Interactive Cardiovascular and Thoracic Surgery Journal Impact Factor & Information

Publisher: European Association for Cardio-thoracic Surgery; European Society for Cardiovascular Surgery, Oxford University Press (OUP)

Journal description

Interactive Cardiovascular and Thoracic Surgery (ICVTS) provides a new platform for the publication of short reports in the field. Basically, ICVTS is conceived as virtual conference relying on both modern media and open discussion. For this purpose, all accepted reports will be posted immediately online on this web site. An electronic, moderated discussion will be open for 28 days through a corresponding link. After closure of the discussion period, the reports pre-published on the web, as well as a selection of the contributions for the moderated discussion, will be published in the ICVTS quarterly with traditional paper format.ICVTS welcomes reports on all aspects of surgery of the heart, great vessels and the chest, including new ideas, short communications, work in progress, follow-up studies, research protocols, registry information, nomenclature, case reports, images, videos, and last but not least, reports on negative experiences.

Current impact factor: 1.11

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 1.109
2012 Impact Factor 1.112

Additional details

5-year impact 0.00
Cited half-life 3.20
Immediacy index 0.35
Eigenfactor 0.01
Article influence 0.00
Website Interactive Cardiovascular and Thoracic Surgery website
Other titles Interactive cardiovascular and thoracic surgery (Online), ICVTS
ISSN 1569-9293
OCLC 53098131
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Oxford University Press (OUP)

  • Pre-print
    • Archiving status unclear
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • Permission to deposit articles must be sought from the publisher, if required by funding agency
    • 6 months embargo
  • Conditions
    • Post-print in Institutional repositories or Central repositories
    • Publisher's version/PDF cannot be used
    • Published source must be acknowledged
    • May link to free publisher version, from public or institutional repository without permission
    • Set phrase to accompany archived copy (see policy)
    • This policy is an exception to the default policies of 'Oxford University Press (OUP)'
  • Classification
    ​ white

