Surgical dilemma - spare or replace regurgitant aortic valve: Late comparative outcomes of two strategies.

Background: To evaluate different aortic root surgery techniques and their contemporary clinical outcomes in patients with regurgitant aortic valve and aortic root aneurysm.

Methods: The study consisted of 141 adult patients who underwent aortic valve reimplantation (David group = 73) or aortic valve replacement surgery (Bentall group = 68) for aortic valve regurgitation (AR) and dilatation of the aortic root at our institution within the same period (April 2004-October 2016). Kaplan-Meier method was used to estimate survival and other clinically relevant outcomes between the groups.

Long-term outcomes and predictors of recurrent aortic regurgitation after aortic valve-sparing and reconstructive cusp surgery: a single centre experience.

Background: Aortic valve sparing surgery (AVS), in combination with aortic cusp repair (ACR), still raises many questions about the increased surgical complexity and applicability for patients with pure aortic valve regurgitation (AR). The aim of this study was to investigate our long-term outcomes and predictors of recurrent AR (> 2+) after AVS and reconstructive cusp surgery.

Methods: We reviewed data of 81 patients who underwent AVS (a reimplantation technique) with concomitant ACR for AR and or dilatation of the aortic root at our institution during the period from April 2004 to October 2016.

Early and long-term results of aortic valve sparing aortic root reimplantation surgery for bicuspid and tricuspid aortic valves.

Introduction: To evaluate early and long-term clinical outcomes following aortic valve sparing aortic root reimplantation surgery in patients with leaking bicuspid and tricuspid aortic valves.

Methods: The study consisted of 92 consecutive adult patients (tricuspid aortic valve group = 63 and bicuspid aortic valve group = 29) who underwent aortic valve sparing aortic root reimplantation surgery with or without aortic cusp repair for dilatation of the aortic root and/or aortic valve regurgitation at our institution from April 2004 to October 2016. Clinical outcomes were investigated using Kaplan-Meier and log-rank tests between groups.

Burnout Among Anesthetists and Intensive Care Physicians.

Unlabelled: Burnout is a syndrome of depersonalization, emotional exhaustion, and low personal accomplishment. Little is known about burnout in physicians. Our objective was to determine the prevalence of burnout among anesthetists and intensive care physicians, and associations between burnout and personal, as well as professional, characteristics.

Prognostic factors of atrial fibrillation following coronary artery bypass graft surgery.

Objective: Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery. To prevent this complication, routine pharmacological prophylactic drugs could be administered. Our study aimed to analyze the various perioperative factors associated with the development of POAF after coronary artery bypass graft (CABG) surgery.

Impact of a Cognitive Behavioral Intervention on Health-Related Quality of Life and General Heart Rate Variability in Patients Following Cardiac Surgery: An Effectiveness Study.

Background: Although there is evidence supporting the efficacy of cognitive-behavioral therapy (CBT) in decreasing psychologic symptoms and improving health-related quality of life in patients who have undergone coronary artery bypass graft surgery, the effectiveness of these interventions in usual health care practice, and their effect on general heart rate variability (HRV), has not been tested.

Objective: This study investigated the effectiveness of CBT in improving health-related quality of life and HRV in patients with postcardiac surgery.

Methods: However, 2 months following surgery, 150 patients were assigned sequentially to a CBT group that received the intervention for 9 months or a comparison group that received usual care.

Comparison of results of endovascular stenting and bypass grafting for TransAtlantic Inter-Society (TASC II) type B, C and D iliac occlusive disease.

Introduction: The priority use of endovascular techniques in the management of aortoiliac occlusive disease has increased in the last decade. The aim of the present article is to report 1- and 2-year results of iliac artery stenting (IAS) and aortoiliac grafting in the management of patients with TASC II type B, C and D iliac lesions and chronic limb ischaemia.

Material And Methods: In this prospective, non-randomised, one-centre clinical study, iliac artery stents and vascular grafts used for the treatment of patients with symptomatic lesions in the iliac artery were evaluated.

Do age, diabetes and left ventricular function affect the outcomes of ischemic mitral valve repair?

