ABSTRACT Introduction: Systemic inflammatory response syndrome (SIRS) is related to increased circulating endothelial microparticles (EMP). Objective: The aim of this study was to compare the plasma concentration of EMP between patients undergoing aortic valve replacement with conventional bioprosthesis implantation and Perceval™ S (LivaNova) and to evaluate its impact on the inflammatory response in the short-term follow-up. Methods: This is a randomized clinical trial with 24 patients submitted to isolated aortic valve replacement divided into two groups: Perceval™ S (Group P) and conventional bioprostheses (Group C). Incidence of severe SIRS (three or more criteria) in the first 48 hours postoperatively, EMP release profile, interleukins (IL) 6 and 8, C-reactive protein, and procalcitonin were analyzed preand postoperatively at 24 hours and three months. Results: There were 24 patients (12 in each group), mean age was 69.92±5.17 years, 83.33% were female, the incidence of severe SIRS was 66.7% and 50% in groups C and P, respectively (P=0.68), and EMP showed a significant increase in the 24-hour postoperative period (P≤0.001) and subsequent decrease in the three-month postoperative period (P≤0.001), returning to baseline levels. For IL-6 and IL-8, there was a greater increase in group C at 24 hours postoperatively (P=.0.02 and P<0.001). Conclusion: The incidence of severe SIRS was similar in both groups, with significantly higher levels of IL-6 and IL-8, at the 24-hour postoperative period, in group C, however with higher levels of EMP in group P, and subsequent return to baseline levels at the three-month postoperative period in both groups. Introduction (SIRS EMP. . (EMP) Objective Perceval LivaNova (LivaNova shortterm short term followup. followup follow up. up follow-up Methods 2 Group P C. C) criteria 4 profile IL (IL 8 Creactive reactive protein months Results 12 (1 group, , group) 6992517 69 92 5 17 69.92±5.1 years 8333 83 33 83.33 female 667 66 7 66.7 50 P=0.68, P068 P=0.68 0 68 (P=0.68) 24hour hour P≤0.001 P0001 001 (P≤0.001 threemonth month P≤0.001, IL6 IL- IL8, IL8 IL-8 P=.0.02 P002 02 (P=.0.0 P<0.001. P<0.001 P<0.001) Conclusion (EMP 1 ( 699251 9 69.92±5. 833 3 83.3 66. P06 P=0.6 (P=0.68 P≤0.00 P000 00 (P≤0.00 P=.0.0 P00 (P=.0. P<0.00 69925 69.92±5 83. P0 P=0. (P=0.6 P≤0.0 (P≤0.0 P=.0. (P=.0 P<0.0 6992 69.92± P=0 (P=0. P≤0. (P≤0. P=.0 (P=. P<0. 699 69.92 P= (P=0 P≤0 (P≤0 P=. (P= P<0 69.9 P≤ (P≤ (P P< 69.

ABSTRACT Introduction: Extracorporeal membrane oxygenation (ECMO) is the first-line therapy for temporary mechanical circulatory support allowing cardiac and pulmonary recovery or as a bridge to further therapeutic alternatives. The aim of this study was to report clinical outcomes in adult patients with refractory cardiac failure after open-heart surgery undergoing ECMO in a single center with an ECMO unit in Chile. Methods: We retrospectively analyzed adults with refractory cardiac failure after open-heart surgery who required a venoarterial (VA) ECMO between 2016 and 2021. Results: Of 16 patients with VA ECMO, 60% were men (n=10), 90% had hypertension (n=14), 69% had < 30% of left ventricular ejection fraction (n=11), and the mean European System for Cardiac Operative Risk Evaluation II score was 12 ± 11%. ECMO support with central cannulation accounts for 81% (n=13), and an intra-aortic balloon pump was used in nine patients (56%). The mean time of support was 4.7 ± 2.6 days (1.5 - 12 days). ECMO weaning was achieved in 88% of patients, and in-hospital mortality was 44% (n=7) after discharge. The freedom from all-cause mortality at one year of follow-up of the entire cohort was 38% (n=6). Conclusion: VA ECMO is now a well-known life-saving therapeutic option, but mortality and morbidity remain high. Implementation of an ECMO program with educational training is mandatory in order to find the proper balance between patient benefits, ethical considerations, and public health financial input in South America. Introduction (ECMO firstline first line alternatives openheart open heart Chile Methods (VA 201 2021 Results 1 60 n=10, n10 n n=10 , 10 (n=10) 90 n=14, n14 n=14 14 (n=14) 69 30 n=11, n11 n=11 11 (n=11) 11% 81 n=13, n13 n=13 13 (n=13) intraaortic intra aortic 56%. 