Ground glass opacity: can we correlate radiological and histological features to plan clinical decision making?

Background: The spectrum of ground glass opacity (GGO) is a diagnostic and clinical management quandary. The role of computed tomographic scans in detecting malignant GGO has inter-observer variability. Pure GGO have been traditionally thought to be predominantly benign in nature and has long volume doubling times.

Meta-Analysis of Mitral Valve Repair Versus Replacement for Rheumatic Mitral Valve Disease.

Background: Rheumatic heart disease remains one of the leading causes of heart valve disease worldwide despite being a preventable condition. Mitral valve repair is superior to replacement in severe degenerative mitral valve disease, however its role in rheumatic valve disease remains controversial. This meta-analysis compared mitral valve repair and replacement in rheumatic heart disease.

Surgery for Type A Aortic Dissection: 14-Year Contemporary Cohort Study.

Background: Type A aortic dissection is a fatal condition warranting emergency surgery to prevent complications and death. We reviewed the contemporary trends, characteristics, outcomes and predictors of this operation at our centre over a 14-year period.

Methods: Consecutive patients undergoing type A aortic dissection surgery at Auckland City Hospital during March 2003-March 2017 were studied, and relevant characteristics and outcomes collected prospectively for statistical analyses.

Characteristics and Outcomes of Patients With Severe Aortic Stenosis Discussed by the Multidisciplinary "Heart Team" According to Treatment Allocation.

Background: Transcatheter aortic valve implantation (TAVI) is an alternative and effective contemporary intervention to surgical aortic valve replacement (SAVR) for patients with severe aortic valve disease at increased surgical risk. Guidelines recommend a multidisciplinary "Heart Team" (MHT) review of patients considered for a TAVI procedure, but this has been little studied. We reviewed the characteristics, treatments and outcomes of such patients reviewed by the MHT at our centre.

Long-Term Outcomes in Patients Undergoing Consecutive Bioprosthetic Aortic Valve Replacement.

Background And Aim Of The Study: Worldwide, there is increased use of bioprosthetic valves in the aortic position. Part of this increase has been patient-driven for quality of life reasons. More recently, bioprosthetic valves have been chosen by progressively younger patients, with a strategy of performing a valve-in-valve TAVI if the prosthesis should wear out.

Transcatheter Aortic Valve Implantation In Patients With a Large Aortic Annulus.

Background: As the indications for transcatheter aortic valve implantation (TAVI) have expanded, so to have the demands on interventionists to allow as many patients to access this technology as possible.

Methods: We retrospectively reviewed our TAVI database for patients who had received a 29mm SAPIEN 3 valve despite having an annular area greater than the manufacturer-recommended upper limit of 683mm, as determined by multi-detector computed tomography (MDCT). Procedural and inpatient outcome data were collected.

Performance of contemporary surgical risk scores for mitral valve surgery.

Background: Risk stratification for mitral valve repair or replacement (MVR) is important in the decision-making for treating several mitral valve disease but is rarely studied. We compared the prognostic utility of EuroSCORE, EuroSCORE II, and Society of Thoracic Surgeons (STS) Score for MVR.

Methods: The three scores were retrospectively calculated for consecutive patients undergoing isolated MVR at Auckland City Hospital during 2005-2012 and their discrimination and calibration for mortality and morbidities assessed.

Relationship Between Diabetic Variables and Outcomes After Coronary Artery Bypass Grafting in Diabetic Patients.

Background: Nearly half of the patients undergoing coronary artery bypass grafting (CABG) have diabetes. There is mixed data as to whether preoperative (haemoglobin A1c{HbA1c}) and/or perioperative diabetes control is associated with mortality and morbidity after CABG. We reviewed the characteristics and outcomes of diabetic patients undergoing CABG with a focus on HbA1c, perioperative glucose levels and diabetic treatment regimens.

Aortic Valve Replacement With or Without Concurrent Coronary Artery Bypass Grafting in Octogenarians: Eight-Year Cohort Study.

Background: With the introduction of transcatheter aortic valve implantation (TAVI), there is increasing interest in evaluating outcomes of aortic valve replacement (AVR) with or without (+/-) concurrent coronary artery bypass grafting (CABG) particularly in high-risk patients. We reviewed the characteristics and outcomes of octogenarians undergoing isolated AVR and AVR+CABG.

Methods: All patients 80 years of age or older undergoing AVR+/-CABG at Auckland City Hospital during 2005-2012 were included, and their characteristics and outcomes analysed.

Comparing Performance of Risk Scores for Combined Aortic Valve Replacement and Coronary Bypass Grafting Surgery.

