Introduction to the 2021 Cardiovascular Surgery Themed Issue of Circulation

Marc Ruel, Michael Fischbein

doi : 10.1161/CIRCULATIONAHA.121.057284

Circulation. 2021;144:1087

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Time to Remove the Left Atrial Appendage at Surgery: LAAOS III in Perspective

Subodh Verma, Deepak L. Bhatt, Elaine E. Tseng

doi : 10.1161/CIRCULATIONAHA.121.055825

Circulation. 2021;144:1088–1090

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Prognostication of Asymptomatic Penetrating Aortic Ulcers: A Modern Approach

Charles DeCarlo, Christopher A. Latz, Laura T. Boitano, Young Kim, Adam Tanious, Samuel I. Schwartz, Rushad Patell, Jahan Mohebali, Anahita Dua

doi : 10.1161/CIRCULATIONAHA.121.054710

Circulation. 2021;144:1091–1101

Literature detailing the natural history of asymptomatic penetrating aortic ulcers (PAUs) is sparse and lacks long-term follow-up. This study sought to determine the rate of asymptomatic PAU growth over time and adverse events from asymptomatic PAU.

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Asymptomatic Penetrating Aortic Ulcer: Benign or Malignant?

Yoshikatsu Saiki

doi : 10.1161/CIRCULATIONAHA.121.056609

Circulation. 2021;144:1102–1103

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Effect of Rivaroxaban and Aspirin in Patients With Peripheral Artery Disease Undergoing Surgical Revascularization: Insights From the VOYAGER PAD Trial

E. Sebastian Debus, Mark R. Nehler, Nicholas Govsyeyev, Rupert M. Bauersachs, Sonia S. Anand, Manesh R. Patel, Fabrizio Fanelli, Warren H. Capell, Taylor Brackin, Franz Hinterreiter, Dainis Krievins, Patrice Nault, Gabriele Piffaretti, Alexei Svetlikov, Nicole Jaeger, Connie N. Hess, Henrik H. Sillesen, Michael Conte, Joseph Mills, Eva Muehlhofer, Lloyd P. Haskell, Scott D. Berkowitz, William R. Hiatt, Marc P. Bonaca

doi : 10.1161/CIRCULATIONAHA.121.054835

Circulation. 2021;144:1104–1116

Patients with peripheral artery disease requiring lower extremity revascularization (LER) are at high risk of adverse limb and cardiovascular events. The VOYAGER PAD trial (Vascular Outcomes Study of ASA [Acetylsalicylic Acid] Along With Rivaroxaban in Endovascular or Surgical Limb Revascularization for PAD) demonstrated that rivaroxaban significantly reduced this risk. The efficacy and safety of rivaroxaban has not been described in patients who underwent surgical LER.

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Of Life and Limb: Addition of Low-Dose Rivaroxaban for Secondary Prevention After Peripheral Artery Disease Surgery

Elizabeth L. George, Shipra Arya

doi : 10.1161/CIRCULATIONAHA.121.056291

Circulation. 2021;144:1117–1119

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No-Touch Versus Conventional Vein Harvesting Techniques at 12 Months After Coronary Artery Bypass Grafting Surgery: Multicenter Randomized, Controlled Trial

Meice Tian, Xianqiang Wang, Hansong Sun, Wei Feng, Yunhu Song, Feng Lu, Liqing Wang, Yang Wang, Bo Xu, Huaibin Wang, Su Liu, Zhigang Liu, Yu Chen, Qi Miao, Pixiong Su, Yan Yang, Shaoxian Guo, Bin Lu, Zhiqiang Sun, Kaiyang Liu, Changwei Zhang, Yue Wu, Haitao Xu, Wei Zhao, Chao Han, Xingtong Zhou, Enshi Wang, Xiaoning Huo, Shengshou Hu

doi : 10.1161/CIRCULATIONAHA.121.055525

Circulation. 2021;144:1120–1129

Vein graft occlusion is deemed a major challenge in coronary artery bypass grafting. Previous studies implied that the no-touch technique for vein graft harvesting could reduce occlusion rate compared with the conventional approach; however, evidence on the clinical benefit and generalizability of the no-touch technique is scare.

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Fifty Years After the Introduction of Vein Grafts for CABG: New Evidence for a No-Touch Harvesting Approach

Gry Dahle, Jörg Kempfert

doi : 10.1161/CIRCULATIONAHA.121.056610

Circulation. 2021;144:1130–1132

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Teprasiran, a Small Interfering RNA, for the Prevention of Acute Kidney Injury in High-Risk Patients Undergoing Cardiac Surgery: A Randomized Clinical Study

Matthias Thielmann, David Corteville, Gabor Szabo, Madhav Swaminathan, Andre Lamy, Lukas J. Lehner, Craig D. Brown, Nicolas Noiseux, Mohamed G. Atta, Elizabeth C. Squiers, Shai Erlich, Daniel Rothenstein, Bruce Molitoris, C. David Mazer

doi : 10.1161/CIRCULATIONAHA.120.053029

Circulation. 2021;144:1133–1144

Acute kidney injury (AKI) affects up to 30% of patients undergoing cardiac surgery, leading to increased in-hospital and long-term morbidity and mortality. Teprasiran is a novel small interfering RNA that temporarily inhibits p53-mediated cell death that underlies AKI.

