Bioprosthetic aortic valve replacement in patients aged 50 years old and younger: Structural valve deterioration at long-term follow-up. Retrospective study.

Background: Structural valve deterioration (SVD) remains the major determinant of bioprosthesis durability. The aim of this study was to investigate the SVD incidence, predictors and outcomes in patients aged 50 years and younger after bioprosthetic aortic valve replacement (bAVR).

Methods: We retrospectively analyzed 73 consecutive patients ≤50 years old who underwent bioprosthetic AVR at our center between 2005 and 2015.

Successful Open Chest Epicardial Ablation for Refractory Ventricular Tachycardia in an LVAD Recipient.

A patient with history of dilated cardiomyopathy, a cardiac resynchronization therapy defibrillator, and endocardial ablation presented for refractory ventricular tachycardia 3 years after implantation of a Jarvik 2000 left ventricular assist device (Jarvik Heart, Inc., New York, New York). Open-chest epicardial ablation safely and effectively terminated the arrhythmia, without ventricular tachycardia recurrence at 9-month follow-up and in the absence of complications during the hospital stay.

Aortic Valve Sclerosis as an Important Predictor of Long-Term Mortality in Patients With Carotid Atheromatous Plaque Requiring Carotid Endarterectomy.

A strong association between aortic valve sclerosis (AVSc), the earliest manifestation of calcific aortic valve disease, and atherosclerosis exists. The aim of the study was to evaluate the predictive capabilities of AVSc on long-term all-cause mortality, in patients requiring carotid endarterectomy (CEA). 806 consecutive CEA patients were enrolled.

Rheumatic mitral regurgitation: is repair justified by the long-term results?

Objectives: The best treatment for rheumatic mitral regurgitation is still under debate. Our goal was to assess the long-term results of mitral repair for rheumatic mitral regurgitation performed in 2 referral centres for mitral repair.

Methods: Patients who underwent mitral valve repair between 1999 and 2009 were selected.

Long-term secondary cardiovascular prevention programme in patients subjected to coronary artery bypass surgery.

Aims: Patients with coronary heart disease (CHD) are at very high risk of recurrent events. A strategy to reduce excess risk might be to deliver structured secondary prevention programmes, but their efficacy has been mostly evaluated in the short term and in experimental settings. This is a retrospective case-control study aimed at assessing, in the real world, the efficacy of a secondary prevention programme in reducing long-term coronary event recurrences after coronary artery bypass surgery (CABG).

Surgical Treatment of Concomitant Atrial Fibrillation: Focus onto Atrial Contractility.

Background: Maze procedure aims at restoring sinus rhythm (SR) and atrial contractility (AC). This study evaluated multiple aspects of AC recovery and their relationship with SR regain after ablation.

Methods: 122 mitral and fibrillating patients underwent radiofrequency Maze.

Quantification of mitral annulus dynamic morphology in patients with mitral valve prolapse undergoing repair and annuloplasty during a 6-month follow-up.

Aims: Mitral valve (MV) repair is the preferred treatment for mitral regurgitation associated with organic MV prolapse (MVP). Our goals were to describe by transthoracic real-time 3D echocardiography (RT3D TTE) the pre-operative changes in mitral annulus (MA) dynamic morphology related to MVP, compared with a normal population, and to evaluate the differential long-term effects induced by annuloplasty, using either an incomplete flexible band or a complete semi-rigid ring.

Methods And Results: Forty-four patients (62 ± 11 years) with organic MVP and ejection fraction >55% were studied by RT3D TTE the day before MV repair, and 3 and 6 months after (23 patients received a complete rigid ring-CAR, 21 an incomplete flexible band-COS).

On- and off-pump coronary surgery and perioperative myocardial infarction: an issue between incomplete and extensive revascularization.

Objective: Complete myocardial revascularization is the standard for coronary artery bypass grafting. It has been shown, however, that off-pump coronary bypass surgery (OPCAB) may reduce completeness of revascularization without affecting perioperative myocardial infarction rates. We evaluated the influence of OPCAB on major postoperative events in a large consecutive cohort of patients, with special emphasis on risk factors for perioperative myocardial infarction.

Do women currently receive the same standard of care in coronary artery bypass graft procedures as men? A propensity analysis.

Background: The purpose of this study was to determine whether, in recent years, sex differences in the type of care during coronary artery bypass graft surgery procedures occurred.

Methods: Between 1995 and 2004, 5,935 consecutive patients (4,867 men and 1,068 women) underwent isolated coronary artery bypass graft surgery; propensity score matching was used to investigate whether sex adversely impacts standard care and early outcomes of coronary revascularization.

Results: Of the 1,068 women undergoing isolated coronary artery bypass graft surgery, only 280 (26.

Systemic inflammation after on-pump and off-pump coronary bypass surgery: a one-month follow-up.

Background: This study sought to assess inflammation activation in the follow-up (up to one month) of coronary bypass surgery performed both on- (CABG) and off-pump (OPCAB).

Methods: Thirty patients, candidates for coronary surgery, were randomized to undergo CABG (n = 16) or OPCAB (n = 14). Blood samples were collected before the intervention, after protamine administration, and 4, 8, and 30 days after surgery.

