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This page shows you the latest news and research items in this category.

Long-Term Outcomes After Invasive Management for Older Patients With Non-ST-Segment Elevation Myocardial Infarction [Original Articles]
Conclusions— Older patients with non–ST-segment elevation MI with significant coronary disease face high long-term risks for mortality and nonfatal cardiovascular outcomes after early catheterization that differ by type of revascularization procedure performed. These findings can help guide the design of studies evaluating long-term therapies among elderly post-MI patients. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 21, 2013 Category: Cardiology Authors: Roe, M. T., Li, S., Thomas, L., Wang, T. Y., Alexander, K. P., Ohman, E. M., Peterson, E. D. Tags: Catheter-based coronary interventions: stents, Acute coronary syndromes, Acute myocardial infarction Original Articles Source Type: research

Influence of Crossover on Mortality in a Randomized Study of Revascularization in Patients With Systolic Heart Failure and Coronary Artery Disease [Original Articles]
Conclusions— CABG reduced mortality in both the per-protocol and crossover STICH patient populations. Crossover from assigned therapy, therefore, diminished the impact of CABG on survival in STICH when analyzed by intention to treat. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00023595. (Source: Circulation: Heart Failure)
Source: Circulation: Heart Failure - May 21, 2013 Category: Cardiology Authors: Doenst, T., Cleland, J. G. F., Rouleau, J. L., She, L., Wos, S., Ohman, E. M., Krzeminska-Pakula, M., Airan, B., Jones, R. H., Siepe, M., Sopko, G., Velazquez, E. J., Racine, N., Gullestad, L., Filgueira, J. L., Lee, K. L., on behalf of the STICH Investig Tags: Congestive, Other Treatment, CV surgery: coronary artery disease Original Articles Source Type: research

Prognostic Significance of Biomarkers in Predicting Outcome in Patients With Coronary Artery Disease and Left Ventricular Dysfunction: Results of the Biomarker Substudy of the Surgical Treatment for Ischemic Heart Failure Trials [Original Articles]
Conclusions— Elevated levels of sTNFR-1 and BNP are strongly associated with outcomes, independent of therapy, in 2 large and independent studies, thus providing important cross-validation for the prognostic importance of these 2 biomarkers. (Source: Circulation: Heart Failure)
Source: Circulation: Heart Failure - May 21, 2013 Category: Cardiology Authors: Feldman, A. M., Mann, D. L., She, L., Bristow, M. R., Maisel, A. S., McNamara, D. M., Walsh, R., Lee, D. L., Wos, S., Lang, I., Wells, G., Drazner, M. H., Schmedtje, J. F., Pauly, D. F., Sueta, C. A., Di Maio, M., Kron, I. L., Velazquez, E. J., Lee, K. L. Tags: CV surgery: coronary artery disease Original Articles Source Type: research

Reply to the Editor
We thank the authors for their comments and interest in our study showing improved long-term survival after coronary artery bypass grafting (CABG) using the radial artery (RA) in women. We agree with the many important advantages of RA grafting, which they so clearly outline. We also found their novel suggestion that age-dependent levels of androgens and estrogens may affect patency of RA conduits and, thus, survival in men and women to be intriguing. (Source: The Journal of Thoracic and Cardiovascular Surgery)
Source: The Journal of Thoracic and Cardiovascular Surgery - May 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Kamellia R. Dimitrova, Robert F. Tranbaugh Tags: Letters to the Editor Source Type: research

Staged percutaneous coronary intervention and minimally invasive valve surgery: Results of a hybrid approach to concomitant coronary and valvular disease
We read with great interest the recent publication by Santana and colleagues, entitled “Staged Percutaneous Coronary Intervention and Minimally Invasive Valve Surgery: Results of a Hybrid Approach to Concomitant Coronary and Valvular Disease.” A total of 65 patients who underwent staged percutaneous coronary intervention and minimally invasive cardiac surgery (MICS) valve surgery were compared with 51 patients who underwent combined valve/coronary artery bypass grafting. The authors are to be congratulated for their excellent short-term results in the MICS group, particularly the lack of mortality. However, drawing co...
Source: The Journal of Thoracic and Cardiovascular Surgery - May 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Faisal H. Cheema, Harold G. Roberts Tags: Letters to the Editor Source Type: research

