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  • 1
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    Impact of ascending aortic, hemiarch and arch repair on early and long-term outcomes in patients with Stanford A acute aortic dissection
    SAGE Publications ; 2018
    In:  Therapeutic Advances in Cardiovascular Disease Vol. 12, No. 12 ( 2018-12), p. 327-340
    Details
    In: Therapeutic Advances in Cardiovascular Disease, SAGE Publications, Vol. 12, No. 12 ( 2018-12), p. 327-340
    Abstract: Stanford A acute aortic dissection (AAD) is a life-threatening emergency associated with major morbidity and mortality. The aim of this study was to compare outcomes of three different surgical approaches in patients with Stanford A AAD. Methods: From January 2006 to March 2015 a total of 240 consecutive patients with diagnosed Stanford A AAD underwent elective, isolated surgical aortic repair in our centre. Patients were divided into three groups according to the extent of surgical repair: isolated replacement of the ascending aorta, hemiarch replacement and total arch replacement. Patients were followed up for up to 9 years. After univariate analysis multinomial logistic regression was performed for subgroup analysis. Baseline characteristics and endpoints as well as long-term survival were analysed. Results: There were no statistically significant differences among the three groups in terms of demographics and preoperative baseline and clinical characteristics. Incidence of in-hospital stroke ( p = 0.034), need for reopening due to bleeding ( p = 0.031) and in-hospital mortality ( p = 0.017) increased significantly with the extent of the surgical approach. There was no statistical difference in terms of long-term survival ( p = 0.166) among the three groups. Applying multinomial logistic regression for subgroup analysis significantly higher odds for stroke ( p = 0.023), reopening for bleeding ( p = 0.010) and in-hospital mortality ( p = 0.009) for the arch surgery group in comparison to the ascending aorta surgery group as well as significantly higher odds for stroke ( p = 0.029) for the total arch surgery group in comparison to the hemiarch surgery group were identified. Conclusions: With Stanford A AAD the incidence of perioperative complications increased significantly with the extent of the surgical approach. Subgroup analysis and long-term follow up in patients undergoing isolated ascending or hemiarch surgery showed a lower incidence of cerebrovascular events compared with surgery for total arch replacement.
    Type of Medium: Online Resource
    ISSN: 1753-9447 , 1753-9455
    URL: Article
    DOI: 10.1177/1753944718801568
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2387507-0
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  • 2
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    A comparative study of four thoracic mortality scores
    SAGE Publications ; 2023
    In:  Asian Cardiovascular and Thoracic Annals Vol. 31, No. 3 ( 2023-03), p. 244-252
    Details
    In: Asian Cardiovascular and Thoracic Annals, SAGE Publications, Vol. 31, No. 3 ( 2023-03), p. 244-252
    Abstract: The percentage of patients in resectable stages at initial diagnosis of non-small cell lung cancer (NSCLC) raises due to better screening programs. Therefore, risk prediction models are becoming more critical. Here, we validated and compared four established scoring models, the Thoracoscore, Epithor, Eurloung 2, and the simplified Eurolung 2 (2b), in their ability to predict 30-day mortality. Methods All consecutive patients undergoing anatomical pulmonary resection were included. The performance of the four scoring systems was assessed with Hosmer–Lemeshow goodness-of-fit test (calibration) and receiver operating characteristic (ROC) curves (discrimination). We compared the area under the curve (AUC) of the ROC curves by DeLong's method. Results A total of 624 patients underwent surgery for NSCLC at our institution between 2012 and 2018 30-day mortality was 2.2% (14 patients). The AUC for Eurolung 2 and the simplified Eurolung 2 (0.82) were greater than those of the other scoring systems, Epithor (0.71) and Thoracoscore (0.65). In addition, the DeLong analysis showed a significant superiority of Eurolung 2 and Eurolung 2b over the Thoracoscore ( p = 0.04); there were no significant differences compared to Epithor. Conclusion Eurolung 2 and the simplified Eurolung 2 were the favorable scoring systems for predicting 30-day mortality compared to Thoracoscore and Epithor. Therefore, we recommend using Eurolung 2 or the simplified Eurolung 2 for preoperative risk stratification.
    Type of Medium: Online Resource
    ISSN: 0218-4923 , 1816-5370
    URL: Article
    DOI: 10.1177/02184923231159086
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2044527-1
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  • 3
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    Constrictive pericarditis with a life-threatening giant pericardial cyst and pectus excavatum as unusual cause for malign cardiac arrhythmias
    SAGE Publications ; 2019
    In:  Perfusion Vol. 34, No. 6 ( 2019-09), p. 516-518
    Details
    In: Perfusion, SAGE Publications, Vol. 34, No. 6 ( 2019-09), p. 516-518
    Abstract: Pericardial cysts are rare, abnormal, benign and usually congenital anomalies with an estimated incidence of 1:100.000 and are caused by an incomplete coalescence of foetal lacunae of pericardium development. The size of pericardial cysts varies from 1 to 5 cm and generally do not cause any symptoms. Pectus excavatum is one of the most frequent chest wall abnormalities with a caved-in appearance of the chest and mostly of unknown pathogenesis. We present a rare case of constrictive pericarditis with a huge pericardial cyst (11.6 × 8.7 × 7.1 cm) and pectus excavatum which led to compression of the heart and life-threatening cardiac arrhythmias.
