Sequential hybrid ablation vs. surgical CryoMaze alone for treatment of atrial fibrillation: results of multicentre randomized controlled trial.

Aims: Data on the hybrid atrial fibrillation (AF) treatment are lacking in patients with structural heart disease undergoing concomitant CryoMaze procedures. The aim was to assess whether the timely pre-emptive catheter ablation would achieve higher freedom from AF or atrial tachycardia (AT) and be associated with better clinical outcomes than surgical ablation alone.

Methods And Results: The trial investigated patients with non-paroxysmal AF undergoing coronary artery bypass grafting and/or valve repair/replacement with mandatory concomitant CryoMaze procedure who were randomly assigned to undergo either radiofrequency catheter ablation [Hybrid Group (HG)] or no further treatment (Surgery Group).

The influence of epicardial and endocardial use of cryoenergy on the completeness of lesions in surgical ablation of atrial fibrillation.

Introduction: Cryoenergy is the most commonly used method of lesion formation in patients who have undergone surgical ablation of atrial fibrillation. Despite frequent use, the clinical effect of cryoenergy in endocardial and epicardial approaches is unknown.

Aim: To compare the effect of various cryoenergy applications on the postoperative incidence of sinus rhythm and completeness of lesions performed.

De Vega tricuspid valve annuloplasty - a rightly neglected surgical technique?

Introduction: There is a lot of discussion about the best surgical technique for tricuspid valve (TV) regurgitation in patients undergoing an operation for primary mitral valve disease.

Aim: To review and compare our results and experiences regarding the two main surgical strategies: tricuspid valve annuloplasty with a prosthetic ring (RING group) and suture annuloplasty (De Vega group).

Material And Methods: We reviewed 570 patients who underwent TV surgery between 2000 and 2016 with either ring annuloplasty (RING group: = 490 (85.

Clinical performance of a three-dimensional saddle-shaped, rigid ring for mitral valve repair.

Objectives: The Profile 3D annuloplasty ring is a complete, rigid, saddle-shaped ring indicated for reconstruction and/or remodelling of the pathological mitral valve (MV) in patients with mitral insufficiency.

Methods: This prospective, non-randomized, observational, postmarket release study characterized the patient population for which the study ring was chosen for MV repair, assessed the relief from MV dysfunction and determined the level of mitral regurgitation (MR) at follow-up (6-12 months postimplant).

Results: Between February 2013 and July 2015, 151 patients were enrolled at 7 centres; data were excluded for 3 patients.

Correlates of Arrhythmia Recurrence After Hybrid Epi- and Endocardial Radiofrequency Ablation for Persistent Atrial Fibrillation.

Background: Long-term efficacy of catheter-based treatment of persistent atrial fibrillation is unsatisfactory. Minimally invasive surgical ablation techniques have been developed recently, but their efficacy has never been systematically tested.

Methods And Results: Seventy patients (median age, 63.

Delayed Electroanatomic Mapping After Surgical Ablation for Persistent Atrial Fibrillation.

Background: Long-term efficacy of catheter-based treatment of persistent atrial fibrillation is unsatisfactory. Minimally invasive surgical ablation techniques have been developed recently but their true efficacy has never been systematically tested.

Methods: Seventy patients (median age 63.

Epicardial clip occlusion of the left atrial appendage during cardiac surgery provides optimal surgical results and long-term stability.

Objectives: Occlusion of the left atrial appendage (LAA) has become an integral and important part of the surgical treatment of atrial fibrillation. Different methods of surgical occlusion of the LAA have been associated with varying levels of short- and long-term success for closure. The purpose of this study was to evaluate long-term results of epicardial placement and endocardial occlusion in patients undergoing cardiac operative procedures.

[Closure of the left atrial appendage by means of the AtriClip System].

Introduction: Atrial fibrillation (AFib) is related to a high risk of stroke. The main role in etiopathogenesis is played by the left atrial appendage (LAA). As many as 95 % of thrombi in nonvalvular atrial fibrillation are located in the appendage.

Sutureless aortic valve and mitral valve repair in redo cases - really an off-label approach?

Sutureless aortic valve replacement (AVR) was developed as an alternative treatment option to conventional open-heart surgery and transcatheter aortic valve implantation for "gray zone" patients. The need for concurrent mitral valve surgery is generally viewed as a contraindication to sutureless AVR. The purpose of this brief paper is to report our experiences with sutureless valves in patients after previous cardiac procedures with degenerated aortic bioprostheses and concomitant mitral valve disease.

Sequential Hybrid CryoMaze Ablation versus Surgical CryoMaze Alone for the Treatment of Atrial Fibrillation (SurHyb): study protocol for a randomized controlled trial.

Background: Atrial fibrillation is common in patients with structural heart disease who are undergoing cardiac surgery. Surgical CryoMaze has been shown to be an effective treatment in several trials, but success rates have varied considerably, between 47-95 %. The sequential hybrid approach, combining surgical CryoMaze followed by radiofrequency catheter ablation, can achieve high freedom from atrial arrhythmias, even when rigorous methods to detect arrhythmias after the procedure are used.

Short-term and medium-term outcomes of transapical aortic valve implantation as a single-strategy approach: one center's experience.

Introduction: Transcatheter aortic valve replacement has been developed as an alternative option for surgical high-risk or inoperable patients with severe symptomatic aortic stenosis.

Aim Of The Study: Aim of the study was to evaluate the outcomes of patients undergoing transapical aortic valve replacement as a single-strategy option by a single-center multidisciplinary heart team.

