1991 and 2018. Relevant factors were extracted, and survival analysis was performed using the Kaplan–Meier method. Twenty-one patients were identified. Five-year overall survival and recurrence-free survival were 64.6% and 51.8%, respectively. Twelve (57.1%) patients had recurrences. Due to the scarcity of data reported in the literature, our data may be used as a standard in high-grade and poorly differentiated thymic neuroendocrine carcinoma.
      PubDate: Sat, 09 May 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa059
      Issue No: Vol. 31, No. 1 (2020)
       
  • Acute type A aortic dissection in non-agenarians: to cut or not
    • Authors: Hattori S; Noguchi K, Gunji Y, et al.
      Pages: 102 - 107
      Abstract: AbstractOBJECTIVESSurgery for acute type A aortic dissection (type AAD) in non-agenarians is usually contraindicated due to advanced age. The aim of this study was to assess and compare outcomes after surgical or conservative treatment for acute type AAD in non-agenarians by evaluating frailty.METHODSBetween October 2012 and September 2018, 273 patients underwent open repair for type AAD at the Shonan Kamakura General Hospital and the Shonan Fujisawa Tokushukai Hospital, and here, we retrospectively reviewed the case reports of 10 surgically treated non-agenarians and 15 conservatively treated non-agenarians. Exclusion criteria for surgery were the patient’s refusal of surgery, severe dementia and coma. In patients considered to be at a high risk, our judgements were based on the results of comprehensive evaluation.RESULTSBoth in-hospital mortality and 30-day mortality in the surgical group were zero, while in-hospital mortality in conservatively treated non-agenarians was 73.3%. Importantly, 1-year survival in the surgical group and conservative group was 90% and 25%, respectively. The 5-year survival in the surgical group and conservative group was 49.2% and 25%, respectively (log-rank test, P = 0.0105). Four of 6 patients with preoperative clinical frailty scores not higher than 4 were still alive at 1 year with the same level of preoperative frailty.CONCLUSIONSSurgery for acute type AAD in non-agenarians can be performed with acceptable outcomes in carefully selected patients, particularly in those with preoperative clinical frailty scores not higher than 4.
      PubDate: Fri, 01 May 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa061
      Issue No: Vol. 31, No. 1 (2020)
       
  • Neck cannulation for bypass in redo sternotomy in children and adults with
           congenital heart disease
    • Authors: Mustafa M; Neijenhuis R, Furci B, et al.
      Pages: 108 - 112
      Abstract: AbstractOBJECTIVESPatients with complex congenital heart disease carry an increased risk of damage to retrosternal structures each time they undergo redo sternotomy. The aim of this study was to evaluate the safety and efficacy of neck cannulation for peripheral cardiopulmonary bypass to alleviate the risks in high-risk redo sternotomy patients.METHODSChildren and adults with congenital heart disease undergoing high-risk redo sternotomy were included in this retrospective study. The primary outcome was the safety and efficacy of neck cannulation for cardiopulmonary bypass. The secondary outcome was to assess preoperative risk factors as an indication for neck cannulation. The right common carotid artery and right internal jugular vein were cannulated and full cardiopulmonary bypass was initiated with vacuum-assisted venous drainage. Redo sternotomy was performed on a decompressed heart, and bifrontal regional cerebral oxygen saturation was monitored via near-infrared spectroscopy.RESULTSIn total, 35 patients were included. No mortality, neurological or vascular complications occurred postoperatively. Mean left- and right-sided near-infrared spectroscopy were 70.0% (±10.5) and 64.2% (±12.0), respectively, and the mean difference was 5.7% (±6.9). Main preoperative risk factors were; adherent ascending aorta (45.7%), adherent conduit (40%), severely dilated retrosternal right ventricle (17.1%) and skeletal deformations (14.3%).CONCLUSIONSCannulation of the right neck vessels for peripheral cardiopulmonary bypass prior to high-risk redo sternotomy in children and adults with congenital heart disease is a safe and effective strategy. In combination with near-infrared spectroscopy monitoring, adequate cerebral oxygenation can be ensured while the risk of catastrophic haemorrhage is minimized.
      PubDate: Wed, 01 Apr 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa045
      Issue No: Vol. 31, No. 1 (2020)
       
