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Article ; Online: Commentary: The severity of chronic obstructive pulmonary disease affects outcomes of thoracoabdominal aortic aneurysms repair-is GOLD the answer?

Lopez-Marco, Ana / Oo, Aung Y

The Journal of thoracic and cardiovascular surgery

2023

Language	English
Publishing date	2023-10-21
Publishing country	United States
Document type	Editorial
ZDB-ID	3104-5
ISSN	1097-685X ; 0022-5223
ISSN (online)	1097-685X
ISSN	0022-5223
DOI	10.1016/j.jtcvs.2023.10.039
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Article: Intercostal artery reattachment for prevention of spinal cord ischaemia.

Lopez-Marco, Ana / Thet, Myat Soe / Sajiram, Sarvananthan / Adams, Benjamin / Oo, Aung Y

Annals of cardiothoracic surgery

2023 Volume 12, Issue 5, Page(s) 511–513

Language	English
Publishing date	2023-09-20
Publishing country	China
Document type	Editorial
ZDB-ID	2713627-9
ISSN	2304-1021 ; 2225-319X
ISSN (online)	2304-1021
ISSN	2225-319X
DOI	10.21037/acs-2023-scp-09
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Efficacy of chest X-rays after drain removal in adult and pediatric patients undergoing cardiac and thoracic surgery: A systematic review.

Thet, Myat S / Han, Khin P P / Hlwar, Khun E / Thet, Khaing S / Oo, Aung Y

Journal of cardiac surgery

2022 Volume 37, Issue 12, Page(s) 5320–5325

Abstract: Background: Chest X-rays are routinely obtained after the removal of chest drains in patients undergoing cardiac and thoracic surgical procedures. However, a lack of guidelines and evidence could question the practice. Routine chest X-rays increase ... ...

Abstract	Background: Chest X-rays are routinely obtained after the removal of chest drains in patients undergoing cardiac and thoracic surgical procedures. However, a lack of guidelines and evidence could question the practice. Routine chest X-rays increase exposure to ionizing radiation, increase health-care costs, and lead to overutilisation of available resources. This review aims to explore the evidence in the literature regarding the routine use of chest X-rays following the removal of chest drains. Materials & method: A systematic literature search was conducted in PubMed, Medline via Ovid, Cochrane central register of control trials (CENTRAL), and ClinicalTrials. gov without any limit on the publication year. The references of the included studies are manually screened to identify potentially eligible studies. Results: A total of 375 studies were retrieved through the search and 18 studies were included in the review. Incidence of pneumothorax remains less than 10% across adult cardiac, and pediatric cardiac and thoracic surgical populations. The incidence may be as high as 50% in adult thoracic surgical patients. However, the reintervention rate remains less than 2% across the populations. Development of respiratory and cardiovascular symptoms can adequately guide for a chest X-ray following the drain removal. As an alternative, bedside ultrasound can be used to detect pneumothorax in the thorax after the removal of a chest drain without the need for ionizing radiation. Conclusion: A routine chest X-ray following chest drain removal in adult and pediatric patients undergoing cardiac and thoracic surgery is not necessary. It can be omitted without compromising patient safety. Obtaining a chest X-ray should be clinically guided. Alternatively, bedside ultrasound can be used for the same purpose without the need for radiation exposure.
MeSH term(s)	Humans ; Adult ; Child ; X-Rays ; Pneumothorax ; Thoracic Surgery ; Thoracic Surgical Procedures/methods ; Heart ; Radiography, Thoracic
Language	English
Publishing date	2022-11-06
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.17114
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Article ; Online: On-X aortic valve replacement patients treated with low dose warfarin and low dose aspirin.

Oo, Aung Y / Loubani, Mahmoud / Gerdisch, Marc W / Zacharias, Joseph / Tsang, Geoffrey M / Perchinsky, Michael J / Hagberg, Robert Carl / Joseph, Mark / Sathyamoorthy, Mohanakrishnan

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2024

Abstract: Objectives: To assess if warfarin targeted to INR 1.8 (range 1.5-2.0) is safe for all patients with an On-X aortic mechanical valve.: Methods: This prospective, observational registry follows patients receiving warfarin targeted at an INR of 1.8 ( ... ...

