Cardiac surgical care of patients continued to evolve rapidly in 2016. In this article, 3 topics of considerable change are discussed based on recent publications. The first topic reviews the potential risks and benefits of newly instituted low-risk percutaneous aortic valve replacement. The second topic reviews the increasing utilization of more extensive arch replacements in acute type A dissection. The final topic reviews current trends and justification for changes in patterns of use of cardioplegia options. The topics discussed are contemporary issues facing cardiac surgery, so they should serve to address the reasoning for changes in contemporary practice in 2016.
LeonMBSmithCRMackM. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363:1597-1607.
2.
SmithCRLeonMBMackM. Transcatheter v surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364:2187-2198.
3.
AdamsDHPopmaJJReardonMJ. Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med. 2014;370:1790-1798.
4.
LeonMBSmithCRMackMJ. Transcatheter or surgical aortic valve replacement in intermediate-risk patients. N Engl J Med. 2016;374:1609-1620.
5.
ThyregodHGSteinbruchelDAIhlemannN. Transcatheter versus surgical aortic valve replacement in patients with severe aortic stenosis: 1-year results from the All-Comers Notion Randomized Clinical Trial. J Am Coll Cardiol. 2015;65:2184-2194.
6.
MillerDCStinsonEBOyerPE. Operative treatment of aortic dissections: experience with 125 patients over a sixteen year period. J Thorac Cardiovasc Surg. 1979;78:365-382.
7.
MoonMRSundtTM3rdPasqueMK. Does the extent of proximal or distal resection influence outcome for type A dissections?Ann Thorac Surg. 2001;71:1244-1249.
8.
BerrettaPPatelHJGleasonTG. IRAD experience on surgical type A acute dissection patients: results and predictors of mortality. Ann Cardiothorac Surg. 2016;5:346-351.
9.
GeirssonABavariaJESwarrD. Fate of distal and proximal aorta after acute type A dissection repair using a contemporary surgical reconstruction algorithm. Ann Thorac Surg. 2007;84:1955-1964.
10.
HaverichAMillerDCScottWC. Acute and chronic aortic dissections—determinants of long-term outcome for operative survivors. Circulation. 1985;72(3 pt 2):II22-II34.
11.
dell’AquilaAMPollariFFattouchK. Early outcomes in re-do operation after acute type A aortic dissection: results from the multicenter REAAD database [published online October21, 2016]. Heart Vessels. doi:10.1007/s00380-016-0907-x.
12.
MozMMisfeldMLeontyevSBorgerMADavierwalaPMohrFW.Aortic arch reoperation in a single centre: early and late results in 57 consecutive patients. Eur J Cardiothorac Surg. 2013;44:e82-e86.
13.
QuintanaEBajonaPSchaffHV. Open aortic arch reconstruction after previous cardiac surgery: outcomes of 168 consecutive operations. J Thorac Cardiovasc Surg. 2014;148:2944-2950.
14.
ParkKHLimCChoiJH. Midterm change of descending aortic false lumen after repair of acute type I dissection. Ann Thorac Surg. 2009;87:103-108.
15.
UchinoGOhashiTIidaH. Predictors of patent false lumen of the aortic arch after hemiarch replacement. Gen Thorac Cardiovasc Surg. 2016;64:722-727.
16.
BajonaPQuintanaSchaffHV. Aortic arch surgery after previous type A dissection repair: results up to 5 years. Interact Cardiovasc Thorac Surg. 2015;21:81-85.
17.
YasudaSImotoKUchidaK. Evaluation and influence of brachiocephalic branch re-entry in patients with type A acute aortic dissection. Circ J. 2016;81:30-35.
18.
UchidaNShibamuraHKatayamaAShimadaNSutohMIshiharaH.Operative strategy for acute type A aortic dissection: ascending aortic or hemiarch versus total arch replacement with frozen elephant trunk. Ann Thorac Surg. 2009;87:773-777.
19.
MurziMTiwariKKFarnetiPAGlauberM.Might type A acute dissection repair with the addition of a frozen elephant trunk improve long-term survival compared to standard repair?Interact Cardiovasc Thorac Surg. 2010;11:98-102.
20.
Di BartolomeoRLeoneADi MarcoLPaciniD. When and how to replace the aortic arch for type A dissection. Ann Cardiothorac Surg. 2016;5:383-388.
21.
ShangWMaMGeYPLiuNZhuJMSunLZ.Analysis of risk factors of type a aortic dissection (TAAD) operation of frozen elephant trunk and total arch replacement. Eur Rev Med Pharmacol Sci. 2016;20:4586-4592.
22.
SultanIMcGarveyJVallabhajosyulaPDesaiNDBavariaJESzetoWY.Routine use of hemiarch during acute type A aortic dissection repair. Ann Cardiothorac Surg. 2016;5:245-247.
23.
ChiuPMillerDC.Evolution of surgical therapy for Stanford acute type A aortic dissection. Ann Cardiothorac Surg. 2016;5:275-295.
24.
BrazierJCooperNBuckbergGD.The adequacy of subendocardial oxygen delivery: the interaction of determinants of flow, arterial oxygen content and myocardial oxygen need. Circulation. 1974;49:968-977.
25.
RosenkranzERBuckbergGD.Myocardial protection during surgical coronary reperfusionJ Am Coll Cardiol. 1983;1:1235-1246.
26.
del NidoPJWilsonGJMickleDA. The role of cardioplegic solution buffering in myocardial protection: a biochemical and histopathological assessment. J Thorac Cardiovasc Surg. 1985;89:689-699.
27.
MatteGSdel NidoPJ.History and use of del Nido cardioplegia solution at Boston Children’s Hospital. J Extra Corpor Technol. 2012;44:98-103.
28.
OtaTYerebakanHNeelyRC. Short-term outcomes in adult cardiac surgery in the use of del Nido cardioplegia solution. Perfusion. 2016;31:27-33.
29.
MickSLRobichMPHoughtalingPL. del Nido versus Buckberg cardioplegia in adult isolated valve surgery. J Thorac Cardiovasc Surg. 2015;149:626-634.
30.
SorabellaRAAkashiHYerebakanH. Myocardial protection using del nido cardioplegia solution in adult reoperative aortic valve surgery. J Card Surg. 2014;29:445-449.
31.
GovindapillaiAHuaRRoseRFriesenCHO’BlenesSB.Protecting the aged heart during cardiac surgery: use of del Nido cardioplegia provides superior functional recovery in isolated hearts. J Thorac Cardiovasc Surg. 2013;146:940-948.
32.
YerebakanHSorabellaRANajjarM. del Nido cardioplegia can be safely administered in high risk coronary artery bypass grafting surgery after acute myocardial infarction: a propensity matched comparison. J Cardiothorac Surg. 2014;9:141.
33.
TimekTWillekesCHulmeO. Propensity matched analysis of del Nido cardioplegia in adult coronary artery bypass grafting: initial experience with 100 consecutive cases. Ann Thorac Surg. 2016;101:2237-2242.
34.
LucasSKElmerEBFlahertyJT. Effect of multiple- dose potassium cardioplegia on myocardial ischemia, return of ventricular function, and ultrastructural preservation. J Thorac Cardiovasc Surg. 1980;80:102-110.
35.
NajjarMGeorgeIAkashiH. Feasibility and safety of continuous retrograde administration of Del Nido cardioplegia: a case series. J Cardiothorac Surg. 2015;10:176.
