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60-Day Survival Rate under Treatment of Acute Type A Aortic Dissection by Transapical Aortic Cannulation Technique
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Abstracts
Conclusion: BST is a safe procedure for all appropriate patients in ICU.
Initial Centre Experience with the St. Jude Trifecta Aortic Valve Prosthesis and Cor-Knot Suture Fixation Device
References
Karan Sian *, Stuart Sugito, Sheila Li, Ajay Ayengar, Ross Mejia, Peng Seah
[1] Terra RM, Fernandez A, Helbert B, et al. Open bedside tracheostomy: routine procedure for patients under prolonged mechanical ventilation. Clinics 2007;62(4):427–32. [2] Silvester W, Knight S, Seevanayagam S, et al. Percutaneous versus surgical tracheostomy: a randomized controlled study with long-term follow-up. Crit Care Med 2006;34(8):2145–52.
http://dx.doi.org/10.1016/j.hlc.2015.12.072 60-Day Survival Rate under Treatment of Acute Type A Aortic Dissection by Transapical Aortic Cannulation Technique Surakarn Saraithong *, Phunlerd Piyaraj, Shin Yamamoto, Oshima Susumu Phramongkutklao Hospital, Bangkok, Thailand Introduction: Acute type A aortic dissection has several techniques of cardiopulmonary bypass (CPB) for aortic cannulation. The most important for all aortic cannulation sites is perfusing into the true lumen. Objective: This article aims to show a technique and results of 60-day survival rate under treatment of Acute type A aortic dissection by tranapical aortic cannulation technique. Materials and Methods: The study investigated data covering 12 years of surgery experience involving Acute type A acute aortic dissection by transapical aortic cannulation technique at Kawasaki Saiwai Hospital, Kawasaki, Japan. Statistical Analysis: Cox proportional hazard regression was employed to analyse risk ratio, and Kaplan Meier curve was used to estimate the survival time Results: The study population (N=309) was investigated for survival analysis. The person-time was 6363.50 person/ months. We found that, the deaths event totalled 29 persons (9.38%). The mortality rate was 4.55/1000 person/months (95% confidence interval = 3.17-6.56/1000 person-month). Conclusion: Risk factors influencing the survival rate in Acute type A aortic dissection included sex, coronary artery disease (CAD), preoperative deterioration, total arch replacement, CPB technique using only DHCA (Deep Hypothermic Circulatory Arrest), DHCA with RCP (Retrograde Cerebral Perfusion) and DHCA with SCP (Antegrade Selective Cerebral Perfusion). The ascending aortic diameter and proximal descending aorta diameter, increased the death rate by 11% and 18% respectively. When the diameter increased every 1 mm, and when the operation time increased every 1 minute, the death rate was increased by 1%. Keywords: Acute Type A Aortic Dissection; Tranapical Aortic Cannulation Technique; Deep Hypothermic Circulatory Arrest. http://dx.doi.org/10.1016/j.hlc.2015.12.073
John Hunter Hospital, Newcastle, NSW, Australia Objectives: The recently introduced Trifecta valve (St. Jude Medical Inc., St. Paul, MN, USA) is a tri-leaflet stented pericardial valve made for use in the supra-annular aortic position. The Cor-Knot (LSI Solutions, Victor, NY, USA) is a suture fixation device designed for remote equivocal suture tensioning and quick fixation. The present study aims to evaluate our preliminary experiences with this new valve and suture fixation device. Methods: Twenty-nine patients underwent aortic valve replacement (AVR) with the Trifecta valve between November 2013 and July 2015. Cor-Knot was used to secure the aortic valve in 11 (40%) patients. All data, intraoperative, and postoperative was prospectively gathered. Echocardiography was performed prior to discharge from hospital. Mean Euro SCORE II was 2.53%. Seven (23%) were female. Mean age was 72.0 +/- 7.07 (range 61-83 years). Fifteen (52%) patients underwent combined procedures. Results: Concomitant procedures included: mitral valve replacement (2), coronary artery bypass grafting (10) and redo AVR (4). In-hospital mortality at 30 days was 1 (3%). Mean gradients were 10, 9, 9, and 7 mm Hg for the 21, 23, 25 and 27 mm valve size, respectively. Cor-Knot demonstrated a mean reduction in total cardio pulmonary bypass and cross-clamp times of 18.7 and 14.5 minutes respectively. Statistical significance however could not be shown. No paravalvular leak or significant aortic regurgitation was demonstrated before discharge. Conclusions: Initial clinical experience and early haemodynamics of the Trifecta valve are promising. Further studies with larger patient cohorts will be required to demonstrate any benefit of the Cor-Knot device in reducing bypass and cross-clamp times. http://dx.doi.org/10.1016/j.hlc.2015.12.074 Lobar Torsion following Bilateral Lung Transplantation Georgina Stephens *, Krishna Bhagwat, Adrian Pick, David McGiffin The Alfred Hospital, Melbourne, VIC, Australia Purpose: To review all cases of lobar torsion following lung transplantation in the literature, with the addition of a further case occurring at The Alfred Hospital. Methodology: A review of the available literature was undertaken to find all reports of lobar torsion following lung transplantation. Cases were examined to determine predisposing factors leading to torsion, clinical presentation, management and prognosis. Results: Ten cases, including our own, have been published. Eight of the cases occurred within the first 5
Abstracts
Conclusion: BST is a safe procedure for all appropriate patients in ICU.
