Impact of preoperative computed tomography scan on neurological outcomes in coronary artery bypass grafting patients: A propensity-score analysis.

Introduction: Neurological complications pose significant risks in coronary artery bypass grafting (CABG). This study explores the potential benefits of preoperative chest computed tomography (CT) in optimizing outcomes and reducing neurological events in high-risk CABG patients.

Methods: From January 2017 to June 2023, a retrospective cohort study of CABG patients categorized groups based on preoperative chest CT use.

Surgical repair and replacement for native mitral valve infective endocarditis.

Aims: The clinical benefits of mitral valve repair over replacement in the setting of mitral infective endocarditis are not clearly established.

Methods: Data of patients who underwent cardiac surgery for infective endocarditis over a 20-year period (2001-2021) at two cardiac centres were reviewed. Among them, 282 patients underwent native mitral valve surgery and were included in the study.

Results and insights after 413 TAVI procedures performed by cardiac surgeons on their own.

Objectives: Current evidence on transcatheter aortic valve implantation (TAVI) has been generated exclusively by cardiology studies and no operative data from cardiac surgeons are available. Here, we describe the development of our TAVI programme and report the results of transfemoral (TF) TAVI done by cardiac surgeons on their own.

Methods: This study included all the TAVI procedures on native valve performed at Cardiac Surgery Unit, Ospedali Riuniti di Ancona, during the period October 2018 to July 2022.

Enhanced recovery after minimally invasive heart valve surgery: Early and midterm outcomes.

Background: Although the use of protocols for "enhanced recovery after surgery" (ERAS) have been associated with improved results in different surgical specialties, only a few data are available for ERAS in cardiac surgery. This study aimed to compare 30-day outcomes of patients undergoing ultra-fast-track minimally invasive valve surgery (UFT-MIVS) versus conventional MIVS (c-MIVS).

Methods: The key features of UFT-MIVS approach involves: 1) less invasive valve surgery techniques, 2) normothermic cardiopulmonary bypass management, 3) UFT-anesthesia with table extubation, 4) immediate rehabilitation therapy and patient-family contact.

Minimally invasive approach: is this the future of aortic surgery?

Unlabelled: Median sternotomy incision has shown to be a safe and efficacious approach in patients who require thoracic aortic interventions and still represents the gold-standard access. Nevertheless, over the last decade, less invasive techniques have gained wider clinical application in cardiac surgery becoming the first-choice approach to treat heart valve diseases, in experienced centers. The popularization of less invasive techniques coupled with an increased patient demand for less invasive therapies has motivated aortic surgeons to apply minimally invasive approaches to more challenging procedures, such as aortic root replacement and arch repair.

Conduction disorders after aortic valve replacement: what is the real impact of sutureless and rapid deployment valves?

Background: Although sutureless and rapid deployment aortic valve replacement (SURD-AVR) has been associated with an increased rate of permanent pacemaker (PPM) implantation compared to conventional AVR (c-AVR), the predictors of new conduction abnormalities remain to be clarified. This study aimed to identify risk factors for conduction disorders in patients undergoing AVR surgery.

Methods: Data from 243 patients receiving minimally invasive AVR were prospectively collected.

COVID 19- Perspective of an Italian Center.

Italy has been hard hit by severe acute respiratory syndrome coronavirus 2 infection with more than 240,000 cases and 35,000 deaths. During the acute phase of the pandemic, the Italian government decided on the lockdown which lasted about 2 months. During this period, all surgical activities were limited to nondeferable procedures only.

Surgery for Bentall endocarditis: short- and midterm outcomes from a multicentre registry.

Objectives: Endocarditis after the Bentall procedure is a severe disease often complicated by a pseudoaneurysm or mediastinitis. Reoperation is challenging but conservative therapy is not effective. The aim of this study was to assess short- and midterm outcomes of patients reoperated on for Bentall-related endocarditis.

[One-year outcomes of surgical aortic valve replacement: a single, high-volume center experience].

Background: The introduction of transcatheter aortic valve replacement (AVR) mandates attention to outcomes after surgical AVR (SAVR). The aim of this study was to assess 1-year outcomes in a contemporary large cohort of patients undergoing AVR.

Methods: Data from 520 patients who underwent isolated SAVR between October 2016 and April 2019 were prospectively collected.

[Surgical treatment of aortic valve disease: early results of a 360° minimally invasive approach].

Background: Over the years, with the introduction of minimally invasive techniques and technologies aimed at reducing surgical trauma, aortic valve surgery has considerably developed and improved. Our approach includes: reduced incisions (upper "J" ministernomy or anterior right minithoracotomy), "ultra fast-track" anesthesia protocols, sutureless and rapid deployment valve prostheses and miniaturized circuits of extracorporeal circulation. The aim of this study was to evaluate the clinical outcomes associated with this multidisciplinary approach.

Mini Bentall operation: technical considerations.

Bentall operation via median sternotomy has been largely shown to be safe and long-term efficacious and currently represents the "gold standard" intervention in patients presenting with aortic valve and root disease. However, over the last years, minimally invasive techniques have gained wider clinical application in cardiac surgery. In particular, minimally invasive aortic valve replacement through ministernotomy has shown excellent outcomes and becomes the first choice approach in numerous experienced centers.

Ultra fast track surgery: a rapid deployment aortic valve replacement through a J-ministernotomy.

