Perioperative and mid-term outcomes of mitral valve surgery with and without concomitant surgical ablation for atrial fibrillation: a retrospective analysis.

Objectives: We retrospectively analysed perioperative and mid-term outcomes for patients undergoing mitral valve surgery with and without atrial fibrillation.

Methods: Patients who underwent mitral valve surgery between January 2018 and February 2023 were included and categorized into 3 groups: 'No AF' (no documented atrial fibrillation), 'AF no SA' (atrial fibrillation without surgical ablation) and 'AF and SA' (atrial fibrillation with concomitant surgical ablation). Groups were compared for perioperative and mid-term outcomes, including mortality, stroke, bleeding and pacemaker implantation.

In-Hospital Outcomes Following Surgical Revascularization of Chronic Total Coronary Occlusions.

: Patients with chronic total occlusions of the coronary arteries are either treated with PCI or referred for surgical revascularization. We analyzed the patients with chronic occluded coronary arteries that were surgically treated and aimed to describe the anatomical characteristics, revascularization rates, and in-hospital outcomes achieved with coronary artery bypass grafting. : Angiographic data of 2005 patients with coronary artery disease treated in our institution between January 2005 and December 2014 were retrospectively analyzed.

Impact of surgically placed radiopaque markers during aortic root surgery on facilitating secondary diagnostic and therapeutic interventions.

Background: Implantation of radiopaque markers during aortic root surgery might possibly facilitate upcoming coronary angiography or transcatheter aortic valve implantation. Aim of this study was to report the impact of surgically placed radiopaque markers on procedural characteristics and on angiographic outcomes.

Methods: We retrospectively analyzed baseline characteristics, preoperative and postoperative data as well as procedural findings.

Bilateral Minithoracotomy for Mitral Valve Repair and Coronary Bypass Grafting.

 Combined mitral valve and coronary artery surgery is usually accomplished via a median sternotomy and is associated with increased mortality and morbidity.  We report on a 67-year-old patient with mitral valve regurgitation and concomitant coronary artery disease (CAD). The mitral valve was repaired using the loops and ring technique, and the left anterior descending artery was revascularized using the left internal mammary artery through a bilateral minithoracotomy approach.

Invasive Coronary Angiography in Patients with Native or Prosthetic Aortic Valve Endocarditis.

Background:  Invasive coronary angiography (ICA) is essential to detect significant coronary artery disease (CAD) but is generally not recommended in patients with infective aortic valve endocarditis. This study aimed to evaluate the risks and benefits of preoperative ICA in patients before aortic valve replacement.

Methods:  Between March 2008 and September 2020, 232 patients were surgically treated for infectious endocarditis of the aortic valve.

Composition of the surgical team in aortic arch surgery-a risk factor analysis.

Objectives: The aim of this study was to analyse the influence of varying experiences within each surgical team to identify team-related risk factors on clinical outcomes after total aortic arch replacement.

Methods: Each surgeon was rated from 1 to 5, and a surgical team's score was calculated (operating surgeon + assisting surgeon = team score) by relying on each member's experience. A composite end point (mortality, stroke or spinal cord injury) was defined.

Clinical Outcomes after Mitral Valve Surgery in Failed MitraClip Procedures.

Background: We retrospectively evaluated in-hospital and overall outcome of patients who received mitral valve replacement (MVR) after failed MitraClip procedure.

Methods: A total of 26 out of 740 patients received MVR after treatment with MitraClip between June 2010 and December 2020. We analyzed in-hospital mortality and overall mortality during the median follow-up period of 72 days after MVR.

Recannulation of the right axillary artery in reoperative proximal thoracic aortic surgery is safe.

Objectives: To evaluate the safety and efficacy of recannulating the axillary artery in reoperative proximal thoracic aortic surgery.

Methods: Between 2008 and 2020, we evaluated patients who underwent reoperative proximal thoracic aortic surgery. The patients were divided into 2 groups: (i) patients with no previous right axillary artery cannulation (primary cannulation group) and (ii) patients with a previous cannulated right axillary artery (recannulation group).

Risk factors for stroke after total aortic arch replacement using the frozen elephant trunk technique.

Objectives: This study aimed to analyse risk factors for postoperative stroke, evaluate the underlying mechanisms and report on outcomes of patients suffering a postoperative stroke after total aortic arch replacement using the frozen elephant trunk technique.

Methods: Two-hundred and fifty patients underwent total aortic arch replacement via the frozen elephant trunk technique between March 2013 and November 2020 for acute and chronic aortic pathologies. Postoperative strokes were evaluated interdisciplinarily by a cardiac surgeon, neurologist and radiologist, and subclassified to each's cerebral territory.

Downstream thoracic endovascular aortic repair following zone 2, 100-mm stent graft frozen elephant trunk implantation.

Objectives: The aim of this study was to analyse outcomes of downstream thoracic endovascular aortic repair (TEVAR) following the frozen elephant trunk (FET) procedure.

Methods: Sixty-six patients underwent downstream TEVAR following the FET procedure to treat thoracic aortic dissections (n = 42, 64%), aneurysms (n = 19, 29%) or penetrating aortic ulcers involving the aortic arch (n = 5, 8%). Patient and outcome characteristics were analysed.

Moderate or Severe Functional MR and Severe AS: Is Mitral Valve Surgery Justified?

Objective:  Mitral regurgitation (MR) and severe aortic valve stenosis often coexist. Concomitant replacement of both valves is associated with a significantly higher morbidity and mortality. This study sought to investigate the progression of MR after isolated aortic valve replacement.

