Total Arch Replacement with Ascyrus Medical Dissection Stent Versus Frozen Elephant Trunk in Acute Type A Aortic Dissection: A Meta-Analysis.

: Acute Stanford Type A aortic dissection (ATAAD) often requires total arch replacement (TAR) with frozen elephant trunk (FET) to address entry tears and support aortic remodeling. In select cases, AMDS may provide a simpler option. The present meta-analysis aims to compare surgical outcomes between these two approaches.

The Dilemma of Surgical Timing in Acute Aortic Valve Endocarditis: Does Early Surgery Improve Risks or Prognosis?

Background: Acute aortic valve infective endocarditis (IE) presents a critical surgical timing dilemma. This study investigates whether early surgical intervention (within seven days of targeted antibiotic therapy initiation) affects mortality and clinical outcomes compared to delayed/conventional surgery.

Methods: A retrospective, multicenter analysis of 204 patients with aortic IE was conducted, excluding emergency cases requiring immediate intervention.

The role of the Prognostic Nutritional Index in predicting survival and rehospitalization after surgical aortic valve replacement.

Purpose: The Prognostic Nutritional Index (PNI), calculated using serum albumin levels and blood lymphocyte count, reflects a patient's nutritional and immune status. It is commonly used as a prognostic tool following oncological surgery and in certain cardiovascular conditions. This study aims to assess whether the PNI can also serve as a prognostic indicator in patients undergoing surgical aortic valve replacement (SAVR).

Exercise Right Ventricular-Pulmonary Arterial Coupling and Functional Outcome in Patients Undergoing Surgery for Secondary Ischemic Mitral Regurgitation.

Background: The exercise assessment of the right ventricular-pulmonary arterial (PA) coupling adds diagnostic and prognostic value in patients with heart failure. In patients with ischemic mitral regurgitation undergoing surgery, data on the exercise assessment of the right ventricular-PA coupling are not available. Resting and exercise echocardiographic predictors of functional outcome in patients with ischemic mitral regurgitation were tested.

Thrombocytopenia Following Isolated Surgical Aortic Valve Replacement With Inspiris Resilia Bioprosthesis.

Aims: Thrombocytopenia (TCP) following aortic valve replacement (AVR) is a significant concern, with varying degrees of platelet count reduction observed postoperatively. This phenomenon occurs more frequently in patients undergoing surgical biological AVR compared to those receiving mechanical AVR or transcatheter aortic valve implantation (TAVI). This study aimed to investigate the incidence of TCP following surgical AVR with the Inspiris Resilia bioprosthesis compared with Carpentier Magna Ease valve.

Extent of surgical repair and outcomes after surgery for type A aortic dissection.

Background: Acute Stanford type A aortic dissection is a severe emergency condition that, if left untreated, is associated with a high mortality rate. The extent of surgical repair may impact the outcomes of these patients.

Method: Patients operated for acute type A aortic dissection from a multicentre European registry were included.

Multimodal imaging in the assessment of quadricuspid aortic valve.

Quadricuspid aortic valve (QAV) is a rare congenital anomaly of the aortic valve, with an incidence of 0.05-0.1%, often associated with aortic regurgitation.

Outcomes of patients with mitral annular disjunction undergoing mitral valve repair†.

Objectives: Mitral annular disjunction (MAD) is an abnormal displacement of the posterior mitral leaflet into the left atrial wall, potentially leading to left ventricular dysfunction, malignant ventricular arrhythmias (VA) and sudden cardiac death. This study investigates the outcomes of patients with and without MAD undergoing mitral valve repair for valve prolapse (MVP).

Methods: The study retrospectively collected a single-center experience from 2021 to 2023 on 326 consecutive patients undergoing mitral valve repair for MVP.

Clinical Outcomes of Cardiac Transplantation in Heart Failure Patients with Previous Mechanical Cardiocirculatory Support.

Heart failure (HF) remains a significant public health issue, with heart transplantation (HT) being the gold standard treatment for end-stage HF. The increasing use of mechanical circulatory support, particularly left ventricular assist devices (LVADs), as a bridge to transplant (BTT), presents new perspectives for increasingly complex clinical scenarios. This study aimed to compare long-term clinical outcomes in patients in heart failure with reduced ejection fraction (HFrEF) receiving an LVAD as BTT to those undergoing direct-to-transplant (DTT) without mechanical support, focusing on survival and post-transplant complications.

Reintervention for Acute Aortic Prosthesis Endocarditis: Early and Mid-Term Outcomes.

This study aimed to analyze the outcomes and challenges associated with surgical redo procedures following aortic valve replacement for acute infective endocarditis. While transcatheter aortic valve implantation is growing in terms of its utilization for degenerative bioprostheses failure, valve-in-valve procedures are limited in acute aortic endocarditis. Surgical interventions for aortic prosthesis endocarditis carry a significant risk, with a higher mortality and morbidity, often requiring concomitant complex procedures.

Reliability of EuroSCORE II on Prediction of Thirty-Day Mortality and Long-Term Results in Patients Treated with Sutureless Valves.

