Delayed Device Embolization After TEER of the Mitral Valve as a Rare But Dangerous Complication.

Background: Delayed device embolization is a rare but dangerous complication after transcatheter edge-to-edge repair (TEER).

Case Summary: A 79-year-old man with acute decompensated severe structural mitral regurgitation underwent TEER with 2 clips after failed medical attempts at recompensation. Six days later, 1 clip embolized into the abdominal aorta, resulting in recurrent, progressive decompensation and severe mitral regurgitation, requiring urgent mitral valve replacement.

Endo-Aortic Balloon Occlusion versus Transthoracic Clamping in Minimally Invasive Mitral Valve Surgery.

Objectives: The present study compared the clinical outcome between endo-aortic balloon occlusion (EABO) and transthoracic clamping (TTC) in patients undergoing minimally invasive mitral valve surgery (MIMVS).

Methods: All patients from the Mini-Mitral International Registry undergoing MIMVS were primarily considered for study inclusion. One-to-one nearest neighbour propensity score matching considering clinically relevant baseline covariates.

The Evolving Risk of Infective Endocarditis After Transcatheter Aortic Valve Implantation.

Objectives: Despite increased use of transcatheter aortic valve implantation (TAVI) in older adults with severe aortic stenosis, contemporary data on infective endocarditis (IE)-an infrequent but serious complication-are lacking. This study addresses this gap in knowledge.

Methods: We analysed 280 073 Medicare beneficiaries who underwent TAVI between 2013 and 2022.

Diagnosis-Driven, Cross-Disciplinary QA System for Coronary Artery Disease - Study Protocol.

Background PCI (Percutaneous Coronary Intervention) and CABG (Coronary Artery Bypass Grafting) are invasive treatment options for CAD (coronary artery disease), aiming to improve quality of life and reduce cardiovascular morbidity and mortality. Guidelines-based revascularization decisions should consider anatomical complexity, comorbidities, and patient preferences, with procedural risk assessed through validated scoring systems. However, the current legal quality assurance (QA) programs in Germany remain procedure specific and therefore lack a patient-centered, diagnosis-oriented approach.

Surgical ablation in non-mitral valve cardiac surgeries: a meta-analysis of early outcomes.

Background: Surgical ablation (SA) is a key treatment for atrial fibrillation (AF) patients undergoing heart surgery. However, direct comparisons between SA and non-mitral valve (non-MV) surgery alone are lacking. We performed a systematic review and meta-analysis comparing concomitant SA to isolated non-MV surgery in AF patients.

Second cross-clamp in less invasive mitral valve repair for degenerative mitral regurgitation: Predictors and outcomes.

Objective: To evaluate the incidence, echocardiographic patterns, operative strategies, and results of patients receiving a second cross-clamping in the large population of the Mini Mitral International Registry.

Methods: We examined 4577 patients with degenerative mitral regurgitation (MR) who underwent less invasive mitral repair. Patients with nondegenerative disease, planned valve replacement, and surgery without cross-clamping were excluded.

Early extraction versus conservative management in patients with noninfected cardiac implantable electronic devices undergoing cardiac surgery for left-sided infective endocarditis: Insights from the multicentric Clinical Multicenter Project for Analysis of Infective Endocarditis in Germany Registry.

Objectives: This study aimed to analyze the outcomes of patients with left-sided infective endocarditis (IE) and noninfected cardiac implantable electronic device (CIED) undergoing cardiac surgery, with a focus on whether the CIED was removed.

Methods: Retrospective analysis based on the Clinical Multicenter Project for Analysis of Infective Endocarditis in Germany Registry, comprising patients with left-sided IE who underwent valve surgery between 1994 and 2018 in 6 German centers. Two treatment strategies were compared: CIED extraction versus no extraction.

Surgical decision-making for concomitant tricuspid valve repair in minimally invasive mitral valve surgery.

Objectives: To identify factors influencing the decision to omit tricuspid valve repair in patients who meet guideline criteria for tricuspid valve repair undergoing minimally invasive mitral valve surgery (MIMVS).

Methods: A retrospective analysis was conducted using the MIMVS International Registry, covering 7513 patients from 17 centres in Europe USA, Asia and Australia. Of these, 1077 had an indication for tricuspid valve repair.

Beating Versus Arrested Heart Technique for Isolated Tricuspid Valve Surgery: A Meta-Analysis of Reconstructed Time-to-Event Data.

Objective: Isolated tricuspid valve (TV) surgery remains underused despite guideline recommendations. This underuse may be related to perceived high risk in comorbid patients but also to high reported needs for postoperative permanent pacemaker implantation (PPI). It is conceivable that PPI can be prevented by operating on the beating heart (BH).

LAA Thrombus and Stroke From Surgical LAA Closure Failure From Suture Insufficiency Treated With LAAO.