Is gender-specific survival in patients undergoing radial artery grafting influenced by hormone levels?
We read with great interest the article by Dimitrova and colleagues on improvement in the 15-year survival in women with radial artery (RA) grafting. We congratulate Dimitrova and coworkers on their well-designed analysis and the results in their publication. They concluded that women who received 2 arterial conduits, coronary artery bypass grafting (CABG) with left internal thoracic artery and RA, had a significant survival benefit up to 15 years compared with women who received a saphenous vein (SV) as a second conduit for myocardial revascularization. (Source: The Journal of Thoracic and Cardiovascular Surgery)
Source: The Journal of Thoracic and Cardiovascular Surgery - May 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Andrea Ruzza, Lawrence S.C. Czer Tags: Letters to the Editor Source Type: research

Dynamic trends in cardiac surgery: why the logistic EuroSCORE is no longer suitable for contemporary cardiac surgery and implications for future risk models [ADULT CARDIAC]
The objective of this study was to explore the reasons for the calibration drift of the logistic EuroSCORE. METHODS Data from the Society for Cardiothoracic Surgery in Great Britain and Ireland database were analysed for procedures performed at all National Health Service and some private hospitals in England and Wales between April 2001 and March 2011. The primary outcome was in-hospital mortality. EuroSCORE risk factors, overall model calibration and discrimination were assessed over time. RESULTS A total of 317 292 procedures were included. Over the study period, mean age at surgery increased from 64.6 to 67.2 years. ...
Source: European Journal of Cardio-Thoracic Surgery - May 16, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Hickey, G. L., Grant, S. W., Murphy, G. J., Bhabra, M., Pagano, D., McAllister, K., Buchan, I., Bridgewater, B. Tags: ADULT CARDIAC Source Type: research

Acetylsalicylic acid treatment until surgery reduces oxidative stress and inflammation in patients undergoing coronary artery bypass grafting [ADULT CARDIAC]
CONCLUSIONS Continued ASA treatment until the time of CABG reduced oxidative and inflammatory responses. Also, a likely beneficial effect upon myocardial injury was noticed. Although none of the genes known to be involved in oxidative stress or inflammation took a different expression in myocardial tissue, the genetic analysis showed interesting differences in the mRNA level. Further research in this field is necessary to understand the role of the genes. (Source: European Journal of Cardio-Thoracic Surgery)
Source: European Journal of Cardio-Thoracic Surgery - May 16, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Berg, K., Langaas, M., Ericsson, M., Pleym, H., Basu, S., Nordrum, I. S., Vitale, N., Haaverstad, R. Tags: ADULT CARDIAC Source Type: research

Editorial Comment: Reduction of oxidative stress: a new indication for acetylsalicylic acid in coronary artery bypass surgery [ADULT CARDIAC]
(Source: European Journal of Cardio-Thoracic Surgery)
Source: European Journal of Cardio-Thoracic Surgery - May 16, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Diehl, P., Olivier, C., Bode, C., Moser, M. Tags: ADULT CARDIAC Source Type: research

Red cell distribution width and coronary artery bypass surgery [ADULT CARDIAC]
CONCLUSIONS 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. (Source: European Journal of Cardio-Thoracic Surgery)
Source: European Journal of Cardio-Thoracic Surgery - May 16, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Warwick, R., Mediratta, N., Shaw, M., McShane, J., Pullan, M., Chalmers, J., Poullis, M. Tags: ADULT CARDIAC Source Type: research

Innominate Artery as an Alternative Site for Proximal Anastomoses in Patients With a Severely Calcified Aorta
ConclusionsThe innominate artery is an alternative site for proximal anastomoses in patients with calcific atheromatous aorta. doi: 10.1111/jocs.12112 (J Card Surg 2013;28:228–232) (Source: Journal of Cardiac Surgery)
Source: Journal of Cardiac Surgery - May 16, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Ibrahim Uyar, Tolga Demir, Adil Polat, Fatma Bahceci, Omer Isik Tags: Original Article Source Type: research

Abstract 2: The Changing Face of Cardiac Surgery: Frailty, Age, and Adverse Outcomes Create a Mandate for Shared Decision Making [Concurrent Session I Session A: Oral Abstract Presentations on Less is More]
CONCLUSIONS We have identified increasing rates of elderly and frail patients with high-risk profiles referred for cardiac surgery. These patients experience higher rates of mortality and prolonged institutional care. We suggest this vulnerable patient population may benefit from the institution of a formalized shared decision making process to effectively communicate risks, benefits and alternatives to the planned procedure. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Gainer, R., Buth, K., David, J., Garson, R., Mufti, H., Hirsch, G. Tags: Concurrent Session I Session A: Oral Abstract Presentations on Less is More Source Type: research

