Correction: A prospective cohort study of dynamic cell-free DNA elevation during cardiac surgery with cardiopulmonary bypass.

[This corrects the article DOI: 10.1371/journal.pone.

A prospective cohort study of dynamic cell-free DNA elevation during cardiac surgery with cardiopulmonary bypass.

Cardiac surgery and cardiopulmonary bypass (CPB) are associated with a systemic inflammatory reaction that occasionally induces a life-threatening organ dysfunction caused by the dysregulated host response to the damage-associated molecular patterns (DAMPs). In severe inflammation, cell-free DNA (cfDNA) and histones are released by inflammatory cells and damaged tissue and act as DAMPs. We sought to characterize the changes in circulating cell-free DNA (cfDNA) levels during CPB.

In-situ left-sided bilateral internal thoracic artery: elevated hemidiaphragm.

Background Procurement of the internal thoracic artery risks ipsilateral phrenic nerve injury and elevated hemidiaphragm. Anatomical variations increase the risk on the right side. Patients receiving left-sided in-situ right internal thoracic artery configurations appear to be at greatest risk.

Retroaortic right internal thoracic artery grafting of circumflex artery targets.

Background: Retroaortic right internal thoracic artery grafting has failed to gain popularity. We aimed to delineate patient correlates of eligibility, distribution of targets, and effects of target remoteness on outcome and risk of retroaortic bleeding.

Methods: Data of 861 patients undergoing skeletonized bilateral internal thoracic artery grafting (2007-2012) were analyzed according to retroaortic (n = 300) or T-graft configuration.

Concomitant grafting of both postbifurcation internal thoracic artery branches.

Objective: We aimed to assess the clinical outcome and graft patency after concomitant grafting of both postbifurcation internal thoracic artery (ITA) branches.

Methods: Between 2007 and 2013, 17 patients (14 men; mean [SD] age, 60 [9.3] years) underwent skeletonized bifurcated ITA grafting.

Bilateral internal thoracic artery grafting in insulin-treated diabetes.

Background: We sought to assess the risk and late outcome of bilateral internal thoracic artery grafting in eligible insulin-treated diabetic subsets.

Methods: 147 insulin-treated diabetic patients undergoing arterial revascularization were grouped as: skeletonized bilateral internal thoracic artery (n = 83) or internal thoracic artery-radial artery (n = 64). Chronic lung disease or overweight and female constituted exclusion criteria for bilateral internal thoracic artery grafts.

Right coronary artery revascularization in patients undergoing bilateral internal thoracic artery grafting: comparison of the free internal thoracic artery with saphenous vein grafts.

From April 1996 to July 1999, 241 consecutive patients underwent complete arterial revascularization with composite T-graft, including right coronary artery grafting with free right internal thoracic artery (ITA) (ITA group). They were compared with 127 bilateral ITA patients in whom saphenous vein grafts (SVG) was used for grafting the right coronary system (SVG group). The SVG group included more diabetics (40 vs.

Endoscopic correction of the adult form of scimitar syndrome and mitral regurgitation: anatomic and technical considerations.

Scimitar syndrome is a congenital cardiac anomaly characterized by anomalous venous drainage of the right lung into the inferior vena cava. We report the combination of scimitar syndrome and mitral regurgitation and describe port-access correction for the adult form by means of an intraatrial baffle combined with mitral valve repair. Related considerations and modifications required in the standard Heartport (Cardiovations, Somerville, NJ) technique are discussed.

Off-pump coronary revascularization of the circumflex system: comparison between sequential and nonsequential arterial grafts.

Background: Sequential grafting increases the availability of arterial grafts. This study aims to determine the safety and efficacy of sequential grafting of the circumflex coronary distribution performed off-pump.

Methods: Between 2000 and 2003, 136 patients undergoing off-pump sequential arterial grafting of the circumflex territory were compared to 278 patients who received nonsequential grafts to the same area.

Thermo-wrap technology preserves normothermia better than routine thermal care in patients undergoing off-pump coronary artery bypass and is associated with lower immune response and lesser myocardial damage.

Objective: Perioperative hypothermia might be detrimental to the patient undergoing off-pump coronary artery bypass surgery. We assessed the efficacy of the Allon thermoregulation system (MTRE Advanced Technologies Ltd, Or-Akiva, Israel) compared with that of routine thermal care in maintaining normothermia during and after off-pump coronary artery bypass surgery.

Methods: Patients undergoing off-pump coronary artery bypass surgery were perioperatively and randomly warmed with the 2 techniques (n = 45 per group).

No-touch aorta off-pump coronary surgery: the effect on stroke.

Objective: Studies examining the neuroprotective effects of off-pump coronary artery bypass grafting have shown inconsistent results. Most studies, however, have not differentiated between clampless and clamp off-pump techniques. The aim of this study was to evaluate the effect of avoiding aortic manipulation on major neurologic outcomes after off-pump coronary artery bypass grafting.

Use of intraoperative epiaortic ultrasonography to delineate aortic atheroma.

Objective: A cerebrovascular accident (CVA) is a devastating complication of coronary artery bypass grafting (CABG) and a major cause for morbidity and mortality. Aortic manipulation, cannulation, and clamping during CABG may lead to release of atheromatous material from the ascending aorta, which may cause a CVA. This study assessed the hypothesis that the use of intraoperative epiaortic ultrasonography (EAUS) would supplement imaging information with that derived from manual aortic palpation and influence the surgical decision-making approach accordingly.

