What Can We Learn from the Past by Means of Very Long-Term Follow-Up after Aortic Valve Replacement?

Background: Studies on very long-term outcomes after aortic valve replacement are sparse.

Methods: In this retrospective cohort study, long-term outcomes during 25.1 ± 2.

Extracellular matrix remodeling precedes atrial fibrillation: Results of the PREDICT-AF trial.

Background: To which extent atrial remodeling occurs before atrial fibrillation (AF) is unknown.

Objective: The PREventive left atrial appenDage resection for the predICtion of fuTure Atrial Fibrillation (PREDICT-AF) study investigated such subclinical remodeling, which may be used for risk stratification and AF prevention.

Methods: Patients (N = 150) without a history of AF with a CHADS-VASc score of ≥2 at an increased risk of developing AF were included.

Prosthesis-patient mismatch affects late survival after valve surgery for severe aortic stenosis.

Background: The effect of prosthesis-patient mismatch (PPM) on late survival after aortic valve replacement (AVR) in patient with symptomatic severe aortic stenosis (AS) remains unclear. Also, late follow-up in previous studies is confined to only one decade. We aimed to determine the effect of PPM on late survival after isolated AVR for symptomatic severe AS during 25 years of follow-up.

Effect of aortic cross-clamp time on late survival after isolated aortic valve replacement.

Objectives: Longer aortic cross-clamp (ACC) time is associated with decreased early survival after cardiac surgery. Because maximum follow-up in previous studies on this subject is confined to 28 months, it is unknown whether this adverse effect is sustained far beyond this term. We aimed to determine whether longer ACC time was independently associated with decreased late survival after isolated aortic valve replacement in patients with severe aortic stenosis during 25 years of follow-up.

Capillary Leukocytes, Microaggregates, and the Response to Hypoxemia in the Microcirculation of Coronavirus Disease 2019 Patients.

Objectives: In this study, we hypothesized that coronavirus disease 2019 patients exhibit sublingual microcirculatory alterations caused by inflammation, coagulopathy, and hypoxemia.

Design: Multicenter case-controlled study.

Setting: Two ICUs in The Netherlands and one in Switzerland.

Continuous postoperative pericardial flushing method versus standard care for wound drainage after adult cardiac surgery: A randomized controlled trial.

Background: Excessive bleeding, incomplete wound drainage, and subsequent accumulation of blood and clots in the pericardium have been associated with a broad spectrum of bleeding-related complications after cardiac surgery. We developed and studied the continuous postoperative pericardial flushing (CPPF) method to improve wound drainage and reduce blood loss and bleeding-related complications.

Methods: We conducted a single-center, open-label, ITT, randomized controlled trial at the Academic Medical Center Amstserdam.

PREventive left atrial appenDage resection for the predICtion of fuTure atrial fibrillation: design of the PREDICT AF study.

Background: Atrial fibrillation is the most common cardiac arrhythmia, posing a heavy burden on patients' wellbeing and healthcare budgets. Patients undergoing cardiac surgery are at risk of developing postoperative atrial fibrillation (POAF), new-onset atrial fibrillation and subsequent atrial fibrillation-related complications, including stroke. Sufficient clinical identification of patients at risk fails while the pathological substrate changes that precede atrial fibrillation remain unknown.

Thoracoscopic vs. catheter ablation for atrial fibrillation: long-term follow-up of the FAST randomized trial.

Aims: Our objectives were to compare effectiveness and long-term prognosis after epicardial thoracoscopic atrial fibrillation (AF) ablation vs. endocardial catheter ablation, in patients with prior failed catheter ablation or high risk of failure.

Methods And Results: Patients were randomized to thoracoscopic or catheter ablation, consisting of pulmonary vein isolation with optional additional lines (2007-2010).

When Not to Go SOLO? Contraindications Based on Implant Experience.

Background And Aim Of The Study: Because of the design and specific implantation technique of the stentless Freedom SOLO bioprosthesis, patient selection is crucial. The aim of the study was to discuss the contraindications to this prosthesis based on the authors' implant experience.

Methods: Between April 2005 and February 2015, one surgeon at the authors' center performed 292 aortic valve replacements using a bioprosthesis, with the initial intention of implanting a SOLO valve in every patient.

Stentless vs Stented Aortic Valve Bioprostheses in the Small Aortic Root.

