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ients with chronic mitral regurgitation, left ventricular ejection fraction is fallacious and global longitudinal strain can be an important tool to assess left ventricular ejection fraction.

Out-of-hours work is believed to lead to a higher complication rate and mortality after surgery. However, there is no data supporting this perception in type A acute aortic dissections (TAAD) repair. We present an observational study of prospectively collected data comparing operative outcomes and late survival of TAAD repair performed after hours versus regular daytime working hours.

A total of 196 patients undergoing emergency TAAD repair (mean age 59 ± 13years, range 18-81, F/M 57/139) were included in the final analysis. Patients were stratified as daytime between 7AM and 7PM (

= 124), and night time between 7PM and 7AM (

= 72). Inverse propensity score (PS) weighting for modelling causal effects was used to assess the effect of time procedure on outcomes of interest.

Overall 30-day mortality was 14.3% (28 patients). No significant differences were found between the night-time and day-time groups with regard to operative mortality (8.3% versus 17.3%; adjusted OR 0.35; 95%CI 0.12-1.04;

= 0.06), re-exploration (12.5% versus 9.7%; adjusted OR 2.09; 95%CI 0.72-6.07;

= 0.18) and neurological deficit (18.1% versus 16.9%; adjusted OR 0.91; 95%CI 0.33-2.54;

= 0.87). Long-term survival at mean 9years follow-up was comparable between the two groups (adjusted log-rank

= 0.28).

Night-time surgical repair of TAAD when compared with day-time repair does not seem to be associated with a greater risk of surgical complications, operative mortality and long-term mortality.

Night-time surgical repair of TAAD when compared with day-time repair does not seem to be associated with a greater risk of surgical complications, operative mortality and long-term mortality.

Bioprosthetic valves are increasingly used for surgical mitral valve replacement (MVR). The long-term outcomes of bovine (BoMVR) vs porcine (PoMVR) remain an enigma regarding the durability. This study aims to examine the outcomes of BoMVR vs PoMVR.

A retrospective analysis of all bioprosthetic MVRs, with concomitant procedures, at a single tertiary referral institution from January 2005 to December 2008 was conducted. Procedures were classified as BoMVR or PoMVR. The age group was from 40 to 70years.

We identified 154 BoMVR patients and 120 PoMVR patients after matching the two groups with respect to age, sex, valve size and concomitant procedures. Kaplan-Meier survival analysis model was used for corresponding statistical analysis. Freedom from reoperation (all cause), freedom from non-structural valve deterioration, freedom from structural valve deterioration, freedom from heart failure and freedom from infective endocarditis were 96.4 ± 0.08, 97.1 ± 0.07, 96.4 ± 0.08%, 98.2 ± 0.07, and 98.6 ± 0.06% in PoMVR, respectively, and 92.6 ± 0.09, 91.6 ± 0.08, 90.6 ± 0.09, 94 ± 0.08, and 92.8 ± 0.08% in BoMVR groups, respectively, at the end of 10-year follow-up (mean follow up of 6.2 ± 2.3years). Overall, 20 (12.9%) patients were lost to follow-up in the BoMVR and 15(12.5%) patients in the PoMVR groups for a global follow-up of 87.1%.

For patients undergoing MVR with a bioprosthetic valve, the choice of PoMVR vs BoMVR favours more in favour of PoMVR as evidenced by the outcome results. Probably long-term follow-up with more patients might throw further light on the debatable topic.

For patients undergoing MVR with a bioprosthetic valve, the choice of PoMVR vs BoMVR favours more in favour of PoMVR as evidenced by the outcome results. Probably long-term follow-up with more patients might throw further light on the debatable topic.

Coronary artery bypass grafting (CABG) is performed either with the aid of cardiopulmonary bypass (on-pump) or without cardiopulmonary bypass (off-pump). There is a scarcity of angiographic data to support the non-inferiority of off-pump technique to on-pump technique. The objective of this study is to ascertain the non-inferiority of off-pump CABG when compared to on-pump CABG in terms of angiographically assessed graft patency at 3months.

A total of 320 patients with multivessel coronary artery disease were enrolled in a multicenter prospective randomized trial either to on-pump CABG (

 = 162) or off-pump CABG (

 = 158) between March 2016 through March 2017. Graft patency was evaluated by using either multidetector computerized tomographic angiography or conventional coronary angiography at 3months. The major adverse cardiac and cardiovascular events (MACCE) were also analyzed at 3months.

The median number of grafts per patient in off-pump was 3.00 (Q13.00 and Q34.00) vs on-pump 4.00 (Q13.00 to Q34. (82.1%) vs on-pump (81.8%)

 = 0.97, radial artery in off-pump (84.4%) vs on-pump (82.6%)

 = 0.81; saphenous vein in off-pump (85.8%) vs on-pump (86.3%),

 = 0.86 and among 3 coronary territories.

Off-pump CABG is non-inferior to on-pump CABG in terms of overall graft patency at 3months and was associated with a fewer combined cumulative MACCE compared to on-pump CABG.

Off-pump CABG is non-inferior to on-pump CABG in terms of overall graft patency at 3 months and was associated with a fewer combined cumulative MACCE compared to on-pump CABG.Tricuspid regurgitation after mitral valve surgery is common and it may affect long-term survival and quality of life. The pathophysiology of this lesion after mitral valve surgery in patients without preoperative tricuspid regurgitation remains elusive in most cases. Correcting a tricuspid annulus of ≥ 40 mm by means of an annuloplasty at the time of mitral valve surgery in patients without tricuspid regurgitation has been proposed as a potential preventative measure but this value of annular dilatation has been challenged in patients with degenerative mitral regurgitation who undergoes mitral valve repair. In addition, even when this approach is used, recurrent tricuspid regurgitation is quite high in long term studies. Further studies on functional tricuspid regurgitation are needed to elucidate its mechanism following heart valve surgery and newer approaches to correct it are needed. Selleckchem Olaparib At present, I believe that tricuspid annuloplasty should be performed at the time of mitral valve surgery whenever there is moderate or severe tricuspid regurgitation and in patients with atrial fibrillation or dilated right ventricular cavity (systolic diameter ≥ 30 mm) even in the absence of significant tricuspid regurgitation.