Abstract 64: Short Term Health Status Outcomes And Preferences In Patients Undergoing Elective Transradial Coronary Intervention [Poster Session I]
Conclusion. When compared with patients undergoing elective PCI via femoral access, TRI patients had stronger preferences for the same vascular access and were more frequently discharged on the day of the procedure. After adjustment for baseline clinical characteristics, there was no significant difference in short-term health status outcomes between the groups. Further collection of observational and clinical trial data regarding the patients’ perspectives of TRI is needed. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Baklanov, D., Tang, F., Safley, D., Fuss, C., Jones, P., Spertus, J. Tags: Poster Session I Source Type: research

Abstract 71: Causes of 30-day Readmission Rates after Percutaneous Coronary Intervention - Lessons from Direct Chart Review [Poster Session I]
Conclusions: In this single center study, the largest proportion of readmissions after PCI is due to symptoms that prompt concern for angina, the overwhelming majority of which (90.0%) do not require repeat revascularization. Hospitals may be able to minimize 30-day readmission rates after PCI substantially by postponing non-urgent, non-coronary procedures after PCI. Transferring the evaluation of low-risk chest pain to the outpatient setting or to emergency department observation units could dramatically reduce 30 day readmission rates after PCI.Table 1: Main reason for readmission (N = 651)Chest pain or other symptoms co...
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Wasfy, J. H., Strom, J. B., Rosenfield, K., Zai, A., Luttrell, J. M., Pomerantsev, E., Spertus, J. A., Mauri, L., Normand, S.-L. T., Yeh, R. W. Tags: Poster Session I Source Type: research

Abstract 90: Ten-year Trends in Mechanical Revascularization, Intra-Aortic Balloon Pump Use and In-Hospital Mortality in Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock [Poster Session I]
Conclusion: Mechanical revascularization rates in patients with cardiogenic shock complicating AMI have increased during the past decade. This is also associated with a decrease in in-hospital mortality during this period. IABP use has also increased over the past 10 years; however, IABP use is associated with higher in-hospital mortality among patients with AMI and cardiogenic shock. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Kolte, D., Khera, S., Aronow, W. S., Palaniswamy, C., Mujib, M., Sule, S., Peterson, S. J., Frishman, W. H. Tags: Poster Session I Source Type: research

Abstract 106: Concomitant Contrast Dependent Procedures are Predictors of Increasing PCI Assoicated Renal Complications among Medicare Beneficiaries [Poster Session I]
Conclusion: The adjusted incidence of renal complications following PCI among hospitalized MBs is increasing over time. In addition, repeated contrast exposure during an admission independently increases the likelihood of renal complications. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Kugelmass, A., Brown, P. P., Reynolds, M. R., Cohen, D. J., Culler, S. D., Simon, A. W. Tags: Poster Session I Source Type: research

Abstract 113: Regional Variation In The Receipt Of Coronary Revascularization Following Diagnostic Catheterization In British Columbia [Poster Session I]
Conclusions: There was substantial regional variation in revascularization practice among hospitals in the province of British Columbia, Canada. Identification of subgroups where variation in practices were significant, such as use of PCI vs. CABG among STEMI patients, offer opportunities for follow-up and quality improvement. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Ng, C. H., Pu, A., Ding, L., Zhang, R., Kmetic, A. Tags: Poster Session I Source Type: research

Abstract 118: Geographic Variability in Potentially Discretionary Red Blood Cell Transfusions After Coronary Artery Bypass Grafting Surgery [Poster Session I]
Conclusion: Potentially discretionary RBC transfusions were common, and varied across centers and regions, even after adjusting for differences in case mix. These data suggest that differences in regional and center practice environments, including transfusion triggers and anemia management, may be the primary drivers for variations in RBC rates. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Likosky, D., Malenka, D., Kommareddi, M., Furnary, A., Helm, R., Bryson, C., Paone, G., Jin, R., Maynard, C., Mackenzie, T., Zhang, M., Hanson, E., Surgenor, S., Cardiac Surgery Quality IMPROVEment (IMPROVE) Network Tags: Poster Session I Source Type: research

