Correlation between Left Ventricular Mass and Cardiac Troponin T in Cardiac Surgery.

Cardiac troponin levels might rise significantly after cardiac surgeries as a surgical outcome rather than ischemic myocardial damage alone, making the diagnosis of postoperative (type 5) myocardial infarction challenging. Previous studies have demonstrated that cardiac troponin is related to left ventricular mass, but this correlation was not investigated after cardiac surgery. We aimed to study a possible correlation between postoperative cardiac troponin levels and left ventricular mass index in patients who underwent cardiac surgery to refine the diagnosis of type 5 myocardial infarction, but observed no such correlation regardless of preoperative troponin levels or surgery type.

The Impact of Multiarterial Grafting in Patients with Left Ventricular Dysfunction.

Background:  Coronary artery bypass grafting (CABG) is one of the revascularization modalities available in patients with left ventricular dysfunction (LVD). Multiple arterial grafting (MAG) is associated with improved long-term outcomes. Data on the benefits of MAG in patients with LVD are limited.

Effect of perioperative erythropoietin on postoperative morbidity and mortality after cardiac surgery: a meta-analysis of randomized controlled trials.

Objective: Cardiac surgery is known to have high rates of perioperative red blood cell (RBC) transfusions which are associated with increased postoperative mortality and morbidity. Perioperative erythropoietin (EPO) has been suggested to lower perioperative RBC transfusions, and the effect on postoperative morbidity or mortality is unknown.

Methods: The registered study protocol is available on PROSPERO (CRD42022314538).

Similar Outcomes in Males and Females Undergoing Surgery for Infective Endocarditis.

: Sex-based differences in mortality have been previously observed in patients with surgically treated infective endocarditis. We sought to evaluate the risk factors leading to this difference. : A retrospective cohort from three centers in Israel comprising 376 surgically treated patients, comparing short- and long-term mortality rates and risk factors between female and male patients.

Mechanical Valves: Past, Present, and Future-A Review.

The mechanical valve was first invented in the 1950s, and since then, a wide variety of prostheses have been developed. Although mechanical valves have outstanding durability, their use necessitates life-long treatment with anticoagulants, which increases the risk of bleeding and thromboembolic events. The current guidelines recommend a mechanical prosthetic valve in patients under 50-60 years; however, for patients aged 50-70 years, the data are conflicting and there is not a clear-cut recommendation.

Minimal Learning Curve for Minimally Invasive Aortic Valve Replacement.

Background: Minimally invasive aortic valve replacement (MiAVR) is an established technique for surgical aortic valve replacement (AVR). Although MiAVR was first described in 1993 and has shown good results compared with full sternotomy AVR (FSAVR) only a minority of patients undergo MiAVR. We recently started using MiAVR via an upper hemisternotomy.

Transient time flow measurement in arterial grafts.

Coronary artery bypass grafting (CABG) is one of the foundations of treatment for coronary artery disease. While it has improved substantially since its inception more than 50 years ago, including a rising use of multiple arterial grafting, intraoperative quality assessment is yet to be disseminated as an integral part of the procedure. Herein we review the fundamentals of intraoperative quality assessment in CABG using transient time flow measurement (TTFM) with a focus on its use in arterial grafting.

The effect of COVID-19 vaccination on 30-day mortality after cardiac surgery - Insights from the Israel national registries.

Background: We compared the effect of perioperative COVID-19, before and after vaccination, on 30-day mortality after cardiac surgery.

Methods: Data was extracted from several national registries. The study period was March 1, 2020-March 31, 2022.

Implementation of a Short-term Treatment Protocol in Anemic Patients before Cardiac Surgery.

We assessed whether implementation of an immediate preoperative treatment in anemic patients could result in fewer perioperative packed red blood cell (PRBC) transfusions and improved outcomes in a real-world setting.From January 1, 2020, to November 31, 2022, we implemented a perioperative protocol for anemic patients (hemoglobin (Hb) level in women <11.5 g/dL, men <12.

Predictors and Long-Term Prognostic Significance of Acute Renal Function Change in Patients Who Underwent Surgical Aortic Valve Replacement.

There are few reports on short-term changes in renal function after surgical aortic valve replacement, and data are scarce regarding its impact on long-term outcomes. This is a retrospective study of patients who underwent isolated aortic valve replacement between 2009 and 2020 in four medical centers. Patients with end-stage renal disease were excluded.

High sensitivity troponin-I threshold to predict perioperative myocardial infarction.

Background: High-sensitivity Troponin I (hs-cTnI) has largely replaced conventional troponin assays in an effort to improve detection of myocardial infarction. However, the mean displacement of hs-cTnI following coronary artery bypass graft (CABG) and the optimal threshold to detect perioperative myocardial infarction (MI) is unclear. Our objective is to describe mean hs-cTnI values at 6-12 h post-CABG and to determine the highest specificity while maintaining 100% sensitivity hs-cTnI cut-off values for diagnosis of perioperative or type-5 MI.

