The Standard Point-of-Care Hemochron Jr. ACT+ Test in Monitoring Heparin Administration for Cardiopulmonary Bypass in Severe Factor XII Deficiency.

Coagulation factor XII (FXII) is a plasma serine protease that belongs to the contact activation complex responsible for initiating the intrinsic coagulation pathway. FXII deficiency is a rare congenital disorder that is not associated with an increased tendency for bleeding. However, as contact activation is impaired in FXII deficiency, both the celite- and kaolin-initiated activated clotting time (ACT) measurements are prolonged markedly, which poses a challenge for anticoagulation monitoring in patients undergoing cardiac surgery.

Immediate outcome after sutureless versus transcatheter aortic valve replacement.

The aim of this study was to compare the immediate outcome of patients undergoing transcatheter (TAVI) versus surgical aortic valve replacement with the sutureless Perceval bioprosthesis (SU-AVR). This is a retrospective multicenter analysis of 773 patients who underwent either TAVI (394 patients, mean age, 80.8 ± 5.

Early and intermediate outcome after aortic valve replacement with a sutureless bioprosthesis: Results of a multicenter study.

Objective: The aim of this study was to evaluate the outcome of aortic valve replacement with the sutureless Perceval S aortic valve bioprosthesis (Sorin Biomedica Cardio Srl, Saluggia, Italy).

Methods: This is a retrospective analysis of 314 patients (mean age, 77.9 ± 5.

Validation of EuroSCORE II in patients undergoing coronary artery bypass surgery.

Background: The European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) has been recently developed to improve the performance of the original EuroSCORE. Herein we evaluated its discriminatory ability in predicting the immediate and late outcome after coronary artery bypass grafting (CABG).

Methods: Complete data on 1,027 patients who underwent isolated CABG were available for validation of EuroSCORE II and to compare its discriminatory ability with the original EuroSCORE and its Finnish modified version.

Individual surgeon's impact on the risk of re-exploration for excessive bleeding after coronary artery bypass surgery.

Objective: Excessive bleeding requiring re-exploration is a severe complication that may affect the outcome after coronary artery bypass grafting. The authors hypothesized that surgeon performance may contribute significantly to such a complication.

Design: Retrospective.

Impact of ascending aortic wall thickness and atherosclerosis on the intermediate survival after coronary artery bypass surgery.

Objectives: We investigated the prognostic impact of atherosclerosis and wall thickness of the ascending aorta in patients undergoing coronary artery bypass grafting (CABG).

Methods: A series of 781 patients who underwent CABG and in whom epiaortic ultrasound was performed to assess the status of the ascending aorta and to measure the thickness of its anterior and lateral walls were the subjects of the present analysis.

Results: At multivariate analysis, thickness of the ascending aortic wall, but not atherosclerosis, was an independent predictor of all-cause intermediate mortality [relative risk (RR): 1.

Use of blood products and risk of stroke after coronary artery bypass surgery.

Background: The impact of blood transfusion on the development of post-operative stroke after coronary artery bypass grafting (CABG) is not well established. We, therefore, investigated this issue.

Materials And Methods: Complete data on peri-operative blood transfusion were available for 2,226 patients who underwent CABG in three Finnish hospitals.

Timing of preoperative aspirin discontinuation and outcome after elective coronary artery bypass graft surgery.

Objective: Whether aspirin should be discontinued before coronary artery bypass grafting is controversial. The potential benefits and harms associated with late use of aspirin (no discontinuation or discontinuation <3 days before surgery) were investigated in this retrospective, multicenter study.

Design: Retrospective, multicenter study.

Off-pump versus on-pump coronary artery bypass surgery in patients aged 80 years and older: institutional results and meta-analysis.

Patients aged ≥80 years are at high risk of adverse events after coronary artery bypass grafting. This study was performed to evaluate whether off-pump coronary artery bypass surgery (OPCAB) is superior to conventional surgery (CCAB) in these high-risk patients. The outcome of 185 patients aged ≥80 years who underwent OPCAB or CCAB at our institution was reviewed and a meta-analysis on this issue was performed.

