Post-infarction ventricular septal defect: percutaneous or surgical management in the UK national registry.

Aims: Post-infarction ventricular septal defect (PIVSD) is a mechanical complication of acute myocardial infarction (AMI) with a poor prognosis. Surgical repair is the mainstay of treatment, although percutaneous closure is increasingly undertaken.

Methods And Resuts: Patients treated with surgical or percutaneous repair of PIVSD (2010-2021) were identified at 16 UK centres.

Minimally invasive versus conventional sternotomy for Mitral valve repair: protocol for a multicentre randomised controlled trial (UK Mini Mitral).

Introduction: Numbers of patients undergoing mitral valve repair (MVr) surgery for severe mitral regurgitation have grown and will continue to rise. MVr is routinely performed via median sternotomy; however, there is a move towards less invasive surgical approaches.There is debate within the clinical and National Health Service (NHS) commissioning community about widespread adoption of minimally invasive MVr surgery in the absence of robust research evidence; implementation requires investment in staff and infrastructure.

Mitral valve diseases: Pathophysiology and interventions.

Valvular heart disease is common and increasingly prevalent among the elderly. The end result of valvular pathologies is cardiac failure and can lead to sudden death; thus, diagnosis and interventions are very important in the early stages of these diseases. The usual treatment methods of mitral regurgitation include percutaneous mitral valve repair, mitral valve replacement and minimally invasive surgery, whereas the treatment methods of mitral stenosis include percutaneous transluminal mitral commissurotomy and mitral commissurotomy as well as open surgical repair.

Telemedicine in cardiovascular surgery during COVID-19 pandemic: A systematic review and our experience.

Objective: The SAR-COV-2 pandemic has had an unprecedented effect on the UK's healthcare systems. To reduce spread of the virus, elective treatments and surgeries have been postponed or canceled. There has been a rise in the use of telemedicine (TM) as an alternative way to carry outpatient consultations.

Off-Pump Conversion: In-hospital Mortality and Long-Term Survival.

 There is an ongoing debate on the benefits and risks of off-pump coronary artery bypass grafting (CABG) surgery. The fate of patients who start with their procedure being an off-pump one and then have to undergo conversion to an on-pump procedure is debated with regard to in-hospital mortality and unknown with regard to long-term survival. We investigated the in-hospital mortality and long-term survival of patients who underwent conversion from off- to on-pump surgery.

A comparison of survival between on-pump and off-pump left internal mammary artery bypass graft surgery for isolated left anterior descending coronary artery disease: an analysis of the UK National Adult Cardiac Surgery Audit Registry.

Objectives: To determine if the use of cardiopulmonary bypass is associated with all-cause in-hospital and mid-term survival for patients undergoing left internal mammary artery (LIMA) to left anterior descending (LAD) coronary artery bypass grafting (CABG) for single coronary vessel disease.

Methods: Data from the National Adult Cardiac Surgery Audit registry for all elective and urgent isolated CABG procedures performed between April 2003 and March 2013 in first-time cardiac surgery patients were extracted. Experienced surgeons (those with ≥300 records) were classified by their technique preference (as 'off-pump preference', 'mixed practice', 'on-pump preference') based on their entire isolated CABG data.

Left ventricular apical masses: distinguishing benign tumours from apical thrombi.

Differential diagnoses for cardiac left ventricular apical masses presenting following acute myocardial infarction include thrombi and cardiac tumours. We present two such cases and the multidisciplinary assessment that is required to assist with diagnosis.

The validity of the original EuroSCORE and EuroSCORE II in patients over the age of seventy.

Objectives: EuroSCORE II, despite improving on the original EuroSCORE system, has not solved all the calibration and predictability issues. We investigated the sensitivity, specificity and predictability of original EuroSCORE and EuroSCORE II system in elderly patients.

Methods: The original logistic EuroSCORE and EuroSCORE II were assessed via receiver operator characteristic (ROC) and Hosmer-Lemeshow test probability analysis with regard to accuracy of predicting in-hospital mortality.

A need for speed? Bypass time and outcomes after isolated aortic valve replacement surgery.

Objectives: To determine in the modern era if cardiopulmonary bypass (CPB) time has a significant effect on postoperative morbidity, mortality and long-term survival in patients undergoing isolated aortic valve replacement (AVR) surgery.

Methods: Analysis of a prospectively collected cardiac surgery database was performed. Uni- and multivariate analysis on the need of resternotomy for bleeding, mediastinal blood loss, intensive care unit (ICU) length of stay, hospital length of stay, in-hospital mortality and long- term survival was performed.