56 56% . (56%) 47 4 7 4. 26 2 6 2. 1.5 15 5 (1. days. days) 88 inhospital hospital 44 n=7 n7 (n=7 discharge allcause all cause followup follow up 38 n=6. n6 n=6 (n=6) Conclusion wellknown well known lifesaving life saving option high benefits considerations America 20 202 n1 n=1 (n=10 9 (n=14 3 (n=11 8 (n=13 (56% 1. (1 n= (n= (n=6 (n=1 (56 ( (n (5

ABSTRACT Introduction: According to recent data, thoracic aortic surgery has reduced morbidity and mortality including ascending aortic aneurysm treatment; however, women are at increased postoperative risk of adverse outcomes. Objective: Our aim was to evaluate early and late outcomes in male and female patients who underwent pre-emptive ascending aortic replacement (AAR). Methods: From January 2013 to September 2021, 91 patients (56 [61.5%] men and 35 [38.5%] women) underwent AAR for small (ranged from 5.0 to 5.5 cm) non-syndromic aneurysms. A propensity score-based adjustment of the groups was performed. We compared clinical outcomes between males and females. Results: Preoperative normalized aortic diameters were significantly larger in females (2.9 [2.7; 3.2] cm/m2) than in males (2.5 [2.3; 2.6] cm/m2, P<0.001), without differences in absolute values (51 [49; 53] mm vs. 52 [50; 53] mm, P=0.356). There were no significant differences in neurological, cardiac, pulmonary, and renal complications in both groups before and after matching. In-hospital mortality was 1 (1.8%) and 2 (5.7%) (P=0.307) in male and female patients in unmatched groups and 1 (2.9%) and 2 (5.7%) (P=0.553) in matched groups, respectively. Univariate logistic regression analysis revealed that the only risk factor for in-hospital mortality was age (odds ratio 1.117, 95% confidence interval 1.003-1.244; P=0.04). The overall survival rate was 83.5±0.06% in men and 94.3±0.04% in women at 36 months (P=0.404). Conclusion: Ascending aortic surgery for aneurysms ranged from 5.0 to 5.5 cm seems to have tolerable early and late outcomes in men and women. Introduction data treatment however Objective preemptive pre emptive AAR. . (AAR) Methods 201 2021 9 56 (5 61.5% 615 61 5 [61.5% 3 38.5% 385 38 [38.5% 50 0 5. 55 nonsyndromic non syndromic scorebased score based performed Results 2.9 29 (2. 2.7 27 7 [2.7 3.2 32 cm/m2 cmm2 cmm m2 m 2.5 25 2.3 23 [2.3 2.6 26 6 P<0.001, P0001 P P<0.001 , 001 P<0.001) 51 49 [49 53 vs [50 P=0.356. P0356 P=0.356 356 P=0.356) neurological cardiac pulmonary matching Inhospital In hospital 1.8% 18 8 (1.8% 5.7% 57 (5.7% P=0.307 P0307 307 (P=0.307 2.9% (2.9% P=0.553 P0553 553 (P=0.553 respectively inhospital odds 1117 117 1.117 95 1.0031.244 10031244 1.003 1.244 003 244 1.003-1.244 P=0.04. P004 P=0.04 04 P=0.04) 835006 83 06 83.5±0.06 943004 94 94.3±0.04 P=0.404. P0404 P=0.404 404 (P=0.404) Conclusion (AAR 20 202 ( 61.5 [61.5 38.5 [38.5 2. (2 [2. 3. cm/m P000 P<0.00 00 4 [4 [5 P035 P=0.35 1.8 (1.8 5.7 (5.7 P=0.30 P030 30 (P=0.30 P=0.55 P055 (P=0.55 111 11 1.11 0031 1.0031.24 1003124 1003 1.00 1244 1.24 24 1.003-1.24 P00 P=0.0 83500 83.5±0.0 94300 94.3±0.0 P040 P=0.40 40 (P=0.404 61. [61. 38. [38. [2 P<0.0 [ P03 P=0.3 1. (1. (5. (P=0.3 P=0.5 P05 (P=0.5 1.1 1.0031.2 100312 100 1.0 124 1.2 1.003-1.2 P0 P=0. 8350 83.5±0. 9430 94.3±0. P04 P=0.4 (P=0.40 [61 [38 P<0. (1 (P=0. 1.0031. 10031 10 12 1.003-1. P=0 835 83.5±0 943 94.3±0 (P=0.4 [6 [3 P<0 (P=0 1.0031 1.003-1 P= 83.5± 94.3± P< (P= 1.003- 83.5 94.3 (P 83. 94.

