Baseline Intraoperative Left Ventricular Diastolic Function Is Associated with Postoperative Atrial Fibrillation after Cardiac Surgery.

Background: Detailed understanding of the association between intraoperative left atrial and left ventricular diastolic function and postoperative atrial fibrillation is lacking. In this post hoc analysis of the Posterior Left Pericardiotomy for the Prevention of Atrial Fibrillation after Cardiac Surgery (PALACS) trial, we aimed to evaluate the association of intraoperative left atrial and left ventricular diastolic function as assessed by transesophageal echocardiography (TEE) with postoperative atrial fibrillation.

Methods: PALACS patients with available intraoperative TEE data (n = 402 of 420; 95.

Correlation Between Periprocedural Myocardial Infarction, Mortality, and Quality of Life in Coronary Revascularization Trials: A Meta-analysis.

Background: The prognostic importance of periprocedural myocardial infarction (pMI) and its inclusion in the composite outcomes of coronary revascularization trials are controversial. We assessed whether pMI is a surrogate for all-cause or cardiac mortality and quality of life (QoL) outcomes in coronary revascularization trials.

Methods: All randomized trials comparing percutaneous coronary intervention vs coronary artery bypass grafting (MEDLINE, EMBASE, Cochrane Library) were identified.

Operative Outcomes of Women Undergoing Coronary Artery Bypass Surgery in the US, 2011 to 2020.

Importance: It has been reported that women undergoing coronary artery bypass have higher mortality and morbidity compared with men but it is unclear if the difference has decreased over the last decade.

Objective: To evaluate trends in outcomes of women undergoing coronary artery bypass in the US from 2011 to 2020.

Design, Setting, And Participants: This retrospective cohort study at hospitals contributing to the Adult Cardiac Surgery Database of the Society of Thoracic Surgeons included 1 297 204 patients who underwent primary isolated coronary artery bypass from 2011 to 2020.

Percutaneous coronary intervention versus repeat surgical revascularization in patients with prior coronary artery bypass grafting: A systematic review and meta-analysis.

Objectives: Repeat coronary artery bypass grafting (RCABG) and percutaneous coronary intervention (PCI) are both used for the treatment of symptomatic patients with coronary artery disease and prior CABG, but the optimal treatment strategy remains unknown. We sought to perform a systematic review and meta-analysis to compare operative and follow-up outcomes following RCABG versus PCI in patients with prior CABG.

Methods: Medline and Embase were searched for studies comparing RCABG versus PCI.

Characteristics of Postoperative Atrial Fibrillation and the Effect of Posterior Pericardiotomy.

Background: Postoperative atrial fibrillation (POAF) is a frequent complication of cardiac surgery. However, only a few detailed descriptions of the arrhythmia have been reported. We aim to describe the characteristics, outcomes, and variables associated with POAF and to evaluate how posterior pericardiotomy (PP) affects POAF characteristics.

Aspiration thrombectomy for inferior vena cava tumor thrombus arising from hepatocellular carcinoma.

Pharmacomechanical therapy and catheter-directed thrombolysis have been shown to be very effective in the treatment of venous thromboembolism; however, there is much less data regarding inferior vena cava thrombi. Tumor thrombi pose an even greater clinical challenge as anti-coagulation and thrombolysis are not effective. We present the case of a 61-year-old male who presented with an inferior vena cava thrombus emanating from an accessory right hepatic vein, treated with aspiration thrombectomy.

Pericardial Effusion Provoking Atrial Fibrillation After Cardiac Surgery: JACC Review Topic of the Week.

Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery. Patients who develop POAF are more likely to experience adverse outcomes, including increased rates of death, stroke, heart failure, and hospitalizations, and higher hospital costs. Understanding the mechanisms underlying POAF is important to improve patients' outcome and optimize health systems' efficiency.

Treatment of severe acute mitral regurgitation following thoracoabdominal aortic aneurysm repair.

An asymptomatic 63-year-old male with chronic type B aortic dissection underwent repair of an expanding 6.1 cm extent I thoracoabdominal aortic aneurysm. His postoperative course was complicated by respiratory failure from severe acute mitral regurgitation likely due to papillary muscle rupture, which was corrected with transcatheter MitraClip edge-to-edge repair.