Publications in this journal

  • Interactive Cardiovascular and Thoracic Surgery 04/2015; 20(5):687-688. DOI:10.1093/icvts/ivu436
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    ABSTRACT: OBJECTIVES Literature reporting on large patient groups with the long-term follow-up is limited due to the low incidence of myxomas. This single-centre, retrospective study reports on the long-term follow-up (e.g. complications, recurrence and survival) of a substantial patient group operated for cardiac myxomas. METHODS Patients were retrospectively selected from a prospectively obtained database comprising patients who had undergone cardiac surgery in the Catharina Hospital from 1990 onwards. Baseline characteristics and perioperative data were obtained from the database. In case of insufficient information, medical reports were analysed. The echocardiogram and clinical follow-up data were collected at outpatient clinics. RESULTS Eighty-two patients were included, of which 48 were females with a mean age of 61.3 years (±13.8). The main presenting symptom was dyspnoea (29.3%), followed by chest pain (24.4%), palpitations (19.5%) and embolism (15.9%). Atrial fibrillation was the most frequent complication; directly postoperative (22%) and at the long-term follow-up (26.3%). The follow-up was completed in 95.1%, with a mean echocardiographic follow-up time of 72 months and with a longest follow-up of almost 23 years. There were no myxoma recurrences. Thirteen patients (16.5%) deceased during the follow-up, with a mean time of 9 years after surgery. CONCLUSIONS Myxomas carry the risk of severe complications. Surgical excision is the only option of treatment and gives excellent early and long-term results. Recurrence rates are low in case of non-hereditary myxomas, even in case of irradical excision. The echocardiographic follow-up therefore could be called into question. Link to full text: http://icvts.oxfordjournals.org/content/early/2015/05/12/icvts.ivv125.full?keytype=ref&ijkey=q5TwhsDgBtpOHQY
    Interactive Cardiovascular and Thoracic Surgery 04/2015; DOI:10.1093/icvts/ivv125
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    ABSTRACT: The goal of our study was to analyse the impact of age on outcomes in patients who underwent continuous-flow left ventricular assist device (CF-LVAD) placement at our institution. One hundred and twenty-eight patients were implanted with a CF-LVAD between January 2008 and June 2014. Eighty-five patients were implanted with the device as a bridge to transplant (BTT); the remaining (n = 43) were on destination therapy (DT). Each group was divided into patients <65 years old and ≥65 years old at device implantation. Patients were followed up for at least 24 months or until transplant or death. Eighty-five patients (66%) received a CF-LVAD as BTT. Patients ≥65 years old (n = 8) had a lower preoperative cardiac index and prothrombin time-international normalized ratio (P = 0.009), and a longer stay in the intensive care unit (P = 0.008). Adverse events including infections, re-exploration for bleeding, ischaemic and haemorrhagic stroke, renal failure and right heart failure were comparable in both age groups. Eighty-two percent (n = 63) of the young patients and 75% (n = 6) of the older patients, who were on LVAD as BTT, underwent heart transplant within the first 24 months of LVAD implantation. Overall survival at 3, 6, 12 and 24 months were 95, 95, 77 and 70%, respectively, post-CF-LVAD implantation as BTT for the younger group and 73% for the older group at 3, 6 and 12 months (P = 0.35). Forty-three patients (34%) received a CF-LVAD as DT. Patients ≥65 years old (n = 14) on DT had a higher incidence of peripheral vascular disease (P = 0.048), higher serum sodium (P = 0.004) and serum creatinine values (P = 0.002), preoperatively. There were more strokes in the older patients post-LAVD implantation (14 vs 0%; P = 0.048). Overall survival at 3, 6, 12 and 24 months were 85, 79, 75 and 62%, respectively, for the younger group and 93, 77, 67 and 34% for the older group, respectively (P = 0.26). This study demonstrates that LVAD therapy can be used in the older patients with acceptable mortality and morbidity, and age alone should not be used as the sole criterion for exclusion from LVAD implantation. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    Interactive Cardiovascular and Thoracic Surgery 03/2015; 20(6). DOI:10.1093/icvts/ivv051
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    ABSTRACT: Positive pleural lavage cytology (PLC) is considered as a precursor condition of pleural dissemination (PD) or malignant pleural effusion (PE), and one of the poor prognostic factors in surgically resected non-small-cell lung cancer (NSCLC) patients. Although PD and PE are classified as M1a, PLC does not contribute to the tumour, node and metastasis (TNM) classification of the Union Internationale Contre le Cancer. This study aimed to evaluate the prognostic effect of positive PLC status in surgically resected NSCLC patients compared with PD and/or PE. We also aimed to consider the contribution of positive PLC status to the TNM classification. We reviewed 1572 consecutive patients with completely resected NSCLC, and analysed the relationship between PLC status, other clinicopathological factors and prognosis. The survival rates of 45 patients with PD and/or PE were also investigated. Positive preresection PLC (pre-PLC) status was observed in 56 patients. Pre-PLC status was significantly associated with other clinicopathological factors. Positive pre-PLC patients exhibited a worse 5-year overall survival (50.6%) compared with negative pre-PLC patients (78.0%), but better survival than PD and/or PE patients (21.0%). Prognosis of positive pre-PLC patients was equal to that of pT3, negative pre-PLC patients; survival equality was observed when patients were stratified according to pN0, pN1 and pN2. Positive pre-PLC had the significant prognostic effect in surgically resected NSCLC patients. However, it is not a contraindication for surgical resection, unlike PD and/or PE. Our data suggest that positive pre-PLC should be classified as pT3 in next TNM classification. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    Interactive Cardiovascular and Thoracic Surgery 03/2015; 20(6). DOI:10.1093/icvts/ivv047
