Sanjay Chaubey

Baylor Scott & White

Objectives The results of coronary artery bypass graft (CABG) surgery with total arterial revascularisation (TA‐CABG) in elderly patients, who may have insufficient vein graft material for conventional CABG (CO‐CABG), have not been fully established. We therefore sought to compare the short‐ and long‐term outcomes of patients >70 years old undergoi...

Background Preoperative frailty may predispose patients to poorer outcomes in cardiac surgery; however, there are limited data concerning how preoperative frailty predicts patient-centred outcomes, such as patient-reported disability. Our objective was to evaluate the association between preoperative frailty and postoperative disability. Methods P...

Objectives Anomalous origins of the right coronary artery (RCA) can cause ischaemia and sudden cardiac death, particularly if the RCA runs between the aorta and pulmonary artery. Conventional coronary artery bypass grafting (CABG) can be affected by early graft failure due to collateral blood flow. We present our institutional experience in managin...

Objectives: Acute aortic dissection type-A (AADA) is a life threatening condition which requires emergency surgery. Surgery is usually performed by cardiac surgeons with various levels of aortic surgical experience. We compared the short-term perioperative outcome and long-term survival of patients operated by specialist aortic surgeons (SASs)and...

Background The results of cardiac surgery in patients with end-stage-liver-disease (ESLD) are poor. Concomitant cardiac surgery and orthotopic liver transplantation (OLT) may be an alternative treatment strategy in these patients. Methods Between 2001 and 2018, eight patients underwent concomitant cardiac surgery and OLT (Conc_OLT) in our institut...

Background We explored the hypothesis that increased cholinergic tone exerts its proarrhythmic effects in Brugada syndrome (BrS) through increasing dispersion of transmural repolarization in patients with spontaneous and drug-induced BrS. Methods BrS and supraventricular tachycardia patients were studied after deploying an Ensite Array in the righ...

Objectives: Minimally invasive cardiac valve surgery is safe, effective and increasingly popular. It is performed worldwide with the use of either external aortic clamping or endoaortic balloon occlusion. Methods: We conducted a literature search using MEDLINE, EMBASE, Scopus and Web of Science. Primary outcomes included aortic dissection, conve...

Objective: This paper reports a 20 years' experience in the management of atrial myxomas at our institution. Apart from presenting our experience of their clinical presentation, surgical management, post-operative complication, and long-term follow-up we investigated any correlation between left and right sided tumor with their symptom of presenta...

Objectives: The choice of substitute during aortic valve replacement for infective endocarditis (IE) is still widely debated. We retrospectively reviewed all patients operated for aortic IE and compared groups according to the complexity of IE and substitutes implanted. Methods: From 2000 to 2015, 187 patients were treated using stentless biopro...

Background Because of demographic changes, a growing number of elderly patients present with mitral valve (MV) disease. Although mitral valve repair (MV‐repair) is the “gold standard” treatment for MV disease, in elderly patients, there is controversy about whether MV‐repair is superior to mitral valve replacement. We reviewed results after MV surg...

Cardiac involvement is rare in antineutrophil cytoplasmic autoantibody (ANCA)–associated systemic vasculitis but can involve aortic and mitral valves. We present an unusual case of a 65-year-old woman who presented 16 years after an aortic valve replacement with severe mitral regurgitation with ACNA-associated vasculitis. The extensive nature of th...

Figure S1. Grade of MR 1 year after MV‐repair and MVR (P<0.01). Data were available for 127 patients (47.4% of survivors). MV indicates mitral valve; MVR, mitral valve replacement. Figure S2. Direct correlation of LV function in individuals with available follow‐up. LV indicates left ventricular.

Objective Bicuspid aortic valve disease (BAV) is associated with aortic root dilation (RD), increasing the risk of adverse aortic root events. Current guidelines recommend concomitant root replacement (ARR) in patients undergoing aortic valve replacement (AVR) when the root diameter (ARD) is ≥45 mm. However, ARR is believed to increase surgical ris...

Introduction Mitral valve (MV) surgery is the standard treatment for MV disease. During past decades interventional treatments were implemented, raising awareness of MV treatment particularly in the elderly patient group. We analysed changes of referral patterns, baseline characteristics and outcomes of elderly patients undergoing MV surgery during...

Background: Carcinoid heart disease (CHD) is common in patients with carcinoid syndrome (CS). Surgical treatment improves the poor prognosis of CHD, although the reported perioperative mortality is high (∼17%). We attempted to improve outcomes by implementation of a protocol for the management of patients with CHD at a UK Neuroendocrine Centre of...

Introduction: Mitral valve (MV) surgery is the standard treatment for MV disease. During past decades interventional treatments were implemented, raising awareness of MV treatment particularly in the elderly patient group. We analyzed changes of referral patterns, baseline characteristics and outcomes of elderly patients undergoing MV surgery durin...

