American Journal of Cardiovascular and Thoracic Surgery最新文献

{"title":"The Postoperative Cardiac Function and Complications after Mitral Valve Replacement with Complete Preservation of Subvalvular Apparatus versus Posterior Subvalvular: A Meta Analysis","authors":"Zhou Ai-ming, Zeng Shun, Xiao Ruihan, G. Ke, Li Daxing","doi":"10.15226/2573-864x/4/2/00159","DOIUrl":"https://doi.org/10.15226/2573-864x/4/2/00159","url":null,"abstract":"Results: 31 cases of researches were selected, including 17 cases of case-control researches, 11 cases of cohort researches, and 3 cases of randomized controlled trials, with a total of 3468 patients. Left ventricular end diastolic dimension: 6 months after operation, 12 months after operation; Left ventricular end systolic dimension: 6 months after operation, 12 months after operation; Left ventricular ejection fraction: 6 months after operation, 12 months after operation; Early mortality of postoperative, left ventricular rupture, the differences of above outcome indicators between the two groups have statistical significance.","PeriodicalId":362247,"journal":{"name":"American Journal of Cardiovascular and Thoracic Surgery","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116186490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unusual Presentation of Cardiac Myxoma; a Case Report and Review of Literature","authors":"Mohamed Abdelwahab Alassal, Nasser Altargami, H. Ahmed, Saif Ibrahim, A. Nemlander, Mohamed Aldahmashi, A. Elsharkawy, Ibrahim Altaj, A. Osman, Y. Morsi","doi":"10.15226/2573-864x/4/2/00158","DOIUrl":"https://doi.org/10.15226/2573-864x/4/2/00158","url":null,"abstract":"MR: Mitral Regurgitation; CHF: Congestive Heart Failure; DM II: Diabetes Mellitus Type 2; HTN: Hypertension; COPD: Chornic Obstructive Pulmonary Disease; TTE: Transthoracic Echocardiography; TEE: Transesophageal Echocardiography; EF : Ejection Fraction; DD: Diastolic Dysfunction; IABP : IntraAortic Ballon Pump; MV: Mitral Valve; OR: Operative Room; IAS: Inter-Atrial Septum; POD: Pos-Operative Day; NYHA: New York Heart Association Classification; LA : Left Atrium; RCA: Right Coronary Artery; CABG: Coronary Artery Bypass Graft; AF: Atrial Fibrillation; TTE : Trans-Thoracic Echocardiography; TEE: TransEsophageal Echocardiography; CT: Computed Tomography; MRI : Magnetic Resonance Imaging; F-FDG PET: F-Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET)","PeriodicalId":362247,"journal":{"name":"American Journal of Cardiovascular and Thoracic Surgery","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128593109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anomalous Aortic Origin of Coronary Arteries: Case Report of Unroofing With Coronary Re-Implantation Technique","authors":"C. Riera-Kinkel, David Roldan-Morales, M. Rosas-Peralta, G. Borrayo-Sánchez, A. Ramirez-Castañeda, L. Moreno-Ruiz, Yatsil Necoechea-Osuna, Erick Ramírez-Árias, A. Lopez-Gutierrez, Jaime Salgado-Vázquez, Sebastian Inzunza-Saldana, H. Márquez-González, Lucelli Yanez-Gutierrrez, G. Saturno-Chiu","doi":"10.15226/2573-864x/4/2/00157","DOIUrl":"https://doi.org/10.15226/2573-864x/4/2/00157","url":null,"abstract":"Anomalous Aortic Origin of Coronary Arteries is a coronary disorder uncommon but occasionally lethal. The possibility of sudden death is the indication for surgery. We inform a case of a patient with anomalous aortic origin of right coronary artery which emerged from left sinus of Valsalva, catalogued as type III. He was previously treated by CBAG, however the bypass was occluded and therefore he was sent to our service. We made a correction using the unroofing technique. Unroofing technique is a reproducible technique with good results, ultimately solving the problem. The outcome was excellent, 6 months later he was reported asymptomatic.","PeriodicalId":362247,"journal":{"name":"American Journal of Cardiovascular and Thoracic Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129500003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Malperfusion after Central Repair for Acute Aortic Dissection","authors":"T. Hirose, N. Tabayashi, T. Abe, Y. Hayata, Keigo Yamashita, Y. Tamura, S. Taniguchi","doi":"10.15226/2573-864x/4/1/00156","DOIUrl":"https://doi.org/10.15226/2573-864x/4/1/00156","url":null,"abstract":"A 54-year-old man was hospitalized with sudden occurrence of chest and back pains. Computed tomography revealed a thrombus acute type A aortic dissection. Emergency prosthetic graft replacement of the ascending aorta was performed. After completion of the central repair, intraoperative