Bioprosthetic pulmonary valve dysfunction in a primary cardiac sarcoma survivor: Clinical considerations and treatment options.

The case highlights the good survival after radical surgery and chemotherapy of a cardiac sarcoma, and the need for close follow-up due to possible early postsurgical complications.

A 20-year experience in cardiac tumors: a single center surgical experience and a review of literature.

Introduction: Cardiac tumors are rare and heterogeneous entities which still remain a diagnostic and therapeutic challenge. The treatment for most cardiac tumors is prompt surgical resection. We sought to provide an overview of surgical results from a series of consecutive patients treated at our tertiary care center during almost a 20-year experience.

Cardiac Vascular Hamartoma: Adult Diagnosis and Cardiac Reconstruction.

Cardiac hamartoma is a rare benign tumor of the heart, and the vascular type is an extremely rare histologic diagnosis. A small number of cases have previously been described in childhood. We report the case of a 63-year-old woman with an incidentally detected cardiac mass that was finally diagnosed as vascular hamartoma.

Safe cross-clamp time using Custodiol-histidine-tryptophan-ketoglutarate cardioplegia in the adult.

Introduction: Safe cross-clamp time using single-dose Custodiol-histidine-tryptophan-ketoglutarate cardioplegia has not been established conclusively.

Methods: Immediate post-operative outcomes of 1,420 non-consecutive, cardiac surgery patients were reviewed retrospectively. Predictors of a combined endpoint made of in-hospital mortality and any major complication post-surgery were found with the multivariable method.

Clinical Validation of a Coronary Surgery Technique That Minimizes Aortic Manipulation.

Background: To minimize aortic manipulation and maximize use of arterial conduits are aims of modern coronary surgery.

Methods: From March 2012 to October 2016, 890 consecutive patients with multivessel coronary disease underwent isolated coronary operations using both internal thoracic arteries (ITAs). In 205 (23%; mean age, 67.

The Risk of Neurological Dysfunctions after Deep Hypothermic Circulatory Arrest with Retrograde Cerebral Perfusion.

Objective: Retrograde cerebral perfusion (RCP) is a brain protection technique that is adopted generally for anticipated short periods of deep hypothermic circulatory arrest (DHCA). However, the real impact of this technique on cerebral protection during DHCA remains a controversial issue.

Methods: For 344 (59.

Liberal bilateral internal thoracic artery use in people with diabetes neutralizes the negative impact of insulin-requiring status.

Aims: Bilateral internal thoracic artery (BITA) grafts are underused in insulin-dependent diabetic patients because of increased risk of postoperative complications. The impact of the insulin-requiring status on outcomes after routine BITA grafting was investigated in this retrospective study.

Methods: Skeletonized BITA grafts were used in 3228 (71.

Disseminated echinococcosis: follow your heart.

: In this report, we present a rare case of cardiac echinococcosis presenting with cerebral haemorrhage due to rupture of a mycotic aneurysm in a peripheral branch of the media cerebral artery. Further investigations lead to discovery of multiple cysts in the heart and liver. The complementary use of transthoracic and transoesophageal echocardiography, MRI and computed tomography lead to the final diagnosis of disseminated echinococcosis and allowed precise evaluation of the anatomical and structural characteristics of the cardiac mass, its boundaries and its relationship with the surrounding anatomic structures.

A predictive scoring system for deep sternal wound infection after bilateral internal thoracic artery grafting.

Objectives: Despite long-term survival benefits, the increased risk of sternal complications limits the use of bilateral internal thoracic artery (BITA) grafts for myocardial revascularization. The aim of the present study was both to analyse the risk factors for deep sternal wound infection (DSWI), which complicates routine BITA grafting and to create a DSWI risk score based on the results of this analysis.

Methods: BITA grafts were used as skeletonized conduits in 2936 (70.

Bilateral internal thoracic artery grafting in octogenarians: where are the benefits?

The use of bilateral internal thoracic artery (BITA) grafting for myocardial revascularization is usually discouraged in the very elderly because of increased risk of perioperative complications. The aim of the study was to analyze early and late outcomes of BITA grafting in octogenarians. From January 1999 throughout February 2014, 236 consecutive octogenarians with multivessel coronary artery disease underwent primary isolated coronary bypass surgery at the authors' institution.

Current role and outcomes of ascending aortic replacement for severe nonaneurysmal aortic atherosclerosis.

Background: Severe atherosclerosis of the ascending aorta is a challenging issue potentially affecting indications for surgery, operative choices, and patients' outcome. No standard treatment has emerged to date, and uncertainties persist about criteria for selecting patients and procedures.

Methods: Replacement of the atherosclerotic ascending aorta was performed in 64 patients at time of either aortic (n = 49), mitral (n = 21), or tricuspid (n = 7) valve surgery.

Early and late outcomes of cardiac surgery in octogenarians.

Background: Expanding demand for cardiac surgery in the elderly requires constant assessment of selection criteria and outcomes.

Methods: Records of consecutive patients 80 years old or greater (n = 355) having cardiac operations from September 1998 through May 2007 were reviewed. There were 172 isolated coronary bypass grafting (CABG), 73 isolated valve, 79 valve and CABG combined, and 31 other procedures.

Diagnosis and management of severe atherosclerosis of the ascending aorta and aortic arch during cardiac surgery: focus on aortic replacement.

Objective: Severe atherosclerosis of the ascending aorta and arch frequently causes difficulties during heart operations, hindering surgical manoeuvres and potentially leading to systemic embolism. The aim of our study was to assess the safety and effectiveness of replacing the atherosclerotic ascending aorta in this setting.

Methods: Aortic atherosclerosis was characterized by epiaortic ultrasonographic scanning in 90.

Surgical management of the atherosclerotic ascending aorta: is endoaortic balloon occlusion safe?

Background: Occlusion of the atherosclerotic ascending aorta by an endoaortic inflatable balloon has been proposed as an alternative to conventional cross-clamping to prevent injury to the vessel and distal embolization of debris. The safety and the effectiveness of endoaortic occlusion have not been documented in this setting.

Methods: Endoaortic occlusion was employed in 52 of 2,172 consecutive patients.

The impact of epiaortic ultrasonographic scanning on the risk of perioperative stroke.

Objective: To assess the impact of epiaortic scanning on the incidence of perioperative stroke in patients undergoing cardiac surgery.

Methods: Patients consecutively enrolled in our surgical database between January 2000 and August 2004 were subdivided into three groups depending on the planned use of epiaortic ultrasonographic scan. Patients treated before the availability of the equipment constituted group A (n=366).

[A quality improvement program in cardiac surgery. Four-year experience from the Ospedali Riuniti of Trieste].

Background: Dissatisfaction with clinical outcomes prompted an intervention to assess and improve processes and outcomes in a cardiac surgery unit.

Methods: Starting on September 1st, 1998, 1836 consecutive patients requiring a heart operation in our unit were prospectively enrolled by recording a series of anamnestic, clinical and procedural descriptors in a dedicated database. Expected mortality rates were estimated by means of nine different stratification models, one of which also allowed the prediction of excess intensive care unit and total hospital length of stay.