Reassessment of kidney function equations in predicting long-term survival in cardiac surgery.

Background/objectives: Chronic kidney disease (CKD) is a risk factor for long-term survival in cardiac surgery. The Cockcroft-Gault, Modification of Diet in Renal Disease (MDRD) study, CKD Epidemiology Collaboration (CKD-EPI), revised Lund-Malmö (LM), and full age spectrum equations are used to estimate glomerular filtration rates (eGFR), but each have advantages and disadvantages. Our objective was to determine which equation better predicts long-term survival.

Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation in Patients Aged 70 Years or Older.

Background: There is uncertainty whether venoarterial extracorporeal membrane oxygenation (VA-ECMO) should be used in older patients with cardiopulmonary failure after cardiac surgery.

Methods: This was a retrospective multicenter study of 781 patients who required postcardiotomy VA-ECMO for cardiopulmonary failure after adult cardiac surgery from 2010 to 2018 at 19 cardiac surgery centers. A parallel systematic review with meta-analysis of the literature was performed.

Transcarotid Transcatheter Aortic Valve Replacement: Feasibility and Safety.

Objectives: The purpose of this study was to assess the feasibility and safety of transcarotid transcatheter aortic valve replacement (TAVR).

Background: Many candidates for TAVR have challenging vascular anatomy that precludes transfemoral access. Transcarotid arterial access may be an option for such patients.

Stroke Presentation of Acute Type A Aortic Dissection with 100% Perfusion-Weighted Imaging-Diffusion-Weighted Imaging Mismatch: A Call for Urgent Action.

Background And Purpose: Acute stroke in the setting of acute type A aortic dissection is not rare and may contraindicate immediate surgery. Evaluating irreversible brain damage is critical in this setting and magnetic resonance imaging is a key determinant in the decision of selecting surgical over medical treatment for these patients.

Summary Of Cases: We report herein 2 cases assessed at a tertiary care center for acute stroke.

Lipid-lowering drugs prevent neurovascular and cognitive consequences of cardiopulmonary bypass.

Inflammatory injury and hypoperfusion following cardiopulmonary bypass (CPB) are associated with potential brain injury in relationship between CPB, memory impairment, changes in cerebral vascular reactivity and both systemic and cerebral inflammatory reaction. The objective of this study was to assess the preventive effect of a pretreatment with simvastatin or fenofibrate on neurovascular and cognitive consequences of CPB. Male Sprague-Dawley rats were treated by control diet, simvastatin 10 mg/kg/day or fenofibrate 200 mg/kg/day for 14 days before CPB surgery and were sacrificed immediately after surgery or 24h later.

Transcatheter aortic valve implantation for paradoxical low-flow low-gradient aortic stenosis patients.

Objectives: We compared the outcomes of transcatheter aortic valve implantation (TAVI) in three different aortic stenosis syndromes: paradoxical low-flow low-gradient aortic stenosis (PLFLG), high-gradient aortic stenosis (HGAS), and low ejection fraction low-gradient severe aortic stenosis (LEF-LG).

Background: Outcomes for PLFLG patients after TAVI procedure are not well known.

Methods: Between 2010 and 2013, patients with severe (indexed aortic valve area iAVA≤0.

Implantation of a Sapien XT aortic bioprosthesis through the left carotid artery.

Transcatheter aortic valve implantation (TAVI) is still under active investigation. When the femoral route is impossible for anatomic reasons, the transapical, transaxillary and direct aortic approaches have demonstrated their effectiveness. We report the successful implantation of a Sapien XT bioprosthesis with the NovaFlex catheter through a left carotid approach.

Staged procedure to prevent major adverse events in extensive aortic aneurysm repair.

Surgical management of extensive thoracoabdominal aortic aneurysms is associated with high rates of mortality and morbidity, including spinal cord ischemia. We report a successful three-stage repair combining open and endovascular surgery in a patient presenting with an ascending, arch, and thoracoabdominal aneurysm. Spinal cord protective measures included a staged approach, preserved antegrade flow to the left subclavian and hypogastric arteries, absence of aortic cross-clamping, and aggressive perioperative hemodynamic monitoring.

Impact of antimicrobial therapy on prognosis of patients requiring valve surgery during active infective endocarditis.

Objectives: We examined the characteristics and outcomes of patients requiring valve surgery during active infective endocarditis (IE), focusing on the impact of antimicrobial therapy.

Methods: In this retrospective study, medical charts of all consecutive patients admitted to our cardiovascular surgery department from January 1998 to December 2010, with a diagnosis of IE requiring surgical management, were reviewed. Adult patients were enrolled in the study if they had definite or possible active IE and if the antimicrobial treatment was evaluable.