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12. Comparison of Two Surgical Approaches for Coronary Artery Bypass of Left Anterior Descending Artery.

Author

Salamate, Saad, Bakhtiary, Farhad, Bayram, Ali, Sirat, Sami, Doss, Mirko, Ciobanu, Veaceslav, Monsefi, Nadejda, and El-Sayed Ahmad, Ali

Subjects
THORACOTOMY, INTERNAL thoracic artery, CORONARY artery bypass, RED blood cell transfusion, PROPENSITY score matching
Abstract

Background/Objectives: The minimally invasive approach through left mini-thoracotomy is a promising alternative to the median sternotomy for coronary artery bypass. The aim of this study was to compare the short-term outcomes of patients undergoing minimally invasive coronary artery bypass (MIDCAB) with off-pump coronary artery bypass through sternotomy (OPCAB) for single-vessel disease. Methods: From January 2017 to February 2023, 377 consecutive patients aged above 18 years undergoing off-pump bypass of the left anterior descending artery (LAD) with left internal thoracic artery underwent OPCAB. Propensity score matching was then applied. Primary endpoints were in-hospital mortality and 30-day mortality. Results: Prior to matching, 30-day mortality occurred in 2 (0.7%) patients in the MIDCAB group vs. 1 (1%) patient in the OPCAP group (p = 1). Transfusion of red blood cells (RBC) was required in 9.4% and 29% of patients within the MIDCAB and the OPCAB groups, respectively (p < 0.001). Median intensive care stay (ICU) was 1 [1–2] day in the MIDCAB group, vs. 2 [1–3] in the OPCAB (p < 0.001). In the matched cohort, 10% of MIDCAB patients received RBCs vs. 27.5% of OPCAB patients (p = 0.006). Median ICU stay was significantly lower in the MIDCAB group, 1 [1–2] vs. 2 [1–3] days. Conclusions: MIDCAB is as safe and effective as OPCAB for single coronary artery bypass of the LAD with the LITA in select patients. It is associated with a decreased ICU stay and lower transfusion rates when compared with OPCAB. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Totally Endoscopic Replacement of the Ascending Aorta and the Aortic Root including the Aortic Valve via Right Mini-Thoracotomy: A Multicenter Study.

Author

Hamiko, Marwan, Salamate, Saad, Nassari, Maedeh Ayay, Spaeth, Andre, Sirat, Sami, Doss, Mirko, Amer, Mohamed, Silaschi, Miriam, Ahmad, Ali El-Sayed, and Bakhtiary, Farhad

Subjects
AORTIC valve, ENDOSCOPIC surgery, AORTA, INTENSIVE care units, CARDIOPULMONARY bypass, CARDIAC surgery
Abstract

Background: Recently, minimally invasive access via right anterolateral mini-thoracotomy (RAMT) has been gaining popularity in cardiac surgery. This approach is also an option for surgeons performing aortic surgery. The aim of this study is to present our surgical method, highlighting the total endoscopic minimally invasive approach via RAMT for replacement of the ascending aorta (AAR) with or without involvement of the aortic root and the aortic valve. Methods: Clinical data of 44 patients from three participating institutions with AAR with or without involvement of the aortic valve or aortic root via RAMT between April 2017 and February 2024 were retrospectively analyzed. According to surgical procedure, patients were divided into two groups, in the AAR and in the Wheat/Bentall group with concomitant valve or root replacement. Operative time, length of ventilation, perioperative outcome, length of intensive care unit (ICU) as well as postoperative hospital stay, and mid- and long-term results were retrospectively analyzed. Results: Mean age was 61.4 ± 10.7 years old with a frequency of male gender of 63.6%. Mean cardiopulmonary bypass (CBP) time and aortic cross-clamping time was 94.9 ± 32.5 min and 63.8 ± 25.9 min, respectively. CPB and aortic clamp time were significantly lower in AAR group. In the first 24 h, the mean drainage volume was 790.3 ± 423.6 mL. Re-thoracotomy due to bleeding was zero. Sternotomy was able to be avoided in all patients. Patients stayed 35.9 ± 23.5 h at ICU and were discharged 7.8 ± 3.0 days following surgery from hospital. Mean ventilation time was 5.8 ± 7.6 h. All patients survived and 30-day mortality was 0.0%. At a median follow-up time of 18.2 months, all patients were alive. The results were similar in both groups. Conclusions: The full endoscopic RAMT approach with 3D visualization is a safe, feasible and promising technique that can be transferred in the field of aortic surgery without compromising surgical quality, postoperative outcomes, or patient safety when performed by an experienced team in a high-volume center. [ABSTRACT FROM AUTHOR]