ABSTRACT Introduction: Atrial fibrillation is one of the common complications of mitral valve disease. Currently, in the absence of freezing equipment, it’s still impossible to fully conduct a minimally invasive Cox-maze IV procedure to treat atrial fibrillation. Methods: We analyzed the clinical data of 28 patients who underwent thoracoscopic minimally invasive mitral valve full maze surgery in our hospital from October 2021 to September 2022; 13 patients were male and 15 were female, three suffered from paroxysmal atrial fibrillation, and 25 suffered from permanent atrial fibrillation; average age was 61.88±8.30 years, and mean preoperative left atrial diameter was 47.12±8.34 mm. Isolation of left atrial posterior wall (box lesion) was completed in all patients by cut-and-sew technique and bipolar clamp ablation. Results: For these subjects, the median cardiopulmonary bypass time was 169 (109.75-202.75) minutes, aortic cross-clamping time was 106 (77.75-125.50) minutes, and ventilator assistance time was 6.5 (0-10) hours. Among them, eight subjects had the endotracheal tubes removed immediately after surgical operation. Three subjects were in the blanking period; two subjects still had atrial fibrillation at three months after operation, one of whom resumed sinus rhythm after electrical cardioversion therapy; and all the remaining 23 subjects had sinus rhythm. Conclusion: The minimally invasive cut-and-sew technique for electrical isolation of left pulmonary veins can improve sinus conversion rate of patients suffering from both mitral valve disease and atrial fibrillation. In selected subjects, it is safe and has good results in the short-term postoperative period. Introduction Currently equipment its s Coxmaze Cox Methods 2 202 2022 1 female 6188830 61 88 8 30 61.88±8.3 years 4712834 47 12 34 47.12±8.3 mm box lesion cutandsew cut sew ablation Results 16 109.75202.75 1097520275 109.75 202.75 109 75 (109.75-202.75 minutes crossclamping cross clamping 10 77.75125.50 777512550 77.75 125.50 77 125 50 (77.75-125.50 65 6 5 6. 010 0 (0-10 hours them operation period therapy Conclusion shortterm short term 20 618883 3 61.88±8. 471283 4 47.12±8. 75202 109.75202.7 109752027 10975 109.7 20275 202.7 7 (109.75-202.7 75125 77.75125.5 77751255 7775 77.7 12550 125.5 (77.75-125.5 01 (0-1 61888 61.88±8 47128 47.12±8 7520 109.75202. 10975202 1097 109. 2027 202. (109.75-202. 7512 77.75125. 7775125 777 77. 1255 125. (77.75-125. (0- 6188 61.88± 4712 47.12± 752 109.75202 1097520 (109.75-202 751 77.75125 777512 (77.75-125 (0 618 61.88 471 47.12 109.7520 109752 (109.75-20 77.7512 77751 (77.75-12 ( 61.8 47.1 109.752 (109.75-2 77.751 (77.75-1 61. 47. (109.75- (77.75- (109.75 (77.75 (109.7 (77.7 (109. (77. (109 (77 (10 (7 (1

ABSTRACT Objective: To define a reference chart comparing pressure drop vs. flow generated by a set of arterial cannulae currently utilized in cardiopulmonary bypass conditions in pediatric surgery. Methods: Cannulae from two manufacturers were selected considering their design and outer and inner diameters. Cannula performance was evaluated in terms of pressure drop vs. flow during simulated cardiopulmonary bypass conditions. The experimental circuits consisted of a Jostra HL-20 roller pump, a Quadrox-i pediatric oxygenator (Maquet Cardiopulmonary AG, Rastatt, Germany), and a custom pediatric tubing set. The circuit was primed with lactated Ringer’s solution only (first condition) and with human packed red blood cells added (second condition) to achieve a hematocrit of 30%. Cannula sizes 8 to 16 Fr were inserted into the cardiopulmonary bypass circuit with a “Y” connector. The flow was adjusted in 100 ml/min increments within typical flow ranges for each cannula. Pre-cannula and post-cannula pressures were measured to calculate the pressure drop. Results: Utilizing a pressure drop limit of 100 mmHg, our results suggest a