  • The poor long-term outcomes of owl’s eye pulmonary reconstruction
           technique after arterial switch operation
    • Authors: Dedemoğlu M; Korun O, Coşkun G, et al.
      Pages: 113 - 120
      Abstract: AbstractOBJECTIVESThis study aims to compare the early- and long-term outcomes of patients who undergo owl’s eye pulmonary artery (PA) reconstruction to those of patients who undergo conventional PA reconstruction.METHODSFrom January 2016 to January 2017, 64 consecutive patients underwent an arterial switch operation. The patients were divided into 2 groups in terms of neo-PA reconstruction method: 30 patients who underwent neo-PA reconstruction by owl’s eye technique were defined as group 1 and 34 patients who underwent neo-PA reconstruction by the conventional approach were defined as group 2. In the final model, after propensity matching, 23 patients from each group with similar propensity scores were included in the study.RESULTSThere was no significant difference between the groups regarding patient characteristics and operative findings. In the early period, the duration of intensive care unit and hospital stays and the rate of mild neo-pulmonary stenosis (neo-PS) were significantly higher in the owl’s eye group (P = 0.04, 0.04 and 0.03). In the late period, the rate of severe neo-PS and reintervention was significantly higher in the owl’s eye group (P = 0.02 and 0.04). Furthermore, the rates of 3-year freedom from pulmonary reintervention and freedom from moderate–severe neo-PS were significantly lower in group 1 (P = 0.04). In addition, the owl’s eye reconstruction was the only factor independently related to moderate–severe neo-PS in the long term (hazard ratios = 11.2, P = 0.02).CONCLUSIONSWe have abandoned the owl’s eye method for neo-PA reconstruction of the neo-PA because of serious complications. According to our series and the literature, reconstruction of the neo-PA with an oversized, pantaloon-shaped fresh autologous pericardial patch is still superior to the other techniques.
      PubDate: Thu, 04 Jun 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa067
      Issue No: Vol. 31, No. 1 (2020)
       
  • Transcatheter aortic root replacement with chimney grafts for coronary
           perfusion: a preliminary test in a three-dimensional-printed root model
    • Authors: Ferrari E; Scoglio M, Piazza G, et al.
      Pages: 121 - 128
      Abstract: AbstractOBJECTIVESTranscatheter aortic root repair is still not available because of the technical challenge of coronary perfusion. The use of chimney grafts for coronary ostia can be an option and we tested the flow-through coronary chimney grafts deployed in a 3-dimensional-printed root model as part of a transcatheter aortic root repair system.METHODSA 3-dimensional-printed root was used to test the coronary flow after the deployment of 1 root endograft (28 mm diameter) and two 6-mm diameter 10-cm long coronary chimney grafts. Continuous coronary flows were measured in a bench test at different pressure levels (60, 80 and 100 mmHg) and compared to target coronary flows (250 ml/min at rest for the left and 150 ml/min at rest for the right coronary artery).RESULTSThe computed tomography scan-based root was modified with two 5-mm diameter coronary conduits to overcome the limits of the original 3-dimensional-printed coronary ostia. The root was placed in the hydrodynamic system: adjusted coronary free flow at 60, 80 and 100 mmHg of pressure was 1913, 2200 and 2480 ml/min for left coronary and 1633, 2026 and 2366 ml/min for right coronary, respectively. After endografts deployment, mean chimney graft flow at 60, 80 and 100 mmHg of pressure was 1053 ml/min (−45%), 1306 ml/min (−41%) and 1502 ml/min (−40%) for the left coronary and 1100 ml/min (−33%), 1460 ml/min (−28%) and 1626 ml/min (−31%) for the right coronary, respectively.CONCLUSIONSIn this preliminary study, chimney grafts for transcatheter aortic root repair provided 830% of target flow in the right coronary (−31% of free flow) and 414% of target flow in the left coronary (−42% of free flow) which is more than sufficient for both coronaries in real-life conditions. The potential of this approach should be further explored with specifically designed endografts.
      PubDate: Fri, 17 Apr 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa056
      Issue No: Vol. 31, No. 1 (2020)
       