Abstract 120: Regional Variation in Infection Rates after Coronary Artery Bypass Grafting [Poster Session I]
Conclusions: There was a 16-fold variability in rates of HAIs across medical centers among patients undergoing isolated CABG surgery. This variability could not be explained by patient case mix. Future work should focus on the impact of other factors (e.g. organizational and systems of clinical care) on risk of HAIs. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Likosky, D., Kommareddi, M., Boeve, T., Harrington, S., Holmes, R., Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative Tags: Poster Session I Source Type: research

Abstract 121: Statin Use For Secondary Prevention Of Coronary Artery Disease In Patients Undergoing Repeat Percutaneous Coronary Intervention: Real World Data [Poster Session I]
Conclusions: Real world data shows that we fail at adequate usage of statins or getting lipids to target goals. Interestingly around 90% of patients are prescribed statins on discharge from the cardiac catheterization lab. In practice statins are discontinued or higher doses to achieve target LDLs are avoided as they are generally less well tolerated due to side effects (muscle and liver toxicity). In this subset of patients, referral to lipid specialists and specialty centers and advent of newer lipid lowering drugs may prove to be beneficial. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Rajamanickam, A., Zhang, Y., Rao, A., Aguiar, R., Bradley, E., Weintraub, W., Goldenberg, E. Tags: Poster Session I Source Type: research

Abstract 132: Utilization of Cardiac Rehabilitation Programs Among Veterans [Poster Session I]
Conclusions: Presence of an on-site CR program was associated with greater utilization of CR. However, the proportion of eligible patients who participated in CR was extremely low (<10%) regardless of the presence or absence of an on-site program. These findings suggest that disseminating existing models of onsite CR programs may not substantially improve utilization of this evidence-based program. Alternative strategies must be evaluated to facilitate participation in CR. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Schopfer, D. W., Takemoto, S., Allsup, K., Forman, D. E., Whooley, M. A. Tags: Poster Session I Source Type: research

Abstract 151: Association Between Glycated Hemoglobin A1c And SYNTAX Score In Non-Diabetic Patients Undergoing Coronary Artery Bypass Grafting [Poster Session II]
Conclusion: In non-diabetic patients undergoing CABG, there is no statistically significant association between HbA1c and location of coronary artery disease, number of diseased vessels or SYNTAX score. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Bhat, T. M., Chauhan, D., Shah, N., Wahba, J., Shariff, M. A., Nabagiez, J. P., Silverman, R., Tamburrino, F. V., McGinn, J. T. Tags: Poster Session II Source Type: research

Abstract 162: Procedural and 1-Year Outcomes between PCI Centers with and without On-Site CT Surgery: Insights from the VA CART Program [Poster Session II]
Conclusions: Our findings demonstrate that procedural and 1-year patient outcomes are similar between PCI centers with and without on-site CT surgery. These results indicate that the clinical trial evidence of PCI safety without on-site CT surgery can be effectively translated to clinical practice. The VA’s policy allowing for PCI centers without on-site CT surgery in the setting of a quality oversight program may serve as a potential model for improving PCI access in large, integrated health care systems. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Maddox, T. M., Stanislawski, M., O'Donnell, C., Plomondon, M. E., Bradley, S., Ho, P. M., Tsai, T. T., Shroff, A., Speiser, B., Jesse, R. J., Rumsfeld, J. S. Tags: Poster Session II Source Type: research

Abstract 220: Cost-effectiveness of CABG vs PCI for Treatment of Multivessel Coronary Disease among Diabetes Patients---A Secondary Analysis from ASCERT [Poster Session II]
Conclusions: This study shows that over a period of 4 years or longer, CABG is associated with better outcomes but at higher cost than PCI in patients with diabetes. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Zhang, Z., Kolm, P., Jurkovitz, C., Edwards, F., Grau-Sepulveda, M., Ponirakis, A., McKay, C., Shahian, D. M., Grover, F. L., Mayer, J. E., Shaw, R., O'Brien, S. M., Weintraub, W. S. Tags: Poster Session II Source Type: research