Abstract	Objectives: To assess if warfarin targeted to INR 1.8 (range 1.5-2.0) is safe for all patients with an On-X aortic mechanical valve. Methods: This prospective, observational registry follows patients receiving warfarin targeted at an INR of 1.8 (range 1.5-2.0) plus daily aspirin (75-100 mg) after On-X aortic valve replacement. The primary end-point is a composite of thromboembolism, valve thrombosis, and major bleeding. Secondary end-points include the individual rates of thromboembolism, valve thrombosis, and major bleeding, as well as the composite in subgroups of home or clinic-monitored INR and risk categorization for thromboembolism. The control was the patient group randomized to standard-dose warfarin (INR 2.0-3.0) plus daily aspirin 81 mg from the PROACT trial. Results: A total of 510 patients were enrolled at 23 centers in the UK, United States, and Canada. Currently, the median follow-up duration is 3.4 years, and median achieved INR is 1.9. The primary composite end-point rate in the low INR patients is 2.31% vs 5.39% (95% confidence interval 4.12%-6.93%) per patient-year in the PROACT control group, constituting a 57% reduction. Results are consistent in subgroups of home or clinic-monitored, and high-risk patients, with reductions of 56%, 57%, and 57%, respectively. Major and total bleeding are decreased by 85% and 73%, respectively, with similar rates of thromboembolic events. No valve thrombosis occurred. Conclusions: Interim results suggest that warfarin targeted at an INR of 1.8 (range 1.5-2.0) plus aspirin is safe and effective in patients with an On-X aortic mechanical valve with or without home INR monitoring.
Language	English
Publishing date	2024-04-15
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezae117
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Article ; Online: An unusual cause of heart failure in a young female: a case of massive left atrial mxyoma.

Shafi, Ahmed Mohamed Abdel / Akhtar, Mohammed A / Smith, Alexander / Yates, Martin / Oo, Aung Y

Journal of cardiac surgery

2020 Volume 35, Issue 11, Page(s) 3227–3230

Abstract: Benign cardiac tumors are rare; they can present with nonspecific symptoms and represent a diagnostic challenge to the clinician. We describe an interesting case of a 26-year-old female who presented with a 6-month history of cough, breathlessness, ... ...

Abstract	Benign cardiac tumors are rare; they can present with nonspecific symptoms and represent a diagnostic challenge to the clinician. We describe an interesting case of a 26-year-old female who presented with a 6-month history of cough, breathlessness, palpitations, dizziness, and fever. Despite repeated clinical reviews in the community, diagnosis of cardiac tumor was not made until she developed decompensated cardiac failure with bilateral pleural effusions and pulmonary edema. Echocardiogram revealed an enormous left atrial mass that extended one-third into left ventricle during systole. The patient underwent successful surgical resection with histological confirmation of a benign atrial myxoma.
MeSH term(s)	Adult ; Cardiac Surgical Procedures/methods ; Echocardiography ; Female ; Heart Atria ; Heart Failure/etiology ; Heart Failure/surgery ; Heart Neoplasms/complications ; Heart Neoplasms/diagnostic imaging ; Heart Neoplasms/pathology ; Heart Neoplasms/surgery ; Humans ; Myxoma/complications ; Myxoma/diagnostic imaging ; Myxoma/pathology ; Myxoma/surgery ; Systole ; Treatment Outcome
Language	English
Publishing date	2020-08-25
Publishing country	United States
Document type	Case Reports
ZDB-ID	639059-6
ISSN	1540-8191 ; 0886-0440
ISSN (online)	1540-8191
ISSN	0886-0440
DOI	10.1111/jocs.14978
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Article ; Online: Outcomes of patients diagnosed with COVID-19 in the early postoperative period following cardiac surgery.

Yates, Martin T / Balmforth, Damian / Lopez-Marco, Ana / Uppal, Rakesh / Oo, Aung Y

Interactive cardiovascular and thoracic surgery

2020 Volume 31, Issue 4, Page(s) 483–485

Abstract: The coronavirus 2019 (COVID-19) pandemic has disrupted patient care across the NHS. Following the suspension of elective surgery, priority was placed in providing urgent and emergency surgery for patients with no alternative treatment. We aim to assess ... ...

