Mini-Stern Trial: A randomized trial comparing mini-sternotomy to full median sternotomy for aortic valve replacement.

Objective: Aortic valve replacement (AVR) can be performed either through full median sternotomy (FS) or upper mini-sternotomy (MS). The Mini-Stern trial aimed to establish whether MS leads to quicker postoperative recovery and shorter hospital stay after first-time isolated AVR.

Methods: This pragmatic, open-label, parallel randomized controlled trial (RCT) compared MS with FS for first-time isolated AVR in 2 United Kingdom National Health Service hospitals.

Amaze: a randomized controlled trial of adjunct surgery for atrial fibrillation.

Objectives: Atrial fibrillation (AF) reduces survival and quality of life (QoL). It can be treated at the time of major cardiac surgery using ablation procedures ranging from simple pulmonary vein isolation to a full maze procedure. The aim of this study is to evaluate the impact of adjunct AF surgery as currently performed on sinus rhythm (SR) restoration, survival, QoL and cost-effectiveness.

Effect of the full implementation of the European Working Time Directive on operative training in adult cardiac surgery.

Objectives: Surgical specialties rely on practice and apprenticeship to acquire technical skills. In 2009, the final reduction in working hours to 48 per week, in accordance with the European Working Time Directive (EWTD), has also led to an expansion in the number of trainees. We examined the effect of these changes on operative training in a single high-volume [>1500 procedures/year] adult cardiac surgical center.

Age cutoff for the loss of survival benefit from use of radial artery in coronary artery bypass grafting.

Background: Controversy still exists about the superiority of the radial artery (RA) over the saphenous vein graft (SVG) as a second conduit for surgical myocardial revascularization. We aimed to investigate the presence of any survival benefit from use of the RA and relate it to patients' age.

Methods: Propensity score matching was conducted on 9005 patients who underwent first-time isolated coronary artery bypass grafting (CABG) using the left internal thoracic artery at a single institution from 1996 to 2012.

Obesity paradox in coronary artery bypass grafting: myth or reality?

Objective: A high body mass index has been suggested to be protective in patients with coronary artery disease and in those undergoing coronary artery bypass grafting (CABG). However, these conflicting results might be related to the different risk profiles among the various body mass index categories. We sought to clarify the effect of varying degrees of excessive body weight on hard clinical outcomes in patients undergoing CABG.

Focus on the unique mechanisms involved in thoracic aortic aneurysm formation in bicuspid aortic valve versus tricuspid aortic valve patients: clinical implications of a pilot study.

Objectives: The involvement of different factors in the onset of thoracic aortic aneurysm (TAA) in patients with a bicuspid aortic valve (BAV) vs those with a tricuspid aortic valve (TAV) is well recognized. However, the molecular, genetic and cellular mechanisms driving TAA remain unclear. The aim of this study was to identify the different mechanisms involved in TAA development in patients with BAV vs TAV.

A particular phenotype of ascending aorta aneurysms as precursor of type A aortic dissection.

Objectives: We aimed to identify a phenotype of ascending thoracic aortic aneurysm (TAA), which, more than others, evolves into type A dissection (TAD).

Methods: Aortic specimens were obtained from patients undergoing surgical repair of TAA and TAD (108 and 26, respectively). Histopathological and immunohistochemical analyses were performed by using adequate tissue specimens, appropriate techniques and criteria.

Optimal myocardial protection strategy for coronary artery bypass grafting without cardioplegia: prospective randomised trial.

Although hypothermia and ischaemic preconditioning (IP) are independently recognised mechanisms of cardioprotection, interactions between myocardial temperature and preconditioning have not been investigated. Therefore, this study explored the possibility of inducing IP during hypothermia and quantifying its effects at two temperature regimens commonly used in clinical practice. One hundred and four patients undergoing coronary artery bypass grafting (CABG) with intermittent cross-clamping and ventricular fibrillation were randomised to four groups: N=normothermia (36.

Long-term outcomes following VATS lobectomy for non-small cell bronchogenic carcinoma.

Objectives: Despite advantages regarding pain and muscle function, video-assisted thoracic surgery (VATS) lobectomy is infrequently performed and is particularly controversial in bronchogenic carcinoma. We have, therefore, reviewed our experience with VATS lobectomy for non-small cell lung cancer (NSCLC) in an attempt to define the long-term results of VATS lobectomy in this setting.

Methods: Patients were selected for surgery on the basis of clinical Stage I or II disease with routine use of thoracic/upper abdominal CT scanning and cervical mediastinoscopy.