Safety of prolonged bilateral antegrade cerebral perfusion in aortic arch surgery with moderate hypothermia.

Objectives: This study investigates the impact of bilateral antegrade cerebral perfusion (ACP) time on outcomes in aortic arch surgery.

Methods: In total, 961 patients underwent either hemiarch (n = 385) or total arch replacement (n = 576) with bilateral ACP and moderate hypothermia management between 2006 and 2020 across 2 aortic centres. ACP time was categorized into 4 groups (≤30 min: n = 169, 30-60 min: n = 298, 60-90 min: n = 261, >90 min: n = 233).

Importance of surgeon's experience in practicing valve-sparing aortic root replacement.

Background: Valve-sparing root replacement (VSRR) requires a unique skill set. This study aimed to examine the influence of surgeon's procedural volume on outcomes of VSRR.

Methods: This retrospective study included 1697 patients from 2 large, high-volume aortic centers who underwent aortic root replacement (ARR) between 2004 and 2021 and were potentially eligible for VSRR.

Relationship between indexed surgery and postcardiotomy extracorporeal life support outcomes.

Objectives: Veno-arterial extracorporeal life support (V-A ECLS) is increasingly being utilized for postcardiotomy shock (PCS), though data describing the relationship between type of indexed operation and outcomes are limited. This study compared V-A ECLS outcomes across four major cardiovascular surgical procedures.

Methods: This was a single-center retrospective study of patients who required V-A ECLS for PCS between 2015 and 2022.

Adverse Technical Events During Aortic Root Replacement.

Background: Although adverse technical events during aortic root replacement (ARR) are not uncommon and are extremely challenging, there is scant literature to help surgeons prepare for such situations. We describe our experience of outstanding technical events during ARR.

Methods: This is a retrospective study of 830 consecutive ARRs at a single center from 2012 to 2022.

Blood flow assessment technology in aortic surgery: a narrative review.

Background And Objective: Blood flow assessment is an emerging technique that allows for assessment of hemodynamics in the heart and blood vessels. Recent advances in cardiovascular imaging technologies have made it possible for this technique to be more accessible to clinicians and researchers. Blood flow assessment typically refers to two techniques: measurement-based flow visualization using echocardiography or four-dimensional flow magnetic resonance imaging (4D flow MRI), and computer-based flow simulation based on computational fluid dynamics modeling.

Open, endovascular or hybrid repair of aortic arch disease: narrative review of diverse strategies with diverse options.

Objectives: The management of aortic arch disease is complex. Open surgical management continues to evolve, and the introduction of endovascular repair is revolutionizing aortic arch surgery. Although these innovative techniques have generated the opportunity for better outcomes in select patients, they have also introduced confusion and uncertainty regarding best practices.

Utility of structured follow-up imaging after aortic surgery.

Background: Although postoperative follow-up after aortic surgery is recommended by guidelines, its clinical utility is not well documented. We hypothesized that structured follow-up imaging by an aortic program would improve outcomes. We then documented radiologic findings on asymptomatic postoperative imaging.

Cardiac cavernous hemangioma with high fluorodeoxyglucose uptake on preoperative positron emission tomography/computed tomography: a case report.

Background: Reports on cardiac hemangioma detection by F-18-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) are extremely rare.

Case Presentation: Here we describe a case of a 61-year-old man with hemangioma. CT revealed a tumor with a size of 60 mm.

Side-by-side deployment of gore excluder legs at a narrow terminal aorta for endovascular aneurysm repair.

Purpose: A narrow terminal aorta is a risk factor for endograft occlusion after endovascular aneurysm repair. To minimize limb complications, we used Gore Excluder legs positioned side-by-side at the terminal aorta. We investigated the outcomes of our strategy for endovascular aneurysm repair in patients with a narrow terminal aorta.

Tricuspidization technique with reimplantation for a bicuspid aortic valve: a case report.

Background: Bicuspid aortic valve (BAV) is the most frequent congenital cardiac anomaly. We report a successful case in which the tricuspidization technique with valve-sparing aortic root replacement was used for BAV with severe aortic regurgitation.