Prognostic impact of invasive exercise haemodynamics in patients with severe mitral regurgitation.

Objectives: Abnormal invasive exercise haemodynamics in asymptomatic patients with severe mitral regurgitation were associated with higher regurgitation burden. We analysed the association between parameters of invasive exercise testing with mortality and valve surgery compared to guideline defined non-invasive criteria.

Methods: This single centre, retrospective cohort study assesses the association of invasive exercise haemodynamics and mortality with and without surgery in patients with severe mitral regurgitation and normal ejection fraction (≥55%) as primary outcome.

Coronary revascularization in acute coronary syndrome: does the choice of the conduit matter?

Background: Our retrospective study evaluates the impact on short - and long-term outcome according to the graft selection during emergency coronary revascularization surgery.

Methods: Three hundred thirty-nine Patients with acute coronary syndrome undergoing emergency coronary bypass surgery at our institution from 2008 until 2018 were analyzed using propensity score analysis. The primary endpoint was in-hospital survival.

Efficacy of Vascular Closure Devices in Closing Large-Bore Sheath Arterial Sites after Treatment with Extracorporeal Life Support System.

Background:  We retrospectively evaluated vascular complications and wound infections after surgical or percutaneous transfemoral removal of temporary extracorporeal life support systems (ECLSs).

Methods:  A total of 83 patients were weaned from ECLS between August 2015 and September 2020. We analyzed for a composite endpoint of vascular complications and wound infections requiring negative-pressure wound therapy.

Treatment of infectious aortic disease with bovine pericardial tube grafts.

Objectives: Our aim was to evaluate the mid-term outcomes of bovine pericardial tube graft repair for infectious aortic disease in any aortic segment.

Methods: Between May 2015 and July 2020, 45 patients were treated for infectious aortic disease of the native (n = 9) aorta or after (endo-)graft (n = 36) implantation with bovine pericardial tube grafts. Clinical, infectious details, outcomes and follow-up data were evaluated.

Direct Versus Side Graft Cannulation From the Right Axillary Artery in Thoracic Aortic Surgery.

Background: The axillary artery can be cannulated for antegrade cerebral perfusion directly or by employing a prosthetic vascular graft anastomosed to the artery.

Methods: From 2008 until 2019, 688 patients underwent axillary artery cannulation. Of those, 287 underwent direct cannulation and 401 cannulation through a side graft.

Postcardiotomy mechanical support in patients with mitral valve prostheses is associated with poor survival.

Aims: To elaborate on early survival in patients with mitral valve replacement requiring temporary extracorporeal life support system (ECLS).

Methods: We analyzed survival, significant bleeding, wound infection, and ECLS duration in 421 from 14,400 patients with postoperative need for ECLS from January 2008 to December 2017 at our institution. Finally, patients were stratified according to the type of surgery performed: the mitral group (mitral valve replacement)  = 63 and the control group (any cardiac surgery excluding the mitral valve)  = 358.

Transcatheter valve-in-valve implantation in degenerated aortic bioprostheses: are patients with small surgical bioprostheses at higher risk for unfavourable mid-term outcomes?

Background: To examine outcomes of valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) according to the inner diameter (ID) of the degenerated aortic valve bioprosthesis.

Methods: We analyzed survival, stroke, permanent pacemaker (PPM) implantation, paravalvular (PV) leakage, acute kidney injury and vascular complications in fifty-nine patients during a ten-year period. Patients were stratified according to the ID of the indwelling degenerated biological aortic valve (true ID ≤ and >20 mm).

The frozen elephant trunk technique for aortic dissection is safe after previous aortic repair.

Objectives: The goal of this study was to evaluate outcomes of aortic arch replacement using the frozen elephant trunk (FET) technique after previous proximal and/or distal open or endovascular thoracic aortic repair.

Methods: Sixty-three patients [median age: 63 (55-74) years; 65% men] were operated on for acute or chronic aortic dissection after previous proximal and/or distal open or endovascular thoracic aortic repair. Intraoperative details, clinical outcome and follow-up results were evaluated.

The Frozen Elephant Trunk Technique for the Treatment of Type B and Type Non-A Non-B Aortic Dissection.

Objective: To evaluate outcomes of patients with acute complicated or chronic Type B or non-A non-B aortic dissection who underwent the frozen elephant trunk (FET) technique.

Methods: Between April 2013 and July 2019, 41 patients presenting with acute complicated (n = 29) or chronic (n = 12) descending thoracic aortic dissection were treated by the FET technique, which was the treatment of choice when supra-aortic vessel transposition would not suffice to create a satisfactory proximal landing zone for endovascular aortic repair, when a concomitant ascending or arch aneurysm was present, or in patients with connective tissue diseases.

Results: One patient (2%) died intra-operatively secondary to an aortic rupture in dwnstream aortic segments.

Surgically placed radiopaque markers: Proof-of-concept of a novel technique to facilitate percutaneous interventions in neonates and infants.

Objectives: Aim of this study was to evaluate feasibility and benefit of self-designed, radiopaque markers as a novel technique in neonates and infants with shunt- or duct-dependent lesions.

Background: Surgically placed radiopaque markers have the potential to facilitate postoperative percutaneous interventions.

Methods: All consecutive children with surgically placed radiopaque markers involving systemic-to-pulmonary artery connections or arterial ducts in the context of hybrid palliation and subsequent cardiac catheterization between January 2013 and March 2019 were included in this analysis.