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
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shaggy aorta on outcomes of open thoracoabdominal aortic
Koki Yokawa, MD, Yuki Ikeno, MD,
PhD, Soichiro Henmi, MD, Katsuhiro Yamanaka, MD, PhD,
Kenji Okada, MD, PhD, Yutaka Okita, MD, PhD
was a significant risk factor for spinal cord injury
and early mortality after open thoracoabdominal aortic
Shaggy aorta in thoracoabdominal aortic aneurysm
repair, an insidiously growing threat
Asai, MD, PhD
Shaggy aorta carries high risks for
organ embolization and spinal cord injury in
thoracoabdominal aortic aneurysm repair.
Beware the shaggy aorta during thoracoabdominal aortic
T. Kouchoukos, MD
The presence of shaggy aorta is a
major risk factor for death and major complications
after repair of thoracoabdominal aortic aneurysms.
Extent II thoracoabdominal aortic
aneurysm repair in a 74-year-old patient with shaggy
AORTA: INVITED EXPERT OPINION
Building on a
genetic framework: Can we personalize the timing of
surgical repair for patients with heritable thoracic
Ashley Dawson, MD, Scott A.
expansion of genetic research combined with the
rigorous requirements for identifying clinically valid
genes has important implications for the surgical
management of heritable aortic disease.
Curating the culprits: Moving closer to personalized
Elbatarny, MD, Jennifer C.Y. Chung, MD, MSc, Maral
Ouzounian, MD, PhD
Hereditary thoracic aortic aneurysm
is heterogeneous, with many implicated genes.
Personalized treatment requires evidence-based
Early and late
outcomes following aortic root enlargement: A multicenter
propensity score–matched cohort analysis
Derrick Y. Tam, MD, Christoffer
Dharma, MSc, Rodolfo V. Rocha, MD, Maral Ouzounian, MD,
PhD, Harindra C. Wijeysundera, MD, PhD, Peter C.
Austin, PhD, Stephen E. Fremes, MD, MSc
addition of ARE to isolated AVR can be safely performed
to increase implanted prosthesis size without
compromising early or late mortality. Additional
studies with longer follow-up are necessary.
Lesson one of medical school: Observe the patient
before deciding the treatment
Bryce Robinson, MD, Irbaz Hameed, MD, Ajita Naik, MD,
Mario Gaudino, MD
Hidden confounders and treatment
allocation bias are intrinsic in observational
The bigger the better, in everything
Di Mauro, MD, PhD, MSc, Antonio Calafiore, ,
Alessandro Parolari, MD
Making bigger the aortic annulus
during aortic valve replacement can be safely
performed to increase implanted prosthesis size
without compromising early mortality.
Aortic root enlargement, a useful and reproducible way
to a larger prosthesis
J. Antunes, MD, PhD, DSc
The safety and reproducibility of
aortic root enlargement have been clearly
demonstrated, and this procedure may have a
significant effect on the future of the patient.
different revascularization strategies among patients
presenting with acute coronary syndromes without ST
Eilon Ram, MD, Leonid Sternik, MD,
Robert Klempfner, MD, Zaza Iakobishvili, MD, Yael
Peled, MD, Nir Shlomo, MSC, Ehud Raanani, MD
real-life setting, revascularization by CABG provides
excellent long-term outcomes in patients with NSTEMI or
CABG vs PCI in NSTEMI/UA: Abbreviated alternatives
Abdelsattar, MD, MS, Juan A. Crestanello, MD
CABG and PCI are alternatives for
the management of NSTEMI/UA. Optimal patient
management should include a discussion within a
CORONARY: BASIC SCIENCE
cognitive deficits and neuroinflammation in a rat model
of cardiopulmonary bypass
Yi Wang, MD, PhD, Carlos
Tache-Leon, MD, Maro G. Machizawa, PhD, Turner Lisle,
MD, Cedric Williams, PhD, Ryon H. Clarke, PhD, Matthew
J. Anzivino, BS, Irving Kron, MD, Kevin S. Lee, PhD
cognitive dysfunction and neuroinflammation were
demonstrated in an established rat model of CPB.