Introduction: It is well documented that older age, chronic concomitant diseases (such as diabetes mellitus, chronic obstructive lung disease, etc.), and poor left ventricular function can increase the postoperative complication rate and worsen the general outcomes of coronary artery bypass (CABG) and concomitant repair of ischemic mitral regurgitation (MR).

Material And Methods: Retrospective data of 394 patients after CABG and mitral valve (MV) repair (mainly annuloplasty) were analyzed.

Prognostic value of myocardial perfusion abnormalities for long-term prognosis in patients after coronary artery bypass grafting.

Aims: The objective was to evaluate the prognostic value of exercise myocardial perfusion scintigraphy (MPS) in patients who underwent coronary artery bypass grafting (CABG).

Subjects And Methods: A retrospective, one-center study of 361 patients with multivessel coronary artery disease was carried out. All the patients underwent MPS after CABG due to worsened health status.

A case-control study of readmission to the intensive care unit after cardiac surgery.

Background: The aim of this study was to identify predictors of repeated admission to the intensive care unit (ICU) of patients who underwent cardiac surgery procedures.

Material/methods: This retrospective study analyzed 169 patients who underwent isolated coronary artery bypass grafting (CABG) between January 2009 and December 2010. The case group contained 54 patients who were readmitted to the ICU during the same hospitalization and the control group comprised 115 randomly selected patients.

Burnout among Lithuanian cardiac surgeons and cardiac anesthesiologists.

Objective: The aim of this study was to determine the prevalence of burnout among Lithuanian cardiac surgeons and cardiac anesthesiologists, and associations between burnout and the personal and professional characteristics of physicians.

Material And Methods: A total of 29 cardiac surgeons and 30 cardiac anesthesiologists employed in Vilnius and Kaunas university hospitals as well as in Klaipėda Hospital were surveyed. Data on personal characteristics (age, gender, marital status, number of children, sleeping hours, and addictions), professional characteristics (years in practice, work character, work profile, and workload), career satisfaction, and symptoms of depression were collected by using an anonymous questionnaire.

Simultaneous nephrectomy and coronary artery bypass grafting through extended sternotomy.

Background: The advances in surgical techniques, resuscitation and anesthesiology support over the last years have allowed simultaneous thoracic and abdominal operations to be made for cancer and concomitant severe heart vessel disease relieving the patient from several diseases simultaneously and achieving long lasting remission or cure.

Clinical Case: A simultaneous nephrectomy and coronary artery bypass grafting procedure through extended sternotomy is reported. A 63-year-old man with severe coronary artery disease was found to have renal carcinoma.

Depression predicts perioperative outcomes following coronary artery bypass graft surgery.

Objectives: To assess preoperative depression in middle-aged men undergoing coronary artery bypass graft surgery (CABG) and to determine if depression is related to perioperative outcomes.

Design: One hundred and nine middle-aged male patients were randomly selected and assessed for depression one day before CABG using the Symptom Checklist-90 Revised (SCL-90R). Perioperative outcomes were: (1) postoperative length of hospital stay, (2) the presence of any early complications (at intensive care unit), and (3) the presence of any late complications (at cardiac surgery unit).

Perioperative use of metformin in cardiac surgery.

Metformin is an oral antidiabetic agent, used to reduce blood glucose concentration in patients with non-insulin-dependent diabetes mellitus. Metformin was approved in Europe in 1957, and it is used for the treatment of non-insulin-dependent diabetes mellitus for more than 50 years. One of the most serious complications of the treatment with this drug is metformin-induced lactic acidosis.

[Late results of coronary revascularization with saphenous vein and internal thoracic artery grafts].

Objective: To evaluate the patency of saphenous vein and internal thoracic artery grafts by coronary system using angiographies performed in symptomatic patients after coronary artery bypass grafting.

Material And Methods: From 1999 to 2006, 685 patients (mean age, 59.1+/-11.

[Aortic root surgery: early postoperative results of different surgical techniques].

Unlabelled: The aim of the study was to evaluate early postoperative results of different surgical techniques of aortic root surgery.

