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, browse the feature video library and other journal highlights please visit www.jtcvs.org
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AORTA
The significance of bicuspid aortic valve after surgery for acute type A aortic dissection
Ari Mennander, MD, PhD, Christian Olsson, MD, PhD, Anders Jeppsson, MD, PhD, Arnar Geirsson, MD, Vibeke Hjortdal, MD, PhD, Emma C. Hansson, MD, PhD, Kati Jarvela, MD, PhD, Shahab Nozohoor, MD, PhD, Jarmo Gunn, MD, PhD, Anders Ahlsson, MD, PhD, Tomas Gudbjartsson, MD, PhD
Survival is comparable in patients with or without BAV after surgery for acute type A aortic dissection despite aortic regurgitation and complex aortic root surgery.
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Commentary: In surgery for acute type A aortic dissection, follow the principles and do what you need to do
Ourania Preventza, MD, Kim I. de la Cruz, MD, Joseph S. Coselli, MD
Whether patients who need surgery for acute type A aortic dissection have a BAV or TAV is irrelevant. The surgical procedure should be tailored to the individual patient.
Commentary: When is a simple tube graft a disservice in type-A dissection?
Joanna Chikwe, MD
Registry data may help determine the role for aggressive resection in acute aortic dissection.
Axillary artery cannulation reduces early embolic stroke and mortality after open arch repair with circulatory arrest
Jung-Hwan Kim, MD, Seung Hyun Lee, MD, PhD, Sak Lee, MD, PhD, Young-Nam Youn, MD, PhD, Kyung-Jong Yoo, MD, PhD, Hyun-Chel Joo, MD, PhD
In patients undergoing open aortic arch repair with circulatory arrest using antegrade cerebral perfusion, axillary artery cannulation could reduce the early embolic stroke and early mortality.
Commentary: Always do right
Kenji Minatoya, MD, PhD
The right axillary artery showed positive results in open aortic arch repair. However, this cannulation is only one of several options, and not a final solution, to completely prevent stroke.
Commentary: Does right axillary artery cannulation prevent aorto-cerebral embolic phenomena?
Thomas G. Gleason, MD
Right axillary artery cannulation for arch reconstruction is safe and effective, but large randomized, controlled trials are needed to prove whether it is superior to other cannulation techniques.
Time-resolved 3-dimensional magnetic resonance phase contrast imaging (4D Flow MRI) reveals altered blood flow patterns in the ascending aorta of patients with valve-sparing aortic root replacement
Thekla H. Oechtering, MD, Malte M. Sieren, MD, Peter Hunold, MD, Anja Hennemuth, PhD, Markus Huellebrand, MS, Michael Scharfschwerdt, PhD, Doreen Richardt, MD, Hans-Hinrich Sievers, MD, Jörg Barkhausen, MD, Alex Frydrychowicz, MD
4D Flow MRI reveals altered hemodynamics distal to prostheses in patients after VSARR, whereas in the ascending aorta of healthy volunteers, 2 counter-rotating helices typically developed.
Commentary: More valuable data on aortic blood flow patterns in valve-sparing aortic root replacements
Tohru Asai, MD, PhD
Four-dimensional flow magnetic resonance imaging study revealed disturbed flow patterns distal to the aortic root prosthesis in most patients undergoing patients undergoing valve-sparing aortic root replacement.
AORTIC FEATURED VIDEO
Echocardiography-guided aortic cannulation by the Seldinger technique for type A dissection with cerebral malperfusion
Video Legend: Echo-guided central cannulation
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MECHANICAL CIRCULATORY SUPPORT
Right ventricular function and residual mitral regurgitation after left ventricular assist device implantation determines the incidence of right heart failure
Paul C. Tang, MD, PhD, Jonathan W. Haft, MD, Matthew A. Romano, MD, Abbas Bitar, MD, Reema Hasan, MD, Maryse Palardy, MD, Xiaoting Wu, PhD, Keith D. Aaronson, MD, Francis D. Pagani, MD, PhD
After LVAD implantation, significant mitral regurgitation accompanied by poor RV function is associated with worse outcomes. Concurrent surgery to improve competency warrants further investigation.
Commentary: When suction alone is not enough
J.F. Matthias Bechtel, MD
A significant proportion of patients with preoperative severe mitral regurgitation will have it after LVAD implantation. How to identify these patients before LVAD implantation needs exploration.
Commentary: A tale of two valves
Jay K. Bhama, MD
Valve surgery at the time of left ventricular assist device implantation: it was the best of times, it was the worst of times.
PERIOPERATIVE MANAGEMENT
Association of urinary ionomic profiles and acute kidney injury and mortality in patients after cardiac surgery
Ziyan Shen, MD, Jie Lin, PhD, Jie Teng, MD, Yamin Zhuang, MD, Han Zhang, MD, Chunsheng Wang, MD, Yan Zhang, PhD, Xiaoqiang Ding, MD, PhD, Xiaoyan Zhang, MD
An index with urinary ion concentrations at 2 hours after cardiac surgery based on ion profiling was associated with cardiac surgery-associated acute kidney injury incidence and short-term outcomes.
Commentary: Acute kidney injury after cardiac surgery—Is the “-omics” way the right way?
Luigi Barberini, PhD, Andrea Montisci, MD, Ambra Cerri, MD, Antonio Miceli, MD, PhD
The application of “-omics” could open new horizons in the fight against acute kidney injury after cardiac surgery.
Commentary: Keep your ion the urine: A new way to predict postoperative acute kidney injury?
Alexander Zarbock, MD, Daniel T. Engelman, MD
Profiling ions in the urine immediately after cardiac surgery may be a new method to predict the development of cardiac-surgery associated AKI, need for renal replacement therapy, and mortality.
The impact of obesity on early postoperative atrial fibrillation burden
Corina Serban, DVM, Johnmary T. Arinze, MBBS, Roeliene Starreveld, MSc, Eva A.H. Lanters, MD, Ameeta Yaksh, MD, Charles Kik, MD, Yalin Acardag, BS, Paul Knops, BS, Ad J.J.C. Bogers, MD, PhD, Natasja M.S. de Groot, MD, PhD
Obese patients have a higher incidence of particularly long-lasting episodes of early PoAF and a higher burden for early PoAF compared with nonobese patients.
Commentary: Obesity and cardiac surgery: Double trouble for the surgeon and arrhythmologist
Hussam Ali, MD, FESC, FEHRA, FAIAC, Riccardo Cappato, MD, FESC, FHRS
Obesity is associated with a higher AF burden after cardiac surgery, requiring a multidisciplinary approach, and the potential preventive role of weight-reduction strategies needs future studies.
Commentary: Obesity and atrial fibrillation after cardiac surgery: The weight continues
Kimberly A. Holst, MD
This robust series of PoAF after cardiac surgery in obese and nonobese patients leaves us wondering about the contributions of other clinical factors and possible correlative difference in outcomes.