Initial Centre Experience with the St. Jude Trifecta Aortic Valve Prosthesis and Cor-Knot Suture Fixation Device
References
Karan Sian *, Stuart Sugito, Sheila Li, Ajay Ayengar, Ross Mejia, Peng Seah
[1] Terra RM, Fernandez A, Helbert B, et al. Open bedside tracheostomy: routine procedure for patients under prolonged mechanical ventilation. Clinics 2007;62(4):427–32. [2] Silvester W, Knight S, Seevanayagam S, et al. Percutaneous versus surgical tracheostomy: a randomized controlled study with long-term follow-up. Crit Care Med 2006;34(8):2145–52.
http://dx.doi.org/10.1016/j.hlc.2015.12.072 60-Day Survival Rate under Treatment of Acute Type A Aortic Dissection by Transapical Aortic Cannulation Technique Surakarn Saraithong *, Phunlerd Piyaraj, Shin Yamamoto, Oshima Susumu Phramongkutklao Hospital, Bangkok, Thailand Introduction: Acute type A aortic dissection has several techniques of cardiopulmonary bypass (CPB) for aortic cannulation. The most important for all aortic cannulation sites is perfusing into the true lumen. Objective: This article aims to show a technique and results of 60-day survival rate under treatment of Acute type A aortic dissection by tranapical aortic cannulation technique. Materials and Methods: The study investigated data covering 12 years of surgery experience involving Acute type A acute aortic dissection by transapical aortic cannulation technique at Kawasaki Saiwai Hospital, Kawasaki, Japan. Statistical Analysis: Cox proportional hazard regression was employed to analyse risk ratio, and Kaplan Meier curve was used to estimate the survival time Results: The study population (N=309) was investigated for survival analysis. The person-time was 6363.50 person/ months. We found that, the deaths event totalled 29 persons (9.38%). The mortality rate was 4.55/1000 person/months (95% confidence interval = 3.17-6.56/1000 person-month). Conclusion: Risk factors influencing the survival rate in Acute type A aortic dissection included sex, coronary artery disease (CAD), preoperative deterioration, total arch replacement, CPB technique using only DHCA (Deep Hypothermic Circulatory Arrest), DHCA with RCP (Retrograde Cerebral Perfusion) and DHCA with SCP (Antegrade Selective Cerebral Perfusion). The ascending aortic diameter and proximal descending aorta diameter, increased the death rate by 11% and 18% respectively. When the diameter increased every 1 mm, and when the operation time increased every 1 minute, the death rate was increased by 1%. Keywords: Acute Type A Aortic Dissection; Tranapical Aortic Cannulation Technique; Deep Hypothermic Circulatory Arrest. http://dx.doi.org/10.1016/j.hlc.2015.12.073
John Hunter Hospital, Newcastle, NSW, Australia Objectives: The recently introduced Trifecta valve (St. Jude Medical Inc., St. Paul, MN, USA) is a tri-leaflet stented pericardial valve made for use in the supra-annular aortic position. The Cor-Knot (LSI Solutions, Victor, NY, USA) is a suture fixation device designed for remote equivocal suture tensioning and quick fixation. The present study aims to evaluate our preliminary experiences with this new valve and suture fixation device. Methods: Twenty-nine patients underwent aortic valve replacement (AVR) with the Trifecta valve between November 2013 and July 2015. Cor-Knot was used to secure the aortic valve in 11 (40%) patients. All data, intraoperative, and postoperative was prospectively gathered. Echocardiography was performed prior to discharge from hospital. Mean Euro SCORE II was 2.53%. Seven (23%) were female. Mean age was 72.0 +/- 7.07 (range 61-83 years). Fifteen (52%) patients underwent combined procedures. Results: Concomitant procedures included: mitral valve replacement (2), coronary artery bypass grafting (10) and redo AVR (4). In-hospital mortality at 30 days was 1 (3%). Mean gradients were 10, 9, 9, and 7 mm Hg for the 21, 23, 25 and 27 mm valve size, respectively. Cor-Knot demonstrated a mean reduction in total cardio pulmonary bypass and cross-clamp times of 18.7 and 14.5 minutes respectively. Statistical significance however could not be shown. No paravalvular leak or significant aortic regurgitation was demonstrated before discharge. Conclusions: Initial clinical experience and early haemodynamics of the Trifecta valve are promising. Further studies with larger patient cohorts will be required to demonstrate any benefit of the Cor-Knot device in reducing bypass and cross-clamp times. http://dx.doi.org/10.1016/j.hlc.2015.12.074 Lobar Torsion following Bilateral Lung Transplantation Georgina Stephens *, Krishna Bhagwat, Adrian Pick, David McGiffin The Alfred Hospital, Melbourne, VIC, Australia Purpose: To review all cases of lobar torsion following lung transplantation in the literature, with the addition of a further case occurring at The Alfred Hospital. Methodology: A review of the available literature was undertaken to find all reports of lobar torsion following lung transplantation. Cases were examined to determine predisposing factors leading to torsion, clinical presentation, management and prognosis. Results: Ten cases, including our own, have been published. Eight of the cases occurred within the first 5