Intermittent warm blood versus cold crystalloid cardioplegia for myocardial protection: a propensity score-matched analysis of 12-year single-center experience.

Objectives: This study analyzes the efficacy in myocardial protection of two types of cardioplegia solutions, namely, blood and crystalloid cardioplegia, both given intermittently in patients undergoing coronary artery bypass grafting (CABG).

Methods: Adult patients undergoing primary isolated coronary artery bypass grafting between January 1998 and January 2011 with cardiopulmonary bypass, using either blood or crystalloid cardioplegia, were identified in our database. Propensity score matching was performed to create comparable patient groups.

Distal anastomotic patency of the Cardica C-PORT(R) xA system versus the hand-sewn technique: a prospective randomized controlled study in patients undergoing coronary artery bypass grafting.

Objectives: The C-Port® Distal Anastomosis Systems (Cardica, Inc., Redwood City, CA, USA) demonstrated favourable results in feasibility trials. However, distal vein anastomoses created with the C-Port® or C-Port xA® system have never been compared with hand-sewn distal vein anastomoses.

Safety of the extended radial artery conduit in performing complete arterial revascularization.

Purpose: We have developed a technique to elongate the radial artery (RA) with the distal segment of the left internal thoracic artery. This study investigated the safety and durability of this extended conduit compared with the composite Y-grafts.

Methods: From January 1998 through December 2010, 750 patients underwent complete arterial revascularization with the use of the left internal thoracic artery (LITA) and RA.

Clinical outcome of the PAS-Port® proximal anastomosis system in off-pump coronary artery bypass grafting in 201 patients.

Aim: The PAS-Port® Proximal Anastomosis System (Cardica, Inc, Redwood City, CA, USA) has been used worldwide since March 2003. The objective of the present study was to evaluate the clinical outcome of the PAS-Port® Proximal Anastomosis System.

Methods: All the patients who underwent off-pump coronary artery bypass grafting in the Catharina Hospital Eindhoven between August 2006 and April 2010 were included in a non-randomized retrospective case-control study, if they had at least one proximal vein graft anastomosis.

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.

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.

Inability to ventilate after tube exchange postoperative to pneumonectomy.

We report a case of inability to ventilate a patient after completion of pneumonectomy, due to migrated tumor tissue to the contralateral side. This represents an unusual complication with a high mortality rate. We have managed to find the cause in time and were able to remove the obstructive tissue using bronchoscopy.

New-onset postoperative atrial fibrillation predicts late mortality after mitral valve surgery.

Background: New-onset postoperative atrial fibrillation (POAF) is a common rhythm disturbance after mitral valve surgery. In this study we investigated the independent effect of POAF on early and late mortality after mitral valve surgery.

Methods: Data of patients who consecutively underwent mitral valve surgery with or without concomitant coronary or tricuspid valve surgery between January 2003 and June 2010 were prospectively collected.

Which method of estimating renal function is the best predictor of mortality after coronary artery bypass grafting?

Objectives: Definitions of renal function in patients undergoing coronary artery bypass graft surgery (CABG) vary in the literature. We sought to investigate which method of estimating renal function is the best predictor of mortality after CABG.

Methods: We analysed the preoperative and postoperative renal function data from all patients undergoing isolated CABG from January 1998 through December 2007.

Predictive value of the additive and logistic EuroSCOREs in patients undergoing aortic valve replacement.

Objectives: The purpose of this study was to evaluate the accuracy of the additive and logistic EuroSCOREs in predicting the operative mortality in patients undergoing aortic valve replacement (AVR) with or without coronary artery bypass graft (CABG) surgery.

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

Setting: This was a single-center study performed in an educational hospital.

Body mass index predicts new-onset atrial fibrillation after cardiac surgery.

Objective: New-onset postoperative atrial fibrillation (POAF) after cardiac surgery is associated with increased morbidity and mortality. Since obesity is becoming increasingly prevalent, identifying body mass index (BMI) as a risk factor for POAF could be of importance. The aim of our study is to investigate the effect of BMI on POAF, independent of other risk factors.

Sutureless mitral valve replacement with bioprostheses and Nitinol attachment rings: feasibility in acute pig experiments.

Objective: There is a need for fast, minimally invasive sutureless replacement of mitral valves.

Methods: Unchanged FDA-approved biological valve prostheses were sutured to Nitinol attachment rings (Endosmart, Stutensee, Germany) that were covered with textile (devices). The lower flange of the device was stretched in ice water and maintained in a stretched position with stretching sutures.

Sutureless replacement of aortic valves with St Jude Medical mechanical valve prostheses and Nitinol attachment rings: feasibility in long-term (90-day) pig experiments.

Objective: Nitinol attachment rings (devices) used to attach mechanical aortic valve prostheses suturelessly were studied in long-term (90 days) pig experiments.

Methods: The aortic valve was removed and replaced by a device around a St Jude Medical mechanical valve prosthesis in 10 surviving pigs. Supravalvular angiography was done at the end of the operation.

The impact of new-onset postoperative atrial fibrillation on mortality after coronary artery bypass grafting.

Background: New-onset postoperative atrial fibrillation (POAF) is a frequent rhythm disturbance after coronary artery bypass grafting (CABG). This study investigated the independent effect of POAF on early and late mortality after isolated CABG.

Methods: Data of patients who consecutively underwent isolated CABG between January 2003 and December 2007 were prospectively collected.

