Cor-Knot

comment : 省時,省力, secure
                  儘快進用

Clinical Results of Single-Vessel versus Multiple-Vessel Infrapopliteal Intervention

根據鹿特丹醫療團隊的研究
對於膝下的 CLI (critical limb ischemia)治療
multi-vessel intervention 並沒有比 single-vessel intervention 的 outcome 好

Journal of Vascular Surgery
Vol.64 , No.6

case report : TE fistula with ASD occluder and mitral disc impingement after TAVI

case 1. the small TEF was treated with Gore ASD occluder successfully
case 2. single disc mitral prosthesis was malfunctioned after TAVI procedure

SYNTAX score and decision making b/w PCI and CABG

cardiac death from MI is 10 times higher in PCI group than CABG group in high risk patients.
surgery is recommended for 3VD patients with intermediate to high SYNTAX score.
surgery is recommended for LM patients with high SYNTAX score.

 J of thoracic and cardiovascular surgery, volume 152, Nov 5

comment : 我們應該強裂建議  1. heart team approach
                                                    2. SYNTAX score

Comparison b/w antegrade and retrograde cerebral perfusion or profound hypothermia as brain protection strategies during repair of type A aortic dissection

from university of Iowa hospitals and clinics :

During surgical repair of type A aortic dissection, ACP,RCP, or DHCA have acceptable morbidity and mortality in selected patients.

The presence of hemodynamic instability prior to surgery and prolonged CPB time increases the risk of early and late mortality regardless of cerebral protection strategy.

Ann Cardiothoracic Surg 2016;5(4): 328-335

comment : selective antegrade brain perfusion 目前為本院使用模式,請大家要熟悉

2016 ESC Heart Failure Guideline

please search online guideline for reference

Tranexamic Acid in Patients Undergoing Coronary-Artery Surgery

Transamin in CABG

1. lower risk of bleeding
2. without higher risk of death or thrombo-embolic events in 30 days post-op
3. higher risk of post-op seizure

Oct 23,2016 Doi:0.1056
NEJM oa1606424

comment: 本院 CPB使用 transamin 的時機為 pre- and post- CPB
                  dosage : 20mg/kg each

Acute Aortic Dissection and Intramural Hematoma : A systemic review

根據 Columbia university medical center, New York :

AAS (acute aortic syndrome)
type A : surgical repair
type B : TEVAR


JAMA 2016 ;316(7):754-763

comment: IMH-A 可採保守治療,但要很小心觀察

Myocardial Regeneration for Humans

enhancing biology and manipulating evolutional selection of cellular properties will be critical to achieving clinically relevant and biologically meaningful cardiac regeneration.

   J of circulation 2016 Dec

comment: cardiac tissue engineering 還在發展早期階段 , 大家可以持續關注

OSA 對 CABG 術後的影響

根據巴西內科醫師的統計分析
有OSA ( Obstructive Sleep Apnea ) 阻塞性睡眠呼吸中止症的病患
其CABG術後發生 MACCEs ( major adverse cardiac or cerebrovascular events )
的比例會增加, 且為獨立因子 ( independent factor )

Chest 2015 Jan

TEVAR for MAS

以胸主動脈支架治療主動脈瘤,以及併發性主動脈剝離,已經是目前的趨勢
不意外, MAS ( Middle Aortic Syndrome ) 降主動脈狹窄
也有韓國仁川的醫師用支架治療的成功案例 !

annals of thoracic surgery, 2016 Sep

aortic ViV caution story

隨著 TAVI 日趨普及,將來也會遇到越來越多的 case 需要做 ViV (Valve-in-Valve)

如何精準定位, 避免新瓣膜彈跳到遠端或是掉入心臟

將是未來心臟內外科醫師面臨的挑戰 !

annals of thoracic surgery 2016 Sep