Articles

Concomitant ablation of atrial fibrillation in octogenarians: an observational study

Cardiac surgery is increasingly required in octogenarians. These patients frequently present atrial fibrillation (AF), a significant factor for stroke and premature death. During the last decade, AF ablation h...

Authors: Herko Grubitzsch, Sven Beholz, Pascal M Dohmen, Simon Dushe and Wolfgang Konertz

Accelerated intimal hyperplasia in aortocoronary internal mammary vein grafts in minipigs

More than 50% of aortocoronary saphenous vein grafts are occluded 10 years after surgery. Intimal hyperplasia is the initial critical step in the progression toward occlusion. Internal mammary veins, which are...

Authors: Aron Frederik Popov, Hilmar Dorge, Jose Hinz, Jan Dieter Schmitto, Tomislav Stojanovic, Ralf Seipelt, Vassilios Didilis and Friedrich Albert Schoendube

Left atrial giant thrombus infected by Escherichia Coli. Case report

Left atrial thrombi are mostly related to mitral valve disease. The differential diagnosis of clots and myxomas in the left atrium is mostly based on echocardiography. Infection of intracardiac thrombi is extr...

Authors: Panagiotis Dedeilias, Antonios Roussakis, Efstratios N Koletsis, Dimitrios Zervakis, Panagiotis Hountis, Christos Prokakis, Christina Balaka and Konstantinos Bolos

Does preservation of the sub-valvular apparatus during mitral valve replacement affect long-term survival and quality of life? A Microsimulation Study

Techniques to preserve the sub-valvular apparatus in order to reduce morbidity and mortality following mitral valve replacement have been frequently reported. However, it is uncertain what impact sub-valvular ...

Authors: Christopher Rao, Jonathan Hart, Andre Chow, Fotios Siannis, Polyxeni Tsalafouta, Bari Murtuza, Ara Darzi, Frank C Wells and Thanos Athanasiou

Alterations in plasma soluble vascular endothelial growth factor receptor-1 (sFlt-1) concentrations during coronary artery bypass graft surgery: relationships with post-operative complications

Plasma concentrations of sFlt-1, the soluble form of the vascular endothelial growth factor receptor (VEGF), markedly increase during coronary artery bypass graft (CABG) surgery with extracorporeal circulation...

Authors: Yves Denizot, Alexandre Leguyader, Elisabeth Cornu, Marc Laskar, Isabelle Orsel, Christelle Vincent and Nathalie Nathan

Long term survival after coronary endarterectomy in patients undergoing combined coronary and valvular surgery – a fifteen year experience

Coronary Endarterectomy (CE) in patients undergoing coronary artery bypass graft (CABG) surgery has been shown to be beneficial in those with diffuse coronary artery disease. There are no published data on its...

Authors: Sanjay Kumar, Sandeep Agarwala, Charlie Talbot and R. Unnikrishnan Nair

Influence of ultra-low dose Aprotinin on thoracic surgical operations: a prospective randomized trial

The blood saving effect of aprotinin has been well documented in cardiac surgery. In thoracic surgery, very few recent studies, using rather high doses of aprotinin, have shown a similar result. In a randomize...

Authors: Efstratios Apostolakis, Nikolaos Panagopoulos, Efstratios N. Koletsis, James Crockett, Helen Stamou-Kouki, Efrosini Sourgiadaki, Kriton Filos and Dimitrios Dougenis

VATS intraoperative tattooing to facilitate solitary pulmonary nodule resection

Video-assisted thoracic surgery (VATS) has become routine and widely accepted for the removal of solitary pulmonary nodules of unknown etiology. Thoracosopic techniques continue to evolve with better instrumen...

Authors: Lourens Willekes, Cherif Boutros and Michael A. Goldfarb

Migration of superior vena cava stent

There has been a recent increase in the use of endovascular prostheses resulting in complex surgical and interventional complications not previously recognised. We report a case of Superior vena cava stenosis ...

Authors: Nitin B. Bagul, Phillipa Moth, Narayan J. Menon, Fiona Myint and George Hamilton

Cardiac surgery in patients with previous pneumonectomy

Severe pulmonary dysfunction is a commonly occurring postoperative complication following cardiac surgery. Resection of a lung causes major anatomical and physiological changes. Shift of the mediastinum and re...

Authors: Sanjay V. Ghotkar, Vikram Aerra and Neeraj Mediratta

Surgical strategy to prevent cardiac injury during reoperation in infants

Simplified Aortic Cannulation (SAC), wherein the innominate artery is used as the arterial inflow site rather than the ascending aorta, has proved to be a useful technique for arterial cannulation especially f...

Authors: Christopher J Knott-Craig, Steven P Goldberg and James K Kirklin

Factors which influence the cardiac surgeon's decision not to operate on patients referred for consideration of surgery

The aim of this study was to document what proportion of patients referred for consideration of cardiac surgery are turned down, the reasons given for not operating and also to evaluate what happens to those p...