Abstract	The coronavirus 2019 (COVID-19) pandemic has disrupted patient care across the NHS. Following the suspension of elective surgery, priority was placed in providing urgent and emergency surgery for patients with no alternative treatment. We aim to assess the outcomes of patients undergoing cardiac surgery who have COVID-19 infection diagnosed in the early postoperative period. We identified 9 patients who developed COVID-19 infection following cardiac surgery. These patients had a significant length of hospital stay and extremely poor outcomes with mortality of 44%. In conclusion, the outcome of cardiac surgical patients who contracted COVID-19 infection perioperatively is extremely poor. In order to offer cardiac surgery, units must implement rigorous protocols aimed at maintaining a COVID-19 protective environment to minimize additional life-threatening complications related to this virus infection.
MeSH term(s)	Adult ; Aged ; Betacoronavirus ; COVID-19 ; Cardiac Surgical Procedures/methods ; Comorbidity ; Coronavirus Infections/epidemiology ; Elective Surgical Procedures/methods ; Female ; Heart Diseases/epidemiology ; Heart Diseases/surgery ; Humans ; Length of Stay ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/epidemiology ; Postoperative Period ; SARS-CoV-2 ; Time Factors ; Young Adult
Keywords	covid19
Language	English
Publishing date	2020-08-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2095298-3
ISSN	1569-9285 ; 1569-9293
ISSN (online)	1569-9285
ISSN	1569-9293
DOI	10.1093/icvts/ivaa143
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Article: Matrix Metalloproteinase in Abdominal Aortic Aneurysm and Aortic Dissection.

Maguire, Eithne M / Pearce, Stuart W A / Xiao, Rui / Oo, Aung Y / Xiao, Qingzhong

Pharmaceuticals (Basel, Switzerland)

2019 Volume 12, Issue 3

Abstract: Abdominal Aortic Aneurysm (AAA) affects 4-5% of men over 65, and Aortic Dissection (AD) is a life-threatening aortic pathology associated with high morbidity and mortality. Initiators of AAA and AD include smoking and arterial hypertension, whilst key ... ...

Abstract	Abdominal Aortic Aneurysm (AAA) affects 4-5% of men over 65, and Aortic Dissection (AD) is a life-threatening aortic pathology associated with high morbidity and mortality. Initiators of AAA and AD include smoking and arterial hypertension, whilst key pathophysiological features of AAA and AD include chronic inflammation, hypoxia, and large modifications to the extra cellular matrix (ECM). As it stands, only surgical methods are available for preventing aortic rupture in patients, which often presents difficulties for recovery. No pharmacological treatment is available, as such researchers are attempting to understand the cellular and molecular pathophysiology of AAA and AD. Upregulation of matrix metalloproteinase (MMPs), particularly MMP-2 and MMP-9, has been identified as a key event occurring during aneurysmal growth. As such, several animal models of AAA and AD have been used to investigate the therapeutic potential of suppressing MMP-2 and MMP-9 activity as well as modulating the activity of other MMPs, and TIMPs involved in the pathology. Whilst several studies have offered promising results, targeted delivery of MMP inhibition still needs to be developed in order to avoid surgery in high risk patients.
Language	English
Publishing date	2019-08-06
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2193542-7
ISSN	1424-8247
ISSN	1424-8247
DOI	10.3390/ph12030118
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Article: Outcomes of patients diagnosed with COVID-19 in the early postoperative period following cardiac surgery

Yates, Martin T / Balmforth, Damian / Lopez-Marco, Ana / Uppal, Rakesh / Oo, Aung Y

Interact Cardiovasc Thorac Surg

Abstract	The coronavirus 2019 (COVID-19) pandemic has disrupted patient care across the NHS. Following the suspension of elective surgery, priority was placed in providing urgent and emergency surgery for patients with no alternative treatment. We aim to assess the outcomes of patients undergoing cardiac surgery who have COVID-19 infection diagnosed in the early postoperative period. We identified 9 patients who developed COVID-19 infection following cardiac surgery. These patients had a significant length of hospital stay and extremely poor outcomes with mortality of 44%. In conclusion, the outcome of cardiac surgical patients who contracted COVID-19 infection perioperatively is extremely poor. In order to offer cardiac surgery, units must implement rigorous protocols aimed at maintaining a COVID-19 protective environment to minimize additional life-threatening complications related to this virus infection.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #714481
Database	COVID19

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Article ; Online: Outcomes of patients diagnosed with COVID-19 in the early postoperative period following cardiac surgery

Yates, Martin T / Balmforth, Damian / Lopez-Marco, Ana / Uppal, Rakesh / Oo, Aung Y

Interactive CardioVascular and Thoracic Surgery

2020 Volume 31, Issue 4, Page(s) 483–485

Abstract: Abstract The coronavirus 2019 (COVID-19) pandemic has disrupted patient care across the NHS. Following the suspension of elective surgery, priority was placed in providing urgent and emergency surgery for patients with no alternative treatment. We aim to ...