Background: Left atrial appendage (LAA) occlusion (LAAO) is used to prevent thromboembolic events in high stroke risk patients. However, surgical LAA closure can fail, resulting in residual flow and thrombus formation.

Case Summary: A 77-year-old man with a history of bioprosthetic valve replacements and prophylactic LAA closure presented with dizziness.

Surgical Implications of the 2023 ESC Endocarditis Guidelines Endorsed by EACTS: Bridging Guidelines and Practice.

Infective endocarditis (IE) remains a challenging condition with high morbidity and mortality despite advances in diagnosis and management. The 2023 European Society of Cardiology guidelines, endorsed by the European Association of Cardio-Thoracic Surgery, introduce significant updates, including several new recommendations with regard to surgical intervention. This review synthesizes current evidence on the surgical management of IE, emphasizing indications, timing, and outcomes.

Surgical versus transcatheter treatment of aortic valve stenosis-a meta-analysis of low-risk randomized trials with completed 5-year follow-up.

Objectives: Transcatheter aortic valve implantation (TAVI) has shown similar short-term outcomes when compared to surgical aortic valve replacement (SAVR) in randomized controlled trials (RCTs). Longer-term outcomes for low-risk cohorts are now emerging. Here, we analyse all low-risk TAVI versus SAVR RCTs that completed 5-year follow-up.

Association of Subclinical Liver Fibrosis With Death in Patients With Coronary Artery Disease: A Post Hoc Analysis of the ISCHEMIA Trial.

Background: The fibrosis-4 index (FIB-4) score, a noninvasive marker of subclinical liver fibrosis, has shown prognostic utility in general surgical populations. Current risk assessment models for patients with coronary artery disease undergoing percutaneous coronary intervention or coronary artery bypass grafting do not account for liver dysfunction apart from overt liver cirrhosis. We analyzed the distribution of the baseline FIB-4 score and its association with all-cause death in patients with coronary artery disease using data from the International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) trial.

Survival Trends of Patients After Coronary Artery Bypass Grafting and Sex-Specific Differences-A Meta-Analysis of Reconstructed Time-to-Event Data.

Randomized evidence suggest that coronary artery bypass grafting (CABG) has the potential to improve life expectancy. Women are considered to have worse outcomes after CABG, but they are generally underrepresented in randomized trials meanwhile registry data and trial sub-analyses provide controversial results. We systematically assessed the survival after CABG in both sexes by analyzing studies that assessed CABG outcomes compared to the age-matched general population.

Modulation of cardiac fatty acid or glucose oxidation to treat heart failure in preclinical models: a systematic review and meta-analysis.

Background: Current expert opinion on cardiac metabolism in heart failure (HF) suggests that inhibiting cardiac fatty acid oxidation (FAO) or stimulating cardiac glucose oxidation (GO) can improve heart function. However, systematic evidence is lacking, and contradictory data exist. Therefore, we conducted a comprehensive meta-analysis to assess the effects of modulating myocardial GO or FAO on heart function.

Sex differences on the effect of hemoadsorption during cardiac surgery - A REMOVE trial post-hoc analysis.

Objectives: Multi-organ failure is one of the leading causes of mortality after cardiac surgery for infective endocarditis (IE). Although the randomized evidence does not support the use of hemoadsorption during cardiac surgery for IE, observational studies suggest a beneficial effect in selected patient groups. We aimed to analyze the effect of sex differences on hemoadsorption in patients with IE.

Cryoanalgesia in Lung Transplantation - A Systematic Review and Meta-analysis.

Background: Lung transplantation is a crucial treatment for end-stage lung diseases. However, postoperative pain management remains a significant challenge. Therefore, this study aims to examine the implications of adoption cryoanalgesia on lung transplantation pain control protocol.

Cardiac Surgery 2024 Reviewed.

For the 11th consecutive time, we systematically reviewed the cardio-surgical literature for the past year (2024), using the PRISMA approach for a results-oriented summary. In 2024, the discussion on the value of randomized and registry evidence increased, triggered by consistent findings in the field of coronary artery disease (CAD) and discrepant results in structural heart disease. The literature in 2024 again confirmed the excellent long-term outcomes of CABG compared with PCI in different scenarios, generating further validation for the CABG advantage reported in randomized studies.

Infective endocarditis in octogenarians-a multicenter analysis†.

Objectives: In an older population, infective endocarditis (IE) tends to present uniquely. In this study, we investigate the clinical presentation, microbiological profile and outcomes of IE in octogenarians.

Methods: This multicentre retrospective analysis includes 4917 consecutive patients suffering from IE.

Mini-Sternotomy vs. Right Anterior Mini-Thoracotomy for Surgical Aortic Valve Replacement - A Systematic Review and Meta-Analysis.

Introduction: Minimally invasive techniques for aortic valve replacement have become increasingly popular. The most common minimally invasive approaches are mini-sternotomy and right anterior mini-thoracotomy. We aimed to review the literature and compare clinical outcomes for these two approaches.