Minimally Invasive and Full Sternotomy Aortic Valve Replacements Lead to Comparable Long-Term Outcomes in Elderly Higher-Risk Patients: A Propensity-Matched Comparison.

Background: Minimally invasive aortic valve replacement (AVR) via upper ministernotomy (MiniAVR) is a standard alternative to full sternotomy access. Minimally invasive cardiac surgery has been proven to provide a number of benefits to patients. The aim of this study was to compare the short- and long-term outcomes after MiniAVR versus conventional AVR via full sternotomy (FS) using a biological prosthesis in an elderly higher-risk population.

Correction: Hlavicka et al. Long-Term Outcomes after Aortic Valve and Root Replacement in a Very High-Risk Population. 2022, , 197.

The authors would like to make the following corrections to the published paper [...

Trilateral versus Bilateral Antegrade Cerebral Perfusion in Frozen Elephant Trunk: A Propensity Score Analysis.

Objective:  Spinal cord injury (SCI) with subsequent paraplegia and/or stroke after arch repair with frozen elephant trunk (FET) remain the most devastating complications. In this study, we aim to examine the impact of different cerebral perfusion strategies on the neurological outcome comparing bilateral antegrade cerebral perfusion (bACP) and trilateral antegrade cerebral perfusion (tACP).

Methods:  Between 2009 and 2021, 88 patients underwent total arch replacement using a hybrid prosthesis in FET technique for acute (40.

Right-Sided Minimally Invasive Direct Coronary Artery Bypass: Clinical Experience and Perspectives.

Minimally invasive direct coronary artery bypass grafting (MIDCAB) using the left internal thoracic artery to the left descending artery is a clinical routine in the treatment of coronary artery disease. Far less is known on right-sided MIDCAB (r-MIDCAB) using the right internal thoracic artery (RITA) to the right coronary artery (RCA). We aimed to present our experience in patients with complex coronary artery disease who underwent r-MIDCAB.

Treatment of acute type A aortic dissection with the Ascyrus Medical Dissection Stent in a consecutive series of 57 cases.

Objectives: The Ascyrus Medical Dissection Stent (AMDS) has been recently introduced as an alternative for total arch replacement in acute aortic dissection type A (AADA). The aim of this study was to evaluate the postoperative outcomes after AMDS treatment in a large contemporary cohort of AADA patients.

Methods: Data acquisition was performed retrospectively at 2 German aortic centres between 2020 and 2022 and comprised the perioperative parameters and postoperative results of all AADA patients.

Reply to Jasinski M et al.: "Indeed, there is still room for improvement in long-term durability of BAV repair".

We read the letter to the editor by Dr Jasinski et al. entitled "Long-term durability of valve-sparing or repair procedures in BAV-Is there room for improvement?" with great interest.

Long-Term Outcomes after Aortic Valve and Root Replacement in a Very High-Risk Population.

: Aortic valve and root replacement (AVRR) is a standardised procedure to treat patients with aortic valve and root disease. In centres with a well-established aortic valve and root repair program (valve repairs and Ross operations), only patients with very complex conditions receive AVRR; this procedure uses a mechanical or biological composite valve graft (modified Bentall-de Bono procedure). The aim of the study was to evaluate the short- and long-term results after AVRR in a high-risk population with complex pathologies.

Cerebral oxygen saturation as outcome predictor after transfemoral transcatheter aortic valve implantation.

Background: Cerebral oxygen saturation (ScO) can be measured non-invasively by near-infrared spectroscopy (NIRS) and correlates with cerebral perfusion. We investigated cerebral saturation during transfemoral transcatheter aortic valve implantation (TAVI) and its impact on outcome.

Methods And Results: Cerebral oxygenation was measured continuously by NIRS in 173 analgo-sedated patients during transfemoral TAVI (female 47%, mean age 81 years) with self-expanding (39%) and balloon-expanding valves (61%).

Type A aortic dissection repair with a dissection stent in presence of aberrant subclavian artery.

Aberrant right subclavian artery is a rare congenital aortic arch anomaly. We report on a case of type A aortic dissection and aberrant right subclavian artery. The 65-year-old female patient received a replacement of the ascending aorta and arch repair using an uncovered AMDS (Ascyrus Medical Dissection Stent; CryoLife Inc.

Early- and longer-term outcomes of David versus Florida sleeve procedure: propensity-matched comparison.

Objectives: The aim of this study was to compare short- and longer-term outcomes of David (DV) versus Florida sleeve (FS) procedure in patients requiring valve-sparing aortic root replacement.

Methods: Between January 1996 and December 2020 285 patients received a DV procedure (median age 60 years; 26% females) and 57 patients underwent an FS procedure (median age 64 years; 19% females) in our department. Propensity score matching using patient characteristics led to 58 (DV) versus 57 (FS) patients.

Longer-term outcomes after bicuspid aortic valve repair in 142 patients.

Background: The aim of this study was to evaluate the longer-term results of bicuspid aortic valve (BAV) repair with or without aortic root replacement.

Methods: From 1999 to 2017, 142 patients with or without aortic root dilatation who underwent repair of a regurgitant BAV were included in the study. Ninety-four patients underwent isolated BAV repair (Group 1; median age 43 years) and 48 patients underwent valve-sparing aortic root replacement plus BAV repair (aortic valve reimplantation-Group 2; median age 48 years).

