Article
Cardiac & Cardiovascular Systems
Josephina Haunschild, Zara Khachatryan, Konstantin von Aspern, Johanna Herajaervi, Susann Ossmann, Joerg Naumann, Michael A. Borger, Christian D. Etz
Summary: The study evaluates the effects of distal aortic perfusion (DaP) on regional spinal cord blood flow during descending aortic cross-clamping and iatrogenic elevation of cerebrospinal fluid pressure. DaP leads to hyperperfusion of the distal spinal cord but does not provide adequate flow to upper and middle spinal cord segments, and is unable to counteract an experimental cerebrospinal fluid pressure elevation, resulting in decreased blood flow to certain spinal cord segments.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Jae H. Lee, Hakju Kim, Hyoung W. Chang, Dong J. Kim, Jun S. Kim, Cheong Lim, Kay-Hyun Park
Summary: This study investigated the impact of segmental artery reimplantation on spinal cord ischemia in thoracoabdominal aorta replacement. The results showed that the patency rate of reimplanted segmental artery was 83.3%, and the incidence of spinal cord ischemia was lower in patients with successful reimplantation.
JOURNAL OF CARDIOVASCULAR SURGERY
(2022)
Article
Surgery
Ivancarmine Gambardella, Berhane Worku, Christopher Lau, Robert F. F. Tranbaugh, Sheida Tabaie, Natalia Ivascu, Leonard N. N. Girardi
Summary: The objective of this study was to investigate the impact of diabetes mellitus (DM) on spinal cord injury (SCI) after open descending thoracic and thoracoabdominal aneurysm repair (DTAAAR). The results showed that DM was associated with increased operative mortality and decreased survival, and it was an independent predictor of SCI after DTAAAR.
Article
Cardiac & Cardiovascular Systems
Josephina Haunschild, Konstantin von Aspern, Johanna Herajaervi, Zara Dietze, Joerg Naumann, Susann Ossmann, Martin Misfeld, Michael A. Borger, Christian D. Etz
Summary: This study found that segmental steal poses a threat to spinal cord perfusion, even with the utilization of distal aortic perfusion (DaP). The blood volume lost by back-bleeding of segmental arteries should not be underestimated, and the occlusion of segmental arteries should be considered in thoraco-abdominal aneurysm repair.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)
Review
Cardiac & Cardiovascular Systems
Josephina Haunschild, Konstantin Von Aspern, Martin Misfeld, Piroze Davierwala, Michael A. Borger, Christian D. Etz
Summary: Spinal cord injury is a major complication of aortic aneurysm repair surgeries, despite the existence of various neuroprotective adjuncts. No strategy currently guarantees definitive preservation of spinal cord integrity during and after aortic aneurysm repair surgeries.
JOURNAL OF CARDIOVASCULAR SURGERY
(2021)
Review
Cardiac & Cardiovascular Systems
Davorin Sef, Myat Soe Thet, Szabolcs Miskolczi, Theodore Velissaris, Ravi De Silva, Suvitesh Luthra, Marko Turina
Summary: A systematic review found that neuromonitoring techniques can reduce the risk of spinal cord ischemia during open thoracoabdominal aortic aneurysm repair. Most studies used motor-evoked potentials (MEP) for monitoring, while a few studies used somatosensory-evoked potentials (SSEP) and near-infrared spectroscopy. The conclusion states that proper precautions and perioperative maneuvers can lower the occurrence of postoperative spinal cord ischemia. Simultaneous monitoring of MEP and SSEP is a reliable method for detecting important findings and guiding adequate protective maneuvers during open TAAA repair.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2023)
Article
Geriatrics & Gerontology
Anna Kutschenko, Anja Manig, Angelika Moennich, Beatrice Bryl, Cecile-Simone Alexander, Martin Deutschland, Stefan Hesse, David Liebetanz
Summary: The study found that intramuscular injections of TeNT significantly increased muscle thickness in dogs with SCI, but did not affect gait function. The treatment was well tolerated by all dogs without any signs of generalized tetanus symptoms or any spreading of effects beyond the lumbar level of the injected hindlimbs.
JOURNAL OF CACHEXIA SARCOPENIA AND MUSCLE
(2022)
Article
Surgery
Luca Bertoglio, Andrea Kahlberg, Enrico Gallitto, Aaron Fargion, Giacomo Isernia, Gianluca Faggioli, Germano Melissano, Massimo Lenti, Carlo Pratesi, Mauro Gargiulo, Roberto Chiesa
Summary: For patients with extensive TAAAs treated with fenestrated/branched endovascular aortic repair, both historical and planned procedural staging were associated with reduced permanent SCI rates. However, no additional benefit was observed when procedural staging was performed in patients with historical staging and an intact collateral network. Further investigation is needed to explore the protective role of preoperative cerebrospinal fluid drainage placement.