recommended flow limit of 500, 900, 1400, 2600, and 3100 mL/min for Braile arterial cannulae sizes 8, 10, 12, 14, and 16 Fr, respectively. For Medtronic DLP arterial cannulae sizes 8, 10, 12, 14, and 16 Fr, the recommended flow limit is 600, 1100, 1700, 2700, and 3300 mL/min, respectively. Conclusion: This study reinforces discrepancies in pressure drop between cannulae of the same diameter supplied by different manufacturers and the importance of independent translational research to evaluate components’ performance. Objective vs surgery Methods diameters HL20 HL 20 HL-2 pump Quadroxi Quadrox i Maquet AG Rastatt Germany, Germany , Germany) Ringers Ringer s first condition second 30 30% 1 Y “Y connector 10 mlmin ml min cannula Precannula Pre postcannula post Results mmHg 500 900 1400 2600 310 mLmin mL 12 14 respectively 600 1100 1700 2700 330 Conclusion components HL2 2 HL- 3 50 90 140 260 31 60 110 170 270 33 5 9 26 6 11 17 27

ABSTRACT In this article, we present the case of a 47-year-old man who underwent Bentall-Bono procedure and frozen elephant trunk prosthesis implantation due to severe aortic regurgitation and aortic dilatation with a second-time endovascular stent-graft repair in descending aorta. Over eight years, a subacute graft infection by Propionibacterium acnes was developed, culminating in cardiogenic shock secondary to severe aortic regurgitation due to a complete aortic root dehiscence because of multiple aortic pseudoaneurysms. The patient underwent emergency surgery in which the replacement of the graft by a biological valve tube was performed accompanied by a complete debranching of the three supra-aortic vessels. article 47yearold yearold 47 year old BentallBono Bentall Bono secondtime second time stentgraft stent aorta years developed pseudoaneurysms supraaortic supra vessels 4

ABSTRACT Luis Tavares revolutionized cardiac surgery, always bringing the most modern instruments and equipment from his travels to England - surgical forceps, scissors, scalpels, etc. He always insisted that he was not just a thoracic surgeon, for his work extended over a wide field and created three important cardiac surgery centers which promoted a great development of cardiology. He carried out the first open heart surgery (atrial septal defect) employing extracorporeal circulation and closure of a ventricular septal defect with deep surface hypothermia of north and northeast Brazil. He promoted an intense scientific exchange program between Recife and England, resulting in significant advances in medicine, and participated directly in the creation of HEMOPE), leading to radical changes and improvements in blood therapy in the whole country. The PROCAPE, inaugurated in 2006, was the result of the cardiac center created by him in early 1970 at Hospital Oswaldo Cruz and can be considered the second largest public-university cardiology center in Brazil. He is thus widely regarded as an outstanding name in medicine in the 20th century and one of the fathers of modern cardiac surgery in Brazil. forceps scissors scalpels etc surgeon atrial Brazil HEMOPE, HEMOPE , HEMOPE) country PROCAPE 2006 197 publicuniversity public university th 200 19 20 1 2

ABSTRACT Introduction: Acute aortic dissection Stanford type A (AADA) is a surgical emergency associated with high morbidity and mortality. Although surgical management has improved, the optimal therapy is a matter of debate. Different surgical strategies have been proposed for patients under 60 years old. This paper evaluates the postoperative outcome and the need for secondary aortic operation after a limited surgical approach (proximal arch replacement) vs. extended arch repair. Methods: Between January 2000 and January 2018, 530 patients received surgical treatment for AADA at our hospital; 182 were under 60 years old and were enrolled in this study - Group A (n=68), limited