Aortic valve surgery has been undergone continuous development over the last years, involving less invasive techniques and the use of new technologies to reduce the traumatic impact of the intervention and extend the operability toward increasingly high-risk patients. Minimally invasive aortic valve replacement (AVR) has gradually been recognized as a less traumatic technique compared to median sternotomy, becoming first choice approach in numerous experienced centers. Herein we present our multidisciplinary minimally invasive approach for AVR, involving: (I) reduced chest incision; (II) rapid deployment AVR; (III) minimally invasive extracorporeal circulation system; and (IV) ultra fast track (UFT) anaesthetic management.

Prosthetic valve endocarditis: predictors of early outcome of surgical therapy. A multicentric study.

Objectives: Prosthetic valve endocarditis (PVE) is an uncommon yet dreadful complication in patients with prosthetic valves that requires a distinct analysis from native valve endocarditis. The present study aims to investigate independent risk factors for early surgical outcomes in patients with PVE.

Methods: A retrospective cohort study was conducted in 8 Italian Cardiac Surgery Units from January 2000 to December 2013 by enrolling all PVE patients undergoing surgical treatment.

Prevention of atrial fibrillation and inflammatory response after on-pump coronary artery bypass using different statin dosages: a randomized, controlled trial.

Background: This randomized controlled trial aimed to evaluate the effects of seven-day preoperative treatment with two different dosages of atorvastatin on the incidence of postoperative atrial fibrillation (POAF) and release of inflammatory markers such as high-sensitive C-reactive protein (hsCRP) and interleukin-6 in patients undergoing elective first-time on-pump coronary artery bypass grafting (CABG).

Methods: The cohort study comprised 212 consecutive patients, already taking statins, who underwent elective first-time CABG with cardiopulmonary bypass without history of atrial fibrillation (AF). Patients were randomly divided into two groups: those who received atorvastatin 40 mg (TOR40 group, 111 patients) and those who received 80 mg (TOR80 group, 101 patients) once a day for 7 days before the planned operation.

'Early' and 'late' timing for renal replacement therapy in acute kidney injury after cardiac surgery: a prospective, interventional, controlled, single-centre trial.

Objectives: Acute kidney injury after cardiac surgery (CS-AKI) is strongly associated with in-hospital mortality and morbidity. We aimed to investigate whether 'early' or 'late' initiation of renal replacement therapy (RRT) in patients with CS-AKI is associated with a survival benefit or more favourable outcomes.

Methods: All patients who had undergone cardiac surgery at 'Ospedali Riuniti' of Ancona from July 2011 to February 2013 were prospectively enrolled and divided into two treatment groups: the 'early' approach was used during the first 10 months, and the 'late' approach during the next 10 months.

Absorption of carbon dioxide during endoscopic vein harvest.

Objectives: Carbon dioxide (CO(2)) insufflation was used by some devices for endoscopic vein harvest to create a subcutaneous tunnel and facilitate the vein harvest. In the literature, some cases of CO(2) micro- and macro-embolisms or hypercarbia during this procedure are described. The purpose of this study was to evaluate if the use of an open CO(2) system rather than a sealed system might be associated with different CO(2) absorption during the procedure.

[Does cardiac surgery in women carry a higher risk than in men?].

Cardiovascular diseases are the leading cause of death in women, and female patients exhibit peculiar features as to symptoms, diagnosis and treatment. This sex difference is also observed in cardiac surgery, with mortality and morbidity being higher in female patients. Whether female gender is an independent variable for mortality still remains controversial.

The changing face of cardiac surgery patients: an insight into a Mediterranean region.

Objectives: Data of 9 years of surgical activity (on about 10000 patients), obtained from the database of our cardiac surgery care centre, were analysed to assess time-related variations in demographics, clinical and surgical characteristics.

Methods: Data of patients submitted to major cardiac surgery procedures between 1999 and 2007 were examined using the chi-square test, analysis of variance (ANOVA) test or non-parametric tests, where applicable. The 'linear-by-linear' association test was used to verify the existence of a time-related trend.

Atrial myxoma: a 25-year single-institutional follow-up study.

Objective: A single-institutional study on atrial myxoma. Patient data and data obtained from the survivors during follow-up were reviewed.

Methods: We studied 109 patients (61.

Left superior vena cava draining into the left atrium, associated with partial anomalous pulmonary venous connection: surgical correction.

A persistent left superior vena cava draining into the left atrium may produce a symptomatic right-to-left shunt. Although intra-atrial rerouting techniques, in patients with no connecting vein, have proved to be reliable and successful, in many cases the extracardiac repair is preferable. We report a case of a 5-month-old patient with a not connected left superior vena cava draining into the left atrium, associated with atrial septal defect and partial anomalous pulmonary venous connection.

Cannulation of the brachiocephalic trunk during surgery of the thoracic aorta: a simplified technique for antegrade cerebral perfusion.

Here we present our simplified technique of cannulation of the brachiocephalic trunk for cardiopulmonary bypass and antegrade cerebral perfusion institution.

Aortic valve-sparing surgery for aortic root aneurysm.

Background: Replacement of the aortic valve and ascending aorta with a composite graft is the most common surgical treatment for aortic root aneurysms with or without aortic regurgitation (AR). In the early 90's reconstructive procedures of the aortic root have been described with encouraging results. This paper presents our experience with this technique.

[Mortality risk estimation in cardiac surgery].

Background: The aim of this study was to compare the ability of three risk models to predict operative mortality after cardiac surgery.

Methods: Risk factors of 3111 patients (73% male, mean age 65.2 +/- 10.