Routine intraoperative graft assessment is safe but does not lead to a marked reduction in graft occlusion 1-year after bypass grafting. The incidence of saphenous vein graft failure remains high despite contemporary practice and routine intraoperative graft surveillance.

The clinical feasibility of DTEVAR for high-risk patients requiring zone 0 landing or emergency surgery is still controversial. Atherosclerotic disease of the aorta has a significant negative effect on midterm outcomes in any surgical approach.

Background Surgical ring annuloplasty is generally performed in patients with symptomatic atrial functional mitral regurgitation (MR) caused by long‐standing atrial fibrillation (AF). However, its clinical results have not been well reported. Methods Twenty consecutive patients with atrial functional MR (mean age of 68 ± 9 years) and a left ventricular (LV) ejection fraction (EF) greater than 50% underwent mitral annuloplasty. Concomitant procedures included tricuspid valve surgery in 16 patients, AF ablation in 13 patients, and coronary artery bypass grafting in 2 patients. We reviewed the clinical outcomes of those patients and investigated the specific preoperative echocardiographic findings related to MR recurrence. Results At discharge, the mean left atrial (LA) volume index and mean tricuspid regurgitation peak gradient had significantly decreased from 94 ± 59 mL/m 2 to 58 ± 30 mL/m 2 and from 34 ± 11mm Hg to 23 ± 5mm Hg, respectively. During the follow‐up period of 28 ± 17 months, the New York Heart Association functional class significantly improved from 2.3 ± 0.6 to 1.3 ± 0.6. Four patients developed recurrent MR, and of those, two required reoperation. Those with recurrent MR had a significantly larger preoperative LV dimension than those without recurrent MR. Preoperative three‐dimensional transesophageal echocardiography was performed in 12 patients, revealing a greater degree of leaflet tethering in patients with recurrent MR than that in patients without recurrent MR. Conclusions In patients with the combination of atrial functional MR, left ventricular dilatation and excessive leaflet tethering, mitral annuloplasty alone may not be sufficient to achieve long‐term correction of MR.

Matching analysis revealed a significantly greater incidence of stroke in the HAR group but equivalent midterm outcomes in the hybrid group compared with the CTAR group.

TTF can identify non-functional grafts during CABG, but is of questionable value to improve one-year graft patency.

No abstract

PFL caused by DANE after acute type I aortic dissection repair showed greater aortic growth rate of the descending aorta and was one of the significant risk factors for distal aortic events.

BackgroundConventional reoperative mitral valve surgery by median sternotomy has several difficulties. We performed mitral valve replacement (MVR) under ventricular fibrillation (VF) through right mini-thoracotomy with three-dimensional videoscope for avoiding the problems.MethodsBetween 2006 and 2011, we performed 257 cases of MVR, in which 125 cases underwent isolated MVR. Ten cases of patients underwent reoperative MVR under VF through thoracotomy with three-dimensional videoscope (Group I), and 27 cases of patients underwent reoperative conventional MVR through median sternotomy (Group II). We retrospectively reviewed the outcomes and compared Group I with Group II. Preoperative left ventricular ejection fraction (LVEF) was significantly lower (50.5 ± 19.8% vs 64.4 ± 12.0%; p = 0.046), and significantly higher Euro SCORE was found in Group I (4.8 ± 2.0 vs 3.8 ± 2.4; p = 0.037).ResultsAlthough Group I required cooling and rewarming time, average operative times was significantly shorter in Group I (262 ± 46 min vs 300 ± 57 min; p = 0.044), and cardiopulmonary bypass times and average VF times in Group I and aortic cross-clamp times in Group II were equivalent. There was no significant difference in the average of postoperative maximum creatine kinase (CK)-MB. In-hospital mortality was 0/10 (0%) and 1/27 (3.7%), and postoperative paravalvular leakage occurred in 0/10 (0%) and 1/27 (3.7%), and stroke occurred in 1/10 (10%) and 1/27 (3.7%) for Groups I and II. Two patients underwent reoperation for bleeding in Group II. Intensive care unit stay in Group I was significantly shorter than in Group II (1.8 ± 0.6 days vs 3.0 ± 1.7 days; p = 0.025).ConclusionsThe higher risk of preoperative background in Group I had no effect on the operation. Mitral valve surgery under VF through right mini-thoracotomy can be an alternative procedure for reoperation after conventional various cardiothoracic surgeries.