arch repair (proximal arch replacement), and group B (n=114), extended arch repair (> proximal arch replacement). Results: More pericardial tamponade (P=0.005) and preoperative mechanical resuscitation (P=0.014) were seen in Group A. More need for renal replacement therapy (P=0.047) was seen in the full arch group. Mechanical ventilation time (P=0.022) and intensive care unit stay (P<0.001) were shorter in the limited repair group. Thirty-day mortality was comparable (P=0.117). New onset of postoperative stroke was comparable (Group A four patients [5.9%] vs. Group B 15 patients [13.2%]; P=0.120). Long-term follow-up did not differ significantly for secondary aortic surgery. Conclusion: Even though young patients received only limited arch repair, the outcome was comparable. Full-arch replacement was not beneficial in the long-time follow-up. A limited approach is justified in the cohort of young AADA patients. Exemptions, like known Marfan syndrome and the presence of an intimal tear in the arch, should be considered. Introduction (AADA improved debate 6 vs Methods 200 2018 53 hospital 18 n=68, n68 n n=68 , 68 (n=68) replacement, n=114, n114 n=114 114 (n=114) > ( replacement. . Results P=0.005 P0005 P 0 005 (P=0.005 P=0.014 P0014 014 (P=0.014 P=0.047 P0047 047 (P=0.047 P=0.022 P0022 022 (P=0.022 P<0.001 P0001 001 (P<0.001 Thirtyday Thirty day P=0.117. P0117 P=0.117 117 (P=0.117) 5.9% 59 5 9 [5.9% 1 13.2% 132 13 2 [13.2%] P=0.120. P0120 P=0.120 120 P=0.120) Longterm Long term followup follow up surgery Conclusion Fullarch Full longtime long followup. up. Exemptions considered 20 201 n6 n=6 (n=68 n11 n=11 11 (n=114 P=0.00 P000 00 (P=0.00 P=0.01 P001 01 (P=0.01 P=0.04 P004 04 (P=0.04 P=0.02 P002 02 (P=0.02 P<0.00 (P<0.00 P011 P=0.11 (P=0.117 5.9 [5.9 13.2 [13.2% P012 P=0.12 12 n= (n=6 n1 n=1 (n=11 P=0.0 P00 (P=0.0 P<0.0 (P<0.0 P01 P=0.1 (P=0.11 5. [5. 13. [13.2 (n= (n=1 P=0. P0 (P=0. P<0. (P<0. (P=0.1 [5 [13. (n P=0 (P=0 P<0 (P<0 [ [13 P= (P= P< (P< [1 (P

ABSTRACT Introduction: There is no consensus on the impact of coronary artery disease in patients undergoing transcatheter aortic valve implantation. Therefore, the objective of this study was, in a single-center setting, to evaluate the five-year outcome of transcatheter aortic valve implantation patients with or without coronary artery disease. Methods: All transcatheter aortic valve implantation patients between 2009 and 2019 were included and grouped according to the presence or absence of coronary artery disease. The primary endpoint, five-year all-cause mortality, was evaluated using Cox regression adjusted for age, sex, procedure years, and comorbidities. Comorbidities interacting with coronary artery disease were evaluated with interaction tests. In-hospital complications was the secondary endpoint. Results: In total, 176 patients had aortic stenosis and concomitant coronary artery disease, while 170 patients had aortic stenosis only. Mean follow-up was 2.2±1.6 years. There was no difference in the adjusted five-year all-cause mortality between transcatheter aortic valve implantation patients with and without coronary artery disease (hazard ratio 1.00, 95% confidence interval 0.59-1.70, P=0.99). In coronary artery disease patients, impaired renal function, peripheral arterial disease, or ejection fraction < 50% showed a significant interaction effect with higher five-year all-cause mortality. No significant differences in complications between the groups were found. Conclusion: Five-year mortality did not differ between transcatheter aortic valve implantation patients with or without coronary artery disease. However, in patients with coronary artery disease and impaired renal function, peripheral arterial disease, or ejection fraction < 50%, we found significantly higher five-year all-cause mortality. Introduction Therefore singlecenter single center setting fiveyear five year Methods 200 201 endpoint allcause all cause age sex years comorbidities tests Inhospital hospital Results total 17 only followup follow up 2216 2 1 6 2.2±1. hazard 100 00 1.00 95 0.591.70, 059170 0.59 1.70, 0 59 70 0.59-1.70 P=0.99. P099 P P=0.99 . 99 P=0.99) function 50 Conclusion Fiveyear Five However 20 221 2.2±1 10 1.0 9 591 0.591.70 05917 059 0.5 1.70 5 7 0.59-1.7 P09 P=0.9 22 2.2± 1. 0.591.7 0591 05 0. 1.7 0.59-1. P0 P=0. 2.2 0.591. 0.59-1 P=0 2. 0.591 0.59- P=

