Expert Consensus on Clinical Application of Implantable Biventricular Assist Devices.

While biventricular assist devices (BiVADs) remain underutilized in Western countries for biventricular heart failure (BHF), their application is expanding in China. This consensus synthesizes international guidelines, medical evidence, and Chinese clinical expertise to establish standardized protocols for BiVAD management. Key recommendations include: (1) Preoperative right heart catheterization and echocardiography for central venous pressure (CVP): pulmonary capillary wedge pressure (PCWP) ratio and pulmonary artery pulsatility index (PAPi) assessment (Class I); (2) BiVAD indication in refractory BHF or high-risk right heart failure post-left ventricular assist device (LVAD) implantation (Class IIa); (3) Right atrial implantation as the preferred surgical approach (Class IIa); (4) Warfarin-based anticoagulation (INR 2.

Beyond 2025: Projections of cardiothoracic surgeon demographics in France.

Background: Cardiothoracic surgeons are essential healthcare practitioners but there are demographic challenges and training complexities. Understanding workforce trends is critical to ensure future capacity and adaptability in France.

Aims: This study assessed the current state of the cardiothoracic surgery workforce in France and projected demographic trends through 2040.

Mastering aortic valve repair: A standardized step-by-step teaching approach of remodeling root replacement with external ring annuloplasty.

Objective: By developing a reproducible step-by-step approach to aortic valve (AV) repair, we aim to increase the global rate of successful AV repair. Although valve-sparing root replacement is a Class I recommendation with level B evidence for root aneurysm, regardless of the degree of aortic regurgitation, its utilization remains limited. This study evaluated the feasibility, reproducibility, and effectiveness of a standardized AV repair performed by a fellow versus an expert.

Implementation of a goal directed perfusion strategy to reduce cardiac surgery associated kidney injury: A before and after study.

Purpose: Cardiac surgery associated acute kidney injury (CSA-AKI) is a frequent and severe complication. Goal Directed Perfusion (GDP) during cardiopulmonary bypass (CPB) has been developed to reduce post-operative complications, in particular CSA-AKI. Hence, we aimed to assess the implementation of a GDP strategy during CPB on the incidence of CSA-AKI in a large, unselected cardiac surgery population.

Innovative approaches to organ preservation in heart transplantation: A comprehensive review by the French Society of Thoracic and Cardiovascular Surgery.

Improved approaches for organ preservation have been recently applied in heart transplantation to prevent the risk of primary graft dysfunction. To review heart-graft preservation systems and to identify criteria for using innovative devices in each specific situation. A working group of the French Society of Thoracic and Cardiovascular Surgery performed a literature review focusing on organ preservation and post-transplant outcomes.

CytoSorb hemoadsorption of apixaban during cardio-pulmonary bypass for heart transplantation.

Background: Heart transplantation is an emergency surgery requiring cardio-pulmonary bypass (CPB) and its timing is unpredictable. Patients on the transplant waiting list often have multiple reasons for being anticoagulated. Intraoperative removal of apixaban using CytoSorb seems to be an interesting solution for patients on DOACs requiring an emergency CPB intervention.

Prophylaxis against Pneumocystis jirovecii pneumonia and toxoplasmosis with low-dose Trimethoprim-sulfamethoxazole (cotrimoxazole 20/100 mg) in heart transplant patients. The PAPTO-LOCO observational comparative study.

Objectives: Practice concerning post-transplant Pneumocystis prophylaxis remains heterogeneous. SXT benefits must be balanced with frequent toxicity. We aimed to assess whether a low-dose SXT strategy might limit toxicities while maintaining an undisrupted prophylaxis compared with a standard dose in a retrospective cohort of heart transplant population.

Contribution of cardiac surgeons in transcatheter aortic valve replacement activity in France.

Objectives: This study provides a thorough analysis of cardiac surgeons' involvement in transcatheter aortic valve replacement (TAVR) activities in France, covering decision-making, procedural roles, training and outcome analysis.

Methods: A nationwide survey was sent to all cardiac surgeons and all cardiac surgery trainees in France. Subgroup analysis was performed for age, status (established versus in-training) and type of practice facility.

Fifteen-year experience of direct bridge with venoarterial extracorporeal membrane oxygenation to heart transplantation.

Objective: The study objective was to evaluate outcomes of patients directly bridged with venoarterial extracorporeal membrane oxygenation to heart transplantation.

Methods: A single-center retrospective study was performed on 1152 adult patients undergoing isolated cardiac transplantation between January 2007 and December 2021. Among these, patients bridged with an extracorporeal membrane oxygenation to transplantation (extracorporeal membrane oxygenation group, n = 317) were compared with standard cohorts of patients (no extracorporeal membrane oxygenation group, n = 835).

Lower Ministernotomy: An Approach for Treating All Valvulopathies?

Background: Lower ministernotomy offers the advantage of providing excellent visualization of the 4 cardiac cavities, thus allowing surgical treatment of the aortic, mitral, and tricuspid valves as well as any intracavitary procedure. Information on technical issues, as well as safety and echocardiographic results of this approach, are sparse. The aim of this retrospective study was to describe outcomes of lower ministernotomy to treat valvulopathies and for other intracardiac surgical procedures.

Chlorhexidine-alcohol compared with povidone-iodine-alcohol skin antisepsis protocols in major cardiac surgery: a randomized clinical trial.

Purpose: Whether skin disinfection of the surgical site using chlorhexidine-alcohol is superior to povidone-iodine-alcohol in reducing reoperation and surgical site infection rates after major cardiac surgery remains unclear.

Methods: CLEAN 2 was a multicenter, open-label, randomized, two-arm, assessor-blind, superiority trial conducted in eight French hospitals. We randomly assigned adult patients undergoing major heart or aortic surgery via sternotomy, with or without saphenous vein or radial artery harvesting, to have all surgical sites disinfected with either 2% chlorhexidine-alcohol or 5% povidone-iodine-alcohol.

Perioperative Risk Factors of Acute Kidney Injury After Heart Transplantation and One-Year Clinical Outcomes: A Retrospective Cohort Study.

Objectives: This study aimed to identify perioperative risk factors of acute kidney injury after heart transplantation and to evaluate 1-year clinical outcomes.

Design: A retrospective single-center cohort study.

Setting: At a university hospital.

Outcomes of aortic valve-sparing root replacement with cusp repair in connective tissue disease.

Background: Although, valve sparing is commonly performed in patients with Marfan syndrome, feasibility and results of cusp repair for aortic insufficiency have not been studied.

Aim: To report on the outcomes and durability of aortic cusp repair in valve sparing in patients with Marfan syndrome.

Methods: All consecutive adult patients with Marfan syndrome who underwent remodelling and annuloplasty with aortic valve repair for aortic insufficiency between May 2005 and December 2020 were included.