Perioperative Tx may be associated with excess AF following CABG. This risk increases with increasing number of Tx.

Patients with anomalous origin of a coronary artery during aortic valve replacement (AVR) are at risk of coronary compromise. Large case series are lacking. In this retrospective study, we review our experience with this condition. From August 2014 through June 2016, 8 adult patients (mean age, 74 ± 17.5 yr; age range, 33–86 yr; 5 men) with anomalous aortic origin of a coronary artery underwent surgical or transcatheter AVR at our institution. Six patients had aortic stenosis; 2 had aortic insufficiency, one of whom had an associated aortic root aneurysm. In 7 patients, the left anomalous coronary artery originated from the right aortic sinus, and in one, the right coronary artery arose from the left cusp. The anatomic course was revealed by means of 3-dimensional computed tomographic angiography. No patient underwent primary aortic reimplantation of the anomalous artery. Two had the artery mobilized from encircling the annulus too closely and then underwent coronary artery bypass grafting. Two high-risk patients underwent transcatheter AVR. After surgical AVR, 2 patients had perioperative myocardial infarction caused by coronary compression, so percutaneous coronary intervention was performed. One patient died of sepsis 3 months after discharge from the hospital. In our patients, AVR sometimes led to severe perioperative complications. Successful AVR depended on 3-dimensional computed tomographic angiographic findings, individual anatomic variations, and appropriate treatment choices.

Background: Multiple genetic changes, availability of cellular nutrients and metabolic alterations play a pivotal role in oncogenesis Aims: We focus on cancer cell's metabolic properties, and we outline the cross talks between cellular oncogenic growth pathways in cancer metabolism. The review also provides a synopsis of the relevant cancer drugs targeting metabolic activities that are at various stages of clinical development. Methods: We review literature published within the last decade to include select articles that have highlighted energy metabolism crucial to the development of cancer phenotypes. Results: Cancer cells maintain their potent metabolism and keep a balanced redox status by enhancing glycolysis and autophagy and rerouting Krebs cycle intermediates and products of β-oxydation. Conclusions: The processes underlying cancer pathogenesis are extremely complex and remain elusive. The new field of systems biology provides a mathematical framework in which these homeostatic dysregulation principles may be examined for better understanding of cancer phenotypes. Knowledge of key players in cancer-related metabolic reprograming may pave the way for new therapeutic metabolism-targeted drugs and ultimately improve patient care.

Aorto-pulmonary fistula (APF) due to an eroding pseudoaneurysm of the ascending aorta (AOP) is rare and can be life threatening. We report an 83-year-old male with multiple comorbidities who presented with an AOP, which was successfully treated with an endovascular exclusion device. doi: 10.1111/jocs.12758 (J Card Surg 2016;31:453-455).

We report an extremely rare complication of a delayed aorto-pulmonary artery wall disruption with false aneurysm formation after repair of acute type-A aortic dissection with BioGlue®. The potential role of BioGlue® in this complication is the subject of this report.