Use of Postoperative Peak Arterial Lactate Level to Predict Outcome After Cardiac Surgery.

Objectives: In the present study, the authors investigated the predictive value of postoperative peak arterial lactate levels for early and late mortality after cardiac surgery.

Design: Retrospective analysis of prospectively collected data.

Setting: Single-center study in an academic hospital.

Conventional Aortic Valve Replacement after Displacement of a Percutaneously Implanted Aortic Prosthesis: Case Report.

A case is described of aortic stenosis that was initially treated with transcatheter aortic valve implantation (TAVI) due to a high-risk profile. Following dysfunction of the TAVI prosthesis, conventional aortic valve replacement (AVR) was successfully performed; the subsequent postoperative course was uneventful. In conclusion, the target population for TAVI must be more accurately specified, with further research helping to define whether AVR or TAVI is the best treatment option for 'intermediate-risk' patients.

Mid-term haemodynamic and clinical results after aortic valve replacement using the Freedom Solo stentless bioprosthesis versus the Carpentier Edwards Perimount stented bioprosthesis.

Objectives: The aim of this study was to investigate the mid-term haemodynamic and clinical results after aortic valve replacement (AVR) using the Sorin Freedom Solo (SFS) stentless bioprosthesis, compared with the standard Carpentier Edwards Perimount (CEP) stented bioprosthesis.

Methods: In this retrospective cohort study of prospectively collected data, 116 patients were included in the SFS group (53 males; median age 74 years, range 56-85 years), and 122 patients in the CEP group (85 males; median age 73 years, range 43-88 years) between July 2007 and January 2013. Echocardiography was performed at 6 weeks after surgery in our centre, and the most recent echocardiography (in our centre or in referring cardiology departments) was requested.

Long-term follow-up of 82 patients after surgical excision of atrial myxomas.

Objectives: Literature reporting on large patient groups with the long-term follow-up is limited due to the low incidence of myxomas. This single-centre, retrospective study reports on the long-term follow-up (e.g.

Frequency and prognosis of new bundle branch block induced by surgical aortic valve replacement.

Objectives: Recently, transcatheter aortic valve implantation has been introduced, but one of its complications is left bundle branch block (LBBB), a conduction disturbance that has been associated with increased mortality. We investigated the incidence and fate of both right bundle branch block (RBBB) and LBBB after aortic valve replacement (AVR) using a retrospective analysis. We also studied the predictive value of both disorders for all-cause mortality.

Postoperative conduction disorders after implantation of the self-expandable sutureless Perceval S bioprosthesis.

Background And Aim Of The Study: Minimally invasive techniques for aortic valve replacement (AVR) have been developed as an alternative to conventional AVR for patients with high operative risk. Yet, these techniques are still associated with an increased risk of postoperative conduction disorders. The study aim was to identify the incidence and fate of postoperative conduction disorders in patients undergoing sutureless (SU) AVR with the Perceval S bioprosthesis.

Impact of postoperative renal replacement therapy on long-term outcome after cardiac surgery increases with age.

Background And Aim Of The Study: In the present study, we investigated the survival of patients who received postoperative renal replacement therapy (RRT) after cardiac surgery. We specifically focused on factors predicting long-term outcome in elderly patients.

Methods: Data of all patients that received unintentional renal replacement therapy following cardiac surgery between 2004 and 2010 were analyzed.

Patency of the internal mammary arteries after removal of the Nuss bar: an initial report.

Objectives: Surgical correction of pectus excavatum (PE) has shifted to the modern minimally invasive Nuss procedure, which proved to be safe and effective. In order to restore the dented deformity, custom-curved metal bars provide continuous retrosternal pressure but cross the habitat of the internal mammary arteries (IMAs) directly affecting their patency. In this initial report, we sought to assess the patency of the IMAs in the first 6 patients who underwent Nuss bar removal in our department.

Does removal of steel wires relieve post-sternotomy pain after cardiac surgery?

Background: Post-sternotomy pain in the absence of cardiac ischemia and sternal instability is most commonly due to the sternal wire sutures or a protruding wire. We performed a retrospective study to investigate the effect of removal of the steel wires for relief of post-sternotomy pain.

Methods: All 206 patients who underwent sternal wire removal in our institution from January 2003 through August 2011 were included in this study.

Does the body mass index predict mortality after isolated aortic valve replacement?

Background And Aim Of The Study: Data relating to the impact of body mass index (BMI) on outcomes after isolated aortic valve replacement (AVR) are scarce and controversial. The study aim was to investigate the predictive value of BMI for early and late mortality after isolated AVR.

Methods: Data obtained from patients who underwent isolated AVR between January 1998 and December 2010 at the authors' institution were analyzed retrospectively.

