Ongoing questions in the surgery for type A aortic dissection include arterial cannulation site and the type of distal anastomosis for ascending or hemiarch replacement.
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Ascending Aorta
April 26, 2018
The authors retrospectively evaluated the long-term fate of the aortic arch in 168 patients with bicuspid aortic valves who had undergone either ascending aortic (24%) or aortic root (76%) replacement. At a median follow-up of 5.9 years, the mean aortic arch diameter went from 2.9 cm preoperatively to 3.0 cm at follow-up (p=ns). The authors conclud
April 13, 2018
The authors present their experience in treating 39 patients with thoracic aortic endovascular repair of the ascending aorta who were determined to be very high risk for open surgical repair from 2006 to 2016.
March 18, 2018
The authors studied 852 adults with bicuspid aortic valves. The prevelance of three morphotypes was tallied. Relative fusion rates were: RL 72.9%, RN 24.1% and LN 3%. Additionally, 18.3% had no raphe. Aortic regurgitation was unrelated to morphotype. Aortic stenosis was more common in the RN fusion group and in the presence of a raphe. Seventy-
March 1, 2018
This Stanford group retrospectively reviewed their experience over a 10-year period with 293 patients who underwent either limited aortic root repair or root replacement.
Results:
March 1, 2018
The authors present a thorough expert consensus review on the prevention—preoperative, intraoperative, and postoperative—and the postoperative management of sternal wound infections. The authors conclude with a guideline with class recommendations and levels of evidence.
This article should be in every cardiac surgeon's armamentarium.
February 26, 2018
A succinct, readable, and well-referenced editorial on extending criteria for surgery on bicuspid aortopathy below the threshold of 4.5 cm diameter. It is even more interesting in the era of increasing industry pressure for transcatheter aortic valve replacement.
February 14, 2018
Wang and colleagues present a systematic review of outcomes reported in 26 articles for 67 patients who underwent endovascular treatment for diseases of the ascending aorta, excluding type A dissection. The authors expect a gain in popularity of this intervention in select high-risk patients, but they consider further analysis necessary.
January 2, 2018
A dense but short and readable editorial arguing for the complexity of risk stratification of aortic pathology.
December 8, 2017
Patient Care
US states that implemented policies for screening newborns for critical congenital heart disease have seen reductions in infant cardiac deaths compared to states that didn’t implement screening.