EuroSCORE II improves on the original logistic EuroSCORE, though mainly for combined AVR and CABG cases. Concerns still exist, however, over its use for isolated AVR procedures, aortic surgery and miscellaneous procedures. There is still room for improvement in risk modelling.

Objective-Off-Pump Coronary Artery Bypass (OPCAB) surgery is gaining more popularity worldwide. The aim of this United Kingdom (UK) multi-center study was to assess the early clinical outcome of the OPCAB technique and perform a risk-stratified comparison with the conventional Coronary Artery Bypass Grafting (CABG) using the Cardio-Pulmonary Bypass (CPB) technique. Methods-Data were collected on 5,163 CPB patients from the database of the National Heart and Lung institute, Imperial College, University of London, and on 2,223 OPCAB patients from eight UK cardiac surgical centers, which run established OPCAB surgery programs. All patients had undergone primary isolated CABG for multi-vessel disease through a midline sternotomy approach, between January 1997 and April 2001. Postoperative morbidity and mortality were compared between the CPB and OPCAB patients after adjusting for case-mix. The mortality of the OPCAB patients was also compared, using risk stratification, to the mortality figures reported by the Society of Cardiothoracic Surgeons of Great Britain and Ireland (SCTS) based on 28,018 patients in the national database who were operated on between January 1996 and December 1999. Results-Morbidity and mortality were significantly lower in the OPCAB patients compared with the CPB patients and the UK national database of CABG patients, over the same period of time, after adjusting for case-mix. Conclusion-This study demonstrates that risk stratified morbidity and mortality are significantly lower in OPCAB patients than CPB patients and patients in the UK national database. (Circulation. 2003;108[suppl II]:II-1-II-8.) Key Words: coronary surgery ischemic heart disease coronary heart disease cardiopulmonary bypass O ff-Pump Coronary Artery Bypass (OPCAB) surgery is gaining more popularity worldwide. 1 The theoretical and proven disadvantages of the use of the Cardio-Pulmonary Bypass (CPB) for multi-vessel Coronary Artery Bypass Grafting (CABG) has prompted many cardiac surgeons in the United Kingdom (UK) to convert to OPCAB practice in their units. 2 To date, no collective data on the initial OPCAB experience in UK is available. The aim of this UK multi-center study was to assess the early clinical outcome of the OPCAB technique and perform a risk-stratified comparison with the established CPB technique.

Objective The SAR‐COV‐2 pandemic has had an unprecedented effect on the UK's healthcare systems. To reduce spread of the virus, elective treatments and surgeries have been postponed or canceled. There has been a rise in the use of telemedicine (TM) as an alternative way to carry outpatient consultations. This systematic review aims to evaluate the extent to which TM may be able to support cardiac and vascular surgery patients in the COVID‐19 era. Methods We looked into how TM can support the management of patients via triaging, preoperative, and postoperative care. Evaluations targeted the clinical effectiveness of common TM methods and the feasibility of applying those methods in the UK during this pandemic. Results Several studies have published their evidence on the benefit of TM and its benefit during COVID‐19, the data related to cardiovascular surgery and how this will impact future practice of this speciality is emerging and yet larger studies with appropriate timing of outcomes to be published. Conclusion Overall, the use of virtual consultations and remote monitoring is feasible and best placed to support these patients via triaging and postoperative monitoring. However, TM can be limited by the need of sophisticated technological requirement and patients’ educational and know‐how computer literacy level.

The original EuroSCORE and the EuroSCORE II risk models should be used with caution in patients aged 70 or older undergoing cardiac surgery in the modern era. Below the age of 70, both models are sensitive, specific and have good predictive power. Our work needs validation by other large groups.

Despite all the modern anti-arrhythmic drugs, the incidence of AF remains unchanged. Patients who develop AF postcardiac surgery show a significantly worse outcome compared to those without AF. This study also highlights the importance of anticoagulation in AF to prevent the devastating consequences as a result of a cerebral stroke. We believe that not only immediate treatment of AF postoperatively should be implemented, but also measures should be taken to identify the risk factors of AF and to prevent AF postcardiac surgery.

The reported benefits of intraoperative cell salvage are decreased requirement for blood transfusion and cost-effectiveness. This study was designed to challenge this hypothesis. We assessed intraoperative blood loss and the use of cell saver in our institution. In <7% of cases the volume of blood loss was sufficient enough to be washed and returned. We conclude that the routine use of cell savers in all cardiac operations affords no benefit and consumes additional revenue. We recommend that the system only be considered in selected high-risk cases or complex procedures.

Despite improvements over time with regard to morbidity, mortality and long-term survival, CPB time remains a significant factor determining mediastinal blood loss, ICU and hospital length of stay, and in-hospital mortality.

The RDW is a significant factor determining in-hospital mortality and long-term survival in patients undergoing isolated CABG. The mechanism of association requires further study.