    Type of Medium: Online Resource
    ISSN: 0267-6591 , 1477-111X
    URL: Article
    DOI: 10.1177/0267659119826827
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
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  • 4
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    Predictors of acute kidney injury in patients after extracorporeal cardiopulmonary resuscitation
    SAGE Publications ; 2023
    In:  Perfusion Vol. 38, No. 2 ( 2023-03), p. 292-298
    Details
    In: Perfusion, SAGE Publications, Vol. 38, No. 2 ( 2023-03), p. 292-298
    Abstract: Extracorporeal cardiopulmonary resuscitation (eCPR) is increasingly used due to its beneficial outcomes and results compared with conventional CPR. Data after eCPR for acute kidney injury (AKI) are lacking. We sought to investigate factors predicting AKI in patients who underwent eCPR. Methods: From January 2016 until December 2020, patients who underwent eCPR at our institution were retrospectively analyzed and divided into two groups: patients who developed AKI ( n = 60) and patients who did not develop AKI ( n = 35) and analyzed for outcome parameters. Results: Overall, 63% of patients suffered AKI after eCPR and 45% of patients who developed AKI needed subsequent dialysis. Patients who developed AKI showed higher values of creatinine (1.1 mg/dL vs 1.5 mg/dL, p ⩽ 0.01), urea (34 mg/dL vs 42 mg/dL, p = 0.04), CK (creatine kinase) (923 U/L vs 1707 U/L, p = 0.07) on admission, and CK after 24 hours of ECMO support (1705 U/L vs 4430 U/L, p = 0.01). ECMO explantation was significantly more often performed in patients who suffered AKI (24% vs 48%, p = 0.01). In-hospital mortality (86% vs 70%; p = 0.07) did not differ significantly. Conclusion: Patients after eCPR are at high risk for AKI, comparable to those after conventional CPR. Baseline urea levels predict the development of AKI during the hospital stay.
    Type of Medium: Online Resource
    ISSN: 0267-6591 , 1477-111X
    URL: Article
    DOI: 10.1177/02676591211049767
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2029611-3
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  • 5
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    Gender-related propensity score match analysis of ECMO therapy in postcardiotomy cardiogenic shock in patients after myocardial revascularization
    SAGE Publications ; 2022
    In:  Perfusion Vol. 37, No. 5 ( 2022-07), p. 470-476
    Details
    In: Perfusion, SAGE Publications, Vol. 37, No. 5 ( 2022-07), p. 470-476
    Abstract: Gender is known to influence the pathophysiology and pathogenesis of the coronary vascular disease. Data on gender-related differences in patients with veno-arterial extracorporeal membrane oxygenation due to postcardiotomy cardiogenic shock is lacking in current literature. We aimed to analyze the impact of gender on intraoperative and short-term outcomes of vaECMO patients after coronary surgery and postcardiotomy cardiogenic shock. Methods: Between 2006 and 2017, a total of 92 patients with PCS after CABG underwent vaECMO-implantation at our institution. After a 1:1 propensity score match (PSM) for relevant preoperative data, we identified a cohort of 32 patients, 16 males, and 16 females. Periprocedural and short-term outcome data were analyzed with respect to sex differences. Results: The mean age was 64 ± 11 years, and 79% ( n = 73) were male patients. Clinical outcomes showed a 30-day all-cause mortality of 64% ( n = 59). After PSM, male patients showed a significantly smaller number of arterial grafts (0.4 ± 0.53 male vs 1.1 ± 0.7 female; p = 0.037). Thirty-day all-cause mortality did not differ between the groups (56% male vs 75% female; p = 0.262). In general, short-term outcome data were comparable without significant differences for the matched groups. Conclusion: Gender has no impact on patients with vaECMO therapy due to PCS in isolated coronary surgery.
    Type of Medium: Online Resource
    ISSN: 0267-6591 , 1477-111X
    URL: Article
    DOI: 10.1177/02676591211004363
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 6
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    Minimally invasive resection of a giant left atrial myxoma: a case report
    SAGE Publications ; 2020
    In:  Perfusion Vol. 35, No. 3 ( 2020-04), p. 263-266
    Details
    In: Perfusion, SAGE Publications, Vol. 35, No. 3 ( 2020-04), p. 263-266
    Abstract: Cardiac tumors are a rarity. Most diagnosed primary tumors of the heart are benign, with an incidence ranging between 0.001% and 0.03%. Cardiac myxoma is one of these benign entities. A 44-year-old Caucasian woman who presented with symptoms of a common cold was diagnosed with a massive obstructing myxoma of the left atrium. Despite its large size, the tumor was completely removed using minimally invasive access through right anterior thoracotomy. However, the myxoma was adherent to the left atrial septum and was excised in toto. Pathological examinations confirmed the diagnosis of a primary cardiac myxoma. Total resection of obstructive cardiac myxomas is the therapy of choice, whereas minimally invasive surgical approach might be feasible despite large size and septal localization, but is technically challenging.