Graft flow evaluation with intraoperative transit-time flow measurement in off-pump versus on-pump coronary artery bypass grafting.

Objective: We aimed to compare transit-time flow measurement (TTFM) parameters for on-pump (ONCAB) and off-pump (OPCAB) coronary artery bypass procedures.

Methods: The database of the Registry for Quality AssESsmenT with Ultrasound Imaging and TTFM in Cardiac Bypass Surgery (REQUEST) study was retrospectively reviewed. Only single grafts were included (ie, no sequential or Y/T grafts).

Outcome of patients undergoing isolated tricuspid repair or replacement surgery.

Objectives: The interest in isolated tricuspid valve disease has rapidly increased recently. However, clinical trials and registry data are rare in the surgical literature. This study aimed to describe the early and long-term outcomes of a real-world experience in isolated tricuspid procedures comparing repair and replacement strategies.

Biological or mechanical mitral valve replacement in patients 50-70 years of age-a propensity-adjusted analysis.

Objectives: The choice of a bioprosthetic valve (BV) over a mechanical valve (MV) in middle-aged adults in the mitral position is still under debate. Each valve type has benefits and drawbacks. We examined the mid-term survival of patients aged 50-70 years after BV versus MV mitral valve replacement (MVR).

Outcomes of cardiac surgery in patients with end-stage renal disease: Insights from the Israel national registries.

Background: End-stage renal disease (ESRD) has been shown to be associated with increased mortality in patients undergoing cardiac surgery. We aimed to compare the short- and mid-term mortality after cardiac surgery of patients with dialysis-dependent ESRD (DD-ESRD) to patients with normal renal function (NRF), using national registries: the ESRD registry, the adult cardiac surgery registry (ACSR), and the National Mortality Registry.

Methods: The study population comprised 8207 adult patients who underwent either isolated coronary artery bypass grafting (CABG), isolated aortic valve replacement (AVR), isolated mitral valve replacement (MVR), or CABG + valve-related procedure, between January 2017 and April 2019.

Mechanical vs Bioprosthetic Aortic Valve Replacement in Patients Younger Than 70 Years of Age: A Hazard Ratio Meta-analysis.

Background: The choice between mechanical valves (MVs) and bioprosthetic valves (BVs) in patients undergoing aortic valve surgery is complex, requiring a balance between the inferior durability of BV and the indicated long-term anticoagulation therapy with MV. This is especially challenging in the middle age group (< 70 years), which has seen an increased use of BV over recent years.

Methods: A meta-analysis of randomised controlled trials (RCTs), observational studies using propensity score matching (PSM) and inverse probability weighting (IPW) was conducted to examine the clinical outcomes of patients < 70 years of age undergoing aortic valve replacement.

Surgical ablation in rheumatic heart disease-Uncharted territory.

Background: Atrial fibrillation is a common arrhythmia with a large impact on society and on patients. Rheumatic valve disease is still prevalent in low- and medium-income countries. Performing surgical ablation during surgery for mitral valve disease has been shown to restore sinus rhythm in most patients.

Transit time flow measurement of coronary bypass grafts before and after protamine administration.

Background: Intraoperative graft assessment with tools like Transit Time Flow Measurement (TTFM) is imperative for quality control in coronary surgery. We investigated the variation of TTFM parameters before and after protamine administration to identify new benchmark parameters for graft quality assessment.

Methods: The database of the REQUEST ("REgistry for QUality AssESsmenT with Ultrasound Imaging and TTFM in Cardiac Bypass Surgery") study was retrospectively reviewed.

Midterm Results of Isolated Tricuspid Valve Replacement-Implications for Clinical Decision Making.

Background: Isolated tricuspid valve replacement (TVR) is considered high-risk surgery. We investigated our outcomes of TVR with the aim of identifying variables that may influence morbidity and mortality of isolated TVR compared with combined TVR and left-sided valve surgery.

Methods: Retrospective analysis of patients undergoing TVR surgery.

Beating Versus Arrested Heart Isolated Tricuspid Valve Surgery: Long-term Outcomes.

Background: Isolated tricuspid valve (TV) surgery is a rare procedure generally considered at high risk for perioperative mortality and poor long-term outcomes. Surgical treatment can be performed with either an arrested heart (AH) or beating heart (BH) technique. The aim of this study was to compare the outcomes of isolated tricuspid surgery with 2 different approaches.

Impact of Modifiable Risk Factors on Long-Term Outcomes after Coronary Artery Bypass Surgery.

Background:  Risk factors control and secondary prevention measures are often reported to be suboptimal in patients undergoing coronary artery bypass grafting (CABG) and may lead to worse clinical outcomes. We aimed to examine potentially modifiable risk factors in patients undergoing CABG and investigate their association with long-term coronary events.

Methods:  Cardiovascular risk factors were recorded preoperatively in the setting of a cardiac catheterization laboratory and were analyzed in relation to long-term coronary events, defined as acute coronary syndrome (ACS) or revascularization after CABG.