Thrombocytopenia after aortic valve replacement: comparison between mechanical and biological valves.

Background And Aim Of The Study: Concerns have been recently raised regarding the postoperative decrease in platelet count after aortic valve replacement (AVR). Thus, a retrospective analysis was conducted of patients after AVR with regards to postoperative platelet count.

Methods: The data were analyzed from all patients undergoing AVR with (n = 829) or without (n = 1,230) coronary artery bypass grafting (CABG) at a single center between January 1998 and May 2009.

The impact of preoperative atrial fibrillation on early and late mortality after coronary artery bypass grafting.

Objectives: There are still doubts on the effect of preoperative atrial fibrillation (AF) on early and late mortality after coronary artery bypass grafting (CABG). This retrospective study demonstrates the effects of preoperative AF on the short-term and long-term survival after CABG.

Methods: We retrospectively analysed the data of 10626 patients who underwent CABG between January 1998 and December 2007.

[Myocardial revascularization and radial artery: different surgical strategies and short-term results].

Background: The radial artery is routinely used as a graft for surgical arterial myocardial revascularization. The proximal radial artery anastomosis site remains unknown. In this study, we analyzed the short-term results and the operative risk determinants after having used four different common techniques for radial artery implantation.

Fast sutureless implantation of mechanical aortic valve prostheses using Nitinol attachment rings: Feasibility in acute pig experiments.

Objective: There is a need for fast sutureless implantation of valve prostheses with a better outcome than that of current valved stents.

Methods: The suture ring of a St Jude mechanical valve prosthesis (St Jude Medical, Minneapolis, Minn) was replaced by a proprietary non-stent-based attachment ring made of Nitinol memory metal (Endosmart, Stutensee, Germany) and covered with textile. In acute pig experiments, the aortic valve was removed and the device was introduced in a temporary stretched shape and activated by removing constrainers and heating to reach its final attachment shape.

Hospital outcome after aorta-radial versus internal thoracic artery-radial artery grafts.

Background: We researched our data to determine whether use of radial artery (RA) led to similar hospital morbidity as use of pedicled internal thoracic artery (ITA) with vein grafts. We also investigated if use of RA, different RA operative techniques, or number of inflow grafts were predictors for hospital outcome.

Method: Retrospectively the hospital outcome of the first 512 patients with RAs (RA group) was compared with 108 matched patients with left ITA (LITA) and vein grafts (LITA control group).

[The waiting time for heart interventions: trends for percutaneous coronary interventions and cardiothoracic interventions].

Objective: (a) To describe trends in the number of heart interventions performed over time, (b) to determine the length of waiting lists for elective heart interventions in the Netherlands according to the monthly survey of the Supervisory Committee for Heart Interventions in the Netherlands [Begeleidingscommissie Hartinterventies Nederland (BHN)], (c) to compare the length of the waiting lists with existing standards, and (d) to determine the reliability of the waiting list survey.

Design: Prospective.

Method: Data were obtained from the monthly waiting list survey of the 13 heart centres in the Netherlands (1 January 1999-30 November 2002) and from the intervention registry (1 January 1999-30 June 2001), which was complete for 10 centres.

Better ischemic event-free survival after two internal thoracic artery grafts: 13 years of follow-up.

Background: We researched our data to determine whether pedicled bilateral internal thoracic artery (BITA) grafting led to better ischemic event-free survival compared to single ITA grafting, at 10 years mean follow-up.

Methods: Retrospectively 249 patients with BITAs with or without additional vein grafts (BITA group) were matched with 233 comparable patients with left ITA and additional vein grafts (LITA group), at a mean follow-up interval of 10 years.

Results: At 13 years, 76.

Noninvasive assessment of coronary flow reserve in the right gastroepiploic artery graft.

Background: To investigate the functional capacity of the right gastroepiploic artery graft (GEA) and its ability to adapt to provide adequate flow at peak myocardial demand, we investigated the feasibility of determining coronary flow reserve (CFR) provided by this vessel using transabdominal color Doppler echocardiography and the correlation between this noninvasive determination of flow reserve and nuclear stress scintigraphy.

Methods: In 40 selected patients, who underwent complete arterial myocardial revascularization using the GEA and the internal thoracic arteries (ITAs), CFR of the GEA was measured at maximum coronary hyperemia induced by intravenous adenosine infusion, 7 months (range 3 to 20) after surgery. In the same period, in 31 of this group of patients, exercise thallium scintigraphy was performed.

Cardiogenic shock due to coronary narrowings one day after a MAZE III procedure.

A MAZE III procedure was performed on a patient with a small body surface area. On the first postoperative day, the patient developed severe dysfunction of the left ventricle, due to significant narrowings of the right and circumflex coronary arteries in the areas that were cryoablated during the MAZE III procedure. The coronary narrowings were treated by percutaneous transluminal coronary angioplasty (PTCA).

Noninvasive assessment of right gastroepiploic artery graft patency using transcutaneous color Doppler echocardiography.

Background: Because the right gastroepiploic artery graft (GEA), when routed antegastrically, is situated just behind the abdominal wall, we investigated the possibility of evaluating graft patency and flow characteristics using transabdominal color Doppler echocardiography.

Methods: The right GEA graft was evaluated in 71 patients who underwent complete arterial revascularization, 4 months (range, 2 to 17 months) postoperatively. Selective angiography of the right GEA was performed in the patients in whom the graft could not be visualized using color Doppler echocardiography.