Abstract 221: National and Regional Trends in Hospitalizations for Ischemic Stroke after Acute Myocardial Infarction in the United States: 1999-2010 [Poster Session II]
Conclusions: From 1999 to 2010, the hospitalization rates of ischemic stroke after AMI decreased overall and for demographic subgroups and those undergoing PCI, CABG, or no revascularization. Declines were seen for all regions, but were consistently higher for stroke belt states. Post-AMI strokes 30-day mortality rates decreased over time. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Shi, R., Wang, Y., Lichtman, J. H., Krumholz, H. M., Dharmarajan, K., Masoudi, F. A., Dodson, J. A., Chen, J., Chaudhry, S. I., Spertus, J. A., Nallamothu, B. K. Tags: Poster Session II Source Type: research

Abstract 250: Economic Burden of Mortality and Cardiovascular Events among Patients with Acute Coronary Syndromes in a Commercial Health Plan [Poster Session III]
Conclusion: Our findings suggest that a modest 10% increase in anticoagulant use among patients with ACS would reduce mortality, MI, ST and related healthcare costs by 4%, 0.7%, and 3%, respectively. Addition of anticoagulation therapy potentially reduces the incidence of ACS-related mortality, MI, ST and associated healthcare costs to a commercial health plan, and benefits from anticoagulation use should be balanced against the risk of bleeding. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Ogden, K., Patel, A. A., Mody, S. H., Veerman, M., Crivera, C., Quock, T. P. Tags: Poster Session III Source Type: research

Abstract 251: Risk Factors for Recurrence of Cardiovascular Events Following Acute Coronary Syndrome: Longitudinal Analysis from 2006-2011 [Poster Session III]
Conclusion: Following an ACS event, patients with pre-admission statin use or a prior CABG had decreased risk, while older patients or those with baseline comorbidities had increased risk of an adverse CV event occurring sooner. Ultimately, identifying high-risk ACS subgroups may facilitate tailored and more aggressive treatment to improve outcomes. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Reddy, V. S., Luthra, R., Xu, Y., Wilhelm, K., Power, T. P., Fisher, M. D., Cziraky, M. J. Tags: Poster Session III Source Type: research

Abstract 276: A Qualitative Analysis of Shared Decision Making in Cardiac Surgery [Poster Session III]
CONCLUSIONS Data from these groups will aid in the development of decision aids that serve to educate patients about their disease, the procedure proposed, and its risks and alternatives. Utilizing validated risk prediction models from our own experience allows us to provide patient specific risks for in-hospital mortality, major morbidity, and prolonged institutional care as well as long term outcomes freedom from mortality and re-hospitalization for cardiac cause. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Gainer, R., Buth, K., David, J., Garson, R., Mufti, H., Hirsch, G. Tags: Poster Session III Source Type: research

Abstract 328: Coronary Artery Disease Performance Measures And Statin Use Between Patients With Recent Percutaneous Coronary Intervention (PCI)and Patients With Recent Coronary Artery Bypass Grafting (CABG): An Analysis From The NCDR(R). [Poster Session III]
Conclusion: Although overall compliance with CAD PMs between patients undergoing recent CABG compared to recent PCI is similar, only about one-fourth of patients in both groups met between 75-100% of eligible CAD PMs. Furthermore, distinct gaps were noted for specific PMs in the recent CABG group. Our study highlight areas for future quality improvement initiatives aimed at improving compliance in PMs in patients who have undergone recent revascularization. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Bandeali, S. J., Gosch, K., Negi, S. I., Alam, M., Kayani, W. T., Wilson, J. M., Chan, P. S., Maddox, T. M., Virani, S. S. Tags: Poster Session III Source Type: research

Abstract 332: Persistent Use Of Evidence-Based Medications After Discharge Among Patients With Non-ST Elevation Myocardial Infarction Treated At Academic Versus Non-Academic Hospitals [Poster Session III]
Conclusion: Rates of persistence to evidence-based medications were similar between older NSTEMI patients treated at academic vs. non-academic hospitals, and may reflect similar in-hospital treatment and post-discharge cardiac follow-up. However, persistence rates are low both early and late post-discharge, highlighting a continued need for quality improvement efforts to optimize post-MI management. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Rymer, J., McCoy, L., Thomas, L., Peterson, E., Wang, T. Tags: Poster Session III Source Type: research

