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  • 1
    Online Resource
    Online Resource
    Angiosarcoma of the Left Atrium: A Case Report
    Georg Thieme Verlag KG ; 2018
    In:  The Thoracic and Cardiovascular Surgeon Reports Vol. 07, No. 01 ( 2018-01), p. e4-e6
    Details
    In: The Thoracic and Cardiovascular Surgeon Reports, Georg Thieme Verlag KG, Vol. 07, No. 01 ( 2018-01), p. e4-e6
    Abstract: Background Primary cardiac tumors are rare, and many diagnosed tumors are benign with an incidence of 0.001% to 0.03%. The primary angiosarcoma is one of the malignant entities. Discussion We discuss a case report of a 76-year-old male who underwent a preoperative diagnosis for an upcoming shoulder operation when his cardiologist diagnosed a large cardiac tumor. The patient was referred to our department where he received further diagnostics. The transesophageal echocardiography and the cardiac-magnetic resonance imaging showed a massive tumor with a dimension of 8.6 × 5.6 cm with no signs of malignity. Method The operation was performed by standard median sternotomy. The tumor was adherent to the septum and the left atrium, and we were able to remove the specimen in toto. Pathological examinations showed an angiosarcoma with neovascularization and core expression of ERG+ and cytoplasmic expression of CD31+/CD34+, due to the size of the mass. The resection of primary cardiac tumors is mostly the therapy of choice, but in this case concerning an angiosarcoma the prognosis is poor, considering that the angiosarcoma responds very badly to chemotherapy and radiotherapy.
    Type of Medium: Online Resource
    ISSN: 2194-7635 , 2194-7643
    URL: Article
    DOI: 10.1055/s-0038-1627443
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2018
    detail.hit.zdb_id: 2706759-2
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  • 2
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    Rapid Deployment Aortic Valve Replacement with the Perceval S and Intuity Elite
    Georg Thieme Verlag KG ; 2021
    In:  The Thoracic and Cardiovascular Surgeon Vol. 69, No. 05 ( 2021-08), p. 412-419
    Details
    In: The Thoracic and Cardiovascular Surgeon, Georg Thieme Verlag KG, Vol. 69, No. 05 ( 2021-08), p. 412-419
    Abstract: Background Rapid deployment aortic valve replacement (RDAVR) has emerged as an alternative to conventional aortic valve replacement. This single-center study retrospectively analyzed clinical outcomes and hemodynamic performance of the Perceval S (LivaNova) and Intuity Elite (Edwards LifeSciences) rapid deployment valves (RDVs) in a propensity score matched patient cohort. Methods A total of 372 consecutive patients with symptomatic aortic valve stenosis underwent RDAVR between 2012 and 2018 at our institution. The Intuity Elite (INT group) and Perceval S (PER group) were implanted in 251 and 121 patients, respectively. After 1:1 propensity score matching for relevant preoperative comorbidities, 107 patient pairs were compared with respect to relevant perioperative data including hemodynamic parameter, postoperative pacemaker implantation, and 30-day all-cause mortality. Results Propensity score matching resulted in balanced characteristics between groups. Cardiopulmonary bypass and aortic cross-clamp time did not differ between groups, but more patients in the INT group received coronary artery bypass grafting compared with the PER group (56 vs. 42%; p = 0.055). Thirty-day mortality (4.7 vs. 2.2%) and need for permanent pacemaker implantation (7 versus 4.4%) were comparable between the INT and PER groups for isolated AVR and also for combined procedures, respectively. Cerebrovascular events showed comparable low rates for both RDVs (INT group [1.9%] vs. PER group [2.8%] ). Indexed effective orifice area was higher in the INT group (0.90 vs. 0.82 cm2/m2) and coupled to a lower peak (17 ± 7 vs. 22 ± 8) and mean (10 ± 5 vs. 12 ± 4) pressure gradients compared with the PER group. Conclusions Our propensity score analysis in AVR patients showed good hemodynamic characteristics with comparable 30-day mortality rate and complications rates for both investigated RDVs.
    Type of Medium: Online Resource
    ISSN: 0171-6425 , 1439-1902
    URL: Article
    DOI: 10.1055/s-0040-1716892
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
    detail.hit.zdb_id: 2056554-9
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  • 3
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    Online Resource
    Major Bleeding after Surgical Revascularization with Dual Antiplatelet Therapy
    Georg Thieme Verlag KG ; 2020
    In:  The Thoracic and Cardiovascular Surgeon Vol. 68, No. 08 ( 2020-12), p. 714-722
    Details
    In: The Thoracic and Cardiovascular Surgeon, Georg Thieme Verlag KG, Vol. 68, No. 08 ( 2020-12), p. 714-722
    Abstract: Objective Patients with acute coronary syndrome are treated with dual antiplatelet therapy containing acetylsalicylic acid (ASA) and P2Y12 antagonists. In case of urgent coronary artery bypass grafting this might be associated with increasing risks of bleeding complications. Methods Data from 1200 consecutive urgent operations between 2010 and 2018 were obtained from our institutional patient database. For this study off-pump surgery was excluded. The primary composite end point major bleeding consisted of at least one end point: transfusion ≥ 5 packed red blood cells within 24 hours, rethoracotomy due to bleeding, chest tube output 〉 2000 mL within 24 hours. Demographic data, peri-, and postoperative variables and outcomes were compared between patients treated with mono antiplatelet therapy, ASA + clopidogrel (ASA-C) +ticagrelor (ASA-T) or +prasugrel (ASA-P)  〈  72 hours before surgery. Furthermore, we compared patients with dual antiplatelet therapy with ASA monotherapy. Results From 1,086 patients, 475 (44%) received dual antiplatelet therapy. Three-hundred seventy-two received ASA-C (77.7%), 72 ASA-T (15%), and 31 ASA-P (6.5%). Major bleeding (44 vs. 23%, p  〈  0.0001) was more frequently in patients receiving dual therapy with higher rates of massive drainage loss within 24 hours (23 vs. 11%, p  〈  0.0001) of mass transfusion (34 vs. 16%, p  〈  0.0001) and rethoracotomy (10 vs. 5%, p = 0.002) when compared with ASA. In this analysis, ASA-T and ASA-P were not associated with higher bleeding complications compared with ASA-C. Conclusion Dual antiplatelet therapy is associated with higher rates of major bleeding. Further studies should examine the difference in the prevalence of major bleeding complications in the different dual antiplatelet therapy regimes in patients requiring urgent surgery.
    Type of Medium: Online Resource
    ISSN: 0171-6425 , 1439-1902
    URL: Article
    DOI: 10.1055/s-0040-1710508
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2020
    detail.hit.zdb_id: 2056554-9
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