Abstract:
OBJECTIVES:Previous work suggests that aortic root and valve prostheses alter blood flow patterns in the ascending aorta, creating aberrant haemodynamics compared with those of healthy volunteers. Various valve designs have been proposed to better restore physiological haemodynamics. In this study, magnetic resonance imaging (MRI) was used to non-invasively assess three-dimensional (3D) ascending aortic haemodynamics after aortic root replacement (ARR) with a mechanical valved conduit postulated to create less turbulent blood flow. METHODS:Ten patients (40 ± 9 years) underwent transthoracic echocardiography and contrast-enhanced multidimensional four-dimensional (4D) flow MRI at 1.5 T after ARR with an On-X mechanical valved conduit. Preoperative 4D flow MRI was available in 7 patients. Ten age- and gender-matched healthy volunteers (42 ± 13 years) were also analysed to characterize physiological flow. The presence of vortex/helix formation was graded by two blinded observers. Peak transvalvular pressure gradients were computed using the simplified Bernoulli equation. Patients' postoperative pressure gradients and helicity/vorticity grades were compared with preoperative gradients and those from healthy volunteers. RESULTS:Intra- and interobserver ratings showed good agreement (κ = 0.93, P < 0.01 and κ = 0.84, P < 0.01, respectively). Highly helical and/or vortical flow was observed in all patients preoperatively, which was significantly reduced postoperatively (P < 0.01 and <0.01, respectively), restoring similar flow patterns similar to those seen in volunteers (P = 0.56 and 0.56). Peak transvalvular pressure gradients (ΔP) were also significantly reduced [43 ± 21 vs 12 ± 7 mmHg, P < 0.05 (Echo); 48 ± 22 vs 16 ± 9 mmHg, P < 0.05 (MRI)], but remained significantly higher than those of volunteers (6 ± 1 mmHg, P < 0.01). CONCLUSIONS:Preliminary evidence suggests that ARR with an On-X mechanical valve significantly reduces aberrant aortic haemodynamics, producing flow patterns that resemble those in healthy volunteers.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Keller EJ,Malaisrie SC,Kruse J,McCarthy PM,Carr JC,Markl M,Barker AJ,Collins JDdoi
10.1093/icvts/ivw173subject
Has Abstractpub_date
2016-09-01 00:00:00pages
416-23issue
3eissn
1569-9293issn
1569-9285pii
ivw173journal_volume
23pub_type
杂志文章abstract::A best evidence topic was written according to a structured protocol. The question addressed was: in patients with inoperable early-stage primary lung cancer does microwave ablation (MWA) or stereotactic ablative body radiotherapy (SBRT) achieve improved outcomes in terms of local control, recurrence, survival and com...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivz123
更新日期:2019-10-01 00:00:00
abstract::Postpneumonectomy bronchopleural fistulas (BPFs) remain difficult management problems associated with considerable morbidity and mortality. Traditional therapies have included primary repair or delayed closure with the creation of an Eloesser cavity and tissue flap reinforcement. New bronchoscopic modalities have incl...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.215202
更新日期:2009-11-01 00:00:00
abstract::Fusarium is a mould widely distributed in soil and water which causes various diseases in plants and occasionally in animals. The Fusarium species cause a broad spectrum of infections in humans, of which, the degree of severity is largely determined by the immune-status of the host, occurring in the most severe and in...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt071
更新日期:2013-07-01 00:00:00
abstract::A 68-year old man with a cardiac tumour was admitted for robotic tumour resection using the da Vinci S Surgical System. While undergoing preoperative examination, he was found to have a persistent left superior vena cava. After general anaesthesia and single-lung ventilation, cardiopulmonary bypass was established, wi...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw059
更新日期:2016-07-01 00:00:00
abstract::Because of its favourable haemodynamic characteristics and easy implantability, Mitroflow aortic valve bioprosthesis has been the valve of choice for many surgeons in patients with small aortic annulus. Disappointingly, early structural valve deterioration and high transvalvular gradients have been reported mostly in ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx434
更新日期:2018-05-01 00:00:00
abstract::Coronary vasospasm is a life threatening complication in the early postoperative period after coronary artery bypass grafting. We report a 45-year-old patient with normal preoperative ventricular function who could not be stabilized using established treatments such as: systemic application of glyceryl trinitrate, dil...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2004.103788
更新日期:2005-08-01 00:00:00