In patients with a small aortic root undergoing aortic valve replacement (AVR), the Freedom SOLO bioprosthesis may be the ideal prosthesis because of its stentless design and supra-annular implantation. This study investigated if the stentless Freedom SOLO has an advantage when compared with a stented bioprosthesis in patients with a small aortic root. From April 2005-July 2014, 269 consecutive patients underwent AVR with either a Freedom SOLO (n = 76) or Mitroflow (n = 193) bioprosthesis size 19mm or 21mm, respectively.

Management of large mediastinal masses: surgical and anesthesiological considerations.

Large mediastinal masses are rare, and encompass a wide variety of diseases. Regardless of the diagnosis, all large mediastinal masses may cause compression or invasion of vital structures, resulting in respiratory insufficiency or hemodynamic decompensation. Detailed preoperative preparation is a prerequisite for favorable surgical outcomes and should include preoperative multimodality imaging, with emphasis on vascular anatomy and invasive characteristics of the tumor.

Midterm Follow-Up of the Stentless Freedom Solo Bioprosthesis in 350 Patients.

Background: The stentless Freedom Solo aortic bioprosthesis is implanted supraannularly using one running suture line in the sinuses of Valsalva. We report our 9-year experience with this bioprosthesis.

Methods: From April 2005 to July 2014, 350 consecutive patients at our institution underwent aortic valve replacement with the Freedom Solo bioprosthesis.

Atrial fibrosis and conduction slowing in the left atrial appendage of patients undergoing thoracoscopic surgical pulmonary vein isolation for atrial fibrillation.

Background: Atrial fibrosis is an important component of the arrhythmogenic substrate in patients with atrial fibrillation (AF). We studied the effect of interstitial fibrosis on conduction velocity (CV) in the left atrial appendage of patients with AF.

Methods And Results: Thirty-five left atrial appendages were obtained during AF surgery.

Ectopic pancreas in a giant mediastinal cyst.

Ectopic pancreas located in the mediastium is an extremely rare anomaly. We present a case of an ectopic pancreas located in a giant mediastinal cyst in an 18-year-old man. He presented with symptoms of dyspnea due to external compression of the cyst on the left main bronchus.

Internal mammary artery pedicle: a solution for prophylactic flap coverage in high-risk trans-sternal thoracic surgery.

Prophylactic use of vascularized flaps to buttress and reinforce bronchial or oesophageal closure is nowadays the preferred approach in high-risk cases, especially for extended resections with tracheobronchial reconstructions or after neoadjuvant chemoradiotherapy. However, the majority of these options and techniques are described for an approach through a thoracotomy. Due to anatomical restrictions, these options are less suitable when a trans-sternal approach is used.

Impact of different surgical strategies on perioperative protein S100β release in elderly patients undergoing coronary artery bypass grafting.

Objective: This study was designed to compare neurological injury-associated protein S100β release during three different treatment modalities, minimized closed circuit coronary artery bypass grafting (CABG) (MCABG), off-pump CABG (OPCAB), and conventional CABG (CCABG), comprising high-volume prime and cold crystalloid cardioplegia. Our working hypothesis was that fluid restriction as provided by MCABG may decrease neurological injury-associated protein S100β release.

Methods: In this prospective trial, in a tertiary center, 30 surgical patients (aged >70 years, 25 men and 5 women) undergoing first-time elective CABG were enrolled.

Konno procedure for prosthetic aortic valve endocarditis: 34-year follow-up.

A 34-year follow-up is described after a Konno aortoventriculoplasty to correct a restricted aortic annulus and a recurrent aortic prosthetic valve endocarditis with subannular and interventricular abscesses.

Navigating the mini-maze: systematic review of the first results and progress of minimally-invasive surgery in the treatment of atrial fibrillation.

Background: In this paper we present a systematic literature overview and analysis of the first results and progress made with minimally-invasive surgery using RF energy in the treatment of AF. The minimally-invasive treatment for atrial fibrillation (AF) tries to combine the success rate of surgical treatment with a less invasive approach to surgery. It has the additional potential advantage of ganglion plexus (GP) ablation and left atrial appendage exclusion.

Epicardial confirmation of conduction block during thoracoscopic surgery for atrial fibrillation--a hybrid surgical-electrophysiological approach.

Background: Totally thoracoscopic epicardial pulmonary vein ablation is an emerging treatment of atrial fibrillation (AF). A hybrid surgical-electrophysiological procedure with periprocedural confirmation of conduction block might reduce recurrences of AF or atrial tachycardia and improve surgical success.

Methods And Results: We report our joint surgical-electrophysiological approach for confirmation of conduction block across pulmonary vein ablation lines and those compartmentalizing the left atrium during totally thoracoscopic surgery.