Authors: Paul D Waterworth, Sing Y Soon, Rohith Govindraj, Rajesh Sivaprakasam, Mark Jackson and Antony D Grayson

Clinical implications of granulomatous inflammation detected by endobronchial ultrasound transbronchial needle aspiration in patients with suspected cancer recurrence in the mediastinum

Granulomatous inflammation has been previously reported in association with cancer. Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is a new minimally invasive test for investigati...

Authors: Marcus P Kennedy, Carlos A Jimenez, Ashwini D Mhatre, Rodolfo C Morice and Georgie A Eapen

Extracardiac Fontan with T-shape conduit in non-confluent pulmonary arteries

A 34 months-old male patient with double inlet right ventricle with nonconfluent pulmonary arteries who underwent successful extracardiac fenestarated Fontan procedure using pre-designed T-shaped PTFE vascular...

Authors: Jae Gun Kwak, Jeong Ryul Lee, Woo-Sung Jang and Eun Jung Bae

Axillary artery to left anterior descending coronary artery bypass with an externally stented graft: a technical report

With the proliferation of minimally invasive cardiac surgery a number of alternative inflow sites for coronary artery bypass grafting have been utilized, especially in higher risk patients. The use of axillary...

Authors: Thanos Athanasiou, Emmanouil I Kapetanakis, Christopher Rao, Loris Salvador and Ara Darzi

Aortic valve replacement in a young patient with essential thrombocytosis

Essential Thrombocythcythaemia (ET) is an uncommon type of myeloproliferative disorder, characterised by both thrombotic and haemorrhagic diathesis. No clear guidelines exist for the pre- and post-operative ma...

Authors: Kashif Ahmed, Hunaid A Vohra, Alison Milne and Stephen M Langley

How I do it: transapical cannulation for acute type-A aortic dissection

Aortic dissection is the most frequently diagnosed lethal disease of the aorta. Half of all patients with acute type-A aortic dissection die within 48 hours of presentation. There is still debate as to the opt...

Authors: Andrzej W Sosnowski, Rajwinder S Jutley, Nicola Masala, Christos Alexiou and Justiaan Swanevelder

Oesphageal Stenting for palliation of malignant mesothelioma

Dyspahgia in patients with malignant mesothelioma is usually due to direct infiltration of the eosophagus by the tumour. It can be distressing for the patient and challenging for the physician to treat. We des...

Authors: Enoch Akowuah and Joseph Rahamim

Use of continuous subcutaneous anesthetic infusion in cardiac surgical patients after median sternotomy

The use of opioid analgesics to control pain after median sternotomy in cardiac surgical patients is worldwide accepted and established. However, opioids have a wide range of possible side effects, concerning ...

Authors: Ioannis Koukis, Mihalis Argiriou, Antonia Dimakopoulou, Victor Panagiotakopoulos, Nikolaos Theakos and Christos Charitos

Coronary artery aneurysm: case report

Aneurysms of the left main coronary artery are rare with an incidence of 0.1% in large angiographic series. The majority are atherosclerotic in origin. Other causes include connective tissue disorders, trauma,...

Authors: Jeffrey E Everett and Harold M Burkhart

Length of pressure-controlled reperfusion is critical for reducing ischaemia-reperfusion injury in an isolated rabbit lung model

Ischaemia-reperfusion injury is still a major problem after lung transplantation. Several reports describe the benefits of controlled graft reperfusion. In this study the role of length of the initial pressure...

Authors: Stefan Guth, Diethard Prüfer, Thorsten Kramm and Eckhard Mayer

No hypoperfusion is produced in the epicardium during application of myocardial topical negative pressure in a porcine model

Topical negative pressure (TNP), commonly used in wound therapy, has been shown to increase blood flow and stimulate angiogenesis in skeletal muscle. We have previously shown that a myocardial TNP of -50 mmHg ...

Authors: Sandra Lindstedt, Malin Malmsjö and Richard Ingemansson

Management of acquired bronchobiliary fistula: 3 case reports and a literature review

Bronchobiliary fistula (BBF), which often presents with bilioptysis, is an abnormal communication between the bronchial system and biliary tree. It is a complication associated with a high mortality rate and r...

Authors: Hatice Eryigit, Selahattin Oztas, Senol Urek, Guven Olgac, Melahat Kurutepe and Cemal Asim Kutlu

Modifiable risk factors remain significant causes of medium term mortality after first time Coronary artery bypass grafting

Whilst there is much current data on early outcomes after Coronary artery bypass grafting(CABG), there is relatively little data on medium term outcomes in the current era. The purpose of this study is to pres...

