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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cardiac surgery a risk factor for open repair of acute
type A aortic dissection?
Elizabeth L. Norton, MS, Carlo
Maria Rosati, MD, Karen M. Kim, MD, Xiaoting Wu, PhD,
Himanshu J. Patel, MD, G. Michael Deeb, MD, Bo Yang,
patients with PCS can be and should be treated
surgically for favorable short- and long-term outcomes.
An equal opportunity to survive—Previous cardiac
surgery is not a contraindication to type A dissection
Lau, MD, Leonard N. Girardi, MD
Patients with acute type A
dissection after previous cardiac surgery should be
offered surgery. Outcomes are like no PCS in
experienced centers and better than medical
management in all settings.
AORTA FEATURED VIDEO
Discussion of surgical treatment
of ATAAD in patients with PCS: short- and long-term
complications after the frozen elephant trunk procedure:
A meta-analysis of more than 3000 patients
Ourania Preventza, MD, Jane L.
Liao, MD, Jacqueline K. Olive, BA, Katherine Simpson,
MS, Andre C. Critsinelis, MD, Matt D. Price, MS,
Marianne Galati, MSW, MLS, Lorraine D. Cornwell, MD,
Vicente Orozco-Sevilla, MD, Shuab Omer, MD, Ernesto
Jimenez, MD, Scott A. LeMaire, MD, Joseph S. Coselli,
10-cm stent length is advisable; length 15 cm or
greater or coverage to or beyond T8 should be avoided
to prevent SCI. FET should be used cautiously for acute
type A aortic dissection.
The elephant in the room: Walking the walk and talking
the talk after a frozen elephant trunk procedure
Lou, MD, Edward P. Chen, MD
FET may increase risk of spinal cord
ischemia with extended stent coverage and should be
used cautiously in acute type A dissection. RCTs
are needed to guide best practice as FET gains
Is it time to thaw the frozen elephant trunk procedure?
T. Kouchoukos, MD
Extensive analysis continues to
indicate that spinal cord ischemic injury is an
important complication of the frozen elephant trunk
technique for repair of extensive thoracic aortic
Summary of meta-analysis study of
more than 3000 patients in whom the FET technique was
used and a discussion of this technique's importance.
geometric orientations for aortic neoroot creation in
bicuspid aortic valve repair with root reimplantation
Mary A. Siki, BS, Andreas
Habertheuer, MD, PhD, Joseph E. Bavaria, MD, Caroline
Komlo, BS, Maxwell Hunt, BS, Melanie A. Freas, CRNP,
Rita K. Milewski, MD, PhD, Nimesh D. Desai, MD, PhD,
Wilson Y. Szeto, MD, Prashanth Vallabhajosyula, MD, MS
the BAV geometry for VSRR neoroot creation yields
excellent midterm outcomes. This may minimize leaflet
billowing and stress from “forcing” a 150°/210° type I
BAV into a 180°/180° neoroot.
Should we attempt to refine an already imperfect
De Paulis, MD
Symmetric bicuspid valves appear to
function better and probably longer. The
reestablishment of a good symmetry at the time of
valve repair appears promising, but it is still
matter of controversy.
Bicuspid aortic valve geometry—A tale of two valves
Hunter Mehaffey, MD, MSc, Robert B. Hawkins, MD, MSc
Valve-sparing root reimplantation is
feasible in bicuspid aortic valve, and respecting
the geometry may provide the optimal outcomes in
the higher-risk Sievers type 1 valves.
after implantation of the Perceval S aortic bioprosthesis
Philipp Stegmeier, MD, Markus
Schlömicher, MD, Hugo Stiegler, MD, Justus T. Strauch,
MD, J.F. Matthias Bechtel, MD
counts after aortic valve replacement with the Perceval
S (LivaNova PLC, London, United Kingdom) bioprosthesis
decrease significantly more compared with other
biological valves, but without apparent clinical
Perceval S bioprosthesis valve and platelets: The
thrombocytopenia is behind the corner and the mystery
Formica, MD, Fabio Guarracino, MD
The Perceval S valve implant is
still linked to thrombocytopenia, a relevant and
unsolved event early after surgery. No severe
complications are directly correlated with this
Thrombocytopenia yes…thrombocytopenia no…that is the
Miceli, MD, PhD
Thrombocytopenia is a transient and
multifactorial phenomenon in the absence of
clinical complications. Mechanical stress induced
by oversizing may be a potential cause of
a risk score for early saphenous vein graft failure: An
individual patient data meta-analysis
Alexios S. Antonopoulos, MD, PhD,
Ayodele Odutayo, MD, PhD, Evangelos K. Oikonomou, MD,
PhD, Marialena Trivella, BSc, MSc, DPhil, Mario Petrou,
PhD, FRCS (CTh), Gary S. Collins, BSc, PhD, Charalambos
Antoniades, MD, PhD, the SAFINOUS-CABG (Saphenous Vein
Graft Failure—An Outcomes Study in Coronary Artery
Bypass Grafting) group
risk score (SAFINOUS score) estimates the
individualized risk for early vein graft failure based
on clinical, anatomical, and operative factors.
Saphenous vein graft risk score: But where is the vein?
Yanagawa, MD, PhD, Mario F.L. Gaudino, MD
It is unlikely that a risk score
could be used to guide grafting strategy.
Better prediction, better execution, better management
J.P. Burns, MD, MPhil
With a summary published risk of
11%, early saphenous vein graft failure remains an
important issue. A novel scoring system for early
failure may help surgeons predict this event.
MECHANICAL CIRCULATORY SUPPORT
with durable left ventricular assist device replacement
using the HeartMate 3
Yaron D. Barac, MD, PhD, Charles
M. Wojnarski, MD, MS, Parichart Junpaparp, MD, Oliver
K. Jawitz, MD, Han Billard, MD, Mani A. Daneshmand, MD,
Richa Agrawal, MD, Adam Devore, MD, Chetan B. Patel,
MD, Jacob N. Schroder, MD, Carmelo A. Milano, MD
replacement with HM3 can be performed safely and may be
considered as the pump of choice in patients requiring
For the pumps they are a-changin’
A. Whitson, MD, PhD
As we are firmly into a new era of
centrifugal, continuous-flow left ventricular
assist devices, our management of the complications
of previous-generation pumps and these pumps
Left ventricular assist devices, they are a-changin'…
J. Goldstein, MD
For patients in need of LVAD pump
exchange, replacement with a HM3 device provides
survival and freedom from recurrent pump thrombosis
Left ventricular assist device exchange: Have we found
the golden ticket?
Bedeir, MD, Tsuyoshi Kaneko, MD, and Sary Aranki, MD,
The tool box of nonfemoral access
for TAVI has evolved, with the optimal alternative
approach yet to be determined.