Permanent pacemaker implantation after combined mitral- and tricuspid valve surgery: a nationwide multicentre study.

Objectives: The threshold to perform concomitant tricuspid valve (TV) repair during primary mitral valve (MV) surgery has decreased, based on recent randomized evidence. Based on these developments, the indication for TV repair during MV surgery is expected to increase further. However, concerns have been raised regarding the risk of permanent pacemaker implantation (PPI) during a concomitant procedure.

Concomitant atrial fibrillation ablation in minimally invasive cardiac surgery.

Concomitant atrial fibrillation (AF) ablation in cardiac surgery effectively restores sinus rhythm and may reduce morbidity and mortality. Cardiac surgery has witnessed the transition from the historical Cox Maze procedure to more modern and less invasive approaches for concomitant AF treatment. As minimally invasive cardiac surgery gains traction, ablation methods and careful patient selection become crucial to optimize results.

Long-term survival after coronary bypass surgery with multiple versus single arterial grafts.

Objectives: This study sought to evaluate the long-term differences in survival between multiple arterial grafts (MAG) and single arterial grafts (SAG) in patients who underwent coronary artery bypass grafting (CABG) in the SYNTAX study.

Methods: The present analysis included the randomized and registry-treated CABG patients (n = 1509) from the SYNTAX Extended Survival study (SYNTAXES). Patients with only venous (n = 42) or synthetic grafts (n = 1) were excluded.

Recovery of conduction disorders after sutureless aortic valve replacement.

Objectives: Conduction disorders and the need for permanent pacemaker (PPM) implantation after surgical aortic valve replacement are well-recognized complications. However, in the case of sutureless valve prostheses, it remains unknown whether pacemaker (PM) dependency and conduction disturbances resolve over time. Our aim was to evaluate whether conduction disorders after Perceval sutureless valve implantation recover during follow-up.

Subxiphoid left atrial ablation for atrial fibrillation.

Atrial fibrillation is becoming a disease that needs to be addressed with definitive long-term treatment as opposed to medical management options. Ablation or isolation of focal triggers around the pulmonary veins can eliminate arrhythmia substrates for patients with paroxysmal, lone atrial fibrillation. However, limited pulmonary vein isolation strategies do not address reentrant circuits common in persistent and longstanding persistent patients with structural heart disease and enlarged atria.

Promoting Physical Activity With Self-Tracking and Mobile-Based Coaching for Cardiac Surgery Patients During the Discharge-Rehabilitation Gap: Protocol for a Randomized Controlled Trial.

Background: Home-based cardiac rehabilitations (CRs) with digital technologies have been researched and implemented to replace, augment, and complement traditional center-based CR in recent years with considerable success. One problem that technology-enhanced home-based CR can potentially address is the gap between cardiac interventions and formal CR programs. In the Netherlands and some other countries (eg, Australia), patients after cardiac interventions stay at home for 3-4 weeks without much support from their physicians, and often engage in very little physical activity (PA).

Minimally invasive totally thoracoscopic stand-alone surgical ablation for atrial fibrillation.

Surgical ablation is a safe and effective treatment for atrial fibrillation. In the procedure demonstrated in this video tutorial, surgery was performed under general anesthesia with a double-lumen tube. After opening of the pericardium and blunt dissection of the oblique and transverse sinuses, surgical ablation was performed.

Predictive value of great saphenous vein mapping prior to endoscopic harvesting in coronary artery bypass surgery.

Objectives: The use of endoscopic vein harvesting in patients undergoing coronary artery bypass grafting is increasing, often using bedside mapping. However, data on the predictive value of great saphenous vein (GSV) mapping are scarce. This study assessed whether preoperative mapping could predict final conduit diameter.

Unraveling postoperative alterations after mitral valve replacement with three-dimensional printing.

Mitral valve (MV) surgery is the second most performed valve operation in Europe. MV pathology is associated with atrial fibrillation, and, therefore, frequently combined with rhythm surgery and left atrial appendage exclusion (LAAE). Currently, no guidelines exist regarding the follow up after LAAE postoperative.

Clamping versus nonclamping thoracoscopic box ablation in long-standing persistent atrial fibrillation.