transesophageal echocardiography showed significant narrowing of the true lumen due to the expansion of the false lumen at the level of the descending thoracic aorta. We successfully performed surgical aortic fenestration at the level of the descending thoracic aorta after the reestablishment of cardiopulmonary bypass. Key words: malperfusion; acute type A aortic dissection; surgical fenestration","PeriodicalId":362247,"journal":{"name":"American Journal of Cardiovascular and Thoracic Surgery","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117011636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventricular Septal Rupture Complicating Acute Myocardial Infarction: Interesting Case and Review","authors":"Selene Janette Salgado-Pastor, Erick Ramírez-Árias, Tomás de Jesús Martínez-Jaimes, José Luis Argüelles-Reynoso, Erick B. Trujillo-Virgen, Leonel Martínez-Ramírez, Joel Álvarez Peña, Juan Miguel Ángel Uitz-Novelo, Nelly Rojas-Jácome, Jaime Salgado-Vázquez, C. Riera-Kinkel, M. Rosas-Peralta, G. Borrayo-Sánchez","doi":"10.15226/2573-864x/4/1/00154","DOIUrl":"https://doi.org/10.15226/2573-864x/4/1/00154","url":null,"abstract":"Man of 72 years old, smoking, who presented acute myocardial infarction with ST-segment elevation (STEMI) localized in anterior wall (Figure 1) and included into the code infarction protocol at emergency room of cardiology hospital in Mexico City-IMSS. The patient was successful re-perfused by percutaneous coronary intervention of left anterior descending artery, documenting several other non-critical coronary artery disease. During its evolution in the first twelve hours, it was identified an apical ventricular septal rupture documented by echocardiogram. (Figure 2) Medical management was implemented. After stabilization patient ask voluntary discharge of hospital, 10 days later he come back due to severe heart failure. He was stabilized again and submitted to surgical reparation (Figure 3 and Figure 4) later and his heart failure was successfully resolved (Figure 4) and he was discharged in an excellent condition. We present a case and review of the literature as well as the position of management of this group of patients in the Hospital’s cardiology of the National Medical Center SXXI, IMSS-México, since it is currently still controversy.","PeriodicalId":362247,"journal":{"name":"American Journal of Cardiovascular and Thoracic Surgery","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133130724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Artery Occlusion; the Night Mare Post AVR","authors":"Marwan Sadek, Muhammed Tammim, M. Mahmoud, A. Azmy, M. Ragab, Yasser Elkady, Mohamed Abubakr Alassal","doi":"10.15226/2573-864x/4/1/00153","DOIUrl":"https://doi.org/10.15226/2573-864x/4/1/00153","url":null,"abstract":"Iatrogenic intra operative acute coronary artery obstruction is a rare and potentially fatal complication of valve surgery [1]. Sudden coronary spasm, embolization of calcium plaque, and surgical factors can induce acute coronary obstruction after AVR [2]. Initially described in 1967, following aortic valve surgery, it is now recognized that patients who develop myocardial ischemia postoperatively following valve surgery, should be investigated deeply to exclude this rare phenomenon as the cause of myocardial dysfunction [3]. Although most reports highlight the potential for coronary artery stenosis in the months following valve surgery there are few documented cases of intraoperative coronary embolism causing circulatory collapse and requiring prompt treatment [5]. After Ethical Committee approval and after written consent taken from the patient family for publication, we present a case of acute intra operative left main coronary artery obstruction after Aortic Valve Replacement (AVR) and its immediate management.","PeriodicalId":362247,"journal":{"name":"American Journal of Cardiovascular and Thoracic Surgery","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132344263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Risk Stratification Methods for Congenital Heart Disease Surgery in Mexico: RACHS-1 and Aristotle Scales","authors":"Luis Manuel Zúñiga-Alanís, Alberto Ramírez Castañeda, M. Peralta, G. B. Sánchez, E. Almeida-Gutiérrez, Adriana Pérez Rubio, Sesbania Bocanegra Flores, Edgar Hernández Rendón, D. R. Morales, H. M. González, Lucelli Yáñez Gutiérrez, Diana López Gallegos, Alejandro Jiménez Hernández, L. M. Concebida, Jesús Hernández Tizcareño, Alpha Larissa Nava Oliva, Javier Figueroa Solano, L. Fernández, Carmen Yandira Vianna Da-Silva