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Topic: New Frontiers in Cardiac Surgery

A special issue of Vessel Plus

ISSN 2574-1209 (Online)

Submission deadline: 30 Nov 2019

Guest Editor(s)

  • Prof. Mario F. L. Gaudino, MD
    Director, Translational and Clinical Research, Department of Cardiothoracic Surgery, Weill Cornell Medical College – New York Presbyterian Hospital, New York, NY, USA.

    Website | E-mail

Special Issue Introduction

Cardiac surgery has evolved immensely in recent years. Over the past two decades, we have witnessed remarkable innovations in the form of off-pump coronary artery bypass, minimally invasive direct coronary artery bypass and valve surgery, robotic surgery, and catheter-based interventions such as mitraclip implantation, transcatheter aortic valve implantation, and transapical mitral valve repair and replacement techniques. Several evolving techniques and surgical prostheses have also diversified surgeons’ armamentarium. In addition to the classic elephant trunk which was considered an evolutionary stride in the treatment of extensive aortic disease, new approaches such as the frozen elephant trunk, hybrid open branched stent grafts, and thoracic endovascular aortic repair (TEVAR) have gained popularity. The primary objective of these and several other innovations remains simplification of surgery, and improvement of surgical quality and patient outcomes.
The patience and persistence of academic cardiac surgeons in transforming clinical practice has indeed been worthwhile. Through innovations that were almost inconceivable in the past, cardiac surgery has become one of the most fascinating and respected specialties worldwide offering treatment to patients with excellent results. However, the question still remains: Are we at the pinnacle of cardiac surgery yet? And if so, is there still room for further advancement in technology and skill? In this issue of Vessel Plus, we do not only devote attention to discuss these questions, but also, most importantly, encourage our authors to report their experience for the benefit of the scientific community interested in discovering the latest frontiers in cardiac surgery.

Keywords

Cardiac surgery; innovations; advancement; technique; technology

Submission Deadline

30 Nov 2019

Submission Information

Articles of special issue are free of charge for article processing.
For Author Instructions, please refer to http://vpjournal.net/pages/view/author_instructions
For Online Submission, please login at http://www.oaemesas.com/vp
Submission Deadline: 30 Nov 2019
Contacts: Magge Ma, Managing Editor, editorialoffice@vpjournal.net

Planned Papers

Type: Review

Title: Mechanical Ventilation and Pulmonary Perfusion During Cardiopulmonary Bypass: A Mechanistic Lung-Protective Intervention in Cardiac Surgery

Authors: Dolly Munlemvo Matondo, Marco Echeverria-Villalobos, Juan Fiorda-Diaz, Michael K. Essandoh

Affiliations: Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA 43210

Abstract: Postoperative pulmonary dysfunction (POPD) is a common multifactorial complication after cardiopulmonary bypass (CPB) [1, 2], abnormal systemic inflammatory response being the major cause of lung injury during CPB [2, 3]. CPB-related POPD has been associated with increased hospital mortality and length of hospital stay [1]. Protective mechanical ventilation (PMV) during CPB is one of the strategies oriented to mitigate the CPB-induced pulmonary changes. Recent evidence suggests that PMV is more effective than continuous positive airway pressure on preventing post-CPB pulmonary dysfunction [1, 2]. A comprehensive review describing the physiopathology and lung protective strategies for post-CPB POPD will be conducted


Type: Review

Title: Why and how to achieve total arterial revascularisation in coronary surgery

Authors: Alistair Royse et al

Affiliations: Royal Melbourne Hospital, The University of Melbourne, Parkville VIC 3010, Australia

Abstract: Single internal mammary artery and supplementary saphenous vein grafts (SVG) continues to be used in approximately 95% of coronary surgery as of 2019. The late failure of SVG is very well documented yet remains the predominant conduit used – why? The left internal mammary artery almost never fails, and late angiography of patent radial artery grafts also appear entirely normal. Logic would suggest that avoiding the conduit known to progressively fail would lead to improved late outcome. Our studies have demonstrated such findings in large single centre and national registry datasets. We describe strategies to achievement of total arterial coronary revascularisation.


Type: Review

Title: Transcatheter aortic valve implantation in the elderly: an umbrella review

Authors: Giuseppe Biondi Zoccai et al

Affiliations: Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Roma RM, Italy

Abstract: The management of aortic stenosis has seen momentous changes in the last decades thanks to the introduction of transcatheter aortic valve implantation. While initially reserved for sick patients deemed inoperable or at high risk of surgical complications, indications to this intervention have expanded progressively to intermediate and low risk patients. Intriguingly, concomitant trends in prolonged life expectancy have lead to an increase in the population of elderly but fit patients with aortic stenosis. We thus aimed to review the current evidence base on transcatheter aortic valve implantation in the elderly by conducting a comprehensive umbrella review (i.e. overview of systematic reviews). Findings of this exercise in evidence synthesis will prove important to guide the current use of transcatheter aortic valve implantation, as well as to inform future research efforts.


Type: Review

Title: Impact of Advances in Percutaneous Catheter Interventions on Redo Cardiac Surgery

Authors: Venkat R. Machiraju et al

Affiliations: Department of Thoracic surgery, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, USA

Abstract: During the end of 20th century, 15-20% of cardiac surgical volume was redo cardiac surgery. Young age at the time of surgery, vein graft atherosclerosis, malfunctioning of mechanical valves and degeneration of bioprosthetic valves were the leading indications. Infective endocarditis, native as well as prosthetic valves also contributed to the surgical volume. Aneurysmal formation of the aorta following surgery for aortic dissection or for aneurysms resulted in repeat operative procedures. In the 21st century, improvements came tackling vein graft atherosclerosis and advances in coronary stenting eliminated the majority of redo coronary artery surgical procedures. TAVR was approved for high risk patients and elderly patients who developed calcific aortic stenosis after previous CABG fit into the criteria perfectly. Valve in valve, aortic stenting for residual and recurrent aneurysms and mitral clip to correct mitral regurgitation in high risk patients are rapidly developing and obviating the need for redo cardiac surgery. Our intent is to review these advances and their impact on re-do cardiac surgery.


Published Articles