Apico-Aortic Conduit for severe aortic stenosis: technique, applications, and systematic review

Patients referred for aortic valve replacement are often elderly and may have increased surgical risk associated with ascending aortic calcification, left ventricular dysfunction, presence of coronary artery disease, previous surgery, and/or presence of several co-morbidities. Some of these patients may not be considered candidates for conventional surgery because of their high risk profile. While transcatheter aortic valve replacement constitutes a widely accepted alternative, some patients may not be eligible for this modality due to anatomic factors. Apico-Aortic Conduit [AAC] insertion [aortic valve bypass surgery] constitutes a possible option in those patients. Apico-Aortic Conduit is not a new technique, as it has been used for decades in both pediatric and adult populations. However, there is a resurging interest in this technique due to the expanding scope of elderly patients being considered for the treatment of aortic stenosis. Herein, we describe our surgical technique and provide a systematic review of recent publications on AAC insertion, reporting that there is continued use and several modifications of this technique, such as performing it through a small thoracotomy without the use of the cardiopulmonary bypass

Is corticosteroids helpful in reducing incidence of atrial fibrillation after cardiac surgery? a prospective, randomized, double blind, placebo controlled study

postoperative atrial fibrillation [AF] is an important problem after cardiac surgery. Postoperative AF may be attributed to the generalised inflammatory response. Corticosteroids represent the only therapeutic drug with multi-inhibitory effects on various components of the inflammatory response. One hundred patients scheduled for open heart surgery divided into 2 groups, one group received 2 doses of dexamethazone and the other placebo to evaluate the effect on AF in 1[st] week postoperative. patients received dexamethazone were significantly less likely to have AF than patients of other group, also concentrations of c-reactive protein postoperatively were significantly lower in dexamethazone group. I.V. administration of dexamethazone is effective and well tolerated in prevention of AF after cardiac surgery