JOURNAL OF VASCULAR SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Subhasis Chatterjee, Ann Shi, Luke Yoon, Susan Y. Green, Qianzi Zhang, Hiruni S. Amarasekara, Vicente Orozco-Sevilla, Ourania Preventza, Scott A. LeMaire, Joseph S. Coselli
Summary: This study investigated whether muscle loss would affect survival after thoracoabdominal aortic aneurysm repair. Data from patients aged 60 years or older who underwent the surgery from 2006 to 2016 were retrospectively analyzed. The results showed that sarcopenia did not influence early mortality or midterm survival, but was associated with an increased risk for delayed and persistent paraplegia.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Joseph S. Coselli, Scott A. LeMaire, Vicente Orozco-Sevilla, Ourania Preventza, Marc R. Moon, Lauren M. Barron, Subhasis Chatterjee
Summary: Spinal cord deficit (SCD) is a serious complication after thoracoabdominal aortic aneurysm repair. Proper management during the perioperative period, including preoperative optimization and identifying high-risk patients, is crucial to prevent SCD. In this manuscript, various intraoperative measures such as cerebrospinal fluid drainage, left heart bypass, mild hypothermia, selective reimplantation of arteries, and targeted vessel perfusion are discussed. Careful attention to maintaining blood pressure and avoiding anemia is important during both the operative and postoperative periods. Early recognition of SCD allows for therapeutic intervention to mitigate the injury.
ANNALS OF CARDIOTHORACIC SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Akiko Tanaka, Hung Nguyen, Jaydeep S. Dhillon, Masaki Nakamura, Shao-Feng Zhou, Harleen K. Sandhu, Charles C. Miller III, Hazim J. Safi, Anthony L. Estrera
Summary: The study aimed to evaluate the impact of motor evoked potentials and somatosensory evoked potentials on spinal cord ischemia during open distal aortic repair. The loss of somatosensory evoked potentials and motor evoked potentials were associated with immediate and delayed spinal cord ischemia. The loss of somatosensory evoked potentials further added predictive value to motor evoked potentials.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Article
Surgery
Enrico Rinaldi, Andrea Melloni, Enrico Gallitto, Aaron Fargion, Giacomo Isernia, Andrea Kahlberg, Luca Bertoglio, Gianluca Faggioli, Massimo Lenti, Carlo Pratesi, Mauro Gargiulo, Germano Melissano, Roberto Chiesa, Baccani Luigi, Bertoglio Luca, Chiesa Roberto, Faggioli Gianluca, Fargion Aaron, Fenelli Cecilia, Gallitto Enrico, Gargiulo Mauro, Isernia Giacomo, Lenti Massimo, Logiacco Antonino, Kahlberg Andrea, Mascoli Chiara, Melissano Germano, Melloni Andrea, Pini Rodolfo, Pratesi Carlo, Rinaldi Enrico, Simonte Gioele, Speziali Sara
Summary: This study reports an Italian multicenter experience on the incidence and risk factors associated with spinal cord ischemia (SCI) in patients with thoracoabdominal aortic aneurysms (TAAAs) treated by fenestrated-branched endovascular aneurysm repair (F-/B-EVAR). The results show that SCI is still a significant issue after certain types of TAAA repair, and identified factors such as TAAA extension, urgent repair for rupture, severe bleeding, and renal insufficiency as significant risk factors. Strategies to reduce SCI rates for high-risk patients should be considered.
JOURNAL OF ENDOVASCULAR THERAPY
(2023)
Article
Surgery
Ivancarmine Gambardella, Christopher Lau, Mario F. L. Gaudino, Berhane Worku, Mohamad Rahouma, Robert F. Tranbaugh, Leonard N. Girardi
Summary: This study aimed to investigate the effects of splanchnic occlusive disease (SOD) on spinal cord injury (SCI) and major adverse events (MAE) after open repair of descending thoracic aneurysm (DTA) and thoracoabdominal aortic aneurysm (TAAA). The results showed that SOD is a significant predictor of SCI in patients undergoing open DTA/TAAA repair.
JOURNAL OF VASCULAR SURGERY
(2021)
Article
Surgery
Federica Locatelli, Petroula Nana, Thomas Le Houerou, Avit Guirimand, Marwan Nader, Antoine Gaudin, Come Bosse, Dominique Fabre, Stephan Haulon
Summary: This study evaluated the rate of spinal cord ischemia (SCI) and the impact of prophylactic cerebrospinal fluid drainage (pCSFD) following complex endovascular repair for thoracoabdominal aortic aneurysm (TAAA). The results showed a low incidence of SCI after the repair, which was associated with increased major adverse cardio-vascular events (MACE) and intensive care unit stay. The prophylactic use of cerebrospinal fluid drainage did not reduce the rate of SCI in type I to III TAAAs and may not be necessary routinely.
