Inflammation in aortic surgery: postoperative evolution of biomarkers according pathologies and segments of the aorta.

Objectives: Aortic pathologies often present with elevated inflammatory biomarkers due to the nature of the disease. Open aortic surgery causes significant trauma to the body due to often mandatory ischemic periods, long cardiopulmonary bypass times and polytransfusion. We aim to determine postoperative trends on inflammation biomarkers for different aortic pathologies and type of surgery in different segments of the aorta.

Managing the Root in Acute Type A Aortic Dissections: Are We Ready for a Standardized Approach?

Objectives:  Surgical repair of Type A aortic dissection (TAAD) requires exclusion of the primary entry tear and reestablishment of flow into the distal true lumen. Provided that the majority of tears occur within the ascending aorta (AA), replacing only that segment seems a safe option; however, this strategy leaves the root susceptible to dilatation and need for reintervention. We aimed to review the outcomes of the two strategies: aortic root replacement (ARR) and isolated ascending aortic replacement.

A multi-centre prospective cohort study of patients on the elective waiting list for cardiac surgery during the COVID-19 pandemic.

Objectives: During the worldwide COVID-19 pandemic, elective cardiac surgery was suspended to provide ICU beds for COVID-19 patients and those requiring urgent cardiac surgery. The aim of this study is to assess the effect of the pandemic on outcomes of patients awaiting elective cardiac surgery.

Design: A multi-centre prospective cohort study.

Concomitant Atrial Fibrillation Procedures During Cardiac Surgery in a UK Center: Reflection of Worldwide Practice?

Background: Guidelines recommend concomitant atrial fibrillation (AF) ablation during cardiac surgery to restore normal sinus rhythm (NSR). The study determines, to what extent patients with AF undergoing cardiac surgery at our institution received a concomitant AF procedure, what these procedures entailed, and short-term outcomes.

Methods: A retrospective study of 2,984 patients undergoing cardiac surgery over 18 months.

Cardiothoracic surgery in the midst of a pandemic: Operative outcomes and maintaining a coronavirus disease 2019 (COVID-19)-free environment.

Objective: In the United Kingdom, the coronavirus disease 2019 (COVID-19) pandemic has led to the cessation of elective surgery. However, there remains a need to provide urgent and emergency cardiac and thoracic surgery as well as to continue time-critical thoracic cancer surgery. This study describes our early experience of implementing a protocol to safely deliver major cardiac and thoracic surgery in the midst of the pandemic.

Surgical excision of a rare cardiac tumor: Cardiac hibernoma.

Background And Aim: Cardiac hibernoma is a very rare benign cardiac tumour. We report a case of its surgical management.

Methods: A case study with retrospective review of prospective patient data.

Alternative and Safe Technique to Tie Down a Biologic Aortic Valve in Small Aortic Roots.

Biologic aortic valves are constructed with 3 stents corresponding to the commissures, which sit in the aortic root. When implanted using interrupted sutures, these stents may make the valve difficult to tie down safely in patients with small, calcified aortic roots. We present an easily reproducible technique to make this valve tie down safer.

The EXCEL Trial: The Surgeons' Perspective.

There have been several investigations comparing the efficacy of percutaneous coronary intervention and coronary artery bypass grafting surgery for treatment of left main stem disease. This includes the Evaluation of XIENCE versus Coronary Artery Bypass Graft Surgery for Effectiveness of Left Main Revascularizaton (EXCEL) trial, which has garnered significant controversy surrounding its experimental design and reporting of its results. The authors review the methodology, results, caveats and statements on the EXCEL trial.

Outcomes of patients diagnosed with COVID-19 in the early postoperative period following cardiac surgery.

The coronavirus 2019 (COVID-19) pandemic has disrupted patient care across the NHS. Following the suspension of elective surgery, priority was placed in providing urgent and emergency surgery for patients with no alternative treatment. We aim to assess the outcomes of patients undergoing cardiac surgery who have COVID-19 infection diagnosed in the early postoperative period.

Safe Surgical Retrieval of Embolized Atrial Septal Defect Closure Device.

Surgical retrieval of atrial septal closure device is associated with significant morbidity. We present a technique for safer removal of such devices from the heart.

Perioperative management and outcomes of aortic surgery during pregnancy.

Objective: Pathology of the aortic valve and ascending thoracic aorta is an uncommon but life-threatening complication of pregnancy. Cardiac surgery during pregnancy is known to carry a high risk of mortality to both the mother and fetus. We present our experience of performing aortic surgery during the patients' pregnancy.

What is the optimal revascularization technique for isolated disease of the left anterior descending artery: minimally invasive direct coronary artery bypass or percutaneous coronary intervention?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was, 'What is the optimal revascularization technique for isolated disease of the left anterior descending artery (LAD) in terms of patient survival, morbidity such as myocardial infarction (MI) and need for repeat target vessel revascularization: minimally invasive direct coronary artery bypass graft (MIDCAB) or percutaneous coronary intervention (PCI)?' Altogether 504 papers were found using the reported search, of which 13 represented the best evidence to answer the clinical question. Outcome parameters that were used in the assessment include the incidence of major adverse cardiovascular or cerebral events (MACCEs), mortality and the rate of repeat target vessel revascularization.

Impact of European Society of Cardiology and European Association for Cardiothoracic Surgery Guidelines on Myocardial Revascularization on the activity of percutaneous coronary intervention and coronary artery bypass graft surgery for stable coronary artery disease.

Objective: Joint guidelines on myocardial revascularization were published by the European Society of Cardiology and European Association for Cardiothoracic Surgery: Patients with left main stem, proximal left anterior descending, or 3-vessel disease should be discussed with a surgeon before revascularization, and ad hoc percutaneous coronary intervention has no elective indication in these categories. We assess the impact of the guidelines on referral patterns to a cardiac surgery service at a large-volume cardiac center in the United Kingdom.

Methods: Joint guidelines were published in August 2010.