ABSTRACT Introduction: The impact of mitral regurgitation (MR) on valve-in-valve transcatheter aortic valve implantation (VIV-TAVI) in patients with failed bioprostheses remains unclear. The purpose of this study was to assess the prognostic impact of residual moderate MR following VIV-TAVI. Methods: We retrospectively analyzed 127 patients who underwent VIV-TAVI between March 2010 and November 2021. At least moderate MR was observed in 51.2% of patients before the procedure, and MR improved in 42.1% of all patients. Patients with postoperative severe MR, previous mitral valve intervention, and patients who died before postoperative echocardiography were excluded from further analyses. The remaining 114 subjects were divided into two groups according to the degree of postprocedural MR: none-mild MR (73.7%) or moderate MR (26.3%). Propensity score matching yielded 23 pairs for final comparison. Results: No significant differences were found between groups before and after matching in early results. In the matched cohort, survival probabilities at one, three, and five years were 95.7% vs. 87.0%, 85.0% vs. 64.5%, and 85.0% vs. 29.0% in the none-mild MR group vs. moderate MR-group, respectively (log-rank P=0.035). Among survivors, patients with moderate MR had worse functional status according to New York Heart Association (NYHA) class at follow-up (P=0.006). Conclusion: MR is common in patients with failed aortic bioprostheses, and improvement in MR-status was observed in over 40% of patients following VIV-TAVI. Residual moderate MR after VIV-TAVI is not associated with worse early outcomes, however, it was associated with increased mortality at five years of follow-up and worse NYHA class among survivors. Introduction (MR valveinvalve VIVTAVI VIV TAVI (VIV-TAVI unclear VIVTAVI. TAVI. Methods 12 201 2021 512 51 2 51.2 procedure 421 42 1 42.1 intervention analyses 11 nonemild none mild 73.7% 737 73 7 (73.7% 26.3%. 263 26.3% . 26 3 (26.3%) comparison Results results cohort one three 957 95 95.7 vs 870 87 0 87.0% 850 85 85.0 645 64 5 64.5% 290 29 29.0 MRgroup, MRgroup group, MR-group logrank log rank P=0.035. P0035 P P=0.035 035 P=0.035) survivors (NYHA followup follow up P=0.006. P0006 P=0.006 006 (P=0.006) Conclusion MRstatus 40 outcomes however 20 202 51. 4 42. 73.7 (73.7 26.3 (26.3% 9 95. 8 87.0 85. 6 64.5 29. P003 P=0.03 03 P000 P=0.00 00 (P=0.006 73. (73. 26. (26.3 87. 64. P00 P=0.0 (P=0.00 (73 (26. P0 P=0. (P=0.0 (7 (26 P=0 (P=0. ( (2 P= (P=0 (P= (P

ABSTRACT Introduction: The evidence for using del Nido cardioplegia protocol in high-risk patients with reduced ejection fraction undergoing isolated coronary surgery is insufficient. Methods: The institutional database was searched for isolated coronary bypass procedures. Patients with ejection fraction < 40% were selected. Propensity matching (age, sex, infarction, number of grafts) was used to pair del Nido (Group 1) and cold blood (Group 2) cardioplegia patients. Investigation of biomarker release, changes in ejection fraction, mortality, stroke, perioperative myocardial infarction, composite endpoint (major adverse cardiac and cerebrovascular events), and other perioperative parameters was performed. Results: Matching allowed the selection of 45 patient pairs. No differences were noted at baseline. After cross-clamp release, spontaneous sinus rhythm return was observed more frequently in