Rodriguez, L. Costabile, Sebastian Izunza Saldaña, Antonio Barragan Zamora, Cecilio Cruz Gaona, Carlos Riera Kinkel","doi":"10.15226/2573-864x/4/1/00152","DOIUrl":"https://doi.org/10.15226/2573-864x/4/1/00152","url":null,"abstract":"Background: Currently, it has two methods of risk stratification in Congenital Heart surgery: Risk Adjustment in Congenital Heart Surgery(RACHS-1) and the complex integral Aristotelian (Aristotle). Although they have been tested in different countries, they have not been validated in hospitals of Mexico. Objectives: Validating both methods at 3rd Level Hospital (Cardiology Hospital CMN-SXXI, IMSS, Mexico City) for patients submitted to cardiac surgery due to congenital heart defects, between January 2015 and December 2016. Methods: A retrospective study of patients in the Hospital’s cardiology of the National Medical Center C-XXI, IMSS-Mexico, of any age and gender undergoing surgery for congenital heart disease elective or emergency with clinical record is prepared full. For studying validity, internal consistency, calibration, capacity for discrimination and morbidity and mortality between the risk levels were analyzed. Results: We included 201 patients with complete data. Both study scales in our study were statistically significant in the Logistic regression analysis (p = 0.001 and p = 0.000, respectively). Calibration test show to be non-significant for both scales (X2 of Hosmer-Lemeshow of 0.357 and 3.235 respectively). The areas under the ROC curve were 0.770 and 0.806, respectively, suggesting a good discrimination. The observed mortality was (6.46%). Nevertheless, each segment of the scales exceeded the expected in mortality according to the internationally accepted parameters for RACHS-1. Conclusion: We conclude that it is valid to use RACHS-1 and basic Aristotle for surgery of congenital heart disease, with a Cronbach’s alpha of 0.740. We suggested developing mechanisms to understand those variables that come out of the control of these instruments, such as the patient’s low weight and a history of reoperation. Key words: surgical risk; congenital heart disease; RACHS-1; Aristotle","PeriodicalId":362247,"journal":{"name":"American Journal of Cardiovascular and Thoracic Surgery","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128840718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EuroSCORE II Validation as a Method for Cardiac Surgery Risk Stratification in Mexico","authors":"Edgar Hernández-Rendón, Luis Manuel Zúñiga-Alaníz, M. Peralta, G. Borrayo-Sánchez, C. Murillo-Benítez, F. González-Díaz, S. Claire-Guzmán, Gloria Ortiz Betance, Alberto Ramírez Castañeda, C. Riera-Kinkel","doi":"10.15226/2573-864x/4/1/00151","DOIUrl":"https://doi.org/10.15226/2573-864x/4/1/00151","url":null,"abstract":"Objective: To Validate the EuroSCORE II as a method for cardiac surgery risk stratification in Mexican adult population. Methods: We included adult patients undergoing to cardiac surgery, in order to determine the predictive value of EuroSCORE II on morbidity and mortality risk. Continuous variables are presented as mean ± SD or median with its interquartile range as appropriate; categorical variables were described as n, % or rate. To validate the EuroSCORE II scale, the assessment was done with Hosmer- Lemeshow (HL) test. In terms of discrimination, we used the features of the receiver operation characteristic (ROC) curves. Results: They were 704 patients, grouped into five categories: simple (one vessel) Coronary Artery Bypass Grafting (CABG) surgery, n= 299 (43%) cases. CABG revascularization (two or more vessels), n= 208 (30%). Double Procedure (CABG + valve replacement) 174 (25%) cases. Triple procedure (CABG + valve + aorta surgery) 23 (3.3%) patients. The mortality observed within 30 days of the surgery was 88 (12.5%). Meanwhile, the mean of the expected mortality predicted by EuroSCORE II was 3.63 ± 5.91 (95% CI: 3.19-4.06). The EuroSCORE II scale presented a good capacity for discrimination in the studied population reaching an area under the ROC curve of 0.821 (p < 0.000, 95% CI: 0.772-0.871). A calibration for the scale measured through logistic regression with goodness of adjustment of Hosmer-Lemeshow was determined (χ2 = 17.74, p = 0.64). Conclusion: EuroSCORE II showed moderate discrimination ability in general. The scale can be useful to identify some problems in our hospital, however, the mortality rate might be underestimated. Key words: Euroscore II; Adult Cardiac Surgery; Surgical Risk","PeriodicalId":362247,"journal":{"name":"American Journal of