Surgical Outcomes in Indigenous Peoples Undergoing Cardiac Surgery.

Introduction: Heart disease is the leading cause of death in indigenous peoples, however cardiac surgical outcomes in this group are rarely studied. We hypothesized that complication rates in indigenous peoples undergoing cardiac surgery would be similar to Caucasians.

Methods: From 2014 to 2020, 1,594 patients underwent cardiac surgery; 36 patients were identified as indigenous peoples.

Regional and Temporal Trends in the Outcomes of Repairs for Acute Type A Aortic Dissections.

Background: Little information exists regarding the use of arch operations for repair of acute type A aortic dissections (AADs) despite increasing interest in this strategy and its potential impact on outcomes. We aimed to determine the relationship between extent of aortic repair, US geographic regions, and outcome.

Methods: We queried The Society of Thoracic Surgeons database for patients who underwent AAD repair from January 1, 2004 to December 31, 2016 and grouped patients by ascending-only operations and operations involving the arch.

Left ventricular ejection hemodynamics before and after relief of outflow tract obstruction in patients with hypertrophic obstructive cardiomyopathy and valvular aortic stenosis.

Objective: There has been debate on the importance and pathophysiologic effects of the dynamic subaortic pressure gradient in hypertrophic obstructive cardiomyopathy. The study was conducted to elucidate the hemodynamic abnormalities associated with the dynamic pressure gradient in hypertrophic obstructive cardiomyopathy.

Methods: Eight patients with hypertrophic obstructive cardiomyopathy and 7 patients with valvular aortic stenosis underwent a detailed hemodynamic study of pressure flow relationships before and after myectomy or aortic valve replacement during operation.

Patient Experience After Cardiac Surgery: Identifying Areas for Improvement.

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a publicly reported survey of patient experience with in-hospital care. We reviewed institutional HCAHPS survey data to assess our patients' experiences after cardiac surgery and to identify targets for practice improvement.

Methods: We reviewed data from patients undergoing the most common cardiac operations, with dismissal from October 1, 2012 to September 30, 2015.

Impact of Medical Therapy on Late Morbidity and Mortality After Aortic Aneurysm Repair for Aortitis.

Background: Patients with active aortitis who undergo repair of ascending aortic aneurysms have an increased risk of late reoperation and decreased late survival. We aimed to determine the reasons for these poor outcomes and the influence of medical management.

Methods: We reviewed records of 186 patients (median age 73.

Aortic Root Dilation: Do Patients With Marfan Syndrome Fare Worse Than Those With Marfanoid Features?

Objective: To discover whether patients with aortic root dilation and leptosomic features but without a diagnosis of Marfan syndrome (MFS) fare similarly to patients with MFS.

Methods: Of 124 patients with aortic root dilation identified from August 1, 1994, through October 31, 2012, 66 had MFS and 58 had leptosomic features but did not meet the Ghent criteria. Genetic testing was performed in 35% of patients (n=43).

Xenoantigenicity of porcine decellularized valves.

Background: The xenoantigenicity of porcine bioprosthetic valves is implicated as an etiology leading to calcification and subsequent valve failure. Decellularization of porcine valves theoretically could erase the antigenicity of the tissue leading to more durable prosthetic valves, but the effectiveness of decellularization protocols in regard to completely removing antigens has yet to be verified. Our hypothesis was that decellularization would remove the more abundant α-gal antigens but not remove all the non α-gal antigens, which could mount a response.

Basic Cardiac Surgery Skills on Sale for $22.50: An Aortic Anastomosis Simulation Curriculum.

Background: Current resident and student duty-hour restrictions necessitate efficient training, which may be aided by simulation. Data on the utility of low-cost simulation in cardiothoracic surgery are scant. We evaluated the effect and value of a low-cost, low-fidelity aortic anastomosis simulation curriculum.

Low-Dose Gamma Irradiation of Decellularized Heart Valves Results in Tissue Injury In Vitro and In Vivo.

Background: Decellularized heart valves are emerging as a potential alternative to current bioprostheses for valve replacement. Whereas techniques of decellularization have been thoroughly examined, terminal sterilization techniques have not received the same scrutiny.

Methods: This study evaluated low-dose gamma irradiation as a sterilization method for decellularized heart valves.

Influence of aortitis on late outcomes after repair of ascending aortic aneurysms.

Objective: To determine outcomes of repair of ascending aortic aneurysms in patients with histopathologic diagnoses of aortitis.

Methods: We reviewed histopathologic findings and outcomes of elective repair of ascending aortic aneurysms between January 1, 1955, and December 31, 2012. Noninfectious aortitis was identified in 186 patients, and we compared outcomes for these patients with outcomes for others operated on at the same time with diagnoses of medial degeneration (n = 317) or atherosclerosis (n = 232).

The effect of postoperative medical treatment on left ventricular mass regression after aortic valve replacement.

Objective: The study objective was to analyze factors associated with left ventricular mass regression in patients undergoing aortic valve replacement with a newer bioprosthesis, the Trifecta valve pericardial bioprosthesis (St Jude Medical Inc, St Paul, Minn).

Methods: A total of 444 patients underwent aortic valve replacement with the Trifecta bioprosthesis from 2007 to 2009 at 6 US institutions. The clinical and echocardiographic data of 200 of these patients who had left ventricular hypertrophy and follow-up studies 1 year postoperatively were reviewed and compared to analyze factors affecting left ventricular mass regression.

Impact of incidental amyloidosis on the prognosis of patients with hypertrophic cardiomyopathy undergoing septal myectomy for left ventricular outflow tract obstruction.

To determine the impact of amyloid on the prognosis of patients with hypertrophic cardiomyopathy (HC), we reviewed outcomes of patients who underwent septal myectomy for HC from March 7, 1996, to October 9, 2012, with amyloid deposits identified in operative specimens. Amyloid subtypes were differentiated by mass spectrometry-based proteomics. The survival rate was compared with that of an age-matched population (2:1) without amyloid who underwent septal myectomy for HC.

Management of mitral regurgitation in Marfan syndrome: Outcomes of valve repair versus replacement and comparison with myxomatous mitral valve disease.

Objectives: The study objective was to evaluate patients with Marfan syndrome and mitral valve regurgitation undergoing valve repair or replacement and to compare them with patients undergoing repair for myxomatous mitral valve disease.

Methods: We reviewed the medical records of consecutive patients with Marfan syndrome treated surgically between March 17, 1960, and September 12, 2011, for mitral regurgitation and performed a subanalysis of those with repairs compared with case-matched patients with myxomatous mitral valve disease who had repairs (March 14, 1995, to July 5, 2013).

Results: Of 61 consecutive patients, 40 underwent mitral repair and 21 underwent mitral replacement (mean [standard deviation] age, 40 [18] vs 31 [19] years; P = .