Authors: Babu Kunadian, Joel Dunning and Russell W. J. Millner

Recombinant activated factor VII in cardiac surgery – first, do no harm

Authors: Oliver J. Warren, Ara W. Darzi and Thanos Athanasiou

Therapeutic angiogenesis in cardiovascular disease

Atherosclerotic disease of the arteries is a major cause of coronary artery disease, peripheral vascular disease and stroke. Some patients are however not candidate for the standard treatment of angioplasty or...

Authors: Hilal Al Sabti

Pleural myxoid liposarcoma: features of 2 cases and associated literature review

Primary pleural myxoid liposarcoma is a rare entity and no agreed treatment options have been formulated once diagnosis has been made. We report two cases with subsequent management and make recommendations fo...

Authors: Paul Goldsmith and Kostas Papagiannopoulos

Recombinant activated factor VII (Novo7^®) in patients with ventricular assist devices: Case report and review of the current literature

Postoperative bleeding might become a serious problem in the management of cardiac surgical patients, with marked medical and economic impact. In these life-threatening situations, massive haemorrhage represen...

Authors: Daniel Heise, Anselm Bräuer and Michael Quintel

Coronary artery surgery: cardiotomy suction or cell salvage?

Coronary artery bypass grafting (CABG) today results in what may be regarded as acceptable levels of blood loss with many institutions avoiding allogeneic red cell transfusion in over 60% of their patients. Th...

Authors: Kelvin Lau, Hetul Shah, Andrea Kelleher and Neil Moat

Fixation artefact in an intra-operative frozen section: a potential cause of misinterpretation

The intra-operative histological assessment of fresh tissue can provide valuable diagnostic information and guide surgical management, however, even a limited exposure to standard fixation agents can potential...

Authors: Andrew M Thomson and William A Wallace

The effect of total arterial grafting on medium-term outcomes following coronary artery bypass grafting

While it is believed that total arterial grafting (TAG) for coronary artery bypass grafting (CABG) confers improved long-term outcomes when compared to conventional grafting with left internal mammary artery a...

Authors: Jean-Francois Légaré, Ansar Hassan, Karen J Buth and John A Sullivan

Augmentation index assessed by applanation tonometry is elevated in Marfan Syndrome

To examine whether augmentation index (AIx) is increased in Marfan syndrome (MFS) and associated with increased aortic root size, and whether a peripheral-to-central generalised transfer function (GTF) can be ...

Authors: Rupert A Payne, Roland C Hilling-Smith, David J Webb, Simon R Maxwell and Martin A Denvir

Hyperdominant left anterior descending artery continuing across left ventricular apex as posterior descending artery coexistent with aortic stenosis

We describe, in a 61 year old man, with coexistent aortic stenosis, the anomalous origin of posterior descending artery (PDA) from a stenotic left anterior descending (LAD) artery, as its continuation across t...

Authors: Kalyana Javangula and Pankaj Kaul

Video-assisted mediastinoscopy (VAM) for surgical resection of ectopic parathyroid adenoma

Ectopic mediastinal parathyroid adenomas or hyperplasia account for up to 25% of primary hyperparathyroidism (HPT). Two percent of them are not accessible by standard cervical surgical approaches. Surgical res...

Authors: Peter Tcherveniakov, Ashvini Menon, Richard Milton, Kostas Papagiannopoulos, Mark Lansdown and James AC Thorpe

Effect of surgeon on transprosthetic gradients after aortic valve replacement with Freestyle^® stentless bioprosthesis and its consequences: A follow-up study in 587 patients

The implantation of stentless valves is technically demanding and the outcome may depend on the performance of surgeons. We studied systematically the role of surgeons and other possible determinants for mid-t...

Authors: Alexander Albert, Ines Florath, Ulrich Rosendahl, Wael Hassanein, Eberhard V Hodenberg, Stefan Bauer, Ina Ennker and Jürgen Ennker

Efficacy of chordal cutting in alleviating ischemic mitral regurgitation: insights from 3-dimensional echocardiography

Ischemic mitral regurgitation often complicates severe ischemic heart disease and adversely affects the prognosis in these patients. There is wide variation in the clinical spectrum of ischemic mitral regurgit...

Authors: Chittoor B Sai-Sudhakar, Rashmi Vandse, Todd A Armen, Katherine M Bickle and Nadia S Nathan

Release of soluble vascular endothelial growth factor receptor-1 (sFlt-1) during coronary artery bypass surgery

This study was conducted to follow plasma concentrations of sFlt-1 and sKDR, two soluble forms of the vascular endothelial growth factor (VEGF) receptor in patients undergoing coronary artery bypass graft (CAB...

Authors: Yves Denizot, Alexandre Leguyader, Elisabeth Cornu, Marc Laskar, Isabelle Orsel, Christelle Vincent and Nathalie Nathan

Monitoring of oxidative and metabolic stress during cardiac surgery by means of breath biomarkers: an observational study

Volatile breath biomarkers provide a non-invasive window to observe physiological and pathological processes in the body. This study was intended to assess the impact of heart surgery with extracorporeal circu...

