Publications

Introduction: Aortic arch procedures require reliable cerebral protection to reduce the incidence of neurological complications, some of which may be due to the introduction of air into the cerebral circulation. For selective antegrade cerebral perfusion, this study described a simple yet novel direct innominate artery cannulation technique designed to eliminate the incidence of air embolism.

Purpose: There are no studies comparing 30-day stroke risk following anaortic off-pump coronary artery bypass grafting (anOPCABG) vs percutaneous coronary intervention (PCI). A network meta-analysis was performed to indirectly compare 30-day stroke risk following anOPCABG vs PCI.

Purpose: Long-term mortality following off-pump vs on-pump coronary artery bypass grafting (CABG) remains controversial, despite recent randomised controlled trials. A systematic review and meta-analysis were performed to assess mortality risk at 5-year follow-up.

Background: Cardiac surgical units must balance trainee education with a duty to provide optimal patient care. This is particularly challenging with valvular surgery, given the lower volume and increased complexity of these procedures. The present meta-analysis was conducted to assess the impact of trainee operator status on clinical outcomes following valvular surgery.

Introduction: This systematic review and meta-analysis was performed to evaluate the impact of preoperative atrial fibrillation (preAF) on early and late outcomes after aortic valve replacement (AVR).

Purpose: In the era of transcatheter aortic valve replacement, new technologies such as sutureless prosthetic valves and improved access via minimally invasive incisions offer a reduction in surgical trauma for patients undergoing surgical aortic valve replacement. It remains unclear whether a reduction in cardiopulmonary bypass and aortic cross-clamp times, or avoiding complete sternotomy offer improved early postoperative outcomes. A network meta-analysis was performed to compare minimally invasive aortic valve replacement (MiAVR) with sutureless aortic valve replacement (SuAVR), and full sternotomy aortic valve replacement (FAVR).

Mycotic aortic aneurysms comprise <5% of all aortic aneurysms, but have a high risk of rupture if not treated urgently. Concomitant valvular infective endocarditis poses additional therapeutic challenges in relation to staged repair. Current surgical recommendations for mycotic aortic aneurysms involve urgent repair, due to the high risk of rupture and associated mortality. The presence of infective endocarditis necessitates early valve replacement to avoid further systemic emboli or seeding of vascular grafts; however, the risk of heparin loading during cardiopulmonary bypass on a friable aorta poses significant risks.

Aim: Minimally invasive aortic valve replacement and transcatheter aortic valve replacement (TAVI) provide aortic valve replacement by less invasive methods than conventional full sternotomy, with each method of valve replacement offering different benefits. This study aims to compare the perioperative outcomes and short-term survival rates of MiAVR and TAVI.

Aim: Mitral valvular–ventricular interaction includes the following mechanisms. 1. Chordal annulo-papillary connection preventing excessive diastolic dilatation. 2. Systolic closure of the valve during isovolumic left ventricular (LV) contraction causes shortening of the LV long axis. This effect “turbo-charges” the systolic function of the LV. 3. The diastolic baffle effect of the anterior leaflet improves laminar flow through the LV. 4. The dynamic action of the annulus improves diastolic LV filling (“lusitropy”).