Severe ischemic cardiomyopathy with mechanical complications: Still a surgical disease.

Background: Surgical treatment of ischemic cardiomyopathy (ICM) with mechanical complications has been limited in favor of suboptimal treatments because of the perception of poor outcome.

Methods And Results: From May 2009 till June 2014 115 patients with severe ICM (ejection fraction, EF, ≤25%) and mechanical complications were operated on. Median EF was 24% (19, 24), mean end-systolic volume index (ESVi) was 86±27ml/m and all patients had an MR grade of 2 or more.

Elective Primary or Secondary Delayed Sternal Closure Improves Outcome in Severely Compromised Patients.

Background: Delayed sternal closure (DSC) in patients with severely compromised preoperative hemodynamics can be helpful as the chest sometimes cannot be able to contain both lungs and heart. We report our experience to evaluate the midterm results of this strategy in an adult population.

Materials And Methods: From May 2009 till July 2015, 33 patients had DSC as first treatment of severe hemodynamic deterioration after cardiac surgery.

Outcome of left ventricular surgical remodelling after the STICH trial.

Objectives: After the publication of the Surgical Treatment for Ischaemic Heart Failure (STICH) trial, surgical indications to left ventricular surgical remodelling (LVSR) have become more restrictive. The experience we report reflects the changes in the real world after the publication of STICH trial.

Methods: From May 2009 to July 2014, 113 patients underwent LVSR, targeted mainly to the left anterior descending territory (89.

Bilateral internal mammary artery grafting: in situ versus Y-graft. Similar 20-year outcome.

Objective: The aim of this study was to evaluate the 20-year clinical outcome of patients undergoing coronary artery bypass grafting with bilateral internal mammary arteries (BIMAs) using two different configurations, in situ versus Y-graft.

Methods: From September 1991 to December 2002, 2150 patients with multivessel coronary artery disease underwent isolated myocardial revascularization with BIMA grafting. BIMA was used as an in situ or Y-configuration in 1332 and 818 cases, respectively.

Mitral valve replacement after MitraClip therapy.

Background: MitraClip therapy (MCT) is becoming more popular to treat mitral regurgitation (MR) in high-risk patients. It is, however, expanding to lower risk patients with the idea that mitral valve (MV) repair can be performed if surgery will be necessary. We report our surgical experience in patients who underwent MCT and subsequently required MV surgery.