Safety and efficacy of the automated suture system in valvular heart surgery: a multicenter, prospective registry.

Background: In the last years, the Cor-Knot device has been increasingly used in heart valve surgery. Our aim was to investigate the incidence of valvular complications in patients who underwent valvular surgery using the Cor-Knot device in multicentric cohorts at one-year follow-up.

Methods: Three hundred and sixty-eight patient underwent heart valve repair or replacement surgery using automated titanium suture fasteners in four cardiothoracic surgery departments between September 2018 and January 2020.

Resection of a cardiac tumour with reconstruction of the atria and the superior vena cava.

Cardiac tumours are very rare and their complete resection, when feasible, remains the only curative treatment. We present the case of a patient who had aortic stenosis. The routine preoperative workup also identified stenosis in the left anterior descending and right coronary arteries, and most importantly, an invasive tumour at the confluence of the superior vena cava-right atrium-left atrium.

Adjustable external Dacron annuloplasty in aortic valve repair.

In aortic valve repair, whilst performing a Yacoub remodelling operation, the external annuloplasty of the aortic ring plays a very important role. Here we present an adjustable external Dacron annuloplasty as an additional tool, in very selected cases, that can help surgeons to further improve their immediate results thus influencing the long-term ones.

Reconstruction of a large pulmonary artery aneurysm using a vascular prosthesis.

A pulmonary artery aneurysm is a rare, heterogeneous disease for which there are currently no surgical guidelines. We present the case of a symptomatic patient presenting with a large aneurysm of the distal pulmonary trunk and left pulmonary artery. The aneurysm was resected through a full median sternotomy under cardiopulmonary bypass and aortic cross-clamping.

Recent improvement in operative techniques lead to lower pacemaker rate after Perceval implant.

Objectives: Our goal was to compare pacemaker rate usage following two different operating techniques for implanting the Perceval aortic valve replacement.

Methods: In this retrospective, single-centre study, we studied patients with isolated or concomitant Perceval aortic valve replacement operated on first between April 2013 and January 2016, following traditional operating techniques, with patients operated on between January 2016 and December 2020, after the adoption of a modified protocol based on different annulus sizing, higher positioning of the valve and no ballooning after valve deployment was adopted. The operations were performed by 2 surgeons, and patients were followed-up for a period of 30 days.

Right anterior minithoracotomy with total central cannulation.

A right anterior minithoracotomy is gaining wider acceptance among the members of the surgical community for the treatment of isolated aortic valve replacement. Usually, the cardiopulmonary bypass circuit is implanted either totally peripherally or with 1 cannula in a central position and the other in a peripheral one. This procedure has its drawbacks because it adds potential peripheral morbidity during or after the operation.

Prognostic value of aerobic capacity and exercise oxygen pulse in postaortic dissection patients.

Background: Although recommendations encourage daily moderate activities in post aortic dissection, very little data exists regarding cardiopulmonary exercise testing (CPET) to personalize those patient's physical rehabilitation and assess their cardiovascular prognosis.

Design: We aimed at testing the prognostic insight of CPET regarding aortic and cardiovascular events by exploring a prospective cohort of patients followed-up after acute aortic dissection.

Methods: Patients referred to our department after an acute (type A or B) aortic dissection were prospectively included in a cohort between September 2012 and October 2017.

Reversed C-shaped Scanner-guided Ministernotomy for Isolated Aortic Valve Replacement.

Here we present our technique of aortic valve replacement through a reversed C-shaped ministernotomy in 36 patients operated between 2017 and 2019. All patients had a preoperative computed tomography that guided the surgical approach. The sternum was incised at the level of the first and third or the second and fourth intercostal spaces.

The Ross procedure in adults patients with reconstruction of the RVOT with a bioprosthetic valve.

The Ross procedure is now a well established treatment for aortic valve pathology in young adult patients. However, there are several technical aspects of this operation that are still under debate. One of them is the necessity for reconstruction of the right ventricular outflow tract.

Standardized loop technique for mitral valve repair offers good midterm results.

Background: We reviewed the midterm results of our approach for mitral valve repair with the use of standardized loops.

Methods: In a retrospective single-center study, mitral repairs performed between November 2015 and December 2019 with the standardized loop technique were included. Predefined loops of 15 and 25 mm (Gore-Tex) were implanted for posterior or anterior mitral prolapses, respectively.

Axillary TAVR under locoregional anesthesia in a patient with peripheral artery disease.

Transcatheter aortic valve replacement (TAVR) is now a relatively commonly performed procedure and the number of eligible patients is growing exponentially.  In candidates with peripheral arterial disease, the axillary artery approach is an option worth considering. Usually TAVR performed using this approach is done under general anesthesia with tracheal intubation.

Ventricular Septal Defect Jeopardizes the Autograft in a Ross Operation.

The Ross operation is the gold standard for aortic valve replacement in young patients because it is a durable and anticoagulation-free alternative to mechanical aortic valve replacement. Careful assessment of the pulmonary valve is critical because it should become a durable neoaortic valve. Here we report the case of a patient in whom the pulmonary autograft was jeopardized by a large, doubly committed ventricular septal defect that did not offer sufficient autologous tissue for the proximal suture line.

A Novel Computed Tomography Scan Tool for Patient Selection in Minithoracotomy Aortic Replacement.

Right anterior minithoracotomy is gaining larger acceptance for isolated aortic valve replacement. In some patients, however, surgical exposure during the intervention may be challenging even for experienced surgeons or centers. In our opinion, proper preoperative selection of the patients by computed tomography scan seems mandatory.

Transaxillary compared with transcarotid access for TAVR: a propensity-matched comparison from a French multicentre registry.

Aims: No randomised study comparing the outcomes of transcarotid (TC) and transaxillary (TAx) TAVR has been conducted to date. The purpose of this study was to understand which approach should be the preferred alternative by comparing their outcomes using a propensity-matched comparison in a French multicentre registry.

Methods And Results: From 2010 to 2018, a French multicentre prospective registry included 502 patients, with 374 undergoing TC-TAVR and 128 TAx-TAVR for symptomatic aortic stenosis.

Severe Acute Proximal Pulmonary Embolism and COVID-19: A Word of Caution.

Acute pulmonary embolism is an uncharacteristic presentation in patients with coronavirus 2019 (COVID-19). Here we describe the case of a young woman presenting with severe pulmonary embolism, without any associated symptoms of infections. A clot in a patent foramen ovale was noted.

Axillary Transcatheter Aortic Valve Replacement in Patients With Peripheral Vascular Disease.

The axillary artery seems an interesting alternative in nonfemoral transaortic valve replacement (TAVR) patients. This study describes our experience with this technique and its short-term follow-up results. This is a retrospective single center study.

Direct axillary artery cannulation in cardiac surgery: clinical outcomes.

Objective Axillary artery cannulation is still regarded with distrust by surgeons because the artery is supposed to be fragile, difficult to access, and its cannulation is often considered time-consuming. This study was carried out to assess our results in a series of patients, using a simplified surgical approach to axillary artery cannulation. Methods Data were collected retrospectively from our prospective database.

A Standardized Loop Technique for Mitral Valve Repair.

The loop technique is widely used for mitral valve repair. However, estimation of the correct loops' length remains challenging. We describe a standardized technique with implantation of standardized 15- and 25-mm loops for posterior and anterior mitral prolapses.