COVID-19 related mortality in post-operative cardiac surgical patients.

Background: COVID-19 has caused a global pandemic of unprecedented proportions. Elective cardiac surgery has been universally postponed with only urgent and emergency cardiac operations being performed. The National Health Service in the United Kingdom introduced national measures to conserve intensive care beds and significantly limit elective activity shortly after lockdown.

Varying Evidence on Deep Hypothermic Circulatory Arrest in Thoracic Aortic Aneurysm Surgery.

Cardiovascular surgeons have long debated the safe duration of deep hypothermic circulatory arrest during thoracic aortic aneurysm surgery. The rationale for using adjunctive cerebral perfusion (or not) is to achieve the best technical aortic repair with the lowest risk of morbidity and death. In this literature review, we highlight the debates surrounding these issues, evaluate the disparate findings on deep hypothermic circulatory arrest durations and temperatures, and consider the usefulness of adjunctive perfusion.

A systematic review and meta-analysis of mechanical vs biological composite aortic root replacement, early and 1-year results.

Objective: Composite aortic root replacement is a standard procedure for various aortic root pathologies. This systematic review was set to identify the postoperative outcomes for composite mechanical root replacement (mCRR) compared to composite biological root replacement (bCRR).

Methods: We systematically reviewed four major databases for all papers assessing outcomes in composite root replacement.

Reconstruction of the right atrium and superior vena cava with extracellular matrix.

We describe our technique for reconstructing the free right atrial wall and superior vena cava using CorMatrix (CorMatrix Alpharetta, GA, USA) extracellular matrix following resection of a large leiomyosarcoma.

Infected calcified homograft root: a sutureless solution.

Aortic valve reoperation after homograft root implantation is high risk and may be technically challenging. Dense calcification of the annulus may prevent suture placement and often necessitates impromptu high-risk redo root replacement. Although transcutaneous aortic valve implantation is an attractive option in such scenarios, in the context of endocarditis it is contraindicated.

Kikuchi-Fujimoto disease masquerading as tuberculosis.

Kikuchi-Fujimoto disease (KFD) is a benign, self-limiting subacute necrotizing lymphadenitis with unknown aetiology that has a predilection for young Far East Asian women. It presents with fever, fatigue and lymphadenomegaly and is often misdiagnosed. We report an unusual presentation in a South Asian woman with isolated mediastinal lymphadenopathy masquerading as tuberculosis.

Coronary revascularization in adults with dextrocardia: surgical implications of the anatomic variants.

Most reports of coronary artery bypass grafting in adult patients with dextrocardia have focused on the surgeon's position with respect to the operating table. Herein, we describe the cases of 2 patients with dextrocardia who underwent surgery at our own institution, then discuss preoperative evaluation, surgical approaches, and patient outcomes that have been reported in the medical literature. Whereas most patients, including ours, have presented with classic situs inversus totalis and dextrocardia, a few patients have had other associated anomalies or atypical morphologic conditions.

The acute chest syndrome of sickle cell disease following aortic valve replacement.

The acute chest syndrome (ACS) of sickle cell disease (SCD) is a leading cause of death in SCD, with a high incidence following surgery, though only one case has been reported following cardiac surgery. We present a case of ACS in an adult undergoing aortic valve replacement (AVR) despite instituting established peri-operative optimization measures to prevent sickling. Early diagnosis of this condition in our patient as a distinct clinical entity facilitated appropriate, specific therapy and a good subsequent postoperative recovery.