Background: Aortic valve replacement (AVR) and/or coronary artery bypass grafting (CABG) make up the majority of cardiac surgery with increasing demand as the population ages. Accuracy of risk stratification is important, in predicting adverse outcomes and selecting modality of intervention, but has been rarely studied for the combined AVR+CABG operation. We compared the prognostic utility of EuroSCORE, EuroSCORE II and Society of Thoracic Surgeons' (STS) Score for AVR+CABG.

Early outcome of patients undergoing transcatheter aortic valve implantation (TAVI): The Auckland City Hospital experience 2011-2015.

Aims: Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement (AVR) in high-risk patients. We report the initial TAVI experience at Auckland City Hospital.

Methods: The records of patients undergoing TAVI between 2011 and 2015 at Auckland City Hospital were reviewed.

Preoperative atrial fibrillation predicts mortality and morbidity after aortic valve replacement.

Objectives: Atrial fibrillation (AF) is the commonest cardiac arrhythmia, becoming increasingly prevalent as the population ages. There is conflicting information around whether AF is associated with adverse outcomes after aortic valve replacement (AVR) from the few studies that have investigated this. We compared the characteristics and outcomes of patients undergoing AVR with their history of AF.

Comparison of four risk scores for contemporary isolated coronary artery bypass grafting.

Background: EuroSCORE and the Society of Thoracic Surgeons' (STS) Score have been the most widely used risk scores for cardiac surgery. The revised EuroSCORE II and the AusSCORE, based on an Australasian population, were recently developed. We compared the prognostic utility of these four scores for mortality as well as morbidity in patients undergoing isolated coronary artery bypass grafting (CABG).

Higher mortality in women undergoing coronary artery bypass grafting.

Aims: While men have higher rates of cardiovascular disease, several studies report women having higher mortality after cardiac surgery, reasons for which are unclear. We compared characteristics and outcomes of coronary artery bypass grafting (CABG) by sex.

Methods: All patients undergoing isolated CABG during July 2010-June 2012 were grouped by sex for retrospective analyses.

Diagnosis of MI after CABG with high-sensitivity troponin T and new ECG or echocardiogram changes: relationship with mortality and validation of the universal definition of MI.

Aims: Criteria for diagnosing myocardial infarction (MI) after coronary artery bypass grafting (CABG) are controversial. Uncertainties remain around the optimal threshold for biomarker elevation and the need for associated criteria. There are no studies of high-sensitivity troponin (hs-TnT) after CABG.

Lack of relationship between obesity and mortality or morbidity after coronary artery bypass grafting.

Aims: Obesity has significant adverse effects on cardiovascular health. Conflicting results have been reported regarding relationships between body mass index (BMI) and outcomes after coronary artery bypass grafting (CABG). We compared outcomes of CABG patients by BMI categories.

Isolated aortic valve replacement in octogenarians before and after the introduction of trans-catheter aortic valve implantation.

Background: Trans-catheter aortic valve implantation (TAVI) became available at Auckland City Hospital in 2011 for patients with severe aortic stenosis in whom surgical aortic valve replacement (AVR) was deemed at high risk. We assessed whether introduction of TAVI affected the characteristics and outcomes of octogenarians undergoing AVR.

Methods: Isolated AVR performed in patients ≥80 years of age during 2008-2012 were divided into two groups, pre- and post-TAVI introduction, for analyses.

Maori have worse outcomes after coronary artery bypass grafting than Europeans in New Zealand.

Aims: Disparities for Maori exist in New Zealand for cardiovascular risk factors, events and access to revascularisation. We compared characteristics and outcomes of coronary artery bypass grafting (CABG) between Maori and Europeans in New Zealand.

Methods: Patients undergoing isolated CABG at Auckland City Hospital from July 2010-June 2012 were retrospectively analysed.

Thoracoscopic lobectomy for synchronous intralobar pulmonary sequestration and lung cancer.

Bronchopulmonary sequestration is a rare congenital pulmonary malformation for which surgical resection is recommended, and several reports have described successful resection by video-assisted thoracoscopic surgery. Coexistence of sequestration with lung malignancy is extremely rare. We report the first case of thoracoscopic resection of synchronous intralobar pulmonary sequestration and non-small cell lung cancer.

Systemic hyperkalemia for cardiac arrest on CPB with or without cross-clamping.

Myocardial protection may be compromised in situations with a patent left internal mammary artery (LIMA) graft or an unclamped aorta. Because of collateral coronary blood flow, electrical arrest may not be achieved. Currently, hypothermia is often used to augment myocardial protection and provide cardiac arrest in these situations.