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
Long-term outcomes after valve-sparing anatomical aortic root reconstruction in acute dissection involving the root
Vadim Irimie, MD, Alaa Atieh, MD, Gjoko Kucinoski, MD, Atanas Jankulovski, MD, Michael Zacher, MD, Paul P. Urbanski, MD, PhD
Selective sinus repair is a very suitable surgical option for anatomical repair of dissected aortic root.
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Commentary: Aortic root reconstruction in acute dissection: What is the reality?
Alan M. Speir, MD
Surgeons without expertise in anatomic restoration of the dissected root with the patch technique may be better served with traditional root replacement.
Commentary: Can partial sinus replacement replace standard valve-sparing replacement?
Ho Jin Kim, MD, Joon Bum Kim, MD, PhD
We discuss performing a modified aortic root remodeling technique in patients with acute type A aortic dissection.
AORTIC FEATURED VIDEO
VSRR in type A dissection
The most important steps of the technique are presented in a female patient with acute type A aortic dissection extending through out the thoraco-abdominal aorta and into the supra-aortic branches.
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Frozen elephant trunk does not increase incidence of paraplegia in patients with acute type A aortic dissection
Shi Sum Poon, MBChB, MRCS (Eng), David H. Tian, MD, PhD, Tristan Yan, MD, PhD, FRACS, Deborah Harrington, FRCS (C-Th), Omar Nawaytou, FRCS (C-Th), Manoj Kuduvalli, FRCS (C-Th), Axel Haverich, MD, PhD, Marek Ehrlich, MD, Wei-Guo Ma, MD, Li-Zhong Sun, MD, Anthony L. Estrera, MD, FACS, Mark Field, DPhil (Oxon), FRCS (C-Th)
The use of TAR with FET in patients with acute type A aortic dissection does not appear to increase the incidence of paraplegia.
Commentary: Frozen elephant trunk in type A aortic dissection—Is it time to play the long game?
Clifford W. Barlow, FRCS (CTh), DPhil (Oxon), Abe DeAnda Jr., MD
The routine use of the frozen elephant trunk technique in the setting of an acute type A dissection may not have a demonstrable downside, including neurologic complications.
Commentary: Spinal cord injury after the frozen elephant trunk procedure: Are we really safe now?
Oliver J. Liakopoulos, MD
This retrospective ARCH registry analysis reports comparable incidences of SCI in patients undergoing aortic arch replacement with or without the FET technique.
AORTIC VALVE
Inter- and intrasite variability of mortality and stroke for sites performing both surgical and transcatheter aortic valve replacement for aortic valve stenosis in intermediate-risk patients
Kevin L. Greason, MD, Eugene H. Blackstone, MD, Jeevanantham Rajeswaran, PhD, Ashley M. Lowry, MS, Lars G. Svensson, MD, PhD, John G. Webb, MD, E. Murat Tuzcu, MD, Craig R. Smith, MD, Raj R. Makkar, MD, Michael J. Mack, MD, Vinod H. Thourani, MD, Susheel K. Kodali, MD, Martin B. Leon, MD, D. Craig Miller, MD
Intersite variability in mortality was present and similar for SAVR and TAVR in the PARTNER-2A trial, but greater for stroke in the SAVR group. Intrasite occurrence of these events was similar.
Commentary: Variability matters—lessons for quality and health policy
Robert B. Hawkins, MD, MSc, J. Hunter Mehaffey, MD, MSc
Considerable variability in mortality after TAVR is in part driven by the inverse volume−mortality relationship. Health policy should address this issue using clinical data to improve quality.
Commentary: Constant variability
Marvin Atkins, MD, Michael J. Reardon, MD
Variability is constant in medicine. Understanding the sources and levels of variability is important to understanding and interpreting clinical trials.
ENDOCARDITIS
Risk of reoperative valve surgery for endocarditis associated with drug use
Makoto Mori, MD, Syed Usman Bin Mahmood, MBBS, Asher J. Schranz, MD, Ibrahim Sultan, MD, Andrea L. Axtell, MD, Nadeen Sarsour, MD, William Hiesinger, MD, Marko T. Boskovski, MD, MPH, Sameer Hirji, MD, Tsuyoshi Kaneko, MD, Joseph Woo, MD, Paul Tang, MD, Arminder S. Jassar, MBBS, Pavan Atluri, MD, Bryan A. Whitson, MD, PhD, Thomas Gleason, MD, Arnar Geirsson, MD
Compared with first-time valve surgery, redo valve surgery in patients with drug-associated endocarditis has twice the risk of mortality, despite these patients being young and relatively healthy.
Commentary: How many times are enough? Infective endocarditis in drug users
Siamak Mohammadi, MD, FRCSC, Dimitri Kalavrouziotis, MD, FRCSC
Reoperations can be performed safely for drug-related endocarditis. Prognosis in these young patients may be influenced more by concerted rehabilitation programs than by progress in surgical technique.
Commentary: When is repeated cardiac valve surgery justified during drug-associated infective endocarditis?
Ari A. Mennander, MD, PhD
Repeated cardiac valve surgery for drug-associated infective endocarditis adheres to persistent follow-up and adjuvant treatment.
TRANSPLANTATION
Left ventricular dysfunction in potential heart donors and its influence on recipient outcomes
Jonatan Oras, MD, PhD, Rana Doueh, MD, Erik Norberg, MD, Björn Redfors, MD, PhD, Elmir Omerovic, MD, PhD, Göran Dellgren, MD, PhD
Donor hearts with left ventricular dysfunction were safely transplanted in this study. Systematic use of such hearts have the potential to significantly increase transplantation rates.
Commentary: Fixing broken hearts—A supply-side proposition
Joseph C. Cleveland Jr., MD
Donor hearts with transient, reversible left ventricular dysfunction can be transplanted with acceptable outcomes.
Commentary: To use or not to use? This is the question
Yaron D. Barac, MD, PhD
Left ventricular dysfunction in cardiac donors may be transient, and these organs should therefore be considered for transplantation.
PERIOPERATIVE MANAGEMENT
Preoperative predictors of new-onset prolonged atrial fibrillation after surgical aortic valve replacement
Andrea L. Axtell, MD, MPH, Philicia Moonsamy, MD, Serguei Melnitchouk, MD, MPH, George Tolis, MD, Arminder S. Jassar, MD, David A. D'Alessandro, MD, Mauricio A. Villavicencio, MD, MBA, Duke E. Cameron, MD, Thoralf M. Sundt III, MD
Advanced age and left atrial enlargement identify a stratum of patients at high risk of developing prolonged postoperative atrial fibrillation after SAVR.
Commentary: Atrial fibrillation after aortic valve replacement: Predict, prevent, protect
Marc Gillinov, MD, Edward G. Soltesz, MD, MPH
Prolonged postoperative atrial fibrillation can be predicted after surgical aortic valve replacement. This can be used to inform patient selection for trials of preventive strategies.
Commentary: Postoperative atrial fibrillation can last years? Oh snap!
Bobby Yanagawa, MD, PhD, Niv Ad, MD, Mario F. Gaudino, MD
Postoperative atrial fibrillation may beget long-term risk of atrial fibrillation.