High prevalence of obstructive sleep apnea in a surgical aortic valve replacement cohort: an observational study.

Study Objectives: A high prevalence of sleep apnea has been reported among transcatheter aortic valve replacement (AVR) patients; however, the prevalence of sleep apnea in the younger and relatively healthier population of surgical AVR (SAVR) patients is unknown.

Methods: We assessed the prevalence of sleep apnea and overall sleep quality in patients having SAVR. Participants aged 50-89 were eligible for recruitment.

Open, endovascular or hybrid repair of aortic arch disease: narrative review of diverse strategies with diverse options.

Objectives: The management of aortic arch disease is complex. Open surgical management continues to evolve, and the introduction of endovascular repair is revolutionizing aortic arch surgery. Although these innovative techniques have generated the opportunity for better outcomes in select patients, they have also introduced confusion and uncertainty regarding best practices.

Navigating the Unexpected: Iatrogenic Aortic Injuries during Transcatheter Aortic Valve Replacement (TAVR).

The introduction of transcatheter aortic valve replacement (TAVR) has undeniably changed the landscape of valvular heart disease management over the last two decades. A reduction in complications through improvements in techniques, experience, and technology has established TAVR as a safe and effective alternative to surgical aortic valve replacement. However, it is important to consider the potential risks associated with TAVR and ways in which life-threatening complications can be identified and managed in a timely fashion.

Membranous Septum Length Predicts New Conduction Abnormalities in Surgical Aortic Valve Replacement: A Novel Predictor for Permanent Pacemaker Implantation After Surgical Aortic Valve Replacement.

Introduction: The membranous septum (MS) length measured by cardiac computed tomography (CT) is useful for the prediction of permanent pacemaker implantation (PPMI) and new left bundle branch block (LBBB) after transcatheter aortic valve replacement. However, its predictive value for patients undergoing surgical aortic valve replacement (SAVR) is unknown.

Methods: A total of 2531 consecutive patients were registered in the institutional Society of Thoracic Surgeons database between July 2017 and June 2020.

Aortic annulus rupture after transcatheter aortic valve replacement: successful management of a dangerous complication.

Objective: Aortic annulus rupture remains one of the most fatal complications of TAVR. While attempts have been made to describe and predict this complication, the data remains insufficient without evidence-based guidelines for management of this rare complication.

Methods: Here we describe a series of 3 aortic annulus ruptures after TAVR which were managed successfully to hospital discharge.

Transcatheter aortic valve replacement 23 years after heart transplant for aortic insufficiency.

Background: Clinicians continue to expand the availability of transcatheter aortic valve replacement (TAVR) for patients who historically would have been ineligible for surgical aortic valve replacement. Historically, reoperative aortic valve surgery after transplant was immensely complicated and high risk due to the repeat sternotomy approach, and the immunosuppression in transplant patients. As heart transplant patients continue to live longer, patients are beginning to develop novo aortic pathology of the transplanted organ.

Infective endocarditis of quadricuspid aortic valve.

Background: Infective endocarditis of the aortic valve is a relatively common disease presentation, with surgical intervention a mainstay of treatment in severe cases. Quadricuspid aortic valves are a rare spontaneous developmental anomaly that are more likely to be asymptomatic, and less likely to require a full valve replacement than their hypocuspid counterparts. However, there is very little literature addressing infective endocarditis of this valve variant.

Repair of an ascending aortic aneurysm associated with an anomalous right coronary artery origin.

Background: Anomalous right coronary artery (RCA) origin off the ascending aorta, above the level of the sinus of Valsalva, is rare and can be associated with altered hemodynamics, decreased coronary perfusion, and presents unique considerations during intraoperative management in the surgical treatment of concomitant ascending aneurysmal disease.

Case Presentation: A 58-year-old female with prior symptomatic visceral aneurysmal rupture and cerebrovascular disease presented with a 5 cm ascending aortic aneurysm, elevated aortic index, and increased rupture risk factors. She was preoperatively diagnosed with an anomalous, high RCA origin off the ascending aorta 15 mm above the sinotubular junction.

Multiphase Assessment of Mitral Annular Dynamics in Consecutive Patients With Significant Mitral Valve Disease.

Objectives: The aim of this study was to clarify the dynamics of the mitral annulus throughout the cardiac cycle and its relevance to transcatheter mitral valve replacement (TMVR) sizing and case selection.

Background: Limited data are available regarding the relevance of mitral annular (MA) and neo-left ventricular outflow tract (LVOT) dynamics in the overall population presenting with significant mitral valve disease.

Methods: Patients attending a combined surgical-transcatheter heart valve clinic for severe symptomatic mitral valve disease were assessed using multiphase computed tomography.

Orbital Atherectomy of the Iliofemoral Arteries Facilitates Large-Bore Access Prior to Transfemoral Transcatheter Aortic Valve Replacement.