abstract::Selective serotonin reuptake inhibitors (SSRIs) are widely used to treat depression. We report a case of serotonin syndrome following cardiac surgery. This syndrome is rare in the cardiac literature. The clinical features, diagnosis and management of this unusual syndrome are described. In patients with polypharmacy, ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.173104
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVES:Although deep hypothermic circulatory arrest (HCA) is routinely used to interrupt normal perfusion of the brain and prevent subsequent cerebral ischemic injury during cardiac surgery, it is associated with various forms of neurologic disturbances. Neurologic sequelae after prolonged HCA include motor, memory...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.112813
更新日期:2005-12-01 00:00:00
abstract::Transcatheter aortic valve implantation (TAVI) was introduced five years ago (2007) as an alternative treatment for patients with severe aortic stenosis, who are considered at too high a risk for surgical replacement. Few cases of postoperative infection by TAVI device are reported in the literature. We report the cas...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs230
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVES:Surgical management of acute DeBakey Type I aortic dissection without intimal tear in the aortic arch is controversial. This study compared short- and long-term outcomes of total arch replacement (TAR) versus limited ascending aorta/hemiarch replacement (no-TAR) in a consecutive series of patients. METHODS:...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx229
更新日期:2018-01-01 00:00:00
abstract::Pectus excavatum is one of the most common congenital deformities of the chest wall. The aim of the study was to analyse 621 artefacts (reliefs, sculptures, paintings) from Ancient Egypt in terms of anatomical defects of the chest. The team which analysed artefacts consisted of historians of medicine and thoracic surg...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 历史文章,杂志文章
doi:10.1093/icvts/ivu440
更新日期:2015-04-01 00:00:00
abstract::Based on the natural mathematical relationships between the components of the human tri-leaflet aortic valve, new calibrated cusp sizers were developed in order to facilitate aortic valve assessment in the operating room and enhance the chance for a perfect restoration of aortic valve competence. These sizers were use...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr082
更新日期:2012-02-01 00:00:00
abstract::Mitral valve injury due to cardiotomy suckers during aortic valve surgery has never been reported. We highlight the possibility of such injury experienced in our unit. We also discuss its preventive measures. ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2007.158865
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVES:Bronchiolitis obliterans syndrome (BOS) is a serious late complication following allogeneic haematopoietic stem cell transplantation (allo-HSCT) and is associated with chronic graft-versus-host disease. However, the outcome of medical treatment for BOS, mainly immunosuppressive therapy, is disappointing. Thi...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw231
更新日期:2016-12-01 00:00:00
abstract::The objective of this study was to compare the results of elective composite (C) vs. David (D) operations in patients requiring additional aortic arch surgery using hypothermic circulatory arrest (HCA) and selective antegrade cerebral perfusion (SACP), with the focus on postoperative neurological outcome and quality o...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.194811
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVES:Left ventricular assist devices are funded in the UK exclusively as a bridge to transplant (BTT). However, patients who potentially could receive a transplant may develop reversible contraindications to transplant. Bridge to candidacy (BTC) has sometimes been controversial, given the uncertain clinical effic...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy288
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVES:Our goal was to report on the contemporaneous single-centre experience of patients with small-cell lung cancer (SCLC) who had lung resection with curative intent. METHODS:Between 2005 and 2018, 31 patients were operated on for SCLC with curative intent. There were 11 women and 20 men whose ages averaged 63 ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz299
更新日期:2020-04-01 00:00:00
abstract::Left ventricular pseudoaneurysm is a rare but serious complication of myocardial infarction that requires urgent intervention to avoid unpredictable fatal rupture. Surgical repair aims at excluding the aneurysmal area with a patch to preserve the left ventricular geometry. Here, we present a case of successful repair ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv288
更新日期:2016-01-01 00:00:00