Estimating the risk of complications related to re-exploration for bleeding after adult cardiac surgery: a systematic review and meta-analysis.

Objective: The aim of this study was to evaluate the impact of re-exploration for bleeding after cardiac surgery on the immediate postoperative outcome.

Methods: Systematic review of the literature and meta-analysis of data on re-exploration for bleeding after adult cardiac surgery were performed.

Results: The literature search yielded eight observational studies reporting on 557,923 patients and were included in the present analysis.

Poor late survival after surgical treatment of pleural empyema.

Background: We have evaluated the outcome of patients who underwent surgical treatment of parapneumonic pleural empyema.

Methods: This study included 143 consecutive patients older than 18 years who were operated on for parapneumonic pleural empyema.

Results: The overall survival at 30 days, 3 months, 5 years, and 10 years was 97.

Successful defibrillator lead remnant extraction from right ventricle using a steerable transseptal sheath and a basket retriever.

We present a case of a 73-year-old man with implantable cardioverter-defibrillator pocket erosion and Staphylococcus aureus infection who was admitted to our hospital for lead extraction. During the mechanical extraction procedure, the 12-year-old lead broke and the distal coil was trapped in the right ventricle. After several attempts to grasp the coil using a femoral workstation and various snaring tools failed, a steerable transseptal sheath was placed into the right ventricle via the right femoral vein.

Immediate and intermediate outcome after off-pump and on-pump coronary artery bypass surgery in patients with unstable angina pectoris.

Background: We have evaluated the immediate and intermediate outcome after off-pump (OPCAB) and conventional on-pump coronary artery bypass surgery (CCAB) in patients with unstable angina pectoris requiring nitrates infusion until arrival in the operating room.

Methods: A consecutive series of 153 and 161 patients with unrelenting angina pectoris underwent CCAB and OPCAB, respectively. Conversion from OPCAB to beating heart surgery with perfusion occurred in 4 patients.

The use of statins and fate of small abdominal aortic aneurysms.

The aim of this study was to evaluate the value of statins in reducing abdominal aortic aneurysm (AAA) growth rate and improving freedom from aneurysm repair or rupture. One hundred and twenty-one patients with AAA undergoing ultrasonographic surveillance for at least one year were included in this retrospective study. Patients treated with statins had a decreased linear aneurysm growth rate than those not receiving statins (1.

Spyder aortic connector system in off-pump coronary artery bypass surgery.

Purpose: The Spyder aortic connector (Medtronic, Minneapolis, MN) is a new, promising connector device and its safety and efficacy have been evaluated in this study.

Description: Twenty-two patients were randomized to proximal vein graft anastomosis with the Spyder aortic connector (Medtronic) or hand-sewn technique.

Evaluation: Twenty patients underwent multi-detector computed tomographic scans of the chest 6 months after surgery to evaluate vein graft patency.

Postoperative stroke after off-pump versus on-pump coronary artery bypass surgery.

Objective: The value of off-pump over conventional coronary artery bypass surgery in reducing the risk of postoperative stroke is controversial. This issue has been evaluated in light of our recent clinical experience.

Methods: Off-pump coronary artery bypass surgery was performed in 557 patients, and conventional coronary artery bypass surgery was performed in 445 patients.

Predictors of diseased ascending aorta in patients undergoing off-pump coronary artery bypass surgery.

Objective: To identify the preoperative risk factors associated with increased prevalence of atherosclerotic lesions of the ascending aorta among patients undergoing off-pump coronary artery bypass surgery (OPCAB).

Material And Methods: OPCAB was performed in 241 patients who were intraoperatively investigated by epiaortic ultrasound for the presence of atherosclerotic lesions of the ascending aorta. The Northern New England Cardiovascular Disease Study Group (NNECVDSG) and the Multicenter Study of Perioperative Ischemia (McSPI) stroke risk scores were retrospectively calculated.