Authors: Florian Pabst, Wolfram Miekisch, Patricia Fuchs, Sabine Kischkel and Jochen K Schubert

Combined sterno-clavicular approach as an alternative technique in hybrid exclusion of aortic arch aneurysm

We describe a modified access technique for the proximal (open) part of single stage hybrid exclusion of aneurysm of the aortic arch.

Authors: Aristotle D Protopapas, Christopher Rao, Andrew Choong, Nicholas JW Cheshire and Thanos Athanasiou

Cardiothoracic surgery at a crossroads: The impact of disruptive technologic change

At the beginning of the twenty-first century, cardiothoracic surgery is arguably the most successful of all medical specialties. There are effective treatments including transplantation, for almost all cardiac...

Authors: David J Cohen

Primary cardiac sarcoma: reports of two cases and a review of current literature

Primary cardiac sarcomas are rare tumors with an unfavourable prognosis. Complete surgical resection is currently the only mode of therapy proven to show any benefit. We report the cases of two patients presen...

Authors: Mohan P Devbhandari, Shaista Meraj, Mark T Jones, Isaac Kadir and Ben Bridgewater

Aortic valve replacement in octogenarians

As our population ages and life expectancy increases the number of people aged over 80 and more referred for cardiac surgery is growing. This study sought to identify the outcome of aortic valve replacement (A...

Authors: Amal K Bose, James D Aitchison and John H Dark

Use of activated recombinant factor VII for severe coagulopathy post ventricular assist device or orthotopic heart transplant

Ventricular assist devices(VAD) implantation/removal is a complex surgical procedure with perioperative bleeding complications occurring in nearly half of the cases. Recombinant activated factor VII (rFVIIa) h...

Authors: Manish J Gandhi, Richard A Pierce, Lini Zhang, Marc R Moon, George J Despotis and Nader Moazami

Cardiopulmonary bypass via common carotid artery cannulation in redo sternotomy

There are certain situations in redo cardiac surgery in adults where it may not be possible to use alternate arterial cannulation sites like the common femoral artery and axillary artery. We report a case wher...

Authors: Sunil K Bhudia, Hunaid A Vohra, Asif Hassan and Qamar Abid

Burkitt lymphoma masquerading as cardiac tamponade

A 61 year old man presented with diffuse large B cell lymphoma of the skin of the back of the shoulder which was excised and treated with chemotherapy (CHOP regime) in 1998. He was in complete remission till h...

Authors: Pankaj Kaul and Kalyana Javangula

Pleural inflammatory myofibroblastoma: a locally aggressive intra-thoracic tumour

A 41-year old non-smoking woman presented with persistent pleural effusion. Pleural fluid was hemorrhagic and fluid cytology was negative for malignant cells. A working diagnosis of chronic haemothorax was mad...

Authors: Chandrashekhar Kubal, Sanjay Ghotkar, John Gosney and Martyn Carr

Extracorporeal membrane oxygenator as a bridge to successful surgical repair of bronchopleural fistula following bilateral sequential lung transplantation: a case report and review of literature

Lung transplantation (LTx) is widely accepted as a therapeutic option for end-stage respiratory failure in cystic fibrosis. However, airway complications remain a major cause of morbidity and mortality in thes...

Authors: Nouman U Khan, Mohamed Al-Aloul, Noman Khasati, Ali Machaal, Colm T Leonard and Nizar Yonan

Non-invasive assessment of coronary artery bypass graft patency using 16-slice computed tomography angiography

Invasive coronary angiography is the gold standard means of imaging bypass vessels and carries a small but potentially serious risk of local vascular complications, including myocardial infarction, stroke and ...

Authors: Emma S Houslay, Tristan Lawton, Anshuman Sengupta, Neal G Uren, Graham McKillop and David E Newby

Skeletonization of radial and gastroepiploic conduits in coronary artery bypass surgery

The use of a skeletonized internal thoracic artery in coronary artery bypass graft surgery has been shown to confer certain advantages over a traditional pedicled technique, particularly in certain patient gro...

Authors: Rachel M Massey, Oliver J Warren, Michal Szczeklik, Sophie Wallace, Daniel R Leff, John Kokotsakis, Ara Darzi and Thanos Athanasiou

Morbidity associated with systemic corticosteroid preparation for coronary artery bypass grafting in patients with chronic obstructive pulmonary disease: a case control study

Coronary artery bypass grafting (CABG) is associated with high morbidity in patients with chronic obstructive pulmonary disease (COPD).

Authors: Daniele Starobin, Mordechai Rehuven Kramer, Moshe Garty and David Shitirt