Cardiovascular and Thoracic Surgery","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129732902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Comparison of Circular versus Single Point-By-Point Pulmonary Vein Isolation","authors":"Nora Al-Jefairi, Ruairidh Martin, A. Frontera, A. Denis, N. Derval, F. Sacher, S. Mahida, S. Zellerhoff, X. Pillois, M. Hocini, M. Haïssaguerre, P. Jaïs","doi":"10.15226/2573-864X/3/1/00132","DOIUrl":"https://doi.org/10.15226/2573-864X/3/1/00132","url":null,"abstract":"Introduction: Point-by-point standard ablation using single-tip (conventional) catheter is the main current technique for pulmonary vein isolation (PVI) but it can be challenging. A circular, multielectrode, mapping and ablation catheter (nMARQ) may provide faster PVI. Methods: We designed a randomized comparison between circular versus conventional PVI with the primary end point of reconnection: acutely, in the index procedure, and at 3 months, at the time of a systematic repeat procedure. Results: Eighty-one patients randomized to circular (nMARQ n = 38) versus conventional (Thermocool Navistar n = 43) underwent PVI for paroxysmal atrial fibrillation. Both groups had similar characteristics: nMARQ age 61 ± 11 years (84% male) and TC age 60 ± 9 years (68% male). NMARQ procedures were shorter (RF and procedure duration), with fewer RIPV reconnections, both acutely and at 3 months (index: 1 (3%) versus 7 (16%), p = 0.044, redo: 21(18%) versus 36 (28%), p = 0.05). Patients ablated with the circular catheter also had shorter repeat procedures suggesting more discrete PV reconnections (nMRAQ: 142 ± 56 versus TC: 186 ± 76 minutes, p = 0.001). At 12 months follow up, 77% of patients in nMARQ group and 79% in TC group were in SR (p = 0.852). No major procedural complications were observed. Conclusion: This randomized study shows that nMARQ catheter is 3 times faster in isolating the PVs, with shorter RF and procedure time. It is also associated with fewer PV reconnections at 3 months. NMARQ appeared to be safe with no major procedural complications.","PeriodicalId":362247,"journal":{"name":"American Journal of Cardiovascular and Thoracic Surgery","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127061113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Cardiovascular Evaluation of Patients Oxygen Balance and Tissue Metabolic Score (TMS)","authors":"A. Mayevsky, Michael Tolmasov, M. Mandelbaum","doi":"10.15226/2573-864X/3/3/00145","DOIUrl":"https://doi.org/10.15226/2573-864X/3/3/00145","url":null,"abstract":"During the perioperative period of cardiovascular surgeries an imbalance between oxygen supply and demand may lead to postoperative cognitive decline that may affect about 20% of the operated patients. In order to minimize the development of brain damage, few companies had developed monitoring devices that could provide real-time information regarding brain oxygenation, brain electrical activities or cerebral blood flow. Nevertheless this approach is not the appropriate way to detect an early warning signal that may serve as an indicator of brain negative oxygen balance. The alternative approach is to monitor tissue oxygen balance of one of the less vital organ in the body that may serve as an early warning signal of deterioration of body oxygen balance. In this review, the use of a multiparametric monitoring device (CritiView) connected to the patient’s urethral wall via a 3-way Foley catheter that measure in real time 4 parameters representing tissue oxygen balance. Mitochondrial NADH is measured by surface fluorometry/reflectometry. In addition, tissue microcirculatory blood flow, tissue reflectance and hemoglobin oxygenation are measured as well. The measured 4 parameters could be integrated together with systemic hemodynamic parameters to provide in real time a new Tissue Metabolic Score (TMS). The device was tested both in vitro and in vivo in a small animal model and in preliminary clinical trials in patients undergoing vascular or open heart surgery. In patients, the monitoring started immediately after the insertion of a 3-way Foley catheter (urine collection) to the patient and was stopped when the patient was discharged from the operation room. The results show that monitoring the Urethral wall oxygen balance provides information in correlation to the surgical procedure performed.","PeriodicalId":362247,"journal":{"name":"American Journal of Cardiovascular and Thoracic Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131050799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}