Frozen Elephant Trunk: Minimally Invasive Implantation of a New Trifurcated Hybrid Aortic Prosthesis.

Implantation of hybrid prostheses using the frozen elephant trunk technique has become a standard procedure for aortic arch and proximal descending aorta pathologies. New devices have been introduced to reduce surgical complexity by enabling the frozen elephant trunk technique to be performed in proximal segments of the aorta. This facilitates a minimally invasive approach and provides a safe and durable aortic arch repair.

Randomized Trial of 2 Endoscopic Radial Artery Harvesting Devices-Immunofluorescence Assessment.

Background: Various devices are available for endoscopic radial artery harvesting during coronary artery bypass grafting. Thermal spread and graft damage, however, are common concerns. The aim of this study was to compare the MiFusion TLS2 system (Endotrust, Nettetal Germany) with direct heat technique and the LigaSure Maryland system (Medtronic, Dublin, Ireland) using advanced bipolar technique in a prospective randomized study.

Reduction of drainage-associated complications in cardiac surgery with a digital drainage system: a randomized controlled trial.

Background: Thoracic chest drains are placed after cardiac surgery allowing for the clearance of blood, fluid, and air to prevent post-operative complications. Despite its importance, there is little data on the application of digital chest drainage systems in cardiac surgery. Therefore, the differences between an analog and a digital chest drainage system in cardiac surgery patients were investigated in a randomized controlled trial.

1-Year Survival After TAVR of Patients With Low-Flow, Low-Gradient and High-Gradient Aortic Valve Stenosis in Matched Study Populations.

Objectives: This study sought to examine whether the prognosis of patients with severe aortic stenosis (AS) having high versus low transvalvular mean pressure gradients (MPGs) is intrinsically different after transcatheter aortic valve replacement (TAVR), even after strict matching of baseline parameters.

Background: Patients with low MPG are characterized by higher cardiovascular risk and more comorbidities than other AS patients are.

Methods: In this retrospective, single-center study involving 2,282 patients, 3 groups were derived according to the following criteria: 1) high-gradient AS (HG-AS) (MPG ≥40 mm Hg); 2) low-flow, low-gradient AS (LFLG-AS) (MPG <40 mm Hg, ejection fraction [EF] ≤40%, stroke volume index ≤35 ml/m); 3) paradoxical LFLG-AS (pLFLG-AS) (similar to LFLG-AS but with EF ≥50%).

The ACURATE neo Transcatheter Heart Valve: A Comprehensive Analysis of Predictors of Procedural Outcome.

Objectives: The aim of this study was to perform a comprehensive analysis of factors that affect procedural outcomes of transcatheter aortic valve replacement using the ACURATE neo prosthesis (Symetis/Boston, Ecublens, Switzerland).

Background: Predictors of procedural outcomes using the ACURATE neo prosthesis are poorly understood.

Methods: A total of 500 patients underwent transfemoral aortic valve replacement with the ACURATE neo prosthesis.

Accuracy of device landing zone calcium volume measurement with contrast-enhanced multidetector computed tomography.

Background: The extent of aortic valve calcification is an important determinant of procedural success in transcatheter aortic valve implantation (TAVI). We sought to validate device landing zone calcium volume (DLZ-CV) measurements on contrast-enhanced multidetector computed tomography (MDCT) with non-contrast-enhanced scans as reference.

Methods: We determined DLZ-CV in 141 patients undergoing transfemoral TAVI.

Randomized (CO)mparison of (TRI)fecta and (P)erimount Magna Ease Supraannular Aortic Xenografts-CO.TRI.P Study.

Background:  Modern supraannular aortic xenografts offer a special design, thus providing maximized opening area for improved hemodynamics. The aim of this study was a prospectively randomized comparison of the Trifecta and the Perimount Magna Ease valves based on metric annulus sizing.

Methods:  A total of 100 patients with aortic stenosis undergoing aortic valve replacement (AVR) with or without concomitant procedures were prospectively included.

Predictors and outcome of conversion to cardiac surgery during transcatheter aortic valve implantation.

Objectives: Due to increasing clinical experience with transcatheter aortic valve implantation (TAVI) procedures, sophisticated imaging and advanced device technology, TAVI complication rates are low; however, patients requiring conversion to surgery are confronted with an increased mortality risk. In this retrospective study, we evaluated the predictors for conversion and the outcomes of these patients.

Methods: We analysed the records of all patients undergoing TAVI in our centre from 2011 to 2016 and focused on cases that required conversion to sternotomy.

TAVI risk scoring using established versus new scoring systems: role of the new STS/ACC model.

Aims: The aim of this study was to validate the recently developed STS/ACC TAVR in-hospital mortality risk score for predicting in-hospital mortality after transcatheter aotic valve implantation (TAVI) and to compare its ability to predict 30-day mortality with that of four other established risk models (EuroSCORE I, EuroSCORE II, STS-PROM, and German AV Score).

Methods And Results: The study cohort included 946 consecutive patients who underwent TAVI between 2013 and 2015. Each of the five scores was fitted as a continuous linear variable into a logistic regression model estimating 30-day mortality.