JOURNAL OF VASCULAR SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Adam M. Carroll, R. Wilson King, Christian V. Ghincea, Muhammad Aftab, T. Brett Reece
Summary: This article discusses the anatomy and pathophysiology of spinal cord injury in aortic surgery. It explores risk factors and mechanisms for spinal cord injury, including loss of perfusion and ischemia-reperfusion injury. The review examines these elements in both the laboratory and clinical settings, as well as neuroprotective strategies used in clinical practice. Given the significant consequences of spinal cord injury, further investigation is crucial.
ANNALS OF CARDIOTHORACIC SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Carolyn Weber, Georgi Petrov, Maximilian Luehr, Hug Aubin, Sems-Malte Tugtekin, Michael A. Borger, Payam Akhyari, Thorsten Wahlers, Christian Hagl, Klaus Matschke, Martin Misfeld
Summary: After adjusting for preoperative comorbidities, long-term survival for prosthetic valve endocarditis and native valve endocarditis is comparable. Therefore, prosthetic valve endocarditis alone should not be a contraindication for redo operations, as suggested by this large cohort study.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Bartosz Rylski, Nikolina Georgieva, Friedhelm Beyersdorf, Christopher Busch, Andreas Boening, Josephina Haunschild, Christian D. Etz, Maximilian Luehr, Klaus Kallenbach
Summary: Acute aortic dissection type A occurs almost twice as frequently in men compared to women. Women with this condition tend to be older, while men are more commonly diagnosed with visceral and renal malperfusion, and receive aortic root replacements more frequently. Despite differences in presentation and treatment, the outcomes of acute aortic dissection type A are similar in both genders.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2021)
Article
Medicine, General & Internal
Mahmoud Diab, Thomas Lehmann, Carolyn Weber, Georgi Petrov, Maximilian Luehr, Payam Akhyari, Sems-Malte Tugtekin, P. Christian Schulze, Marcus Franz, Martin Misfeld, Michael A. Borger, Klaus Matschke, Thorsten Wahlers, Artur Lichtenberg, Christian Hagl, Torsten Doenst
Summary: Performing concomitant coronary artery bypass grafting (CABG) in infective endocarditis patients with coronary artery disease may increase the risk of postoperative stroke without improving long-term survival. Omitting concomitant CABG in the absence of critical coronary artery disease may not impact outcomes. Further randomized trials are needed due to limitations in available data.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Carolyn Weber, Maximilian Luehr, Georgi Petrov, Martin Misfeld, Payam Akhyari, Sems-Malte Tugtekin, Mahmoud Diab, Shekhar Saha, Ahmed Elderia, Artur Lichtenberg, Christian Hagl, Torsten Doenst, Klaus Matschke, Michael A. Borger, Thorsten Wahlers
Summary: The incidence of mitral valve IE and Streptococcus-related IE has significantly increased since 2009. Patients undergoing surgical procedures for IE present with more comorbidities, contributing to higher mortality rates.
ANNALS OF THORACIC SURGERY
(2022)
Editorial Material
Cardiac & Cardiovascular Systems
Maximilian Luehr, Thorsten Wahlers
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2022)
Article
Surgery
Maximilian Luehr, Carolyn Weber, Martin Misfeld, Artur Lichtenberg, Sems-Malte Tugtekin, Mahmoud Diab, Shekhar Saha, Yupeng Li, Klaus Matsche, Torsten Doenst, Michael A. Borger, Thorsten Wahlers, Payam Akhyari, Christian Hagl
Summary: This study aimed to explore the virulence of Staphylococcus species in infectious endocarditis (IE) compared to other commonly causative bacteria in terms of short-term and long-term mortality. The results showed that patients with Staphylococcus IE had significantly higher mortality rates than those with IE caused by other bacteria. It is recommended to make an early diagnosis and refer patients with Staphylococcus infection to specialized centers for surgical treatment to reduce the risk of septic embolism and stroke.
