Coronary Revascularization after Transcatheter and Surgical Aortic Valve Replacement.

Introduction: Due to the selective criteria and short-term follow-up of previous transcatheter aortic valve implantation (TAVI) trials, the coronary revascularization incidence after TAVI has been difficult to determine. This study investigated the epidemiology of coronary revascularization after surgical aortic valve replacement (SAVR) and TAVI in patients with severe aortic valve stenosis (AS), with and without coronary artery disease (CAD), in a mid-term follow-up, single-center, real-world setting.

Methods: Between 2010 to 2020, 1486 patients with AS underwent SAVR or TAVI with balloon-expandable Edwards transcatheter heart valves (THVs).

Does coronary Atherosclerosis Deserve to be Diagnosed earlY in Diabetic patients? The DADDY-D trial. Screening diabetic patients for unknown coronary disease.

Objectives: To evaluate if screening and treatment of asymptomatic coronary artery disease (CAD) are effective in preventing first cardiac event in diabetics.

Methods: Diabetic patients without known CAD were randomly assigned to undergo a screening for silent myocardial ischemia followed by revascularization or to continue follow-up. The reduction of cardiac death (CD) or nonfatal myocardial infarction (MI) represented the primary aim; secondary aim was the prevention of heart failure (HF).

The first coronary by-pass grafting surgery done in western and central Africa.

Africa bears a significant proportion of the global burden of chronic diseases, along with poor countries of Asia and Latin America. The World Health Organisation projects that over the next ten years the Continent will experience the largest increase in death rates from cardiovascular disease, cancer, respiratory disease and diabetes. Probably for the first time in Western and Central Africa, the very first coronary artery bypass surgery grafting was performed in the Cardiac Centre of Shisong in Cameroon.

Aortic valve replacement: results and predictors of mortality from a contemporary series of 2256 patients.

Objective: The study's objectives were to evaluate results and identify predictors of hospital and mid-term mortality after primary isolated aortic valve replacement; compare early and mid-term survival of patients aged more than 80 years or less than 80 years; and assess the effectiveness of the logistic European System for Cardiac Operative Risk Evaluation in predicting the risk for hospital mortality in octogenarians with a logistic European System for Cardiac Operative Risk Evaluation greater than 15% who are undergoing aortic valve replacement.

Methods: Data from 2256 patients undergoing primary isolated aortic valve replacement between January 2003 and December 2007 were prospectively collected in a Regional Registry (Regione Emilia Romagna Interventi Cardiochirurgia) and analyzed to estimate hospital and mid-term results.

Results: Overall hospital mortality was 2.

External security stitch for retrograde cardioplegia cannula.

Retrograde cardioplegia catheter displacement represents a troublesome complication, frequently forcing the surgeon to interrupt the operative procedure and cannulate newly the coronary sinus. However, this maneuver is time consuming, often implies the loss of surgical exposure, and exposes again the coronary sinus to the risk of iatrogenic injuries. We describe the use of an external security stitch through the muscular right atrial wall to avoid the displacement of a retrograde cardioplegia catheter and analyze the anatomic conditions which predispose to this complication.

Assessing clinical performance in cardiac surgery. Does a specialised clinical database make a difference?

We compared mortality rates league tables for six cardiac surgery centres developed using an administrative database (integrated with information on patients' EuroSCORE) with those drawn from a specialised clinical database. Data from 4017 patients undergoing cardiac surgery over the period January 1st-December 31st 2003, and identified both databases were used. Case mix adjusted in-hospital mortality rates were estimated relying on information provided by each database, and league tables were drawn from both.

Papillary fibroelastoma of the right atrium as an unusual source of recurrent pulmonary embolism.

Papillary fibroelastoma is the most common primary tumour of cardiac valves, with the potential for embolic events and obstructive effects. Location in non-valvular endocardium is extremely rare. Transthoracic and transoesophageal echocardiography have greatly increased the ability to make the diagnosis of these surgically treatable tumours in a timely fashion.

Conservative treatment of postoperative chylothorax with octreotide.

Chylothorax is a rare but serious and well-recognized complication of general thoracic and cardiac procedures. No new invasive or non-invasive definitive therapies are available. This article reports the case of a 67-year-old woman who underwent myocardial revascularization and who developed a postoperative chylothorax necessitating continuous drainage and conservative management.