Abstract 341: The Revascularization Heart Team: Feasibility and Cross-sectional Patient Profile in a Large Academic Center [Poster Session III]
The American College of Cardiology guidelines assign a Class IC recommendation for the use of a Heart Team approach in the treatment of complex coronary artery disease (CAD). However, doubts remain regarding the practical application and functionality of this method in providing routine cardiovascular care. We sought to assess the feasibility of the Heart Team approach to adjudicate complex CAD through analyzing personnel participation, as well as anatomic and comorbid patient characteristics.From May to October, 2012 we convened a daily Heart Team meeting to discuss evidence based management of patients with complex CAD. ...
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Dota, A. P., Badhwar, V., Sanchez, C., Lee, J. S., Marroquin, O. C., Smith, A. J., Chu, D., Wei, L., Toma, C., Khandhar, S. J., Bhama, J., Esper, S., Rapsinski, R., Mulukutla, S. Tags: Poster Session III Source Type: research

Abstract 342: Variation In Contrast Volumes For Percutaneous Interventions Across Hospitals In Northern New England: It Is Not Just Patient And Procedural Characteristics [Poster Session III]
Conclusions: Even after controlling for patient and procedural characteristics, there remains significant variation in CV across northern New England PCI sites. Some of the known procedural characteristics may be modifiable. In addition, as yet unmeasured site-specific characteristics (e.g., method of assessing EF, catheter size, automatic vs hand injections) contribute to 39% of the variation. A better understanding of what drives the use of CV represents an opportunity for some sites in northern New England to decrease CV and improve PCI outcomes. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Lee, R. C., Bohn, C. M., Malenka, D. J., Northern New England Cardiovascular Disease StudyGroup Tags: Poster Session III Source Type: research

Abstract 355: Relationship between Female Gender and Mortality after Isolated Aortic Valve Replacement [Poster Session III]
Conclusions: In this study, female patients had increased operative mortality after isolated AVR. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Sun, X., Ellis, J., Kanda, L., Lowery, R., Boyce, S. W., Corso, P. J. Tags: Poster Session III Source Type: research

Abstract 358: Annual Quality of Care Evaluations of Cardiac Surgery in British Columbia [Poster Session III]
Conclusion: Presenting quality of care indicators annually has raised awareness of outcome rates and variations which existed across the province. The annual process of engaging surgeons in the evaluation process and linkage with other administrative databases to obtain outcome data has been associated with a reduction in use of RBC transfusion and instigated further investigations into regional variation in mortality rates. The addition of new indicators and other risk-adjusted analyses in the future may further improve quality of care in cardiac surgery in BC. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Abel, J. G., Wong, D. R., Ng, C. H., Ding, L., Kmetic, A. Tags: Poster Session III Source Type: research

Should High Thoracic Epidural Analgesia Be Dismissed in Cardiac Surgery?
We read with interest the recent paper of Nielsen et al, regarding high thoracic epidural analgesia (HTEA) in cardiac surgery. They studied 60 low-risk patients, 65 to 80 years of age, scheduled for elective coronary artery bypass graft surgery with or without aortic valve replacement and found that HTEA did not reduce the time in the intensive care unit or improve the quality of recovery in the intensive care unit. Should HTEA be dismissed in cardiac surgery? (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 14, 2013 Category: Anesthesiology Authors: Yong X. Liang, He Dong, Jian F. Song Tags: Letters to the Editor Source Type: research

High Thoracic Epidural Analgesia and Cardiac Performance
We read with interest the recent paper of CJ Jakobsen et al regarding high thoracic epidural analgesia (HTEA) in cardiac surgery. They studied 60 low-risk patients between 65 and 80 years of age scheduled for elective coronary artery bypass graft surgery with or without HTEA. They thought HTEA improved perioperative cardiac performance both before and after cardiopulmonary bypass, shown by a higher stroke volume index and cardiac index without increases in heart rate or mean arterial pressure. But we do not think so. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 14, 2013 Category: Anesthesiology Authors: Yong Xin Liang, He Dong, Yun Bo Sun Tags: Letters to the Editor Source Type: research

Anesthetic Management of Robotically Assisted Totally Endoscopic Coronary Artery Bypass Surgery (TECAB)
TOTALLY ENDOSCOPIC coronary artery bypass (TECAB) performed with robotic technology is an innovative procedure that allows coronary revascularization in the closed chest. Experience with TECAB surgery first was reported in 1999, and subsequent results have demonstrated the general application of this technique. Early and midterm patient outcomes are comparable to the conventional approach, but these initial cohorts of patients are still under observation for long-term outcomes. (Source: Journal of Cardiothoracic and Vascular Anesthesia)
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 14, 2013 Category: Anesthesiology Authors: Seema P. Deshpande, Eric Lehr, Patrick Odonkor, Johannes O. Bonatti, Maudy Kalangie, David A. Zimrin, Alina M. Grigore Tags: Review Articles Source Type: research