Fortunately enough, most human beings are not rats
Bachet, MD, FEBCTS
Cardiopulmonary bypass might be
somewhat harmful. In daily practice and in the
great majority of cases, however, its consequences
on cognitive function are negligible.
Neurocognitive dysfunction after cardiopulmonary
bypass: Multiple modalities to rescue the microglia
Augoustides, MD, FASE, FAHA
The microglia offer multiple
therapeutic targets for neurocognitive rescue after
cardiac surgery. Future trials should explore
multimodal interventions, including modulation of
transformation of cardiac surgery practice in the
coronavirus disease 2019 (COVID-19) pandemic: Insights
and clinical strategies from a center at the epicenter
Isaac George, MD, Michael Salna,
MD, Serge Kobsa, MD, PhD, Scott Deroo, MD, Jacob
Kriegel, MD, David Blitzer, MD, Nicholas J. Shea, MD,
MS, Alex D'Angelo, MD, Tasnim Raza, MD, Paul Kurlansky,
MD, Koji Takeda, MD, PhD, Hiroo Takayama, MD, PhD,
Vinayak Bapat, MD, Yoshifumi Naka, MD, PhD, Craig R.
Smith, MD, Emile Bacha, MD, Michael Argenziano, MD
COVID-19 pandemic has forced significant changes in
cardiac surgery, such as reorganizing staff,
repurposing hospital space, redefining surgical
priority, and changing clinical practice.
Preparation for pandemics prevents pandemonium
Uncertainty in emergency and the
quickly evolving healthcare crisis can lead to
chaos. Preparation strategies for the Coronavirus
Disease 2019 pandemic provide purpose and direction
for optimal outcomes.
Vulnerability and resilience demonstrated: Cardiac
surgeons during coronavirus disease 2019 (COVID-19)
C. Silvestry, MD
The COVID-19 pandemic impacted our
practices, our patients, and ourselves. We
acknowledge the changes we implemented and the
impact on our professional and personal lives.
Implications of coronavirus disease 2019 (COVID-19) for
cardiac surgery: Priorities and decisions
Rajagopal, MD, PhD
The COVID-19 pandemic has caused
cardiac surgeons to reassess their duties and
Pandemic deployment and surgical soldiership
J. Goldstein, MD
A necessary quality for aspiring and
practicing surgeons is preparedness. Precious
lessons in how to manage resources, deploy
personnel, and prioritize cardiac surgery patients
in the midst of a pandemic are presented.
new persistent opioid use after coronary artery bypass
Kathleen C. Clement, MD, Joseph K.
Canner, MHS, Jennifer S. Lawton, MD, FACS, Glenn J.R.
Whitman, MD, Michael C. Grant, MD, Marc S. Sussman, MD
persistent opioid use occurs in 8.1% of opioid-naïve
patients after CABG. Prospective studies are needed to
determine the opioid requirements of patients after
CABG to prevent opioid dependence.
The power of the pen—cardiac surgical opioid use in the
P. Landolfo, MD, MSc, Archer Kilbourne Martin, MD
The risk of developing chronic
opioid use in the previously opioid-naïve cardiac
surgical patient is significant. Increased
awareness and multidisciplinary approaches must be
Time to make moves on opioid prescribing following
A. Holst, MD, Elizabeth B. Habermann, PhD
Cardiothoracic surgeons should
improve opioid stewardship for our patients as we
continue to develop our understanding of
postoperative opioid dependence.
EDUCATION: HEALTH POLICY
survey of UK cardiac surgeons' view on clinical decision
making during the coronavirus disease 2019 (COVID-19)
Umberto Benedetto, MD, PhD, Andrew
Goodwin, MD, PhD, Simon Kendall, MD, Rakesh Uppal, MD,
Enoch Akowuah, MD
current scenario, systematic appraisal of national
expert consensus can represent a rapid and efficient
instrument to support heath policy makers in generating
A survey of UK cardiac surgeons' opinions during the
coronavirus disease 2019 pandemic: A point and place in
D. Andersen, MD
A survey of UK cardiac surgeons'
opinions at an early phase of the COVID-19 pandemic
is reported, but opinions and policies are likely
to shift as the pandemic evolves.