Article
Medicine, General & Internal
Shekhar Saha, Ahmad Ali, Philipp Schnackenburg, Konstanze Maria Horke, Andreas Oberbach, Nadine Schlichting, Sebastian Sadoni, Konstantinos Rizas, Daniel Braun, Maximilian Luehr, Erik Bagaev, Christian Hagl, Dominik Joskowiak
Summary: This study compared the perioperative and short-term outcomes of patients with infective endocarditis following surgical aortic valve replacement and transcatheter aortic valve replacement. The results showed that these two groups of patients had similar risk profiles and surgical treatment had comparable results.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Medicine, General & Internal
Shekhar Saha, Ralitsa Mladenova, Caroline Radner, Konstanze Maria Horke, Joscha Buech, Philipp Schnackenburg, Ahmad Ali, Sven Peterss, Gerd Juchem, Maximilian Luehr, Christian Hagl, Dominik Joskowiak
Summary: This study compares the long-term outcomes and health-related quality of life (HRQOL) of patients undergoing surgery for infective native valve endocarditis (NVE) and prosthetic valve endocarditis (PVE). The results show significant differences in various domains of HRQOL between NVE and PVE patients, as well as in comparison to healthy individuals.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Oncology
Christopher Gaisendrees, Stephen Gerfer, Charlotte Schroeder, Georg Schlachtenberger, Sebastian Walter, Borko Ivanov, Kaveh Eghbalzadeh, Maximilian Luehr, Ilija Djordjevic, Parwis Rahmanian, Navid Mader, Ferdinand Kuhn-Regnier, Thorsten Wahlers
Summary: This study investigated the clinical presentation and long-term outcomes of 183 cardiac tumor patients after surgical resection. Most patients were diagnosed with benign cardiac masses, with myxoma being the most common tumor type. Surgery is the gold standard for treating cardiac tumors and has significant efficacy in benign tumors, while malignant tumors have a longer survival period.
EXPERT REVIEW OF ANTICANCER THERAPY
(2022)
Article
Cardiac & Cardiovascular Systems
Maximilian Luehr, Christopher Gaisendrees, Abdul Kadir Yilmaz, Leila Winderl, Georg Schlachtenberger, Arnaud Van Linden, Thorsten Wahlers, Thomas Walther, Tomas Holubec
Summary: This study evaluated the postoperative outcomes of using the Ascyrus Medical Dissection Stent (AMDS) for the treatment of acute aortic dissection type A (AADA). The study found that AMDS had acceptable 30-day mortality in AADA patients, but careful evaluation of patients' aortic anatomy is necessary to avoid complete central AMDS collapse.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2023)
Article
Engineering, Biomedical
Christopher Gaisendrees, Georg Schlachtenberger, Stephen Gerfer, Ihor Krasivskyi, Ilija Djordjevic, Anton Sabashnikov, Marinos Kosmopoulos, Deborah Jaeger, Maximilian Luehr, Elmar Kuhn, Antje-Christin Deppe, Thorsten Wahlers
Summary: In patients undergoing extracorporeal cardiopulmonary resuscitation (eCPR) after cardiac arrest, early administration of levosimendan improves the success rates of ECMO weaning and survival, and reduces the need for mechanical chest compressions.
Article
Oncology
Christopher Gaisendrees, Georg Schlachtenberger, Sebastian Walter, Stephen Gerfer, Ilija Djordjevic, Ihor Krasivskyi, Burak Cagman, Carolyn Weber, Deborah Jaeger, Marinos Kosmopoulos, Maximilian Luehr, Navid Mader, Thorsten Wahlers
Summary: This study aimed to investigate long-term outcomes of minimally-invasive cardiac surgery for cardiac tumor removal in one of the largest patient cohorts. The results showed that minimally-invasive tumor excision is feasible and safe, especially for benign cardiac tumors. Patients requiring cardiac tumor removal should be evaluated for minimally-invasive cardiac surgery at specialized centers, as it is highly effective and associated with good long-term survival.
SURGICAL ONCOLOGY-OXFORD
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Stephen Gerfer, Elmar Kuhn, Thorsten Wahlers, Maximilian Luehr
ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE
(2023)
Article
Cardiac & Cardiovascular Systems
Julia Merkle-Storms, Christopher Gaisendrees, Manuel Feisst, Bartosz Rylski, Daniel-Sebastian Dohle, Christian Hagl, Mario Lescan, Jens Brickwede, Jochen Poeling, Tomas Holubec, Christian D. Etz, Philipp Jawny, Thilo Noack, Rawa Arif, Thorsten Wahlers, Andreas Boening, Maximilian Luehr
Summary: This study analyzed the perioperative data of 3385 patients from the German Registry for Acute Aortic Dissection Type A to investigate the relationship between age and aortic dissection extension length. The results showed that younger patients had more extensive dissection and more organ malperfusion. The postoperative mortality rate remained high regardless of age.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Maximilian Luehr, Murat Yildiz, Wei-Guo Ma, Roland Heck, Andreas Polycarpou, Arminder Jassar, Maximilian Kreibich, Daniel-Sebastian Dohle, Gabriel Weiss, Christian Hagl, Filip Rega, Thomas Schachner, Andreas Martens, Alessandro Della Corte, Hiroaki Osada, Li-Zhong Sun, Konstantinos Tsagakis, Florian Schoenhoff
Summary: This clinical study aims to determine the prevalence and potential causes of acute aortic dissection type A (AADA) in surgically treated patients <= 30 years and evaluate their postoperative outcomes. The study found that the overall prevalence of AADA in patients = 30 years was 1.8%, with connective tissue disease (CTD) being a common factor. The postoperative mortality rate was 8.6%, and the 10-year survival rate was 80%.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2023)