Background: Due to demographic changes, a growing number of elderly patients present with mitral valve (MV) disease. Mitral Valve Repair (MV-repair) is the gold-standard treatment option for patients with degenerative MV disease. Nevertheless, in elderly patients, there is still controversy if MV-repair improves outcomes of patients compared with m...

Objective: Bicuspid aortic valve disease (BAV) is associated with aortic root dilation (RD), increasing the risk of adverse aortic root events. Current guidelines recommend concomitant root replacement (ARR) in patients undergoing aortic valve replacement (AVR) when the root diameter (ARD) is ≥45mm. However, ARR is believed to increase surgical ris...

Objectives The aim of this pilot study was to assess feasibility of a perioperative care bundle for enhanced recovery after cardiac surgery (ERACS). Design A prospective observational audit. Setting A major urban teaching and university hospital and tertiary referral center. Participants Patients undergoing cardiac surgery: 53 patients studied b...

During the past decades, the cardiovascular community was faced with an ageing patient population and thus with an increased number of elderly patients referred for cardiac surgery. This is also perceptible for mitral valve (MV) disease, as gold standard treatment is MV-repair or replacement. Satisfactory results were proven in octogenarians, but c...

Background: Due to demographic changes a growing number of elderly patients present with mitral valve (MV) disease. Mitral Valve Repair (MV-repair) is the gold-standard treatment option for patients with MV disease. Nevertheless, in elderly patients there is still controversy if MV-repair improves outcomes of patients compared to mitral valve repla...

Objectives: To analyse the demographic, mechanism, management and outcome of cardiothoracic trauma during first 3 years of a major trauma centre. Methods: Retrospective analysis of trauma database, electronic and paper records from April 2010 to March 2013. Results: A total of 683 cardiothoracic traumas presented. Mean age was 37 years with 83% m...

Objectives To investigate the effect of endothelial dysfunction on development of cardiac hypertrophy and fibrosis. Background Endothelial dysfunction accompanies cardiac hypertrophy and fibrosis but its contribution to these conditions is unclear. Increased NADPH oxidase-2 (NOX2) activation causes endothelial dysfunction. Methods Transgenic mice...

To investigate a very small iron-oxide particle (VSOP) in a mouse model of acute ischemia-reperfusion to access the mechanism of such particles in areas of myocardial inflammation. Animals were injected with VSOP at several time points, in a mouse model of acute myocardial infarction (MI), before and after MI. MRI was used to localize areas of VSOP...

Cyclosporin-A (CsA) has been reported to reduce myocardial infarct size in both the experimental and clinical settings. This protective effect is dependent on its ability to prevent the opening of the mitochondrial permeability transition pore, a critical determinant of cell death in the setting of acute ischaemia-reperfusion injury. Whether CsA ca...

A meta-analysis comparing outcomes of upper lobectomies with or without pleural tenting was performed. Five trials comprising 396 patients were selected. There was significantly reduced duration of hospital stay, chest drain use, and air leak in the pleural tenting group compared with the group without the pleural tent. There was also a significant...

We compared outcomes of posterolateral thoracotomy vs muscle-sparing thoracotomy after open thoracic operations. Twelve trials were included, comprising 571 patients in the muscle-sparing thoracotomy group and 512 patients in the posterolateral thoracotomy group. There was significantly improved shoulder internal rotation (weighted mean difference,...

Synovial sarcoma comprises approximately 10% of all soft tissue tumors. Primary cardiac synovial sarcoma is exceedingly rare and accounts for <1% of all primary cardiac tumors. These tumors are highly aggressive with survival <1 year, even with surgery, chemotherapy, or radiation. We describe the case of a 45-year-old gentleman with primary cardiac...

Saphenous vein graft aneurysm is a rare complication after coronary artery bypass surgery. It is defined as a localized dilatation of the vessel to 1.5× the expected normal diameter. We report a case of 67-year-old man who presented with angina 23 years after coronary artery bypass graft. He was found to have a giant saphenous vein graft aneurysm t...

Macrophage migration and infiltration is an important first step in many pathophysiological processes, in particular inflammatory diseases. Redox modulation of the migratory signalling processes has been reported in endothelial cells, vascular smooth muscle cells and fibroblasts. However the redox modulation of the migratory process in macrophages...

Aims: Despite the increasing number of device implants worldwide, little is known about the early and late complications of cardiac resynchronisation therapy (CRT) or the incidence of these complications in patients with different heart failure aetiologies. We aim to determine procedural success and early and late complications in CRT patients. M...

Angiosarcomas of the pulmonary artery are rare and carry a very poor prognosis. We describe the case of a patient with pulmonary artery angiosarcoma who underwent radical resection followed by chemotherapy and was alive after 6 years of follow-up. Our case demonstrates that a multidisciplinary approach including cardiac diagnostics, radical surgery...

An 87-year-old lady, known to have permanent atrial fibrillation, underwent tissue mitral valve replacement at our institution. At the two-year follow-up, echocardiography revealed a large left atrial thrombus attached to the anterolateral wall and the mouth of the left atrial appendage remnant. The patient was treated with warfarin. One year later...

