The following is a collection of featured adult cardiac articles in press from the Journal of Thoracic and Cardiovascular Surgery (JTCVS). To read the latest issue, or browse the feature video library and other journal highlights, please visit www.jtcvs.org.
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AORTA
Unilateral is comparable to bilateral antegrade cerebral perfusion in acute type A aortic dissection repair
Elizabeth L. Norton, MS, Xiaoting Wu, PhD, Karen M. Kim, MD, Himanshu J. Patel, MD, G. Michael Deeb, MD, Bo Yang, MD, PhD
Unilateral ACP provides adequate cerebral protection and achieves favorable short-term outcomes and mid-term survival in acute type A aortic dissection repair as effectively as bilateral ACP.
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Commentary: Have we finally settled the debate of unilateral versus bilateral antegrade cerebral perfusion for brain protection during type A repair?
Francois Dagenais, MD
Uni-ACP should be the preferred method of cerebral protection during hemiarch and proximal arch procedures for type A dissection. The safety during full arch procedures requires further investigation.
Commentary: Can unilateral antegrade cerebral perfusion constitute a unified method for acute type A aortic dissection repair?
Hitoshi Matsuda, MD, PhD, Soichiro Kitamura, MD, PhD
Conversion of uni-ACP to bi-ACP was encountered in 2%. It is wise to know the utility of both uni-ACP and bi-ACP and to then use the more effective ACP type for each patient rather than unified ACP.
Handmade fenestrated stent grafts to preserve all supra-aortic branches in thoracic endovascular aortic repair
Huey-Shiuan Kuo, MD, Jih-Hsin Huang, MD, Jer-Shen Chen, MD
The handmade fenestrated stent graft is a reasonable strategy to achieve endovascular total arch replacement.
Commentary: Are we closer than we think to a customizable, endovascular total arch?
Joshua C. Grimm, MD, Wilson Y. Szeto, MD
Endovascular options for acute management of the aortic arch are limited. The authors present a novel technique of on-the-table fenestration to produce a fully customizable arch endograft.
Sex differences in thoracic aortic disease: A review of the literature and a call to action
Jennifer Chung, MD, MSC, Thais Coutinho, MD, Michael W.A. Chu, MD, MEd, Maral Ouzounian, MD, PhD
Important sex-related differences exist in the epidemiology, biology, management, and outcomes of patients with thoracic aortic disease.
MITRAL VALVE
Preoperative left atrial volume index is associated with postoperative outcomes in mitral valve repair for chronic mitral regurgitation
Parvathi Balachandran, MBBS, PhD, Hartzell V. Schaff, MD, Brian D. Lahr, MS, Anita Nguyen, MBBS, Richard C. Daly, MD, Simon Maltais, MD, PhD, Sorin V. Pislaru, MD, Joseph A. Dearani, MD
Preoperative LAVI is an important predictor of postoperative outcomes in patients undergoing MV repair for chronic MR.
Commentary: At the heart of the matter—Left atrial volume index in chronic mitral regurgitation
Madeline L. Fryer, MMSc, Leora B. Balsam, MD
Evidence-based guidelines aid in determining the timing of mitral repair for degenerative disease. The usefulness of left atrial volume index in this decision making is explored in a new study.
FEATURE VIDEO
MV repair with posterior triangular resection and annuloplasty using a 63-mm band.
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CORONARY
Surgical ablation of atrial fibrillation concomitant to coronary-artery bypass grafting provides cost-effective mortality reduction
J. Scott Rankin, MD, Daniel J. Lerner, MD, Mary Jo Braid-Forbes, MPH, Michelle M. McCrea, MS, Vinay Badhwar, MD
Surgical ablation in patients with atrial fibrillation undergoing coronary artery bypass grafting is associated with reductions in 2-year unadjusted mortality and risk-adjusted hazard of late mortality (90 days to 2 years) without an increase in total risk-adjusted inpatient cost.
Commentary: Excitement at the interface of disciplines: The mean cumulative function
Eugene H. Blackstone, MD, Jeevanantham Rajeswaran, PhD
Both analysis of repeated events, such as rehospitalizations, and the costs of those events can be graphically depicted and analyzed multivariably using the mean cumulative function.
Commentary: Is surgical ablation concomitant with coronary artery bypass grafting cost-effective? No answers, just questions
Vijay S. Patel, MD, Richard Lee, MD, MBA
The cost-effectiveness of concomitant surgical ablation remains undefined, despite growing evidence for its perioperative and midterm to long-term morbidity and mortality benefits.
TRANSPLANT
Outcomes in patients with solid organ transplants undergoing cardiac surgery
Valentino Bianco, DO, MPH, Arman Kilic, MD, Thomas G. Gleason, MD, Edgar Aranda-Michel, BS, Matthew E. Harinstein, MD, Floyd Thoma, BS, Forozan Navid, MD, Ibrahim Sultan, MD
Cardiac surgery can be performed with acceptable operative and long-term mortality in patients with prior solid organ transplants, although with a higher rate of unplanned readmissions.
Commentary: The gift of life—With a price
Vivek Rao, MD, PhD
As the results of solid organ transplantation continue to improve, an increasing cohort of patients survive to develop ischemic or valvular heart disease. Surgery can be performed with acceptable outcomes.
Commentary: Surgical sequels in solid organ transplant
David L. Joyce, MD
Previous solid organ transplant should not preclude consideration of subsequent cardiac surgery.