Objective: To compare clinical outcomes of clamping devices and linear nonclamping devices for isolation of the posterior left atrium (box) in thoracoscopic ablation of long-standing persistent atrial fibrillation.

Methods: Eighty patients who underwent thoracoscopic pulmonary vein and box isolation using a bipolar clamping device (42 patients) or bipolar nonclamping device (38 patients) to create the roof/inferior lesions for box isolation were included from 2 centers. Follow-up consisted of 24-hour Holter at regular intervals.

Endocarditis after transcatheter aortic valve replacement; a new nightmare in cardiac surgery.

Treatment of prosthetic valve endocarditis after transcatheter aortic valve replacement (TAVR) remains challenging. An increase in TAVR endocarditis is inevitable, especially with the extension of indications and implantation in low-risk patients. We present a case of complex surgical treatment of prosthetic valve endocarditis after TAVR.

Conduction disorders and impact on survival after sutureless aortic valve replacement compared to conventional stented bioprostheses.

Objectives: Sutureless and rapid-deployment aortic valve prostheses are frequently used for the treatment of aortic stenosis. However, postoperative left bundle branch block (LBBB) and permanent pacemaker (PPM) implantation have emerged as frequent complications. The aim of this study was to compare the incidence of new-onset LBBB and PPM implantation after sutureless aortic valve replacement (sAVR) with stented bioprostheses, and the impact on postoperative survival.

Epicardial Left Atrial Appendage Exclusion Reduces Blood Pressure in Patients With Atrial Fibrillation and Hypertension.

Background: Percutaneous left atrial appendage exclusion (LAAE) has evolved as an alternative strategy for stroke prevention in atrial fibrillation (AF). Recent observational data have suggested that epicardial LAAE can have substantial impact on arrhythmia burden and hemodynamic profile.

Objectives: The authors aimed to study the impact of epicardial versus endocardial LAAE on systemic blood pressure in hypertensive AF patients.

Thoracoscopic Left Atrial Appendage Clipping: A Multicenter Cohort Analysis.

Objectives: This study sought to document the closure rate, safety, and stroke rate after thoracoscopic left atrial appendage (LAA) clipping.

Background: The LAA is the main source of stroke in patients with atrial fibrillation, and thoracoscopic clipping may provide a durable and safe closure technique.

Methods: The investigators studied consecutive patients undergoing clipping as part of a thoracoscopic maze procedure in 4 referral centers (the Netherlands and the United States) from 2012 to 2016.

Significantly Elevated C-Reactive Protein Levels After Epicardial Clipping of the Left Atrial Appendage.

Objective: Besides mechanical and anatomical changes of the left atrium, epicardial closure of the left atrial appendage has also possible homeostatic effects. The aim of this study was to assess whether epicardial clipping of the left atrial appendage has different biochemical effects compared with complete removal of the left atrial appendage.

Methods: Eighty-two patients were included and underwent a totally thoracoscopic AF ablation procedure.

Late asymptomatic atrial lead perforation, a fortuitous finding during lead extraction using thoracoscopic surveillance: a case report and review of the literature.

A 61-year-old male patient was referred for lead extraction of an infected two-chamber pacemaker system first implanted 18 years ago. A new atrial lead was implanted 9 years later because of loss of capture of the original lead. Video-assisted thoracoscopic surgery (VATS) that we use in high-risk cases showed extensive fibrous adhesion between the right atrium wall and the right lung.

Patency of the internal mammary arteries after removal of the Nuss bar: an initial report.

Objectives: Surgical correction of pectus excavatum (PE) has shifted to the modern minimally invasive Nuss procedure, which proved to be safe and effective. In order to restore the dented deformity, custom-curved metal bars provide continuous retrosternal pressure but cross the habitat of the internal mammary arteries (IMAs) directly affecting their patency. In this initial report, we sought to assess the patency of the IMAs in the first 6 patients who underwent Nuss bar removal in our department.

Partial anomalous pulmonary venous connection (including scimitar syndrome).

Partial anomalous pulmonary venous connection (PAPVC) is defined to exist when some but not all venous drainage enters the left atrium, while the remaining veins connect to the right-sided circulation. Scimitar syndrome is a specialized example, in which an anomalous pulmonary vein descends from the right lung and drains into the inferior caval vein. PAPVC is associated with sinus venosus-type atrial septal defect (ASD).