Retraction speed and chronic poststernotomy pain: A randomized controlled trial.

Objectives: Approximately 30% of patients develop chronic poststernotomy pain (CPSP) following cardiac surgery with sternal retraction. Risk factors have been described but no causal determinants identified. Investigators hypothesized that opening the sternum slowly would impart less force (and thereby less nerve/tissue damage) and translate to a reduced incidence of CPSP.

Quantifying neurological function in patients undergoing transcatheter aortic valve implantation.

Background: Transcatheter aortic valve implantation (TAVI) is a routine procedure that is often performed on older adults that are high-risk patients with severe aortic stenosis. Patients after TAVI may experience neurological complications. However, there is a lack of objective neurological testing available for patients undergoing cardiac surgery.

Does Pacemaker Implantation After Surgical Aortic Valve Replacement Impact Long-Term Morbidity and Mortality? A Focused Review.

Permanent pacing remains a serious complication that can occur in the postoperative period of surgical aortic valve replacement. The reported incidence is variable, and there are many perioperative factors that have been linked with a greater need for permanent pacing. Permanent pacing can also be associated with late lead-related and cardiac complications that can affect late outcome.

Is It Feasible to Implant Sutureless Valves in Presence of Diseased Aortic Root and Aortic Aneurysm?

Sutureless bioprosthetic valves are typically used in patients with a normal-sized aortic root and annulus because of concerns that the stent portion of the valve will not be properly anchored. This report describes an initial case series of sutureless valve implantation in the setting of a diseased aortic root and ascending aortic aneurysm, and it shows that the use of the Perceval valve (LivaNova PLC, London, UK) is feasible in these complex situations.

Higher Mortality in Women After Coronary Artery Bypass: Meta-analysis and Bias Analysis of Confounding.

Background: Some studies suggest that the observed higher mortality in women compared with men after coronary artery bypass grafting (CABG) is due to confounding. Our meta-analysis aimed to (1) summarize the effect of sex on mortality after CABG and (2) identify whether unmeasured confounding likely explains the apparent higher mortality in women.

Methods: We searched MEDLINE, Embase, and CENTRAL databases for studies examining sex and 30-day mortality after CABG.

Road to recovery: a study protocol quantifying neurological outcome in cardiac surgery patients and the role of cerebral oximetry.

Introduction: Patients undergoing cardiac surgery may experience both short-term and long-term postoperative neurological problems. However, the underlying cause of this impairment is unclear. Regional cerebral oxygen saturation (rSO) levels may play a role in the development of acute dysfunction, known as postoperative delirium, in addition to longer term outcomes after cardiac surgery.

Outcomes of Operative and Nonoperative Treatment of Thoracic Empyema: A Population-Based Study.

Background: The optimal management of thoracic empyema remains unclear. This study compared mortality and readmission risk after operative vs nonoperative treatment of thoracic empyema.

Methods: Administrative universal health care data were used to conduct a retrospective population-based cohort study of thoracic empyema in Ontario, Canada.

Zone 1 Debranching for Frozen Elephant Trunk and Whole-Body Perfusion.

A 65-year-old man with chronic type A aortic dissection underwent zone 1 debranching and frozen elephant trunk with whole-body perfusion. This approach has the potential to improve technical feasibility of the frozen elephant trunk procedure and reduce its ischemic complications.

Endoscopic saphenous vein harvesting with a non-sealed approach.

Endoscopic saphenous vein harvesting is considered a safe and effective approach for graft procurement during coronary artery bypass graft surgery. As an alternative to open techniques, minimally invasive approaches are associated with superior outcomes in terms of morbidity and patients' discomfort, without affecting graft quality, patency rate, and long-term outcomes.  Both sealed and non-sealed systems are available for endoscopic conduit harvesting.

Endoscopic radial artery harvesting with a non-sealed approach.

Endoscopic radial artery harvesting is considered a safe and effective approach for graft procurement during coronary artery bypass graft surgery. As an alternative to open techniques, minimally invasive approaches are associated with superior outcomes in terms of morbidity and patients' discomfort, without affecting graft quality, patency rate, and long-term outcomes.  Both sealed and non-sealed systems are available for endoscopic conduit harvesting.

Quantified pre-operative neurological dysfunction predicts outcome after coronary artery bypass surgery.

Aims: Patients undergoing coronary artery bypass grafting (CABG) surgery may experience neurological impairment. We examined whether intraoperative regional cerebral oxygen saturation (rSO) and neurological dysfunction prior to surgery, measured by robotic technology, are important predictors of post-operative performance following CABG surgery.

Methods: Adult patients undergoing CABG surgery were recruited for this single-center prospective observational study.

The relationship between cerebral oxygen saturation and quantitative metrics of neurological function after coronary bypass surgery: a feasibility study.

Background: It is well-known that patients undergoing coronary artery bypass grafting (CABG) surgery may experience neurological dysfunction following their operation. However, the nature of this dysfunction has not been properly quantified. Furthermore, the relationship between postoperative impairment and cerebral oxygen saturation during surgery has remained unclear.

A Case of Severe Accidental Hypothermia Successfully Treated with Cardiopulmonary Bypass.

After missing for seven days, a 34-year-old female was found with a rectal temperature of 19.8oC. Instead of attempting aggressive rewarming in the emergency department she was directly transferred to the operating room for extracorporeal rewarming.

The histology of human right atrial tissue in patients with high-risk Obstructive Sleep Apnea and underlying cardiovascular disease: A pilot study.

Background: Obstructive Sleep Apnea (OSA) results in intermittent hypoxia leading to atrial remodeling, which, among other things, facilitates development of atrial fibrillation. While much data exists on the macrostructural changes in cardiac physiology induced by OSA, there is a lack of studies looking for histologic changes in human atrial tissue induced by OSA which might lead to the observed macrostructural changes.

Methods: A case control study was performed.

Effect of preoperative obstructive sleep apnea on the frequency of atrial fibrillation after coronary artery bypass grafting.

Patients with obstructive sleep apnea (OSA) have intermittent hypoxia leading to atrial remodeling and this has been associated with the development of atrial fibrillation (AF). Postoperative AF is a common complication of coronary artery bypass grafting (CABG). The aim of this prospective study was to determine whether the presence of OSA predicts the occurrence of post-CABG AF (PCAF).

Outcomes: wedge resection versus lobectomy for non-small cell lung cancer at the Cancer Centre of Southeastern Ontario 1998-2009.

Background: Sublobar resection for non-small cell lung cancer (NSCLC) remains controversial owing to concern about local recurrence and long-term survival outcomes. We sought to determine the efficacy of wedge resection as an oncological procedure.

Methods: We analyzed the outcomes of all patients with NSCLC undergoing surgical resection at the Cancer Centre of Southeastern Ontario between 1998 and 2009.