The effect of patient sex on survival in patients undergoing isolated coronary artery bypass surgery receiving a radial artery.

Objectives: To determine whether patient sex makes a difference to in-hospital mortality and survival in patients undergoing isolated coronary artery bypass graft surgery (CABG) receiving a radial artery graft.

Methods: Analysis of consecutive patients on a validated prospective cardiac surgery database was performed for patients undergoing isolated CABG. Uni- and multivariate analyses were performed for in-hospital mortality and long-term survival.

Should obese patients undergo on- or off-pump coronary artery bypass grafting?

Objectives: To determine if on- or off-pump coronary artery bypass grafting (CABG) makes a difference to in-hospital mortality and long-term survival in obese patients.

Methods: Analysis of consecutive patients on a validated prospective cardiac surgery database was performed for patients undergoing isolated CABG. Obesity was defined as a body mass index (BMI) >30 kg/m(2).

Statins and long-term survival after isolated valve surgery: the importance of valve type, position and procedure.

Objectives: To investigate whether valve position, type and procedure are important factors in determining the beneficial effects of statin therapy with regard to long-term survival in patients undergoing isolated single valve surgery.

Methods: A prospective single-institution cardiac surgery database was analysed. Univariate, multivariate stepwise linear, logistic and Cox regression analysis and propensity matching were performed to identify if statins were associated with increased survival post-valve surgery.

External validity of the Society of Thoracic Surgeons risk stratification tool for deep sternal wound infection after cardiac surgery in a UK population.

Objectives: Deep sternal wound infection (DSWI) is a devastating complication of cardiac surgery, with a historical incidence of 0.4-5%. Predicting which patients are at higher risk of infection may help instituting various preventive measures.

Comparison of the EuroSCORE II and Society of Thoracic Surgeons 2008 risk tools.

Objectives: Risk stratification in cardiac surgery is uniquely detailed, led latterly by the EuroSCORE and the Society of Thoracic Surgeons (STS) risk calculators. The recently published EuroSCORE II (ES2) algorithms update estimated mortality in a broad spectrum of cardiac procedures. The 2008 STS tool, in comparison, predicts multiple outcomes for specific procedures.

Is single-unit blood transfusion bad post-coronary artery bypass surgery?

Objectives: Publications in the surgical literature are very consistent in their conclusions that blood is dangerous with regard to in-hospital mortality, morbidity and long-term survival. Blood is frequently used as a volume expander while simultaneously increasing the haematocrit. We investigated the effects of a single-unit blood transfusion on long-term survival post-cardiac surgery in isolated coronary artery bypass grafting patients.

Red cell distribution width and coronary artery bypass surgery.

Objectives: The red cell distribution width (RDW) has been identified as an independent risk factor with regard to prognosis in patients with coronary artery disease with or without heart failure. We sought to investigate the role of RDW in patients undergoing isolated coronary artery bypass graft surgery (CABG).

Methods: Analysis of consecutive patients on a validated prospective cardiac surgery database was performed for patients undergoing isolated CABG.

Theoretical treatise: arterial pressure during aortic surgery.

The optimum arterial perfusion pressure during cardiopulmonary bypass (CPB) remains uncertain. A correlation in some form with the patients' resting pressure almost certainly exists. Temperature and hematocrit affect blood viscosity.

In-hospital mortality and long-term survival after coronary artery bypass surgery in young patients.

Objectives: Coronary artery bypass graft (CABG) is performed for symptomatic and prognostic reasons. We aimed to determine the factors that contribute to in-hospital mortality and long-term survival in young patients (aged less than 65) undergoing CABG.

Methods: A prospective database was retrospectively analysed and cross-correlated with the United Kingdom's Strategic Tracing Service to evaluate survival in patients under the age of 65, following isolated primary CABG.

Choice of conduit for coronary artery bypass grafting in poor ventricles.

Background: advantages in the use of arterial grafts for coronary artery revascularizations have been reported previously.

Objectives: we aimed to compare the outcome and survival rates of different conduits in patients with poor ventricular function (ejection fraction<30%).

Methods: in a 10-year period, 979 patients with an ejection fraction<30%, who underwent isolated first-time coronary artery bypass grafting, were divided into in 3 groups: (A) total arterial grafts (n=257), (B) total vein grafts (n=76), and (C) left internal mammary artery and vein grafts (n=610).