Chest wall chondrosarcomas are a rare cause for an anterior mediastinal mass. Commonly patients present with a painless palpable mass with a third of patients describing diffuse chest pain. We present a patient with an anterior mediastinal chest wall chondrosarcoma presenting with neurological symptoms and flushing. As more of these cases are seen...

Anecdotal observations suggest that sub-clinical electrophysiological manifestations of arrhythmogenic right ventricular cardiomyopathy (ARVC) develop before detectable structural changes ensue on cardiac imaging. To test this hypothesis, we investigated a murine model with conditional cardiac genetic deletion of one desmoplakin allele (DSP ±) and...

Accessory mitral valve (AMV) is an unusual congenital cardiac anomaly typically presenting with left ventricular outflow obstruction. We describe a patient with AVM presenting with transient ischemic attack. 

The directed migration of cells (chemotaxis) occurs not only during wound healing and inflammatory responses but also during embryonic development. However, the intracellular signaling pathways that enable a cell to detect a chemoattractant and subsequently migrate toward the source are not clearly defined. The Dunn chemotaxis chamber in conjunctio...

IntroductionMice globally deficient in Nox2 are protected against cardiac fibrosis in response to chronic AngII infusion even though the degree of hypertrophy was unaltered. The selective effect of Nox2 on fibrosis may reflect its activation in a non-cardiomyocyte cell type. We hypothesised that Nox2, which is expressed in endothelial cells and inf...

Calcified amorphous tumour (CAT) of the heart is a rarely reported non-neoplastic cardiac mass. The authors report a 69-year-old female with long-standing severe asthma and on home oxygen, who presented with a 2 cm mobile mass in the left ventricular outflow tract and symptoms of left heart failure and stroke. During minimal access cardiac surgery,...

Perioperative myocardial ischemia contributes to postoperative morbidity and mortality. Remote intermittent ischemia (RI) has been shown to benefit patients undergoing coronary artery bypass graft (CABG) surgery by decreasing postoperative cardiac troponin levels. In addition, there is evidence that volatile anesthetics may provide myocardial prote...

A 49 year old female presented with severe dyspnoea due to mitral regurgitation. Echocardiography revealed an aberrant mitral valve chord causing severe mitral regurgitation. The aberrant chord extended between the anterior mitral valve leaflet (AMVL) and the atrial septum causing AMVL prolapse. Resection of the aberrant chord and correction of the...

Bioglue which constitutes albumin cross linked with glutaraldehyde (ACLG) produced by Cryolife, Inc, Kennesaw, GA was introduced as a better alternative to GRF glue with less tissue necrosis. We report a case of a 69-year-old male who developed stenosis of his saphenous vein and internal thoracic artery bypass grafts, requiring re-do coronary arter...

The effects of cardiovascular risk factors on the vascular anatomy at differing sites of the arterial vasculature have not been well described. The aim of this study was to compare the effect of cardiovascular risk factors on the intima media thickness (IMT) of the wall of the right and left common carotid artery (CCA) at their bifurcation and prox...

Our previous studies have demonstrated that the Nox2 isoform of NADPH oxidase is essential for the development of cardiac fibrosis in response to either angiotensin II or aldosterone. These in-vivo studies could not, however, identify the critical cell type responsible for this protective effect. As monocytes/macrophages are known to play an import...

We report a patient who died as a result of heparin induced thrombocytopenia (HIT) and arterial thromboses following cardiac surgery. The onset was three days after exposure to low molecular weight heparin on the eighth postoperative day. The patient was heterozygous for the factor V Leiden mutation. We have reviewed 15 patients previously diagnose...

Two principal mechanisms are thought to be responsible for Brugada syndrome (BS): (1) right ventricular (RV) conduction delay and (2) RV subepicardial action potential shortening. This in vivo high-density mapping study evaluated the conduction and repolarization properties of the RV in BS subjects. A noncontact mapping array was positioned in the...

This report describes the formation of a true aneurysm 15 years after an internal mammary artery patch aortoplasty of an aortic coarctation. A true aneurysm was confirmed on histology. To our knowledge, this is the first report of a case with such a complication.

An endovascular approach has been used to manage pseudoaneurysms in the past. The case described here highlights the problems faced with an infected pseudoaneurysm and describes a method of removal of the infected graft in a high-risk patient.

A review of the literature shows that there are few reported cases of embolism or thrombus in a nonaneurysmal, effectively normal aorta with no other underlying reason for thrombus formation in the aorta. We report a case of a large, floating thrombus in the descending aorta lumen and discuss surgical and management options.

Invasive investigation of coronary artery disease is relatively expensive, and carries risks including a mortality of approximately 1 in 2000. It would not be practical or appropriate to perform invasive investigation in all patients with a clinical diagnosis of coronary artery disease, still less in the large numbers with chest pain and possible a...