Patient ForumThe content of these European Society of Cardiology (ESC) / European Association for Cardio-Thoracic Surgery (EACTS) Guidelines has been published for personal and educational use only. No commercial use is authorized. No part of the ESC/EACTS Guidelines may be translated or reproduced in any form without written permission from the ESC and the EACTS. Permission can be obtained upon submission of a written request to Oxford University Press, the publisher of the European Heart Journal and the party authorized to handle such permissions on behalf of the ESC (

In these patients with borderline LH disease who underwent SVP, it is possible to increase LH dimensions by using an LV recruitment strategy. In a subset of patients, this strategy allowed establishment of biventricular circulation.

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Valve repair for truncal valve regurgitation is feasible, with good results. Surgical creation of a tricuspid truncal valve seems to provide the best outcomes in this challenging population.

Objectives: Coronary endarterectomy has been shown to be an effective adjunctive technique of revascularization for diffuse coronary artery disease. A long arteriotomy and reconstruction of the left anterior descending artery (LAD) are occasionally required for complete extraction of the atherosclerotic plaque. The aim of this study was to examine early and late results of this technique and compare 2 different reconstruction methods.Methods: We retrospectively reviewed 224 consecutive patients who underwent extensive LAD endarterectomy and reconstruction between January 1992 and March 2010. For reconstruction, 101 patients underwent saphenous vein patch and LAD grafting (group A) and 123 patients had left internal thoracic artery onlay patch grafting (group B). We compared early and late outcomes and assessed the association of the reconstruction method and long-term survival.Results: The mean age was 66 and 67 years in groups A and B, respectively. Operative mortality was 3.0% and 4.1%, and the incidence of perioperative myocardial infarction in the LAD territory was 4.0% and 4.1% in groups A and B, respectively. There was no significant difference in early operative outcomes (P>.05). Actuarial 5-year survival was 78.6% and 87.1% and 10-year survival was 45.4% and 49.4% in groups A and B, respectively. Cox hazard proportional analysis showed that the reconstruction method did not have a significant impact on long-term survival.Conclusions: Extensive LAD endarterectomy and reconstruction is a safe and feasible technique of revascularization for diffuse coronary artery disease. The reconstruction method should be based on the availability of conduits and length of the arteriotomy.

The content of these European Society of Cardiology (ESC) Guidelines has been published for personal and educational use only. No commercial use is authorized. No part of the ESC Guidelines may be translated or reproduced in any form without written permission from the ESC. Permission can be obtained upon submission of a written request to Oxford University Press, the publisher of the European Heart Journal and the party authorized to handle such permissions on behalf of the ESC (journals.permissions@oxfordjournals.org).Disclaimer. The ESC Guidelines represent the views of the ESC and were produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their publication. The ESC is not responsible in the event of any contradiction, discrepancy and/or ambiguity between the ESC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the ESC Guidelines fully into account when exercising their clinical judgment, as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies; however, the ESC Guidelines do not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and in consultation with that patient and, where appropriate and/or necessary, the patient's caregiver. Nor do the ESC Guidelines exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities in order to manage each patient s case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription.The article has been co-published with permission in the European Heart Journal [10.1093/eurheartj/ehx391] on behalf of the European Society of Cardiology and European Journal of Cardio-Thoracic Surgery [10.1093/ejcts/ezx324] on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved in respect of European Heart Journal, V C European Society of Cardiology 2017. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when citing this article.

Aortic cusp extension provides adequate valve repair in a large proportion of children with rheumatic aortic regurgitation. Fresh autologous and PhotoFix pericardium trended toward better durability than glutaraldehyde-fixed bovine pericardium.