The changing characteristics and outcomes of patients undergoing surgical aortic valve replacement in the transcatheter aortic valve implantation era.

Background: Transcatheter aortic valve implantation (TAVI) is thought to change the characteristics and outcome of patients with aortic stenosis undergoing surgical aortic valve replacement (SAVR). We investigated the difference in clinical characteristics and outcomes of SAVR patients in the TAVI era.

Methods: Two cohorts of consecutive patients undergoing isolated SAVR for severe tricuspid aortic stenosis, in 4 years before (period-1) and 4 years after (period-2) the introduction of TAVI were analysed.

Evaluation of the impact of a quality improvement program and intensivist-directed ICU team on mortality after cardiac surgery.

Objective: Quality improvement is an important pursuit for critical care teams.

Design: The authors performed an observational cohort study with historic control.

Setting: Eight-bed cardiac surgery ICU in a tertiary university hospital.

Box lesion in the open left atrium for surgical ablation of atrial fibrillation.

Objective: Cut-and-sew maze with a box lesion around the pulmonary veins is currently the criterion standard procedure for surgical ablation of atrial fibrillation. Recently, we changed our technique from standard bilateral epicardial pulmonary vein isolation with interconnecting lesions to a box lesion procedure with a bipolar radiofrequency ablation device. Our study describes this technique.

Mitral valve repair: isolated posterior compared to anterior or bileaflet pathology.

Objectives: The results of mitral valve (MV) repair for anterior leaflet pathology (ALP) are considered less favorable than those for posterior leaflet pathology (PLP). We compared clinical and echocardiography outcomes of PLP repair with ALP and/or bileaflet pathology (BLP) repair.

Methods: Between 2004 and 2011, 407 patients underwent MV repair due to degenerative MV: 276 patients (68%) had PLP and 131 (32%) had ALP/BLP.

Heparin-free management of intra-aortic balloon pump after cardiac surgery.

Background: Anticoagulation with heparin is recommended in patients with an intra-aortic balloon pump (IABP) to prevent thrombosis and embolization. However, anticoagulation increases the risk of bleeding, particularly in the early postoperative period after cardiac surgery. We investigated the safety of heparin-free management after IABP insertion in patients who underwent cardiac surgery.

The impact of hyperlactatemia on postoperative outcome after adult cardiac surgery.

Purpose: To evaluate the value of blood lactate value in predicting postoperative mortality (primary outcome), duration of ventilation, and length of stay in an intensive care unit (ICU) and hospital (secondary outcomes).

Methods: We performed a prospective observation study on 1,820 consecutive patients undergoing open heart surgery in a tertiary university medical center. Blood lactate levels were obtained from patients on admission to the cardiac surgical ICU and measured serially.

Left atrial ablation for atrial fibrillation: creating the "box lesion" with a bipolar radiofrequency device.

The maze procedure is the gold standard for the ablation of atrial fibrillation, and the "box lesion" around the pulmonary veins is the most important part of this procedure. We have created this lesion with a bipolar radiofrequency ablator, abandoning the usual use of this device (to achieve bilateral epicardial isolation of the pulmonary veins).From March 2004 through the end of May 2010, we performed surgical ablation of atrial fibrillation in 240 patients.

Midterm results of mitral valve repair: closed versus open annuloplasty ring.

Background: Closed and open annuloplasty rings are both used for mitral valve repair. This study compared the clinical and echocardiographic results in patients with degenerative mitral disease undergoing MV repair with closed semirigid rings vs open bands.

Methods: Between 2004 and 2008, 377 patients (mean age, 59 + or - 12 years) underwent mitral valve repair.

Efficacy of surgical ablation of atrial fibrillation in patients with rheumatic heart disease.

Background: Although atrial fibrillation (AF) ablation is efficient in many patient cohorts, its effect on rheumatic heart disease remains controversial. We describe a retrospective comparison of surgical ablation using the same technique in rheumatic versus nonrheumatic patients.

Methods: Between 2004 and 2009, we performed AF ablation as a part of another cardiac surgery in 192 patients with bipolar radiofrequency ablator and a cryoprobe.

[Bipolar radiofrequency and cryoablation for surgical treatment of atrial fibrillation].

Background: The widespread use of new sources of energy for ablation of atrial fibrillation (AF) raised concerns regarding the safety and efficacy of the various devices. This article describes the results of our technique using a combination of bipolar radiofrequency (RF) and cryoablation.

Methods: From February 2004 till July 2006 this method was used on 94 patients.

Mid-term results of the 'hybrid maze': a combination of bipolar radiofrequency and cryoablation for surgical treatment of atrial fibrillation.

Background And Aim Of The Study: Although the use of new sources of energy for the ablation of atrial fibrillation (AF) has simplified the procedure, concerns have been expressed with regard to the safety and efficacy of the various devices. Herein are described the results of a technique using a combination of bipolar radiofrequency (RF) and cryoablation.

Methods: Between February 2004 and August 2005, the combined procedure was used on 60 patients, 32 of whom (54%) had persistent AF, and 28 (46%) permanent AF.