Role of hyperbaric oxygen therapy in the treatment of postoperative organ/space sternal surgical site infections.

Background: A prospective trial was designed to evaluate the effect of hyperbaric oxygen (HBO) therapy on organ/space sternal surgical site infections (SSIs) following cardiac surgery that requires sternotomy.

Methods: A total of 32 patients who developed postoperative organ/space sternal SSI were enrolled in this study from 1999 through 2005. All patients were offered HBO therapy.

Surgery of left ventricular aneurysm: a meta-analysis of early outcomes following different reconstruction techniques.

Background: The purpose of this study is to assess the effects of linear and geometric left ventricular aneurysm reconstruction on early postoperative outcomes.

Methods: A search of computerized databases supplemented with manual bibliographic review was performed for all peer-reviewed English language publications concerning randomized and nonrandomized studies reporting the results of left ventricular reconstruction after both linear and geometric reconstruction techniques. Meta-analyses of several short-term outcomes were performed.

Head-to-head comparison of two- and three-dimensional transthoracic and transesophageal echocardiography in the localization of mitral valve prolapse.

Objectives: The aim of this study, undertaken in patients who underwent mitral valve (MV) repair surgery, was to evaluate the feasibility and accuracy of 3-dimensional (3D) transthoracic (TTE) and transesophageal (TEE) echocardiography in the evaluation of MV pathology.

Background: A pre-operative assessment of MV anatomy is essential to surgical design in patients undergoing MV repair. Although 2-dimensional (2D) echocardiography provides precise information regarding MV anatomy, 3D TTE and 3D TEE could increase the understanding of MV apparatus and individual scallop identification.

[Off-pump coronary bypass surgery: pros and cons].

Off-pump coronary artery bypass surgery is a well established surgical option for patients candidate to coronary artery bypass. Current evidence suggests that there are no differences between off-pump and on-pump coronary surgery in terms of major perioperative outcomes such as perioperative mortality, myocardial infarction, stroke, and renal failure, whereas off-pump coronary surgery seems to reduce some minor complications like atrial fibrillation, transfusion requirements, and postoperative hospital stay. However, some recent papers suggest that graft patency may be lower for grafts performed with the off-pump technique.

The role of tissue factor and P-selectin in the procoagulant response that occurs in the first month after on-pump and off-pump coronary artery bypass grafting.

Background: It has been previously shown that a persistent (up to 1 month) prothrombotic status occurs after coronary bypass surgery performed both on pump and off pump. To assess the pathways involved in the occurrence of postoperative prothrombotic state, in this study we evaluated plasma, monocyte-bound, and platelet-bound tissue factor expression, as well as platelet and soluble P-selectin expression, up to 1 month after off-pump and on-pump coronary artery bypass grafting.

Methods: Thirty patient candidates for coronary surgery were randomized to undergo off-pump coronary artery bypass grafting (n = 15) or on-pump coronary artery bypass grafting (n = 15).

Increased prothrombotic state lasting as long as one month after on-pump and off-pump coronary surgery.

Objective: This study investigated whether the activation of coagulation, fibrinolysis, and endothelium occurring during the first postoperative month after on-pump coronary artery bypass surgery differs from that after off-pump coronary artery bypass grafting.

Methods: Thirty-five patients candidates to coronary surgery were randomized to undergo on-pump (n = 18) or off-pump (n = 17) coronary artery bypass grafting. Blood samples were collected before the intervention and to 1 month after surgery.

Biological effects of off-pump vs. on-pump coronary artery surgery: focus on inflammation, hemostasis and oxidative stress.

Cardiopulmonary bypass (CPB) has been recognized as a cause of complex systemic inflammatory response, which significantly contributes to several adverse postoperative complications. In the last few years, off-pump coronary artery bypass grafting has gained widespread diffusion as an alternative technique to conventional on-pump coronary artery bypass grafting. Surgeons supporting off-pump surgery state that the avoidance of the CPB and myocardial ischemia-reperfusion significantly reduces the postoperative systemic inflammatory response and other biological derangements and, possibly, may improve the clinical outcomes.

Off-pump versus on-pump coronary artery bypass: meta-analysis of currently available randomized trials.

Background: Off-pump coronary artery bypass (OPCAB) challenges the conventional on-pump coronary artery bypass grafting (CABG) as the standard of surgical therapy for coronary disease. The aim of this study is to assess the differences in clinical outcomes between CABG and OPCAB by meta-analysis of data published in randomized trials.

Methods: A literature search (Medline, Pubmed, Cochrane Controlled Trials Register, and the Cochrane Medical Editors Trial Amnesty of unpublished clinical trials) was done for the period starting from January 1990 until May 2002 and was supplemented with a manual bibliographic review for all peer-reviewed English language publications.

Coagulation and fibrinolytic markers in a two-month follow-up of coronary bypass surgery.

Objectives: The alterations of the coagulation-fibrinolytic profile immediately and up to few days after cardiac surgery have been widely documented. However, less information is available on whether these alterations persist for prolonged periods of time after the operation. In this study we have evaluated the coagulation-fibrinolytic profile of patients who underwent coronary artery surgery with cardiopulmonary bypass during a 2-month follow-up period.