Does minimal-access aortic valve replacement reduce the incidence of postoperative atrial fibrillation?

As the most common sequela of cardiac valvular surgery, atrial fibrillation (AF) has an important impact on postoperative morbidity. Minimal-access aortic valve replacement (AVR), with purported benefits on operative outcomes, has emerged as an alternative to conventional AVR. We used meta-analysis to determine whether minimal access influences the incidence of postoperative AF after AVR.

Minimal access aortic valve replacement: is it worth it?

Controversy surrounds the use of minimal access aortic valve replacement (AVR). This meta-analytical study quantified the effects of minimal access AVR on morbidity and mortality compared with conventional AVR and evaluated study heterogeneity and robustness of the findings using sensitivity analysis. Overall, meta-analysis suggested marginal benefits in perioperative mortality (4,667 patients; odds ratio, 0.

The antiphospholipid syndrome and heart valve surgery.

The antiphospholipid syndrome (APLS) is a complex autoimmune disease often connected to systemic lupus erythematodes. Main features are thromboses, fetal loss and specific antibodies. The involved autoantibodies are directed against plasma proteins such as beta2glycoprotein1 (beta2GPI) or prothrombin which depend on negatively charged phospholipids.

A new method of grafting the circumflex through lateral MIDCAB with the use of the radial loop technique.

We report a technique that allows total arterial revascularization of the circumflex territory without cardiopulmonary bypass through limited thoracotomy with the radial as a composite graft. The technique includes anastomosis of the distal end of the radial artery to its more proximal part after the division of the conduit from the brachial artery. In this way we create an adjustable loop that can be divided and used as bifurcated conduit in two coronary targets according to the needs of revascularization.

GRO-alpha regulation in airway smooth muscle by IL-1beta and TNF-alpha: role of NF-kappaB and MAP kinases.

Airway smooth muscle cells (ASMC) are a source of inflammatory chemokines that may propagate airway inflammatory responses. We investigated the production of the CXC chemokine growth-related oncogene protein-alpha (GRO-alpha) from ASMC induced by cytokines and the role of MAPK and NF-kappaB pathways. ASMC were cultured from human airways, grown to confluence, and exposed to cytokines IL-1beta and TNF-alpha after growth arrest.

Aortic valve replacement in a patient with Takayasu's disease without cross-clamping the calcified ascending aorta.

The case of a 42-year-old female requiring surgical management of aortic regurgitation, secondary to Takayasu's disease, with a co-existing heavily calcified ascending aorta is described. In order to address aortic valve surgery with such calcific disease affecting the ascending aorta and peripheral vessels, we present a simple and safe technique that allows aortic valve replacement using a vascular intra-aortic occlusion catheter.

Apical suction device facilitating off-pump bypass for recurrent coarctation: case report.

Apical suction devices to perform complete surgical revascularization without cardiopulmonary bypass have been recently introduced in cardiac surgical practice. We have increasingly explored the possibility of using these devices to perform other procedures on a beating heart that have previously necessitated the need for cardiopulmonary bypass. We present a case of recurrent coarctation in which an ascending-to-abdominal aorta bypass graft was successfully facilitated by the use of an apical suction device.

Relationship between connexins and atrial activation during human atrial fibrillation.

Introduction: Gap junctional connexin proteins (connexin40 [Cx40], connexin43 [Cx43]) are a determinant of myocardial conduction and are implicated in the development of atrial fibrillation (AF). We hypothesized that atrial activation pattern during AF is related to connexin expression and that this relationship is altered by AF-induced remodeling in the fibrillating atria of chronic AF.

Methods And Results: Isochronal activation mapping was performed during cardiac surgery on the right atria of patients in chronic AF (n = 13) using an epicardial electrode array.

Minimally invasive off-pump pulmonary embolectomy.

We report the case of a 35-year-old female with acute massive right pulmonary embolism, successfully treated by a minimally invasive off-pump pulmonary embolectomy-the first case in the literature implemented via the J-ministernotomy.