Off-pump coronary artery bypass grafting: single center experience with 1,000 consecutive patients.

Background: Advances in surgical techniques and retractor-stabilizer devices allowing access to all coronary segments have resulted in increased interest in off-pump coronary artery bypass. The residual motion in the anastomotic site and potential hemodynamic derangements, however, render this operation technically more demanding.

Objectives: To evaluate the OPCAB experience in a single Israeli center.

Comparison of bilateral thoracic artery grafting with percutaneous coronary interventions in diabetic patients.

Background: This study compares the outcome of percutaneous coronary interventions (PCI) with bilateral internal thoracic grafting (BITA) in diabetic patients.

Methods: From May 1996 to December 1999, 802 consecutive diabetic patients underwent myocardial revascularization: 363 by PCI and 439 by BITA. The two groups were similar; however, left main disease (28% versus 3.

Bilateral versus single internal thoracic artery grafting in oral-treated diabetic subsets: comparative seven-year outcome analysis.

Background: Recent interest has focused on the use of arterial conduits in diabetic subsets. To date, the long-term benefits of bilateral internal thoracic artery (BITA) grafting in this subgroup remain in question.

Methods: Two hundred eighty-five consecutive oral-treated diabetics operated on nonemergent basis (1996 to 1998) were compared according to the surgical technique, left-sided skeletonized BITA (n = 228) or single internal thoracic artery- saphenous veins (SITA) (n = 57).

Obstacles in the diagnosis of acute aortic dissection.

Acute aortic dissection (AAD) is a life-threatening condition for which prompt diagnosis is essential for successful management. The imaging modalities for demonstrating the dissecting membrane include retrograde aortography, contrast-enhanced computed tomography (CT), transesophageal echocardiography (TEE), and magnetic resonance imaging. Of these, aortography had long been considered the gold standard in diagnosing aortic dissection.

Bilateral internal thoracic artery grafting in diabetic patients: short-term and long-term results of a 515-patient series.

Background: Despite potential long-term benefits, bilateral internal thoracic artery grafting in diabetics remains controversial because of the risk of sternal infection. We sought to assess the short- and long-term outcome after left-sided bilateral internal thoracic artery grafting and to determine the configuration of choice in diabetic subsets.

Methods: Between 1996 and 2001, 515 diabetics underwent isolated left-sided skeletonized bilateral internal thoracic artery grafting.

Repeat median sternotomy after prior ante-aortic crossover right internal thoracic artery grafting.

Background: In situ bilateral internal thoracic artery (ITA), with ante-aortic crossover right ITA (RITA) is gaining popularity. However, the retrosternal position of the crossover RITA has raised concerns with regard to its compromise during subsequent resternotomy.

Methods: Ten patients underwent repeat median sternotomy after prior ante-aortic crossover RITA grafting.

Reduced strokes in the elderly: the benefits of untouched aorta off-pump coronary surgery.

Background: Avoiding aortic manipulation during off-pump coronary artery bypass (OPCAB) reduces the risk for atheroembolic complications and may, thus, benefit elderly patients who are prone to atherosclerotic aortic involvement.

Methods: During a period of 18 months (2000-2002), 160 consecutive OPCAB patients older than 75 years were evaluated. One hundred and three patients undergoing clampless OPCAB were compared to 57 patients in whom side clamps were applied.

Myocardial revascularization for acute myocardial infarction: benefits and drawbacks of avoiding cardiopulmonary bypass.

Background: Coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI) is associated with increased mortality compared with CABG in non-AMI patients. Operating without cardiopulmonary bypass (CPB) might reduce this mortality.

Methods: Between January 1992 and December 1998, 225 patients underwent CABG within 7 days of AMI, 119 with CPB and 106 without.

Bilateral internal thoracic artery grafting in insulin-treated diabetics: should it be avoided?

Background: It has been advocated that skeletonized bilateral internal thoracic artery (BITA) grafting may be implemented safely in diabetics, thus bestowing these patients with the long-term benefits of this strategy. However, the feasibility of this approach in insulin-treated patients has yet to be determined.

Methods: One-hundred twenty-four insulin-treated diabetics, operated on between April 1996 and December 2001, were compared according to the surgical technique used: BITA (n = 50) or single internal thoracic artery (SITA; n = 74).

Technical aspects of composite arterial grafting with double skeletonized internal thoracic arteries.

Background: Complete myocardial revascularization with internal thoracic arteries (ITAs) improves long-term survival and decreases the rate of repeat operations, compared to vein grafts. Adequate length of the graft in coronary artery bypass graft (CABG) surgery is essential for providing complete arterial revascularization. Extra length can be obtained by skeletonization of both ITAs.

Free right internal thoracic artery composite graft: an option in left anterior descending artery grafting?

Myocardial revascularization using bilateral internal thoracic arteries (ITA) decreases the risk of reinterventions and provides potential survival benefit. From May 1996 to April 2000, 1,057 patients underwent myocardial revascularization using skeletonized bilateral ITAs. A free right ITA as a composite graft was used for the left anterior descending artery grafting in 38 (3.