Aortic valve reconstruction with autologous pericardium for dialysis patients
CONCLUSIONS Medium-term results are excellent. Since warfarin for dialysis patients becomes problematic, a postoperative warfarin-free status is desirable. Aortic valve reconstruction can provide patients with a better quality of life without warfarin. (Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - May 14, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Kawase, I., Ozaki, S., Yamashita, H., Uchida, S., Nozawa, Y., Matsuyama, T., Takatoh, M., Hagiwara, S. Tags: Adult Cardiac Source Type: research

Oxygen delivery during cardiopulmonary bypass (and renal outcome) using two systems of extracorporeal circulation: a retrospective review
CONCLUSIONS Despite aiming for the same target pump flow, periodic limitations of venous return to the pump resulted in a significant reduction in average flow delivered to the patient by Mini-CPB. Less haemodilution compensated for this reduction, so that the average oxygen delivery was the same. The association between oxygen delivery and postoperative change in plasma creatinine was evident in both groups. Further work to understand whether there is a particular cohort of patients who benefit (or are put at risk) by one method of CPB vs the other is warranted. (Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - May 14, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Bennett, M. J., Rajakaruna, C., Bazerbashi, S., Webb, G., Gomez-Cano, M., Lloyd, C. Tags: Adult Cardiac Source Type: research

Is single-unit blood transfusion bad post-coronary artery bypass surgery?
CONCLUSIONS Cox regression and propensity matching both indicate that a single-unit transfusion is not a significant cause of reduced long-term survival. Preoperative anaemia is a significant confounding factor. Despite demonstrating the negligible risks of a single-unit blood transfusion, we are not advocating liberal transfusion and would recommend changing from a double-unit to a single-unit transfusion policy. We speculate that blood is not bad, but that the underlying reason that it is given might be. (Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - May 14, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Warwick, R., Mediratta, N., Chalmers, J., Pullan, M., Shaw, M., Mcshane, J., Poullis, M. Tags: Adult Cardiac Source Type: research

Impact of left ventricular remodelling on outcomes after left ventriculoplasty for ischaemic cardiomyopathy: Japanese surgical ventricular reconstruction group experience
CONCLUSIONS The severity of LV remodelling did not affect survival after SVR plus CABG. The results of SVR were acceptable even for those with globally akinetic LV due to ischaemic cardiomyopathy. (Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - May 14, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Wakasa, S., Matsui, Y., Isomura, T., Takanashi, S., Yamaguchi, A., Komiya, T., Cho, Y., Kobayashi, J., Yaku, H., Kokaji, K., Arai, H., Sawa, Y. Tags: Adult Cardiac Source Type: research

Skeletonized versus pedicled internal thoracic artery and risk of sternal wound infection after coronary bypass surgery: meta-analysis and meta-regression of 4817 patients
In conclusion, skeletonized ITA appears to reduce the incidence of postoperative SWI in comparison with pedicled ITA after CABG, with this effect being modulated by the presence of diabetes. (Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - May 14, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Sa, M. P. B. d. O., Ferraz, P. E., Escobar, R. R., Vasconcelos, F. P., Ferraz, A. A. B., Braile, D. M., Lima, R. C. Tags: Adult Cardiac Source Type: research

Does a minimally invasive approach result in better pulmonary function postoperatively when compared with median sternotomy for coronary artery bypass graft?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was ‘Does a minimally invasive approach result in better pulmonary function postoperatively when compared with median sternotomy for coronary artery bypass graft?’. Procedures such as limited sternotomy and minimally invasive direct coronary artery bypass (MIDCAB) though a minithoracotomy were regarded as minimally invasive. Overall, 681 papers were found, of which eight represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group ...
Source: Interactive CardioVascular and Thoracic Surgery - May 14, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Dooley, A., Asimakopoulos, G. Tags: Adult Cardiac Source Type: research

Ultrasound mapping of the long saphenous vein in coronary artery bypass graft surgery
We describe the technique of ultrasound mapping of the long saphenous vein and its application to conduit harvest in coronary artery bypass graft (CABG) surgery. (Source: Interactive CardioVascular and Thoracic Surgery)
Source: Interactive CardioVascular and Thoracic Surgery - May 14, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Soo, A., Noel, D., MacGowan, S. Tags: Adult Cardiac Source Type: research