Pulmonary embolism after off-pump coronary artery bypass surgery as detected by computed tomography.

Background: The incidence of pulmonary embolism (PE) after coronary artery bypass surgery is ill defined.

Methods: Twenty-four patients undergoing off-pump coronary artery bypass surgery were enrolled in a prospective randomized study evaluating a new proximal aortic anastomotic device. Computed tomography was performed postoperatively about 1 week after surgery.

Results with the Heartstring anastomotic device in patients with diseased ascending aorta.

Background: Avoidance of manipulation of diseased ascending aorta has been shown to be associated with a reduced risk of postoperative stroke after off-pump coronary artery bypass surgery (OPCAB). The use of the Heartstring device (Guidant, Indianapolis, USA) to accomplish a proximal aortic anastomosis without aortic clamping has been suggested in such patients.

Patients And Methods: From April 2004 to December 2005, proximal aortic anastomoses have been accomplished employing the Heartstring device in 19 patients with calcified ascending aorta who underwent OPCAB.

Prospective, randomized study on the use of the cardica PAS-port aortic connector system in off-pump coronary artery bypass surgery.

Background: The use of aortic connector devices for proximal vein graft anastomosis has been shown to be associated with a relevant rate of early graft complications. Cardica PAS-Port is a new aortic connector whose preliminary clinical results seem promising. The safety and efficacy of this aortic connector device have been evaluated in this prospective, randomized study.

Pulmonary artery blood temperature at admission to the intensive care unit is predictive of outcome after on-pump coronary artery bypass surgery.

Objective: To evaluate whether pulmonary artery blood (PA) temperature on admission to the intensive care unit (ICU) is predictive of postoperative outcome after isolated on-pump coronary artery bypass grafting (CABG).

Design: A retrospective study on 1639 patients who underwent isolated on-pump CABG in whom PA temperature at admission to the ICU was available for review.

Results: Thirty-three patients (2.

Fatal complications after use of the Symmetry Aortic Connector in coronary artery bypass surgery.

During the last 2 years, 103 aortic saphenous vein graft anastomoses were performed in 68 patients undergoing off-pump coronary artery bypass by using the Symmetry Bypass System Aortic Connector. Of these patients, 2 died during the early postoperative period. In the first patient, after an episode of ventricular fibrillation and closed-chest cardiac massage, the sternum was opened and hemopericardium secondary to leakage of the proximal anastomotic device was found.

Postoperative atrial fibrillation is a major cause of stroke after on-pump coronary artery bypass surgery.

Background: Atrial fibrillation, occurring after coronary artery bypass grafting (CABG), has been suggested to be associated with the development of postoperative stroke. However, it is not clear what is the incidence of atrial fibrillation-related postoperative stroke, the timing of its occurrence, and the outcome. These issues have been investigated in a consecutive series of patients who have undergone on-pump coronary artery bypass grafting (ONCAB).

Predictors of development of anastomotic femoral pseudoaneurysms after aortobifemoral reconstruction for abdominal aortic aneurysm.

Background: The pathogenesis of anastomotic femoral pseudoaneurysms (AFPs) is still unclear. We have performed this long-term retrospective study of patients who underwent aortobifemoral reconstruction for abdominal aortic aneurysm (AAA) in order to better establish the long-term rate of AFP and to identify the predictors of its late occurrence.

Methods: The long-term outcome of 178 patients who underwent and survived aortobifemoral reconstruction for infrarenal AAA was reviewed.

Preoperative C-reactive protein and outcome after coronary artery bypass surgery.

Background: C-reactive protein (CRP) is a predictor of early and late outcome after coronary angioplasty, but there is scant data on its impact on the outcome after coronary artery bypass grafting (CABG).

Methods: The predictive value of preoperative CRP was evaluated in a series of 764 patients who underwent on-pump CABG.

Results: During the in-hospital stay, 13 patients (1.