scholarly journals Cardiac Surgery 2019 Reviewed

2020 ◽  
Vol 68 (05) ◽  
pp. 363-376
Author(s):  
Torsten Doenst ◽  
Steffen Bargenda ◽  
Hristo Kirov ◽  
Alexandros Moschovas ◽  
Sophie Tkebuchava ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Search Term ◽  
Surgical Aortic Valve Replacement ◽  
Joint Decision

AbstractFor the year 2019, almost 25,000 published references can be found in PubMed when entering the search term “cardiac surgery.” We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach for article selection and reviewed the main fields of adult cardiac surgery (i.e., coronary, valve, aortic, and heart failure surgery). The past decade has experienced an enormous development of interventional techniques that compete more and more with classic surgery. This contest was broadly visible in 2019. It peaked over the interpretation of the EXCEL trial data, where percutaneous coronary intervention and coronary artery bypass grafting (CABG) for left main disease were compared. A novel pathomechanism for CABG was proposed, potentially answering open questions in the field. In aortic valve surgery, two low-risk trials comparing transcatheter aortic valve implantation (TAVI) to classic aortic valve replacement (surgical aortic valve replacement) received attention for showing equal or superior short-term outcomes for TAVI. Longer follow-up information from recent trials became available presenting results emphasizing the need for joint decision making. While publications addressing surgery on the aorta and the mitral and tricuspid valves were less abundant, there was substantial activity regarding left ventricular assist device support and heart transplantation. This article attempts to summarize the most pertinent publications. It does not expect to be complete and cannot be free of individual interpretation. We aimed to provide a condensed summary of 2019s publications with a stimulus for in-depth reading and a basis supporting patient information.

Sutureless versus Stented Bioprostheses for Aortic Valve Replacement: The Randomized PERSIST-AVR Study Design

2018 ◽  
Vol 68 (02) ◽  
pp. 114-123 ◽  
Author(s):  
Roberto Lorusso ◽  
Thierry Folliguet ◽  
Malakh Shrestha ◽  
Bart Meuris ◽  
Arie Pieter Kappetein ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Artery Bypass ◽  
Randomized Study ◽  
Primary Objective ◽  
Surgical Aortic Valve Replacement ◽  
Open Label ◽  
Number Of Patients

Abstract Introduction Sutureless biological valves for surgical aortic valve replacement (SAVR), characterized by the absence of anchoring sutures at the aortic annulus, are gaining popularity because of ease and reproducibility of implant, shorter operating times, and enhancement of minimally invasive approaches. The stentless configuration of the sutureless valve was designed to achieve optimal hemodynamic performance. Materials and Methods PERSIST-AVR (PERceval Sutureless Implant versus STandard Aortic Valve Replacement) is a prospective, randomized, adaptive, open-label, international, postmarket trial (NCT02673697). The primary objective of the trial is to assess the safety and efficacy of the Perceval (LivaNova, London, UK) sutureless bioprosthesis among patients undergoing SAVR in the presence of severe aortic stenosis to demonstrate the noninferiority of Perceval as compared with standard sutured stented bioprosthetic aortic valve as an isolated procedure or combined with coronary artery bypass grafting. Sample size will be determined adaptively through interim analyses performed by an Independent Statistical Unit till a maximum of 1,234 patients, enrolled at ∼60 sites in countries where the device is commercially available. Patients will be followed up for 5 years after implant. The primary end point is the number of patients free from major adverse cardiac and cerebrovascular-related events at 1 year. Additional secondary outcomes will be assessed up to 5 years. Discussion PERSIST-AVR is the first prospective, randomized study comparing in-hospital and postdischarge outcomes in a robust population of patients undergoing SAVR with either the Perceval sutureless bioprosthesis or a conventional sutured stented bioprosthesis up to 5 years.

scholarly journals Video assisted, transaortic removal of left ventricular thrombus during concurrent cardiac surgery: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Aditya Eranki ◽  
Claudia Villanueva ◽  
Nicholas Collins ◽  
Peng Seah
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Coronary Artery Bypass ◽  
Valve Replacement ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Bypass Grafting ◽  
Ventricular Thrombus