EuroSCORE II (ES2) is a reliable tool for preoperative cardiac surgery mortality risk prediction; however, a patient's age, a surgical procedure's weight and the new devices available may cause its accuracy to drift. We sought to investigate ES2 performance related to the surgical risk and late mortality estimation in patients who underwent aortic valve replacement (AVR) with sutureless valves. : Between 2012 and 2021, a total of 1126 patients with isolated aortic stenosis who underwent surgical AVR by means of sutureless valves were retrospectively collected from six European centers.

Heart Transplantation Following Fontan Failure: Long-Term Survival Analysis.

Fontan circulation presents significant challenges for patients with congenital heart disease, often necessitating heart transplantation (HTX) due to deteriorating functionality across multiple organ systems. However, the impact of prior Fontan palliation on HTX outcomes remains poorly understood, with early mortality rates suggesting a heightened risk. The aim of our study is to evaluate the long-term results after heart transplantation in patients with univentricular congenital heart disease previously palliated with Fontan circulation.

Hybrid strategies for stand-alone surgical ablation of atrial fibrillation.

Atrial fibrillation (AF) has been reported as a major cause of cardiac morbidity and mortality, and significantly reduces the quality of life in symptomatic patients. Current guidelines recommend antiarrhythmic drugs and catheter ablation (CA) as first-line therapy. Despite CA showed to be associated with lower incidence of peri-procedural complications, rhythm outcomes are far from optimal.

Left Atrium Volume Reduction Procedure Concomitant With Cox-Maze Ablation in Patients Undergoing Mitral Valve Surgery: A Meta-Analysis of Clinical and Rhythm Outcomes.

Background: The management of an enlarged left atrium (LA) in mitral valve (MV) disease with atrial fibrillation (AF) is still being debated. It has been postulated that a reduction in LA size may improve patient outcomes. This meta-analysis aimed to assess rhythm and clinical outcomes of combined surgical AF treatment with or without LA volume reduction (LAVR) in patients undergoing MV surgery.

Mitral valve surgery in acute infective endocarditis: long-term outcomes of mitral valve repair versus replacement.

Aims: Timing and surgical strategies in acute infective endocarditis are still questionable. We sought to investigate clinical outcomes of patients undergoing mitral valve repair (MVR) compared with mitral valve replacement [mitral valve prosthesis (MVP)] for acute infective endocarditis.

Methods: From 2004 to 2019, 109 consecutive patients with acute mitral valve infective endocarditis were retrospectively investigated.

Sutureless and Rapid Deployment vs. Transcatheter Valves for Aortic Stenosis in Low-Risk Patients: Mid-Term Results.

Background: Recent trials showed that TAVI is neither inferior nor superior to surgical aortic valve replacement. The aim of this study was to evaluate the outcomes of Sutureless and Rapid Deployment Valves (SuRD-AVR) when compared to TAVI in low surgical risk patients with isolated aortic stenosis.

Methods: Data from five European Centers were retrospectively collected.

Rhythm outcomes of minimally-invasive off-pump surgical versus catheter ablation in atrial fibrillation: A meta-analysis of reconstructed time-to-event data.

Background: Mid- and long-term rhythm outcomes of catheter ablation (CA) for atrial fibrillation (AF) are reported to be suboptimal. Minimally invasive surgical off-pump ablation (MISOA), including both thoracoscopic and trans-diaphragmatic approaches, has been developed to reduce surgical invasiveness and overcome on-pump surgery drawbacks. We sought to compare the efficacy and safety of MISOA and CA for AF treatment.

Thoracoscopic AF ablation in situs inversus dextrocardia with interrupted inferior vena cava continuation in azygos vein.

Introduction: Situs inversus totalis, dextrocardia with interrupted inferior vena cava, and azygos vein continuation concomitant with symptomatic atrial fibrillation requiring ablation. This case was deemed not suitable for percutaneous ablation due to anatomic variations and the lack of case reports in the literature.

Methods And Results: We performed bilateral thoracoscopic epicardial ablation and epicardial left atrial appendage exclusion.

Surgical treatment of mediastinitis: The vertical bolstered Donati stitch.

Deep sternal wound infection is a major complication of cardiac surgery, with a low incidence but with catastrophic consequences in terms of morbidity, mortality, and health-care costs. Negative pressure wound therapy and appropriately timed sternal revision, with or without muscle flap mobilization, can improve the outcomes. This video tutorial illustrates the technical aspects of the surgical treatment of mediastinitis with the Robicsek method for sternal closure and an original wound closure technique, very effective and much simpler than the pectoral muscle flap technique.

MIDCAB Tips and tricks for a successful procedure.

Minimally invasive direct coronary artery bypass (MIDCAB) for a left internal mammary artery on left anterior descending (LIMA-LAD) graft, is a safe and relatively less traumatic surgical technique. Adoption in some centers has been slow because of perceived technical difficulty, but it should be considered a first-choice therapy for patients with isolated proximal LAD lesions or multi-vessel disease, and as a component of a hybrid revascularization strategy.  Results in our institute, where we have been using MIDCAB for more than 20 years, confirm both its short- and long-term efficacy.