Prediction of Long-Term Survival after Coronary Artery Bypass with Bilateral Internal Thoracic Artery Grafting: External Validation of A Contemporary Nomogram.

Background: This study aimed to verify the external validation of a contemporary nomogram in predicting long-term survival after an isolated coronary artery bypass with bilateral internal thoracic artery grafting (CABG-BITA). Methods: Consecutive patients who underwent CABG-BITA at a single center were included in the study. All the predictors of the original risk score (age, diabetes mellitus, chronic obstructive pulmonary disease, congestive heart failure, chronic renal failure, old myocardial infarction, ejection fraction, intra-aortic balloon pump and peripheral arterial disease) were available for analysis.

Superiority of bilateral internal thoracic artery grafting in long-term survival after coronary artery bypass through the lenses of a bedside risk score.

Objective: Risk algorithms for the prediction of long-term survival after coronary artery bypass grafting (CABG) do not include the use of bilateral internal thoracic artery (BITA) grafting among the independent predictors. We sought to reveal the superiority of BITA grafting in the long-term outcome through the lenses of an existing bedside risk score (BRS).

Methods: This study analyzed data from 5,666 consecutive patients undergoing isolated (n = 4,715 - BITA = 2,792) and combined (n = 951 - BITA = 246) CABG.

Strain balance of papillary muscles as a prerequisite for successful mitral valve repair in patients with mitral valve prolapse due to fibroelastic deficiency.

Aims: The aim of this study was to assess the papillary muscle strain as a contributor to recurrent mitral regurgitation (MR) after mitral valve repair for fibroelastic deficiency.

Methods And Results: Sixty-four patients with isolated posterior mitral valve prolapse and severe MR referred for surgery were prospectively recruited between 2008 and 2012. Two- and three-dimensional echocardiography and speckle tracking were performed in all patients.

Aprikalim a potassium adenosine triphosphate channel opener reduces neurologic injury in a rabbit model of spinal cord ischemia.

Background: Potassium adenosine triphosphate (KATP) channel openers have been involved in the enhancement of ischemic tolerance in various tissues. The purpose of the present study is to evaluate the effects of aprikalim, a specific KATP channel opener, on spinal cord ischemic injury.

Methods: Fifty-four rabbits were randomly assigned to three groups: group 1 (n = 18, sham operation), group 2 (n = 18, 30 min of normothermic aortic cross-clamping) and group 3 (n = 18, aprikalim 100 μg/kg was administered 15 min before 30 min of normothermic aortic cross-clamping).

The Ross-Konno procedure as reoperative treatment in a young adult with congenital aortic stenosis.

Mechanical and biological prostheses are valid options when aortic valve replacement is necessary. The Ross procedure is also an alternative solution, especially for young patients. We describe the case of a young patient with congenital aortic stenosis and bicuspid aortic valve who presented with dyspnea on exertion.

Postoperative and long-term outcome of patients with chronic obstructive pulmonary disease undergoing coronary artery bypass grafting.

Background: Chronic obstructive pulmonary disease (COPD) has been conventionally associated with increased operative mortality and morbidity after coronary artery bypass grafting. Some studies, however, challenge this association. Moreover, the effect of COPD on long-term survival after coronary artery bypass grafting has not been adequately assessed.

Differential expression of collagen type V and XI alpha-1 in human ascending thoracic aortic aneurysms.

Background: The molecular mechanisms leading to ascending thoracic aortic aneurysms (ATAAs) remain unknown. We hypothesized that alterations in expression levels of specific fibrillar collagens occur during the aneurysmal process.

Methods: Surgical samples from ascending aortas from patients with degenerative ATAAs were subdivided by aneurysm diameter: small, 5 to 6 cm; medium, 6 to 7 cm; and large, greater than 7 cm; and compared with nonaneurysmal aortas (mean diameter, 2.

Independent predictors for early and long-term mortality after heart valve surgery.

Background And Aim Of The Study: Patients with heart valve surgery may have a periprocedural mortality extending up to one year after surgery. The study aim was to determine independent predictors for in-hospital and long-term mortality after heart valve surgery.

Methods: A total of 1,376 consecutive patients who underwent isolated or combined heart valve surgery at a single institution was studied.

Impact of early and delayed stroke on in-hospital and long-term mortality after isolated coronary artery bypass grafting.

Stroke after coronary artery bypass grafting (CABG) is an infrequent, yet devastating complication with increased morbidity and mortality. We sought to determine risk factors for early (intraoperatively to 24 hours) and delayed (>24 hours to discharge) stroke and to identify their impact on long-term mortality after CABG. We studied 4,140 consecutive patients who underwent isolated CABG from 1992 to 2003.

The impact of left ventricular hypertrophy on early and long-term survival after coronary artery bypass grafting.

Background: Left ventricular hypertrophy (LVH) can itself contribute to increased rates of cardiovascular events. We sought to determine the impact of LVH on in-hospital and long-term mortality after coronary artery bypass grafting (CABG).