Objectives: To describe the use of orbital atherectomy to prepare iliofemoral vessels for large-bore access prior to transcatheter aortic valve replacement (TAVR).

Background: Transfemoral (TF)-TAVR has been shown to be at least equivalent to surgery. Nevertheless, many patients do not qualify for the TF approach due to severe iliofemoral occlusive disease.

Two cases of acute endocarditis misdiagnosed as COVID-19 infection.

The COVID-19 pandemic has presented countless new challenges for healthcare providers including the challenge of differentiating COVID-19 infection from other diseases. COVID-19 infection and acute endocarditis may present similarly, both with shortness of breath and vital sign abnormalities, yet they require very different treatments. Here, we present two cases in which life-threatening acute endocarditis was initially misdiagnosed as COVID-19 infection during the height of the pandemic in New York City.

Innominate artery dissection due to selective cerebral antegrade perfusion.

We present the first case of successfully treated innominate artery dissection as a complication of selective cerebral antegrade perfusion during reoperative aortic valve and hemiarch replacements. Innominate artery dissection was suspected based on unilateral decreases in the right radial arterial pressure and right cerebral oximetry value. Intraoperative ultrasonography demonstrated minimal flow in the right internal carotid.

Concomitant temporary mechanical support in high-risk coronary artery bypass surgery.

Objectives: Patients with low left ventricular ejection fraction (LVEF) undergoing high-risk coronary artery bypass grafting (CABG) are at increased risk for postcardiotomy cardiogenic shock. This report describes planned concomitant microaxial temporary mechanical support (MA-TMS) device placement as a viable bridge-to-recovery strategy for high-risk patients receiving surgical revascularization.

Methods: A retrospective review was performed for all patients from October 2017 to May 2019 with low LVEF (<30%), New York Heart Association Class III or IV symptoms, and myocardial viability who underwent CABG with prophylactic MA-TMS support at a single institution (n = 13).

Minimizing Permanent Pacemaker Following Repositionable Self-Expanding Transcatheter Aortic Valve Replacement.

Objectives: This study sought to minimize the risk of permanent pacemaker implantation (PPMI) with contemporary repositionable self-expanding transcatheter aortic valve replacement (TAVR).

Background: Self-expanding TAVR traditionally carries a high risk of PPMI. Limited data exist on the use of the repositionable devices to minimize this risk.

Early airway dehiscence: Risk factors and outcomes with the rising incidence of extracorporeal membrane oxygenation as a bridge to lung transplantation.

Background: Anastomotic complications occur in 7% to 18% of lung transplant recipients, among which airway dehiscence (AD) is particularly catastrophic. Using multi-institutional registry data, this study compared preoperative recipient/donor risk factors and outcomes in patients with and without AD and analyzed the effect of extracorporeal membrane oxygenation (ECMO) on the incidence of AD.

Methods: Data on adult lung transplants from 2007 to 2017 were provided by the Scientific Registry of Transplant Recipients.

Aorto-Right Ventricular Fistula Post-Transcatheter Aortic Valve Replacement: Multimodality Imaging of Successful Percutaneous Closure.

• Aorto-right ventricular fistula is a rare diagnosis and is on the spectrum of aortic periannular rupture. • Multimodality imaging is crucial in identifying aortic periannular rupture, defining its course, and for preprocedural planning. • We describe a case of aorto-right ventricular fistula, which was successfully treated using an Amplazter vascular plug intravenous device (St.

Examining ABO compatible donors in double lung transplants during the era of lung allocation score.

Background: The short-term and long-term effect of using ABO compatible donors in the era of lung allocation score is unknown. This study determined if carefully selected ABO compatible donors could be used in double lung transplantation (DLT) with good outcomes.

Methods: The United Network for Organ Sharing database was retrospectively reviewed for adult DLT from May 2005 to December 2011.

Single-lung transplantation with ABO-compatible donors results in excellent outcomes.

Background: The goal of this study was to determine if carefully selected ABO-compatible donors in single-lung transplantation results in acceptable outcomes.

Methods: The United Network for Organ Sharing database was reviewed for adult single-lung transplant recipients from May 2005 to December 2011. Recipients of lungs from ABO-compatible donors were compared with those of ABO-identical donors.

Analysis of open heart surgery in patients with liver cirrhosis.

Open heart surgery in patients with liver cirrhosis is considered to be very risky, but the predictors of poor outcomes in such cases have not been established. We report the perioperative results of open heart surgery in patients with liver cirrhosis in our hospital. We reviewed the results of 13 cases in 12 patients with liver cirrhosis who underwent open heart surgery between January 2001 and December 2010.

Successful surgical repair of a giant calcified left ventricular aneurysm: a report of a case.

A 68-year-old man presented at the outpatient clinic with epigastric discomfort. He had suffered a myocardial infarction 10 years previously. Chest radiography and computed tomography showed a giant calcified aneurysm in the left ventricle.