Differences Among Clinical Trials and Registries on Surgical and Percutaneous Coronary Interventions.

Background: A need exists for systematic evaluation of the differences in baseline characteristics and early outcomes between patients enrolled in randomized controlled trials (RCTs) and clinical practice for coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI).

Methods: Systematic searches were conducted to identify RCTs comparing CABG vs PCI and CABG or PCI registries. Sixteen predefined baseline characteristics and 30-day mortality were extracted from the included studies.

Representation of racial minorities in cardiac surgery randomized clinical trials.

Background: Racial minorities account for 39.9% of the population in the United States, but are often underrepresented in clinical research. Results from studies predominantly enrolling White patients may not apply to racial minorities.

Sex differences in primary malignant cardiac tumors: A multi-institutional cohort study from National Cancer Database.

Introduction: Despite the significant clinical importance of sex among factors affecting cancer progression and survival, it remains one of the least studied factors. Therefore, we sought to examine these differences in relation to primary malignant cardiac tumors (PMCTs) using a national data set.

Methods: The 2004-2017 National Cancer Database was queried for patients with PMCTs.

Impact of the COVID-19 Pandemic on Non-COVID-19 Clinical Trials.

Randomized controlled trials (RCT) were impacted by the COVID-19 pandemic, but no systematic analysis has evaluated the overall impact of COVID-19 on non-COVID-19-related RCTs. The ClinicalTrials.gov database was queried in February 2020.

Coronary Artery Bypass Surgery After Transradial Catheterization: Implementing 2021 ACC/AHA/SCAI Revascularization Guidelines Into Clinical Practice.

The 2021 ACC/AHA/SCAI coronary artery disease revascularization guideline recommends radial artery (RA) access for coronary angiography and RA grafting over saphenous vein grafting in patients referred for coronary artery bypass grafting. We present a case of a patient who underwent coronary angiography via both RAs and therefore could not receive RA bypass grafts. ().

A survey of retractions in the cardiovascular literature.

Background: Retractions of erroneous and fraudulent papers from the biomedical literature continue to be a major concern. The aim of this analysis is to summarize trends of retractions in the cardiovascular literature over the past four decades.

Methods: A review of the Retraction Watch database for retracted articles published between 1978 and 2020 in the cardiovascular literature was performed.

Never again. Once used for cardiac catherization the radial artery cannot be used for CABG.

The use of the radial artery (RA) as a conduit in coronary artery bypass grafting (CABG) has been steadily increasing since the early 1990s and based on the most recent data may well become the standard of care for patients with multivessel coronary artery disease requiring multiple arterial grafts. The transradial access (TRA) approach for cardiac catherization has also increased steadily in use by interventional cardiologists owing to its reduction in bleeding and vascular complications when compared with the femoral approach and is now considered the preferred arterial access. However, prior use of TRA for cardiac catherization is a contraindication for the use of the RA for CABG because of high rates of structural damage to the vascular wall and potential for graft failure.

Comparison of Long-term Clinical Outcomes of Skeletonized vs Pedicled Internal Thoracic Artery Harvesting Techniques in the Arterial Revascularization Trial.

Importance: Recent evidence has suggested that skeletonization of the internal thoracic artery (ITA) is associated with worse clinical outcomes in patients undergoing coronary artery bypass surgery (CABG).

Objective: To compare the long-term clinical outcomes of skeletonized and pedicled ITA for CABG.

Design, Setting, And Participants: The Arterial Revascularization Trial (ART) was a 2-group, multicenter trial comparing the use of a bilateral ITA vs a single ITA for CABG at 10 years.

Radial artery or saphenous vein for coronary artery bypass grafting.

Coronary artery disease (CAD) is the most common cardiovascular disease worldwide, affecting over 18 million American adults. Coronary artery bypass grafting (CABG) is the standard of care for patients with left main or triple vessel CAD. Historically, the saphenous vein (SV) has been utilized to bypass the majority of the coronary vessels in patients undergoing CABG, but more recent data suggest that the use of the radial artery (RA), rather than the SV, is associated with improved cardiac outcomes and better survival.