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hiPSC Modeling of Lineage-Specific Smooth Muscle Cell Defects Caused by TGFBR1A230T Variant, and Its Therapeutic Implications for Loeys-Dietz Syndrome

Dong Zhou, Hao Feng, Ying Yang, Tingting Huang, Ping Qiu, Chengxin Zhang, Timothy R. Olsen, Jifeng Zhang, Y. Eugene Chen, Dogukan Mizrak, Bo Yang

doi : 10.1161/CIRCULATIONAHA.121.054744

Circulation. 2021;144:1145–1159

Loeys-Dietz syndrome (LDS) is an inherited disorder predisposing individuals to thoracic aortic aneurysm and dissection. Currently, there are no medical treatments except surgical resection. Although the genetic basis of LDS is well-understood, molecular mechanisms underlying the disease remain elusive, impeding the development of a therapeutic strategy. In addition, aortic smooth muscle cells (SMCs) have heterogenous embryonic origins, depending on their spatial location, and lineage-specific effects of pathogenic variants on SMC function, likely causing regionally constrained LDS manifestations, have been unexplored.

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The Use of Intraoperative Transit Time Flow Measurement for Coronary Artery Bypass Surgery: Systematic Review of the Evidence and Expert Opinion Statements

Mario Gaudino, Sigrid Sandner, Gabriele Di Giammarco, Antonino Di Franco, Hirokuni Arai, Tohru Asai, Faisal Bakaeen, Torsten Doenst, Stephen E. Fremes, David Glineur, Teresa M. Kieser, Jennifer S. Lawton, Roberto Lorusso, Nirav Patel, John D. Puskas, James Tatoulis, David P. Taggart, Michael Vallely, Marc Ruel

doi : 10.1161/CIRCULATIONAHA.121.054311

Circulation. 2021;144:1160–1171

Transit time flow measurement (TTFM) allows quality control in coronary artery bypass grafting but remains largely underused, probably because of limited information and the lack of standardization. We performed a systematic review of the evidence on TTFM and other methods for quality control in coronary artery bypass grafting following PRISMA standards and elaborated expert recommendations by using a structured process. A panel of 19 experts took part in the consensus process using a 3-step modified Delphi method that consisted of 2 rounds of electronic voting and a final face-to-face virtual meeting. Eighty percent agreement was required for acceptance of the statements. A 2-level scale (strong, moderate) was used to grade the statements based on the perceived likelihood of a clinical benefit.

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Cardiac Surgery in Women in the Current Era: What Are the Gaps in Care?

Leslie Cho, Melina R. Kibbe, Faisal Bakaeen, Niti R. Aggarwal, Melinda B. Davis, Tara Karmalou, Jennifer S. Lawton, Maral Ouzounian, Ourania Preventza, Andrea M. Russo, Annie-Laurie W. Shroyer, Brittany A. Zwischenberger, Kathryn J. Lindley

doi : 10.1161/CIRCULATIONAHA.121.056025

Circulation. 2021;144:1172–1185

Cardiovascular disease remains the leading cause of morbidity and mortality for women in United States and worldwide. One in 3 women dies from cardiovascular disease, and 45% of women >20 years old have some form of CVD. Historically, women have had higher morbidity and mortality after cardiac surgery. Sex influences pathogenesis, pathophysiology, presentation, postoperative complications, surgical outcomes, and survival. This review summarizes current cardiovascular surgery outcomes as they pertain to women. Specifically, this article seeks to address whether sex disparities in research, surgical referral, and outcomes still exist and to provide strategies to close these gaps. In addition, with the growing population of women of reproductive age with cardiovascular disease and cardiovascular risk factors, indications for cardiac surgery arise in pregnant women. The current review will also address the unique issues associated with this special population.

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Saphenous Vein Versus Right Internal Thoracic Artery as a Y-Composite Graft: Ten-Year Angiographic and Long-Term Clinical Results of the SAVE RITA Trial

Min-Seok Kim, Ki-Bong Kim

doi : 10.1161/CIRCULATIONAHA.121.056438

Circulation. 2021;144:1186–1188

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Hybrid Palliation for Hypoplastic Left Heart Syndrome: Association With Contemporary Outcomes

Andrew B. Ho, Ines Hribernik, Daniel Shillaker, John Thomson, Abdul Salam, Nathalie Dedieu, Alessandro Giardini, Graham Derrick, Barry O’Callaghan, Jack Gibb, Francisco Gonzalez-Barlatay, Demitris Taliotis, Melonie Johns, Nicholas Hayes, James R. Bentham

doi : 10.1161/CIRCULATIONAHA.121.055183

Circulation. 2021;144:1189–1191

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