Can postoperative mean transprosthetic pressure gradient predict survival after aortic valve replacement?

Background: In this study, we sought to determine the effect of the mean transprosthetic pressure gradient (TPG), measured at 6 weeks after aortic valve replacement (AVR) or AVR with coronary artery bypass grafting (CABG) on late all-cause mortality.

Methods: Between January 1998 and March 2012, 2,276 patients (mean age 68 ± 11 years) underwent TPG analysis at 6 weeks after AVR (n = 1,318) or AVR with CABG (n = 958) at a single institution. Mean TPG was 11.

Preoperative hemoglobin level as a predictor of mortality after aortic valve replacement.

Objectives: The predictive value of preoperative hemoglobin (HB) level on the outcome of patients undergoing valve surgery is not well established. This study evaluated the predictive value of preoperative HB level on survival after aortic valve replacement (AVR).

Design: This was a retrospective analysis of prospectively collected data.

Impact of prosthesis-patient mismatch on early and late mortality after aortic valve replacement.

Background: The influence of prosthesis-patient mismatch (PPM) on survival after aortic valve replacement (AVR) remains controversial. In this study, we sought to determine the effect of PPM on early (≤30 days) and late mortality (>30 days) after AVR or AVR combined with coronary artery bypass grafting (AVR with CABG).

Methods: Between January 1998 and March 2012, 2976 patients underwent AVR (n= 1718) or AVR with CABG (n=1258) at a single institution.

Statistical methods to monitor risk factors in a clinical database: example of a national cardiac surgery registry.

Background: Comparison of outcomes requires adequate risk adjustment for differences in patient risk and the type of intervention performed. Both unintentional and intentional misclassification (also called gaming) of risk factors might lead to incorrect benchmark results. Therefore, misclassification of risk factors should be detected.

Fast-track practice in cardiac surgery: results and predictors of outcome.

Objectives: Various studies have shown different parameters as independent risk factors in predicting the success of fast-track postoperative management in cardiac surgery. In the present study, we evaluated our 7-year experience with the fast-track protocol and investigated the preoperative predictors of successful outcome.

Methods: Between 2004 and 2010, 5367 consecutive patients undergoing cardiac surgery were preoperatively selected for postoperative admission in the postanaesthesia care unit (PACU) and were included in this study.

Results of one-hundred and seventy patients after elective Bentall operation.

The aim of this study was to evaluate the short and long-term operative results of patients who underwent a Bentall procedure in a 12-year period. We retrospectively analyzed the data of 170 patients who underwent an elective Bentall procedure between January 1998 and July 2010. All pre- and perioperative variable were entered into a multivariate regression model to identify significant predictors of early and late mortality.

Does new-onset postoperative atrial fibrillation after coronary artery bypass grafting affect postoperative quality of life?

Objectives: New-onset postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery. We investigated the effect of POAF on quality of life after coronary artery bypass grafting.

Methods: All patients who underwent nonemergency coronary artery bypass grafting between March 2009 and January 2011 were requested to complete a Short Form-36 Health Survey before and 6 months after the procedure.

Perioperative serum aspartate aminotransferase level as a predictor of survival after coronary artery bypass grafting.

Background: Elevated cardiac enzymes after coronary artery bypass grafting (CABG) surgery have been identified as a risk factor for worse postoperative outcome. Cardiac enzymes play an important role in the diagnosis of perioperative myocardial infarction. This study aims to investigate the predictive value of aspartate aminotransferase (AST) with respect to early and late mortality after CABG.

Left bundle-branch block induced by transcatheter aortic valve implantation increases risk of death.

Background: Transcatheter aortic valve implantation (TAVI) is a novel therapy for treatment of severe aortic stenosis. Although 30% to 50% of patients develop new left bundle-branch block (LBBB), its effect on clinical outcome is unclear.

Methods And Results: Data were collected in a multicenter registry encompassing TAVI patients from 2005 until 2010.

Long-term clinical outcome of the symmetry aortic connector system in off-pump coronary artery bypass grafting.

Background: Several short-term and midterm follow-up studies of the Symmetry aortic connector system showed controversial results. The objective of the present study was assessing the long-term clinical outcome of patients operated with the Symmetry device and to compare the results with hand-sewn control patients.

Methods: A retrospective case-control study of 156 (46 cases, 110 controls) consecutive patients, that underwent off-pump coronary revascularization, between January 2001 and December 2004, was conducted.

Cardiac herniation after operative management of lung cancer: a rare and dangerous complication.

Cardiac herniation after pneumonectomy is recognized as a rare complication. This case report describes two cases. The mortality rate of this complication remains high as reported in the literature; in early-recognized cases 50 % and in late or unrecognized cases 100 %.