Use of extracorporeal life support for emergency coronary artery bypass grafting
A 14-year old boy was admitted with an anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva, with an interarterial course of the narrow proximal segment. He underwent coronary ostial augmentation and main pulmonary artery translocation to the left pulmonary artery. In the post-cardiopulmonary bypass (CPB) period, he developed thrombotic occlusion of the RCA resulting in arrhythmia and ventricular dysfunction, requiring extracorporeal life support (ECLS) in the form of extracorporeal membrane oxygenation rather than CPB. After confirming this complication by cardiac catheterization, the right ...
Source: Interactive CardioVascular and Thoracic Surgery - May 14, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Panda, B. R., Prabhu, A., Provenzano, S., Karl, T. Tags: Congenital Source Type: research

The Incidence and Clinical Outcome of Constrictive Physiology After Coronary Artery Bypass Graft Surgery
Previous reports have shown changes in the etiologic spectrum of constrictive pericarditis, characterized mainly by a declining incidence of tuberculous pericarditis and an increase in cases resulting from cardiac surgery (1). Constrictive physiology (CP) not only is found in patients with symptomatic constrictive pericarditis but is also more commonly observed in post-cardiac surgery patients when assessed with comprehensive echocardiographic examination. However, few data are available with regard to echocardiographically observed post-operative CP. Therefore, the purpose of this study was to investigate the incidence an...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - May 13, 2013 Category: Cardiology Source Type: research

Statin Therapy in the Reduction of Cardiovascular Events in Patients Undergoing Intermediate‐Risk Noncardiac, Nonvascular Surgery
ConclusionsStatin use in the perioperative period was associated with a reduction in cardiovascular adverse events and 30‐day all‐cause mortality in patients undergoing intermediate‐risk NCNVS. (Source: Clinical Cardiology)
Source: Clinical Cardiology - May 13, 2013 Category: Cardiology Authors: Manjunath G. Raju, Ajay Pachika, Sujeeth R. Punnam, Joseph C. Gardiner, Mehdi H. Shishehbor, Samir R. Kapadia, George S. Abela Tags: Clinical Investigation Source Type: research

Bilateral internal mammary artery grafts, mortality and morbidity: an analysis of 1 526 360 coronary bypass operations
Conclusions BIMA grafting is associated with increased risk of DSWI only in patients with severe, chronic diabetes. The incremental morbidity and mortality of DSWI does not justify denial of BIMA in the majority of patients. (Source: Heart)
Source: Heart - May 13, 2013 Category: Cardiology Authors: Itagaki, S., Cavallaro, P., Adams, D. H., Chikwe, J. Tags: Drugs: cardiovascular system, Heart failure, Interventional cardiology, Epidemiology, Diabetes, Metabolic disorders Cardiovascular surgery Source Type: research

Bilateral internal mammary artery bypass grafting: long-term clinical benefits in a series of 1000 patients
Conclusions Our longitudinal analysis presents encouraging data concerning operative risk of BIMA grafting and provides excellent long-term survival in appropriately selected patients. (Source: Heart)
Source: Heart - May 13, 2013 Category: Cardiology Authors: Popovic, B., Voillot, D., Maureira, P., Vanhuyse, F., Agrinier, N., Aliot, E., Folliguet, T., Villemot, J. P. Tags: Drugs: cardiovascular system, Interventional cardiology, Acute coronary syndromes, Epidemiology Cardiovascular surgery Source Type: research

Renal physiology and kidney stones
Conclusions: The occurrence of a kidney stone is associated with an increased risk of cardiovascular events including AMI, death due to CHD,PTCA/CABG and stroke. These data suggest that people with a clinically recognized kidney stone should be followed more closely to evaluate for the possibility of subsequent cardiovascular events -- younger people and women. (Source: Nephrology Dialysis Transplantation)
Source: Nephrology Dialysis Transplantation - May 10, 2013 Category: Urology & Nephrology Authors: Alexander, R. T., Samuel, S., Wiebe, N., Bello, A., Klarenbach, S., Curhan, G. C., Tonelli, M., Hemmelgarn, B., Mingione, A., Terranegra, A., Aloia, A., Arcidiacono, T., Brasacchio, C., Hou, J., Dell'Antonio, G., Vezzoli, G., Soldati, L., Shimizu, T., Has Tags: Abstracts Source Type: research