Abstract Introduction Left ventricular (LV) thrombus is a complication of acute myocardial infarction and is associated with systemic thromboembolism. We describe a trans-aortic endoscopic approach to the removal of an LV thrombus in a patient undergoing concurrent coronary artery bypass grafting and aortic valve replacement. Case presentation A 47 year old male presented following an embolic middle cerebral artery stroke and underwent transthoracic echocardiography demonstrating a mobile LV thrombus. Additional investigation revealed a moderately stenosed bicispid aortic valve, two vessel coronary artery disease and ischemic cardiomyopathy. The patient underwent early surgery to reduce the risk of further embolic episodes. A trans-aortic approach was utilized with videoscopy and single shafted instrumentation to aide in removal of the thrombus. The patient then underwent aortic valve replacement and coronary artery bypass grafting. Conclusion We report an alternative technique for the removal of a left ventricular thrombus in a patient undergoing concurrent coronary and aortic valve surgery. The transaortic video-assisted approach provided excellent visualisation of the apex and near complete removal of the thrombus without damaging the surrounding trabeculae. The main benefit of this technique is sparing of LV tissue, thereby preserving left ventricular function.

Chylopericardium following aortic valve replacement and coronary artery bypass surgery: a case report and discussion

1994 ◽  
Vol 3 (4) ◽  
pp. 313-315
Author(s):  
M Schactman ◽  
C Scott ◽  
DR Glibbery-Fiesel ◽  
M Murello ◽  
P Kerr
Keyword(s):  
Cardiac Surgery ◽  
Case Report ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Coronary Artery Bypass ◽  
Valve Replacement ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass

The incidence of chylopericardium after cardiac surgery is unusual, but there are documented cases. Those caring for these patients need to be aware of the symptoms and management of chylopericardium because, if left untreated, it may cause catastrophic consequences.

scholarly journals Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Cardiac Surgery: Meta-Analysis and Systematic Review of the Literature

2020 ◽  
Vol 7 (3) ◽  
pp. 36
Author(s):  
Azka Latif ◽  
Noman Lateef ◽  
Muhammad Junaid Ahsan ◽  
Vikas Kapoor ◽  
Rana Mohammad Usman ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Hospital Stay ◽  
Valve Replacement ◽  
Lower Incidence ◽  
Surgical Aortic Valve Replacement ◽  
Clinical Endpoints ◽  
Duration Of Hospital Stay ◽  
All Cause Mortality

The number of patients with severe aortic stenosis (AS) and a history of prior cardiac surgery has increased. Prior cardiac surgery increases the risk of adverse outcomes in patients undergoing aortic valve replacement. To evaluate the impact of prior cardiac surgery on clinical endpoints in patients undergoing transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR), we performed a literature search using PubMed, Embase, Google Scholar, and Scopus databases. The clinical endpoints included in our study were 30-day mortality, 1–2-year mortality, acute kidney injury (AKI), bleeding, stroke, procedural time, and duration of hospital stay. Seven studies, which included a total of 8221 patients, were selected. Our study found that TAVR was associated with a lower incidence of stroke and bleeding complications. There was no significant difference in terms of AKI, 30-day all-cause mortality, and 1–2-year all-cause mortality between the two groups. The average procedure time and duration of hospital stay were 170 min less (p ≤ 0.01) and 3.6 days shorter (p < 0.01) in patients with TAVR, respectively. In patients with prior coronary artery bypass graft and severe AS, both TAVR and SAVR are reasonable options. However, TAVR may be associated with a lower incidence of complications like stroke and perioperative bleeding, in addition to a shorter length of stay.

Bioprosthetic aortic valve haemodynamic deterioration secondary to a thrombus

2020 ◽  
Vol 13 (9) ◽  
pp. e233400
Author(s):  
Martin A Chacon-Portillo ◽  
Bishnu Dhakal ◽  
Rajesh Janardhanan
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Artery Bypass ◽  
Shortness Of Breath ◽  
Coronary Angiogram ◽  
Surgical Aortic Valve Replacement ◽  
History Of ◽  
Root Size

A 77-year-old man with a history of coronary artery bypass grafting and surgical aortic valve replacement for severe aortic stenosis 2 years prior presented with exertional chest pain and shortness of breath. The patient underwent a thorough initial evaluation including a transthoracic echocardiogram and coronary angiogram without significant findings. One month later the patient presented with worsened symptoms and a repeat echocardiogram showed an increased mean aortic valve gradient of 87 mm Hg. The patient had to undergo reoperation for a surgical aortic valve replacement and was found to have an aortic bioprosthetic valve thrombus. This case suggests a mismatch between the aortic prosthesis and the patient’s aortic root size.

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