abstract::Spontaneous lung hernias are unusual conditions which usually follow attacks of excessive straining. Spontaneous bowel hernias are even rarer. Here, we present the first reported case of a combined spontaneous herniation of both the lung and bowel following an attack of acute bronchitis and coughing together with a de...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.231845
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVES:Perioperative low cardiac output syndrome occurs in 3-14% of patients undergoing isolated coronary artery bypass grafting (CABG), leading to significant increase in major morbidity and mortality. Considering the unique pharmacological and pharmacokinetic properties of levosimendan, we conducted a prospective...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,随机对照试验
doi:10.1093/icvts/ivw213
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVES:Superior vena cava obstruction (SVCO) due to mitotic diseases is a serious condition with significant morbidity and mortality. The aim of this study was to examine the follow-up data and demographics of patients with SVCO admitted to the Department of Surgery, Queen Mary Hospital, over a 14-year period. MET...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs562
更新日期:2013-04-01 00:00:00
abstract::Few studies have described video-assisted thoracic surgery (VATS) to bronchoplasty with pulmonary resection. Here, we report the successful implementation of VATS bronchoplasty, as determined retrospectively. Between 2005 and 2010, 362 patients underwent elective lung resection for malignant or benign lung tumors. Of ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.258228
更新日期:2011-04-01 00:00:00
abstract::The objective of this study was to identify and evaluate predictors of postoperative atrial fibrillation (POAF) in a large coronary artery bypass grafting (CABG) cohort. This was a single centre study of 7115 consecutive patients with preoperative sinus rhythm who underwent isolated CABG between January 1996 and Decem...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr162
更新日期:2012-05-01 00:00:00
abstract::Coronary artery bypass grafting surgery may be needed in children and young adults for significant premature coronary artery occlusive disease. We report a case series of seven patients who underwent surgical revascularization in their second and third decade of life for significant multivessel coronary artery occlusi...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw295
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVES:Angiotensin-converting enzyme (ACE) I/D polymorphism has been implicated in aortic aneurysm risk, but individual published studies show inconclusive results. The aim of this study was to explore a more precise estimation of its relation with aortic aneurysm using meta-analysis. METHODS:Electronic searches o...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,meta分析
doi:10.1093/icvts/ivu239
更新日期:2014-11-01 00:00:00
abstract::We assessed the hypotheses that extension of aortic replacement would reduce the patency of the false lumen of the descending aorta and that postoperative patency of the false lumen would result in poor prognosis. One hundred and twenty-four consecutive patients underwent surgical repair for acute type A acute dissect...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2006.132233
更新日期:2007-04-01 00:00:00
abstract::A 68-year-old man presented with destruction of his sternum after cardiac surgery. Classical management with multiple debridements, vacuum dressings and antibiotics failed. A replacement of his sternum was performed using an antibiotic-loaded porous alumina ceramic sternum. Despite the infected wound, the ceramic ster...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz182
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVES:This study compares the uniportal with the 3-portal video-assisted thoracic surgery (VATS) by examining the data collected in the Italian VATS Group Database. The primary end point was early postoperative pain; secondary end points were intraoperative and postoperative complications, surgical time, number of...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,多中心研究
doi:10.1093/icvts/ivz153
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:The extracellular matrix (XCM Biologic Tissue Matrix) is a non-cross-linked 3D patch derived from porcine dermis. Once implanted, it is infiltrated by recipient's cells and becomes incorporated in the repair. Here, we report the first series of using this device for chest wall reconstruction. METHODS:The XC...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt473
更新日期:2014-03-01 00:00:00
abstract::Pericardial effusion is one of the frequent complications of malignancies, up to 15-20% of the autopsy specimens showing pericardial or cardiac metastasis. Often the pericardial fluid accumulates in large quantities leading to cardiac tamponade, which can be fatal in the absence of appropriate treatment. The authors p...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.211250
更新日期:2010-01-01 00:00:00