Material And Methods: Between June 2009 and December 2014, 41 patients underwent transapical transcatheter aortic valve implantation (TA-TAVI) at our institution.

How to manage left ventricular embolization of the transcatheter valve.

Transcatheter aortic valve implantation is a treatment alternative for high-risk patients with severe aortic stenosis who are not eligible for conventional open aortic valve replacement. We describe a case of a rare but serious complication in the form of ventricular embolization of an Edwards Sapien-XT aortic valve following its transapical implantation. The valve was successfully captured and reimplanted into the aortic annulus, which did not require conversion to median sternotomy or use of extracorporeal circulation.

Thoracoscopic Occlusion of the Left Atrial Appendage.

Objective: Left atrial appendage (LAA) plays a crucial role in the etiopathogenesis and the prevention of the stroke in patients with nonvalvular atrial fibrillation (AF). This paper presents our first experience with thoracoscopic LAA occlusion using an external clip.

Methods: We performed a total of 30 LAA occlusions with the AtriClip from left thoracoscopy approach during the period from July 2012 to July 2013.

Sequential Hybrid Surgical CryoMaze and Transvenous Catheter Ablation of Atrial Fibrillation.

Background: The aim of the study was to evaluate whether the sequential hybrid approach combining surgical CryoMaze followed by the radiofrequency (RF) catheter ablation can improve freedom from atrial arrhythmias.

Methods: Thirty-five patients with persistent atrial fibrillation underwent a CryoMaze procedure in conjunction with cardiac surgery for structural heart disease. Three months after surgery, all patients underwent a 7-day electrocardiogram Holter followed by an electrophysiological study and mapping of the left and right atria.

One-year results from cryopreserved mitral allograft transplantation into the tricuspid position in a sheep experimental model.

Mitral allografts are still used only exceptionally in the mitral or tricuspid position. The main indication remains infectious endocarditis of atrioventricular valves for its flexibility and low risk of infection. The aim of our study was to evaluate 1-year results of mitral allografts transplantation into the tricuspid position in a sheep model.

Sequential hybrid procedure for persistent atrial fibrillation.

Background: Catheter ablation of persistent atrial fibrillation yields an unsatisfactorily high number of failures. The hybrid approach has recently emerged as a technique that overcomes the limitations of both surgical and catheter procedures alone.

Methods And Results: We investigated the sequential (staged) hybrid method, which consists of a surgical thoracoscopic radiofrequency ablation procedure followed by radiofrequency catheter ablation 6 to 8 weeks later using the CARTO 3 mapping system.

Health-related quality of life after cardiac surgery--the effects of age, preoperative conditions and postoperative complications.

Background: Factors influencing the postoperative health-related quality of life (HRQOL) after cardiac surgery have not been well described yet, mainly in the older people. The study's aim was to explore differences in clinical conditions and HRQOL of patients before and after cardiac surgery taking into account the influence of age and to describe factors influencing changes of HRQOL in the postoperative period.

Methods: This was a prospective consecutive observational study with two measurements using the SF-36 questionnaire before surgery and 1 year after surgery.

Two-staged hybrid treatment of persistent atrial fibrillation: short-term single-centre results.

Objectives: The treatment of persistent and long-standing persistent atrial fibrillation (AF) has unsatisfactory results using both medical therapy and/or catheter ablation, where incomplete ablation lines remain a significant problem. This study evaluates the feasibility, efficacy and safety of the sequential, two-staged hybrid treatment combining thoracoscopic surgical and transvenous catheter AF ablation.

Methods: Thirty patients with persistent and long-standing persistent AF underwent surgical thoracoscopic radiofrequency (RF) ablation procedure using a predefined protocol (pulmonary veins isolation, box lesion, isthmus line lesion, dissection of the ligament of Marshall, left atrial appendage exclusion with an epicardial clip and ganglionated plexi ablation) followed by diagnostic catheterization and RF ablation 3 months later.

[Left ventricular myxoma - an unexpected cause of dyspnoea and fever in a young patient].

Primary cardiac tumours are rare. In 75% of cases, these are benign, mainly myxomas. The present case study describes a patient with an impressive epidemiological history, examined at a department of infectious diseases for progressing dyspnoea and subfebrile states.

Re-exploration for bleeding or tamponade after cardiac operation.

The aim of this study was to determine the outcome of patients who had a chest resternotomy and to identify risk factors for higher in-hospital mortality after re-exploration for bleeding and/or tamponade after cardiac operations. We present our experience of an acceptably low re-exploration rate after cardiac surgery, and the outcomes of those re-explored. This was a retrospective analysis of medical records of all patients who had a chest re-exploration for the control of bleeding and cardiac tamponade over a 7-year period (2000-06), at the Cardiothoracic Centre of the Hospital České Budějovice, Czech Republic.

[Simultaneous carotid endarterectomy and coronary revascularization: indications and results].

Aim: Evaluation of operative results and complications in high-risk patients who underwent combined carotid and coronary revascularization.

Patients And Methods: Combined operation--carotid endarterectomy (CEA) and coronary artery bypass graft (CABG) was performed in the period 2000-2009 in 68 patients. Simultaneous operation was indicated in patients with unstable angina pectoris and 1.

Mechanical properties of mitral allografts are not reasonably influenced by cryopreservation in sheep model.

A mitral allograft is used exceptionally in the mitral, as well as in the tricuspid position, mostly as an experimental surgical procedure. The authors decided to evaluate the possibility of inserting a cryopreserved mitral allograft into the tricuspid position in a sheep experimental model. Within the framework of this experimental project the mechanical properties of the cryopreserved mitral allograft were tested.