Group 1 (80% vs. 48.9%; P=0.003). Troponin values were similar in both groups 12 and 36 hours after surgery, as well as creatine kinase at 12 hours. A trend favored Group 1 in creatine kinase release at 36 hours (median 4.9; interquartile range 3.8-9.6 ng/mL vs. 7.3; 4.5-17.5 ng/mL; P=0.085). Perioperative mortality, rates of myocardial infarction, stroke, or major adverse cardiac and cerebrovascular events were similar. No difference in postoperative ejection fraction was noted (median 35.0%; interquartile range 32.0-38.0% vs. 35.0%; 32.0-40.0%; P=0.381). There was a trend for lower atrial fibrillation rate in Group 1 (6.7% vs. 17.8%; P=0.051). Conclusion: The findings indicate that del Nido cardioplegia provides satisfactory protection in patients with reduced ejection fraction undergoing coronary bypass surgery. Further prospective trials are required. Introduction highrisk high risk insufficient Methods procedures 40 selected age, age (age sex infarction grafts 2 mortality stroke events, , events) performed Results 4 pairs baseline crossclamp cross clamp 80% 80 (80 vs 48.9% 489 48 9 P=0.003. P0003 P P=0.003 . 0 003 P=0.003) 3 median 4.9 49 3.89.6 3896 3.8 9.6 8 6 3.8-9. ngmL ng mL 7.3 73 7 4.517.5 45175 4.5 17.5 5 17 4.5-17. P=0.085. P0085 P=0.085 085 P=0.085) 35.0% 350 35 32.038.0% 320380 32.0 38.0% 32 38 32.0-38.0 32.040.0% 320400 40.0% 32.0-40.0% P=0.381. P0381 P=0.381 381 P=0.381) 6.7% 67 (6.7 17.8% 178 P=0.051. P0051 P=0.051 051 P=0.051) Conclusion required (8 48.9 P000 P=0.00 00 4. 89 3.89. 389 3. 96 9. 3.8-9 7. 517 4.517. 4517 175 17. 4.5-17 P008 P=0.08 08 35.0 038 32.038.0 32038 320 32. 380 38.0 32.0-38. 040 32.040.0 32040 400 40.0 32.0-40.0 P038 P=0.38 6.7 (6. 17.8 P005 P=0.05 05 ( 48. P00 P=0.0 3.89 3.8- 51 4.517 451 4.5-1 35. 03 32.038. 3203 38. 32.0-38 04 32.040. 3204 40. 32.0-40. P03 P=0.3 6. (6 P0 P=0. 4.51 4.5- 32.038 32.0-3 32.040 32.0-40 P=0 32.03 32.0- 32.04 32.0-4 P=

ABSTRACT Introduction: The aim of our study is to compare the early and mid-term outcomes of patients with hypertrophic obstructive cardiomyopathy who underwent classic and modified Morrow septal myectomy. Methods: Between 2014 and 2019, 48 patients (24 males; mean age 49.27±16.41 years) who underwent septal myectomy were evaluated. The patients were divided into two groups - those who underwent classic septal myectomy (n=28) and those who underwent modified septal myectomy (n=20). Results: Mitral valve intervention was higher in the classic Morrow group than in the modified Morrow group, but there was no significant difference (P=0.42). Mortality was found to be lower in the modified Morrow group than in the classic Morrow group (P=0.01). In both groups, the mean immediate postoperative gradient was significantly higher than the mean of the 3rd and 12th postoperative months. The preoperative and postoperative gradient difference of the modified Morrow group was significantly higher than of the classic Morrow group (P<0.001). Conclusion: Classic Morrow and modified Morrow procedures are effective methods for reducing left ventricular outflow tract obstruction. The modified Morrow procedure was found to be superior to the classic Morrow procedure in terms of reducing the incidence of mitral valve intervention with the reduction of the left ventricular outflow tract gradient. Introduction midterm mid term Methods 201 2019 4 24 (2 males 49271641 49 27 16 41 49.27±16.4 years evaluated n=28 n28 n 28 (n=28 n=20. n20 n=20 . 20 (n=20) Results P=0.42. P042 P P=0.42 0 42 (P=0.42) P=0.01. P001 P=0.01 01 (P=0.01) rd th months P<0.001. P0001 P<0.001 001 (P<0.001) Conclusion obstruction 2 ( 4927164 1 49.27±16. n=2 n2 (n=2 (n=20 P04 P=0.4 (P=0.42 P00 P=0.0 (P=0.01 P000 P<0.00 00 (P<0.001 492716 49.27±16 n= (n= P0 P=0. (P=0.4 (P=0.0 P<0.0 (P<0.00 49271 49.27±1 (n P=0 (P=0. P<0. (P<0.0 4927 49.27± P= (P=0 P<0 (P<0. 492 49.27 (P= P< (P<0 49.2 (P (P< 49.