Published
2024
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32. Clinical performance of a novel bioprosthetic surgical aortic valve in a German high‐volume center.

Author

El‐Sayed Ahmad, Ali, Giammarino, Sabrina, Salamate, Saad, Fehske, Wolfgang, Sirat, Sami, Amer, Mohamed, Bramlage, Peter, Bakhtiary, Farhad, and Doss, Mirko

Subjects
AORTIC valve, BIOPROSTHETIC heart valves, AORTIC valve transplantation, CHRONIC obstructive pulmonary disease, HEART valves, HEART valve prosthesis implantation
Abstract

Background and Aim: Bioprosthetic surgical aortic valve replacement (SAVR) is increasingly adopted in younger patients. We aimed to analyze mid‐term follow‐up data after SAVR to assess the performance of the prosthesis. Methods: Data were collected from a single‐center series of 154 patients, who underwent SAVR with a bioprosthetic heart valve with the RESILIA tissue at our Heart Centre in Siegburg. All procedural and midterm patient outcomes were documented. Results: Patients had a mean age of 56.8 ± 9.9 years, 35.7% were female, and the mean logistic European system for cardiac operative risk evaluation (EuroSCORE) was 3.4 ± 3.6%. Diabetes (12.3%), atrial fibrillation (10.4%), and chronic obstructive pulmonary disease (COPD) (5.8%) were common comorbidities. The mean surgery duration was 163.8 ± 73.4 min, with the 23 mm (34.4%) and 25 mm (33.8%) heart valves being most frequently implanted. At 3‐year follow‐up, mean pressure gradient was 13.9 ± 5.9 mmHg, peak gradient was 23.6 ± 7.7 mmHg, and effective orifice area (EOA) was 1.9 ± 0.4 cm². No patient died during the operation, 3 (2.1%) patients within 30 days, and 4 (2.7%) thereafter with an overall mortality of n = 7. Of the surviving patients, 97.8% were in New York Heart Association (NYHA) class I/II and none had structural valve deterioration (SVD). Conclusion: Results of our single‐center study indicate favorable procedural outcomes. The safety outcomes confirm preliminary earlier results of this novel bioprosthesis but include more patients and a longer midterm follow‐up. [ABSTRACT FROM AUTHOR]

Published
2022
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38. Impact of Aortic Valve Calcification on the Outcome of Transcatheter Aortic Valve Implantation: Results from the Prospective Multicenter German TAVI Registry

Author

Staubach, Stephan, Franke, Jennifer, Gerckens, Ulrich, Schuler, Gerhard, Zahn, Ralf, Eggebrecht, Holger, Hambrecht, Rainer, Sack, Stefan, Richardt, Gert, Horack, Martin, Senges, Jochen, Steinberg, Daniel H., Ledwoch, Jakob, Fichtlscherer, Stephan, Doss, Mirko, Wunderlich, Nina, and Sievert, Horst

Published
2013
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47. Acute right atrial thrombus formation after extracorporeal life support removal during LVAD-implantation.

Author

Woehrle, Anne, Sachs, Alexander, Doss, Mirko, and Popov, Aron Frederik

Abstract

A 58-year-old male underwent LVAD-Implantation after ECLS explantation. After removal of ECLS (A) transesophageal echocardiography revealed thrombus in the inferior vena cava (B) and right atrium (C). The thrombus was removed with a second pump run including RVAD-Implantation. (D) The diameter of thrombus formations was 6 × 1 cm and 5 × 1.5 cm. [ABSTRACT FROM AUTHOR]

Published
2024
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