Case Presentation: A 22-year-old man was admitted for progressively worsening aortic regurgitation due to a congenital BAV.

Coronary artery bypass grafting for coronary artery anomalies in infants and young children.

Objectives: Coronary artery bypass grafting (CABG) has been reported for coronary artery diseases in patients with Kawasaki disease and coronary artery complications after arterial switch operations for transposition of the great arteries. However, only a few studies have explored this modality for congenital coronary artery anomalies. As congenital coronary artery anomalies, particularly left coronary artery atresia and stenosis, are one of the reasons for sudden death, coronary revascularization is often required in infants and young children.

Estimating the Haemodynamic Streamline Vena Contracta as the Effective Orifice Area Measured from Reconstructed Multislice Phase-contrast MR Images for Patients with Moderately Accelerated Aortic Stenosis.

Purpose: In aortic stenosis (AS), the discrepancy between moderately accelerated flow and effective orifice area (EOA) continues to pose a challenge. We developed a method of measuring the vena contracta area as hemodynamic EOA using cardiac MRI focusing on AS patients with a moderately accelerated flow to solve the problem that AS severity can currently be determined only by echocardiography.

Methods: We investigated 40 patients with a peak transvalvular velocity > 3.

Blood flow energy loss: a predictor for the recovery of left ventricular function after bioprosthetic aortic valve replacement.

Objectives: It is difficult to estimate the improvement in left ventricular (LV) function after aortic valve replacement (AVR). The present study aimed to evaluate whether energy loss (EL) can predict the postoperative LV function after AVR.

Methods: Nine patients who underwent AVR with a bioprosthetic valve were enrolled in the present study.

Sufficient cardiac unloading by Impella 5.0 in left ventricular rupture following mitral valve replacement: a case report.

A 72-year-old woman presented with exertional dyspnea. Echocardiography revealed severe mitral valve stenosis; therefore, mitral valve replacement was performed using a bioprosthetic valve. However, left ventricular wall rupture occurred following mitral valve replacement.

Determination of the dominant arch by computational fluid dynamics analysis using computed tomography images in double aortic arch.

Computational fluid dynamics (CFD) analysis using computed tomography images can reveal the details of the blood flow in cardiovascular disease. In double aortic arch, it is difficult to assess the hemodynamics because of the strong influence of various anatomical features, such as the angle of the aortic bifurcation. In the present study, we reported that CFD analysis is a valuable method for hemodynamic assessment in patients with double aortic arch.

Prediction for future occurrence of type A aortic dissection using computational fluid dynamics.

Objectives: The actual underlying mechanisms of acute type A aortic dissection (AAAD) are not well understood. The present study aimed to elucidate the mechanism of AAAD using computational fluid dynamics (CFD) analysis.

Methods: We performed CFD analysis using patient-specific computed tomography imaging in 3 healthy control cases and 3 patients with AAAD.

Computational fluid dynamics of internal mammary artery-left anterior descending artery anastomoses.

Objectives: The aim of this study was to elucidate the remodelling of the internal mammary artery (IMA)-left anterior descending artery anastomosis and compare 2 different anastomosis techniques (end-to-side versus side-to-side) using computational fluid dynamics.

Methods: This study included 9 patients. Computed tomography (CT) angiography was performed immediately after coronary artery bypass grafting (CABG) and at 3-6 months later.

Computerized virtual surgery based on computational fluid dynamics simulation for planning coronary revascularization with aortic root replacement in adult congenital heart disease: a case report.

A 38-year-old woman presented with exertional dyspnea and chest compression. She had undergone repair of congenital supravalvular aortic stenosis at 8 years of age. Contrast-enhanced computed tomography showed re-stenosis in the ascending aorta, bilateral coronary arterial aneurysm, and a highly thickened left ventricular wall.

Delayed patch repair of a ruptured mitral subvalvular pseudoaneurysm caused by infective endocarditis: a case report.

Background: Ruptured subvalvular pseudoaneurysm is a rare but significantly fatal complication of infective endocarditis. We report a successful surgical case of ruptured subvalvular pseudoaneurysm with infective endocarditis.

Case Summary: A 46-year-old man presenting with high fever was admitted to a local hospital.