    Type of Medium: Online Resource
    ISSN: 0267-6591 , 1477-111X
    URL: Article
    DOI: 10.1177/0267659119865125
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
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  • 7
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    Results and outcomes for patients with atrioventricular groove disruption after mitral valve surgery
    SAGE Publications ; 2022
    In:  Perfusion Vol. 37, No. 3 ( 2022-04), p. 284-292
    Details
    In: Perfusion, SAGE Publications, Vol. 37, No. 3 ( 2022-04), p. 284-292
    Abstract: Atrioventricular groove disruption (AVGD) is a rare and severe complication of mitral valve surgery (MVS). Current literature is limited to several case reports and series. Our aim was to analyze outcomes of patients with AVGD after MVS from our tertiary cardiac surgery center. Methods: Between June 2010 and January 2019, 18 patients suffering AVGD were identified in our institutional database and included in our retrospective observation. Preoperative, intraoperative and outcome data were analyzed using IBM SPSS Statistics. Late survival was estimated by using the Kaplan–Meier survival analysis. Results: The mean age of the study population was 76 ± 5 years. Most common indication for MVS was an isolated mitral valve insufficiency (67%). Severe annular calcification was present in four patients (22%). Majority of implanted valves were biological prosthesis (78%). Due to the location, 72% suffered type I rupture. External repair was performed in 94% of all patients. Second look operation in regard of excessive mediastinal hemorrhage was necessary in 67% of patients. Mean hospital stay of the presented collective was 13 ± 11 days with an intra-hospital mortality of 56%. Late follow-up was obtained in eight patients at an average of 3.1 (1.6–5.7) years postoperatively. Conclusion: Mortality rates for AVGD after MVS are high. However, way of managing AVGD depends on the underlying type of rupture and should be evaluated in regard of the myocardial damage. Due to the rare occurrence, registry data might help to address more scientific value concerning therapeutic measures and outcomes of this severe complication.
    Type of Medium: Online Resource
    ISSN: 0267-6591 , 1477-111X
    URL: Article
    DOI: 10.1177/0267659121998938
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 8
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    Impact of age on early outcomes and long-term survival of patients undergoing aortic repair with Stanford A dissection
    SAGE Publications ; 2018
    In:  Perfusion Vol. 33, No. 8 ( 2018-11), p. 687-695
    Details
    In: Perfusion, SAGE Publications, Vol. 33, No. 8 ( 2018-11), p. 687-695
    Abstract: Stanford A acute aortic dissection (AAD) is a life-threatening emergency, typically occurring in older patients and requiring immediate surgical repair. The aim of this study was to evaluate early outcome and short- and long-term survival of patients under and above 65 years of age. Methods: Two hundred and forty patients with Stanford A AAD underwent aortic surgical repair from January 2006 to April 2015 in our center. After statistical analysis and logistic regression analysis, Kaplan-Meier survival estimation was performed, with up to 9-year follow-up, comprising patients under and above 65 years of age. Results: The proportion of patients above 65 years of age suffering from Stanford A AAD was 50% (n=120). The group of patients above 65 years of age compared to the group under 65 years of age showed statistically significant differences in terms of higher odds ratios (OR) for hypertension (p=0.012), peripheral vascular disease (p=0.026) and tachyarrhythmia absoluta (p=0.004). Patients over 65 years of age also showed significantly poorer short- and long-term survival. Our subgroup analysis revealed that male patients (Breslow p=0.001, Log-Rank p=0.001) and patients suffering with hypertension (Breslow p=0.003, Log-Rank p=0.001) were reasonable for these results whereas younger and older female patients showed similar short- and long-term outcome (Breslow p=0.926, Log-Rank p=0.724). After stratifying all patients into 4 age groups ( 〈 45; 55-65; 65-75; 〉 75years), short-term survival of the patients appeared to be significantly poorer with increasing age (Breslow p=0.026, Log-Rank p=0.008) whereas long-term survival of patients free from cerebrovascular events (Breslow p=0.0494, Log-Rank p=0.489) remained similar. Conclusions: All patients referred to our hospital for repair of Stanford A AAD with higher age had poorer short- and long-term survival, caused by male patients and patients suffering from hypertension, whereas survival of women and survival free from cerebrovascular events of the entire patient cohort was similar, irrespective of age.
    Type of Medium: Online Resource
    ISSN: 0267-6591 , 1477-111X
    URL: Article
    DOI: 10.1177/0267659118786332
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2029611-3
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