Abstract	Abstract The coronavirus 2019 (COVID-19) pandemic has disrupted patient care across the NHS. Following the suspension of elective surgery, priority was placed in providing urgent and emergency surgery for patients with no alternative treatment. We aim to assess the outcomes of patients undergoing cardiac surgery who have COVID-19 infection diagnosed in the early postoperative period. We identified 9 patients who developed COVID-19 infection following cardiac surgery. These patients had a significant length of hospital stay and extremely poor outcomes with mortality of 44%. In conclusion, the outcome of cardiac surgical patients who contracted COVID-19 infection perioperatively is extremely poor. In order to offer cardiac surgery, units must implement rigorous protocols aimed at maintaining a COVID-19 protective environment to minimize additional life-threatening complications related to this virus infection.
Keywords	Surgery ; Pulmonary and Respiratory Medicine ; Cardiology and Cardiovascular Medicine ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
ZDB-ID	2095298-3
ISSN	1569-9285 ; 1569-9293
ISSN (online)	1569-9285
ISSN	1569-9293
DOI	10.1093/icvts/ivaa143
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Article ; Online: Effect of Hospital-associated SARS-CoV-2 Infections in Cardiac Surgery: A Multicenter Study.

Spadaccio, Cristiano / Rose, David / Candura, Dario / Lopez Marco, Ana / Cerillo, Alfredo / Stefano, Pierluigi / Nasso, Giuseppe / Ramoni, Enrico / Fattouch, Khalil / Minacapelli, Alberto / Oo, Aung Y / Speziale, Giuseppe / Shelton, Kenneth / Berra, Lorenzo / Bose, Amal / Moscarelli, Marco

The Annals of thoracic surgery

2022 Volume 117, Issue 1, Page(s) 213–219

Abstract: Background: The effect of hospital-associated SARS-CoV-2 infections in cardiac surgery patients remains poorly investigated, and current data are limited to small case series with conflicting results.: Methods: A multicenter European collaboration ... ...

Abstract	Background: The effect of hospital-associated SARS-CoV-2 infections in cardiac surgery patients remains poorly investigated, and current data are limited to small case series with conflicting results. Methods: A multicenter European collaboration was organized to analyze the outcomes of patients who tested positive with hospital-associated SARS-CoV-2 infection after cardiac surgery. The study investigators hypothesized that early infection could be associated with worse postoperative outcomes; hence 2 groups were considered: (1) an early hospital-associated SARS-CoV-2 infection group comprising patients who had a positive molecular test result ≤7 days after surgery, with or without symptoms; and (2) a late hospital-associated SARS-CoV-2 infection group comprising patients whose test positivity occurred >7 days after surgery, with or without symptoms. The primary outcome was 30-day mortality. Secondary outcomes included all-cause mortality or morbidity at early follow-up and SARS-CoV-2-related hospital readmission. Results: A total of 87 patients were included in the study. Of those, 30 were in the early group and 57 in the late group. Overall, 30-day mortality was 8%, and in-hospital mortality was 11.5%. The reintubation rate was 11.4%. Early infection was significantly associated with higher mortality (adjusted OR, 26.6; 95% CI, 2, 352.6; P < .01) when compared with the late group. At 6-month follow-up, survival probability was also significantly higher in the late infection group: 91% (95% CI, 83%, 98%) vs 75% (95% CI, 61%, 93%) in the early infection group (P = .036). Two patients experienced COVID-19-related rehospitalization. Conclusions: In this multicenter analysis, hospital-associated SARS-CoV-2 infection resulted in higher than expected postoperative mortality after cardiac surgery, especially in the early infection group.
MeSH term(s)	Humans ; COVID-19 ; SARS-CoV-2 ; Hospitals ; Cardiac Surgical Procedures/adverse effects ; Hospital Mortality
Language	English
Publishing date	2022-06-08
Publishing country	Netherlands
Document type	Multicenter Study ; Journal Article
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2022.05.034
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