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.
for monthly AATS Journal Alerts here. (Please note you will be asked to login
or create an account for AATS Online.)
previous AATS Journal Alerts here.
add email@example.com to your Safe Sender list.
The fate of
residual aortic regurgitation after ascending aorta
replacement in type A aortic dissection
Do Jung Kim,
MD, Sak Lee, MD, PhD, Seung Hyun Lee, MD, PhD,
Young-Nam Youn, MD, PhD, Byung-Chul Chang, MD, PhD,
Kyung-Jong Yoo, MD, PhD, Hyun-Chel Joo, MD, PhD
Higher preoperative and postoperative AR
grades and high false to true lumen ratio increased the
significant AR risk in patients undergoing AAR with
valve/root preservation for type A aortic dissection.
Moving the goalposts
Dawn S. Hui, MD
proximal reoperations after acute type A dissection
repair have been characterized as rare, patients at
risk for midterm valve dysfunction might be
considered for a more aggressive approach.
Progressive aortic valve regurgitation after
replacement of the dissected ascending aorta: An
Oliver J. Liakopoulos, MD, Yeong-Hoon
single-center retrospective analysis provides new
insights of long-term durability of ascending
aortic replacement in patients presenting with type
A acute aortic dissection.
regurgitation grade decreased significantly after
ascending aortic replacement in patients with acute
type A aortic dissection with severe aortic
and survival with postpericardiotomy syndrome after
surgical aortic valve replacement
MD, PhD, Jarmo Gunn, MD, PhD, Rikhard Björn, MD, Markus
Malmberg, MD, PhD, K.E. Juhani Airaksinen, MD, PhD,
Ville Kytö, MD, PhD, MSocSc, Tuomo Nieminen, MD, PhD,
Juha E.K. Hartikainen, MD, PhD, Fausto Biancari, MD,
PhD, Tuomas O. Kiviniemi, MD, PhD, FESC
Patients with severe PPS were at
increased risk for mortality. A transient increased
risk of new-onset AF was observed, but PPS had no
effect on the occurrence of cerebrovascular events or
Postpericardiotomy syndrome remains an enigma
Kevin L. Greason, MD
syndrome occurs in about 10% of patients after
isolated surgical aortic valve replacement. The syndrome
may put patients at increased risk of long-term
Postpericardial syndrome after cardiac surgery: Is it
Suk Jung Choo, MD, PhD
is generally regarded as a benign condition, but
because severe PPS may increase mortality risk,
patients should be treated for both the condition
itself and to prevent disease progression.
VALVE: BASIC SCIENCE
aortopathy is associated with distinct patterns of matrix
Ya Hua Chim,
PhD, Hannah A. Davies, PhD, David Mason, PhD, Omar Nawaytou,
MD, Mark Field, MD, Jillian Madine, PhD, Riaz Akhtar,
Bicuspid aortic valve aneurysm (BAV-A)
patients display a stiffer aortic wall relative to
idiopathic aortic aneurysm (DA) patients. This is
related to elastin microstructure rather than elastin
Can we move beyond aortic size, using real-time
analysis of aortic tissue, to more precisely guide
therapy for patients with bicuspid aortic valves?
Stephen H. McKellar, MD, MSc
technologies can help guide aortic therapies for
patients with bicuspid aortic valves.
Aortic aneurysms are not created equal
Vikram Sood, MD, Ming-Sing Si, MD
comparison of aneurysms of differing etiologies
reveals microstructural differences.
VALVE: EVOLVING TECHNOLOGY
transcatheter options for tricuspid regurgitation: Many
shades of gray
Bapat, MBBS, MS, MCh, DNB (Surg), DNB (Card Surg),
FCRSEd, FRCSCTh, Gilbert H.L. Tang, MD, MSc, MBA
Transcatheter options are being explored
as an option to treat severe TR. Although early studies
have shown some promise, considerable hurdles remain
with respect to patient selection, imaging, procedure,
and data interpretation.
Transcatheter tricuspid valve interventions for
treating isolated tricuspid regurgitation: Toward a new
Guillem Muntané-Carol, MD, Josep
review adds a new piece of work on TTVI. Promising
early and midterm data have been reported. The
validation of these findings may establish TTVI as
an alternative to surgery in TR patients.
tricuspid valve repair: Bringing the forgotten valve into
Donatelle, MD, Gorav Ailawadi, MD, MBA
The field of transcatheter tricuspid
valve repair is rapidly growing. We examined the
current state of transcatheter tricuspid repair as an
isolated intervention, as well as in combination.
Tricuspid: The frustrating and unloved valve
Patrick M. McCarthy, MD
tricuspid valve was ignored for years, but this has
changed. It is the hardest valve to treat
successfully, however, with many anatomic and
physiologic challenges for evolving therapies.
Structural solutions for isolated, severe, symptomatic
tricuspid regurgitation are eagerly awaited
Ramesh Daggubati, MD, Harold G.
Roberts Jr., MD
durable, structural solutions for tricuspid
regurgitation could potentially save patients from
an inherently high-risk cardiac surgical procedure.
The forgotten valve no longer: But what about the
Vivek Rao, MD, PhD
tricuspid valve therapies will result in greater
referrals of patients for heart team assessment.
Surgeons should maintain an active role in decision
making for this patient population.
cardioplegia in isolated adult coronary artery bypass
Timek, MD, PhD, Tyler Beute, BS, Justin A. Robinson,
BS, Daniel Zalizadeh, MD, Regina Mater, MD, Jessica L.
Parker, MS, Matthew Lypka, MPH, Charles L. Willekes, MD
Del Nido cardioplegia provided
noninferior myocardial protection and clinical outcomes
to blood cardioplegia in routine and greater-risk isolated
coronary artery bypass patients with relatively short
aortic crossclamp times.
Easier is not always better than better
Jennifer S. Lawton, MD
of del Nido cardioplegia driven by surgeon
convenience may be easier, but may not be better or
appropriate for all patients and surgeons.
Myocardial protection is a process, not an event
Nathaniel B. Langer, MD, MSc, Gus J.
protection is a process, not an event.
The impact of
uncorrected mild aortic insufficiency at the time of left
ventricular assist device implantation
MD, Tomohiro Nakajima, MD, PhD, Irene Fischer, MPH, Fei
Wan, PhD, Kunal Kotkar, MD, Marc R. Moon, MD, Ralph J.
Damiano Jr., MD, Muhammad F. Masood, MD, Akinobu Itoh,
Uncorrected mild AI with ventricular
assist device implant was associated with later
moderate or severe AI, worse NYHA status, and more
incidence of heart failure.
The call of the mild: Aortic insufficiency in patients
with left ventricular assist devices
Amit Iyengar, MD, MS, Pavan Atluri, MD
matched retrospective cohort study, the current
authors have demonstrated that uncorrected mild
aortic insufficiency was associated with worsened
functional status after LVAD implantation.
Stop the leak before it floods
Bryan A. Whitson, MD, PhD
the influence of seemingly minor items and
continuously reassessing our surgical approaches,
mantras, and outcomes are what enable us to evolve
our techniques and improve outcomes for our
Two roads diverged in a yellow wood…
Asvin M. Ganapathi, MD, Nahush A.
management of mild aortic insufficiency at the time
of LVAD implantation remains controversial. A
randomized trial will be required to determine the
best treatment strategy.