  • Study of the time-relationship of the mechano-electrical interaction in an
           animal model of tetralogy of Fallot: implications for the risk assessment
           of ventricular arrhythmias
    • Authors: Bove T; Alipour Symakani R, Verbeke J, et al.
      Pages: 129 - 137
      Abstract: AbstractOBJECTIVESThe long-term outcome of tetralogy of Fallot (TOF) is determined by progressive right ventricular (RV) dysfunction through pulmonary regurgitation (PR) and the risk of malignant arrhythmia. Although mechano-electrical coupling in TOF is well-known, its time effect on the inducibility of arrhythmia remains ill-defined. The goal of this study was to investigate the mechano-electrical properties at different times in animals with chronic PR.METHODSPR was induced by a transannular patch with limited RV scarring in infant pigs. Haemodynamic assessment included biventricular pressure–volume loops after 3 (n = 8) and 6 months (n = 7) compared to controls (n = 5). The electrophysiological study included endocardial monophasic action potential registration, intraventricular conduction velocity and induction of ventricular arrhythmia by burst pacing.RESULTSProgressive RV dilation was achieved at 6 months (RV end-diastolic volume 143 ± 13 ml/m2—RV end-systolic volume 96 ± 7 ml/m2; P < 0.001), in association with depressed RV contractility (preload recruitable stroke work-slope: 19 ± 1 and 11 ± 3 Mw.ml−1.s−1 for control and 6 m; P < 0.001) and left ventricular contractility (preload recruitable stroke work-slope: 60 ± 13 and 40 ± 11 Mw.ml−1.s−1 for control and 6 m; P = 0.005). Concomitant to QRS prolongation, monophasic action potential90-duration and dispersion at the RV and left ventricle were increased at 6 months. Intraventricular conduction was delayed only in the RV at 6 months (1.8 ± 0.2 and 2.4 ± 0.6 m/s for group 6M and the control group; P = 0.035). Sustained ventricular arrhythmias were not inducible.CONCLUSIONSIn animals yielding the sequelae of a contemporary operation for TOF, mechano-electrical alterations are progressive and affect predominantly the RV after midterm exposure of PR. Because ventricular arrhythmias were not inducible despite significant RV dilation, the data suggest that the haemodynamic RV deterioration effectively precedes the risk of inducing sustained arrhythmia after TOF repair and opens a window for renewed stratification of contemporary risk factors of ventricular arrhythmias in patients operated on with currently used pulmonary valve- and RV-related techniques.
      PubDate: Fri, 03 Apr 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa047
      Issue No: Vol. 31, No. 1 (2020)
       
  • Arterioplasty using gastroepiploic artery patch for common femoral artery
           occlusive disease
    • Authors: Nakai S; Hamasaki A, Uchida T, et al.
      Pages: 138 - 139
      Abstract: AbstractWe present the first case of arterioplasty of the common femoral artery performed using a gastroepiploic artery (GEA) patch for a 59-year-old man on haemodialysis. He was incidentally diagnosed with coronary artery disease with left main trunk stenosis and double-vessel disease upon screening examination for peripheral artery disease. Preoperative computed tomography revealed a severely narrowed right common femoral artery. We planned a simultaneous off-pump coronary artery bypass grafting (CABG) involving the bilateral internal thoracic arteries and GEA, and endarterectomy of the right common femoral artery. Because the remnant GEA was sufficiently long and its diameter was sufficiently large, we used a GEA patch during arterioplasty to preserve the saphenous vein. This method is limited to simultaneous surgery with CABG using GEA but is a useful alternative for preserving the saphenous vein.
      PubDate: Sat, 16 May 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa058
      Issue No: Vol. 31, No. 1 (2020)
       
  • Operative repair of a rare gastrobronchial fistula
    • Authors: Nawaz M; Sultan J, Shah R.
      Pages: 140 - 140
      Abstract: Gastrobronchial fistulaDiaphragm
      PubDate: Thu, 16 Apr 2020 00:00:00 GMT
      DOI: 10.1093/icvts/ivaa053
      Issue No: Vol. 31, No. 1 (2020)
       
 
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