ABSTRACT Introduction: Coarctation of the aorta (CoA) is a narrowing of the thoracic aorta that often manifests as discrete stenosis but may be tortuous or in long segment. The study aimed to evaluate pre and post-surgical aspects of pediatric patients submitted to CoA surgical correction and to identify possible predisposing factors for aortic recoarctation. Methods: Twenty-five patients were divided into groups according to presence (N=8) or absence (N=17) of recoarctation after surgical correction of CoA and evaluated according to clinical-demographic profile, vascular characteristics via computed angiotomography (CAT), and other pathological conditions. Results: Majority of males (64%), ≥ 15 days old (76%), ≥ 2.5 kg (80%). There was similarity between groups with and without recoarctation regarding sex (male: 87% vs. 53%; P=0.277), age (≥ 15 days: 62.5 vs. 82%; P=0.505), and weight (≥ 2.5 kg: 87.5 vs. 76.5; P=0,492). Altered values of aortic root/Valsalva diameter, proximal transverse arch, and distal isthmus, and normal values for aorta prevailed in preoperative CAT. Normal values for the aortic root/Valsalva sinus diameter were observed with and without recoarctation, the same for both groups regarding ascending and descending aorta in postoperative CAT. No significant difference for altered values of proximal transverse arch and alteration in distal isthmus was observed. Conclusion: No predictive risk for recoarctation was observed. CTA proved to be important in CoA diagnosis and management, since CoA is mainly related with altered diameter of aortic root/sinus of Valsalva and proximal and distal aortic arch/isthmus, however, it failed to show predictive risk for recoarctation. Introduction (CoA segment postsurgical post Methods Twentyfive Twenty five N=8 N8 N 8 (N=8 N=17 N17 17 (N=17 clinicaldemographic clinical demographic profile CAT, CAT , (CAT) conditions Results 64%, 64 64% (64%) 1 76%, 76 76% (76%) 25 2 5 2. 80%. 80 80% . (80%) male (male 87 vs 53% 53 P=0.277, P0277 P P=0.277 0 277 P=0.277) ( 625 62 62. 82% 82 P=0.505, P0505 P=0.505 505 P=0.505) 875 87. 76.5 765 P=0,492. P0492 P=0,492 492 P=0,492) rootValsalva root Conclusion management rootsinus archisthmus arch/isthmus however N= (N= N=1 N1 (N=1 (CAT 6 (64% 7 (76% (80% P027 P=0.27 27 P050 P=0.50 50 76. P049 P=0,49 49 (N (64 (76 (80 P02 P=0.2 P05 P=0.5 P04 P=0,4 4 (6 (7 (8 P0 P=0. P=0, P=0 P=

ABSTRACT Cannulation strategies in aortic arch surgeries are a matter of immense discussion. Majority of time deep hypothermic circulatory arrest (DHCA) is the way out, but it does come with its set of demerits. Here we demonstrate a case with aortic arch dissection dealt with dual cannulation strategy in axillary and femoral artery without need for DHCA and ensuring complete neuroprotection of brain and spinal cord without hinderance of time factor. Inception of new ideas like this may decrease the need for DHCA and hence its drawbacks, thus decreasing the morbidity and mortality associated. discussion (DHCA out demerits factor drawbacks associated