Methods: Between 1992 and 2003, 4140 consecutive patients underwent CABG.

Acute intraoperative aortic dissection following axillary artery cannulation.

We describe a 75-year-old woman who underwent right axillary artery cannulation in preparation for reconstruction of the aortic arch and the proximal descending aorta for athesosclerotic aortic aneurysm via a 'clamshell' incision. As soon as cardiopulmonary bypass was established, the ascending aorta and the aortic arch was dissected. The innominate artery was dissected including one-third of its circumferance anteriorly.

Temporary adrenal dysfunction with descending thoracic aortic occlusion.

Background: We sought to determine whether descending thoracic aortic occlusion (DTAOC) induced ischemia results in adrenal dysfunction.

Methods: Eight pigs underwent DTAOC for 45 min. Six control pigs underwent a sham procedure.

Effect of profound hypothermia during circulatory arrest on neurologic injury and apoptotic repressor protein Bcl-2 expression in an acute porcine model.

Objectives: We reported that the neocortex and hippocampus are selectively vulnerable to injury in an acute porcine model of hypothermic circulatory arrest at 18 degrees C. We hypothesize that further cooling to 10 degrees C could reduce neurologic injury in these regions. To further elucidate the mechanisms of neurologic injury and protection, we assessed the expression of the anti-apoptotic protein Bcl-2.

Endovascular stent-graft repair as a late secondary procedure after previous aortic grafts.

Thoracic and abdominal aortic endovascular procedures as alternatives to aortic reoperations were studied in three different cases. An anastomotic aneurysm after previous thoracic aortic graft for coarctation, a second-stage elephant trunk repair (descending thoracic aortic aneurysm), and a secondary aneurysm proximal to a previous abdominal aortic graft were successfully treated with endovascular stent-grafts. During the follow-up period no lethal events or major aortic or graft-related complications were observed, except a type II endoleak in the anastomotic aortic aneurysm case.

Assessment of independent predictors for long-term mortality between women and men after coronary artery bypass grafting: are women different from men?

Objective: The long-term mortality of coronary artery bypass grafting in women in not certain. The purpose of this study was to determine and compare risk factors for long-term mortality in women and men undergoing coronary artery bypass grafting.

Methods: Between 1992 and 2002, 3760 consecutive patients (2598 men and 1162 women) underwent isolated coronary artery bypass grafting.

Does bilateral internal thoracic artery grafting increase long-term survival of diabetic patients?

Background: The purpose of the present study was to determine whether long-term survival in diabetic patients increased after bilateral internal thoracic artery (BITA) coronary bypass compared with matched patients with single internal thoracic artery (SITA) coronary bypass.

Methods: The propensity for BITA was determined using logistic regression analysis and each BITA patient was matched with one SITA patient. Between January 1992 and March 2002, 980 matched diabetic patients (490 BITA versus 490 SITA) underwent coronary artery bypass surgery.

Evolution of spinal cord injury in a porcine model of prolonged aortic occlusion.

Background: Spinal cord injury and subsequent paraplegia remains an unpredictable and devastating complication of thoracoabdominal aortic surgery. The aim of this study was to investigate spinal cord injury due to prolonged thoracoabdominal aortic occlusion.

Materials And Methods: We used a highly reproducible porcine model of 45-min thoracoabdominal aortic occlusion, which was accomplished by two balloon occlusion catheters.

Latent arterial hypertension in apparently lone atrial fibrillation.

Introduction: Longitudinal studies on lone AF are rare and the incidence of hypertension in this population unknown. This study aimed at investigating the incidence of arterial hypertension in patients with apparently lone atrial fibrillation (AF).

Methods And Results: Out of 292 consecutive patients presented with permanent or paroxysmal AF, 32 patients were diagnosed as having lone AF according to strict criteria.

The impact of preoperative thrombolysis on long-term survival after coronary artery bypass grafting.

Background: Coronary artery bypass grafting (CABG) is frequently used after thrombolytic therapy. However, there is little information regarding long-term survival in this setting. The purpose of the present study was to compare the long-term survival of patients subjected to CABG after thrombolysis to those without thrombolysis.

Does leukofiltration reduce pulmonary infections in CABG patients? A prospective, randomized study with early results and mid-term survival.

Background: We present the first prospective randomized study of primary coronary artery bypass grafting (CABG) patients who were analyzed for postoperative infections after undergoing blood and/or blood product transfusion (BBPT) with a Pall Purecell leukoreducing filter.

Methods And Results: One hundred and four patients were enrolled between March 1998 and March 1999. Seventy-two of the patients received BBPT (average 5.

EuroSCORE predicts long-term mortality after heart valve surgery.

Background: The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is the most rigorously evaluated scoring system in cardiac surgery. We sought to evaluate the performance of EuroSCORE in the prediction of long-term mortality in patients undergoing heart valve surgery.

Methods: Medical records of patients with isolated or combined heart valve surgery, who were discharged alive (n = 1035), were retrospectively reviewed.