Material And Methods: Between January 2004 and November 2007, a cohort of 83 patients underwent aortic root surgery in the Heart Center, Hospital of Kaunas University of Medicine. Patients were divided into three groups: Group 1 (18 patients) - reimplantation of the aortic valve within a vascular graft (David operation), Group 2 (48 patients) - replacement of the ascending aorta and aortic valve using a valved conduit (Bentall de Bono operation), and Group 3 (17 patients) - biological aortic root replacement.

[Surgical treatment of acute type A aortic dissection].

Unlabelled: The objective of this study was to evaluate the short-term results of surgical treatment in patients with acute aortic dissection.

Patients And Methods: A retrospective analysis of 38 patients with acute type A aortic dissection who were surgically treated at the Clinic of Cardiac, Thoracic, and Vascular Surgery, Hospital of Kaunas University of Medicine, from January 2004 to December 2007 was conducted. The diagnosis of aortic dissection was confirmed by employing special techniques.

Matrix metalloproteinase-3 gene polymorphism and dilatative pathology of ascending thoracic aorta.

Matrix metalloproteinase-3 (MMP-3) degrades extracellular matrix and may lead to development of dilatative pathology of ascending thoracic aorta. Expression of MMP-3 depends upon the 5A/6A polymorphism in the promoter region. An increased number of 5A alleles leads to high expression of MMP-3.

[Bleeding after cardiac surgery: risk factors, frequency, and outcomes].

Unlabelled: According to the data from different cardiac surgery centers, the incidence of urgent repetitive resternotomy for bleeding after cardiac on-pump operations varies from 2 to 5%. The aim of the study was to determinate the risk factors influencing resternotomy after cardiac surgery, features of early postoperative period, and outcomes.

Material And Methods: Altogether, 37 consecutive patients undergoing urgent resternotomy due to bleeding early after cardiac surgery were analyzed retrospectively.

[Coronary reoperations: recurrence of angina and clinical outcome].

Objective: To evaluate the features of coronary artery bypass reoperations and to reduce the influence of the factors affecting postoperative morbidity and mortality.

Material And Methods: The records of 53 consecutive patients (88.7% of men, 11.

Assessment of validity for EuroSCORE risk stratification system.

Unlabelled: Prognostic scoring helps doctors, patients and their families to weigh the risks and benefits of medical care and clarifies their expectations.

Objective: We aimed to analyze the risk stratification performance of the EuroSCORE system because of its common use in Lithuania.

Design: EuroSCORE performance is assessed in terms of sensitivity, specificity, accuracy and area under the receiver operating characteristic (ROC) curve (AUC).

[Abnormal gastrointestinal findings in patients with coronary disease revealed by endoscopy before cardiac surgery].

Objectives: To assess incidence of different abnormal gastrointestinal changes revealed by endoscopy before cardiac surgery in different female and male age groups and to establish criteria for carrying out preventive endoscopy in patients with coronary disease.

Material And Methods: Retrospective analysis was performed on 3847 patients (63.2% and 36.

Assessing the validity of cardiac surgery risk stratification systems for CABG patients in a single center.

Background: Most cardiac surgery risk stratification systems were primarily designed using patient-related factors to predict mortality and postoperative morbidity. Relative mortality rates are higher at cardiac surgery centers which perform surgery on elderly patients. Our aim was to assess the validity of risk stratification systems for our regional population.

[Myocardial revascularization and mitral insufficiency correction in case of acute myocardial infarction].

Unlabelled: The aim of our study was to evaluate patients survival, changes of functional status after repair of ischemic mitral insufficiency and coronary artery bypass grafting in acute period of myocardial infarction. In the Clinic of Cardiosurgery of Kaunas University of Medicine (since January 2001 till July 2003) 82 patients with acute myocardial infarction underwent surgery. Patients were operated on the 1(st)-21(st) day after myocardial infarction.

[Prediction and evaluation of surgical treatment results of severe ischemic heart disease].

Objectives: To estimate myocardial perfusion in patients with severe coronary artery disease performing before and early after single-photon emission computed tomography coronary artery bypass grafting; to predict results of complete myocardial revascularisation by preoperative perfusion data.

Material And Methods: Ten patients with stable coronary artery disease and resting left ventricular wall motion abnormalities (mean ejection fraction 31.8+/-6.