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    ABSTRACT: A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Is robotic mitral valve surgery more expensive than its conventional counterpart?' Altogether 19 papers were found using the reported search, of which 5 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. There is a general impression in the surgical community that robotic operations might incur prohibitive additional costs. There is a paucity of data in the literature regarding cost analysis in cardiac robotic surgery. From the five studies, four were single institution experiences and one was a database inquiry study. These four studies showed that operational costs are higher for robotic cases but this was partially (one study) or completely (three studies) offset by lower postoperative costs. Overall hospital costs were similar between the two approaches in three studies and one study showed higher costs in the robotic group. Higher operating theatre (OT) costs were driven mainly by use of robotic instruments (approximately US$ 1500 per case) and longer OT times. Savings in postoperative care were driven by shorter length of hospital stay (on average 2 days fewer in robotic cases) and lower morbidity. If amortization cost, that is, the value of the initial capital investment on the robotic system divided by all operations performed, is included in this analysis, robotic approach becomes significantly more expensive by approximately US$ 3400 per case. The fifth study was a large national database inquiry in which robotic approach was found to be more expensive by US$ 600 per case excluding amortization cost and by US$3700 if amortization is included. We conclude that the total hospital cost of robotic mitral valve surgery is slightly higher than conventional sternotomy surgery. If amortization is taken into consideration, robotic cases are considerably more expensive. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    Interactive Cardiovascular and Thoracic Surgery 03/2015; 20(6). DOI:10.1093/icvts/ivv038
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    ABSTRACT: Surgical aortic valve replacement (AVR) is increasingly performed in elderly patients with good perioperative outcomes and long-term survival, resulting in significant health-related quality-of-life benefits. This study aimed to evaluate the outcome of patients aged ≥80 years undergoing isolated AVR through a right anterior minithoracotomy (RAMT) and compare it with a full sternotomy (FS). Two hundred and eighty-three elderly patients aged 80 years or more underwent isolated AVR between February 2001 and September 2013. With propensity score matching (1 : 1), the outcomes of patients having minimally invasive surgery (RAMT) were compared with those in whom the FS approach had been employed (100 vs 100 patients). TAVRs and partial sternotomy cases were excluded from the analysis. There were two conversions in the RAMT group. Operative times did not significantly differ in the two groups. Patients in the RAMT group received a larger-sized prosthesis (P < 0.001) and were more likely to receive sutureless valves (P < 0.001). Shorter time for extubation (P < 0.001) and shorter hospital length of stay (P = 0.005) were observed in the RAMT group. Zero vs 4 (4.0%) (P = 0.043) patients had postoperative stroke and 2 (2.0%) vs zero (P = 0.16) had a transient ischaemic attack in the RAMT versus FS group, respectively. We registered the same rate of permanent pacemaker implant (P = 0.47) and that of new-onset atrial fibrillation (P = 0.28) for both groups. Six patients died, with no significant difference for in-hospital mortality (P = 0.68). No variable had a statistically significant predictive value for in-hospital mortality. RAMT patients were more likely to be discharged home directly or via rehabilitation (P = 0.031). FS, along with four other factors, independently predicted longer hospital stay. Though the median follow-up duration was longer in the FS group (59 vs 24 months, P < 0.001), the two groups had similar survival rates at 5 years (80 vs 81%, P = 0.37). Ten factors were associated with long-term survival by Cox regression analysis, and RAMT had no statistical impact (P = 0.38). Minimally invasive AVR through right anterior minithoracotomy can be safely performed in patients aged ≥80 years with acceptable morbidity and mortality rates. It is an expeditious and effective alternative to full sternotomy AVR and might be associated with lower postoperative stroke incidence, earlier extubation and shorter hospital stay. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    Interactive Cardiovascular and Thoracic Surgery 03/2015; 20(6). DOI:10.1093/icvts/ivv030
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    ABSTRACT: Pancoast tumour is a rare neoplasia in which the optimal therapeutic management is still controversial. The traditional treatment of Pancoast tumour (surgery, radiotherapy or a combination of both) have led to an unsatisfactory outcome due to the high rate of incomplete resection and the lack of local and systemic control. The aim of the study was to determine the efficacy of the trimodality approach. Fifty-six patients (male/female ratio: 47/9, median age: 64 years) in stage IIB to IIIB were treated during a period between 1994 and 2013. Induction therapy consisted of 2-3 cycles of a platinum-based chemotherapy associated with radiotherapy (30-44 Gy). After restaging, eligible patients underwent surgery 2 to 4-week post-radiation. Thirty-two (57.1%) patients were cT3 and 24 (42.9%) cT4, 47 (83.9%) were N0 and 9 (16.1%) N+. Forty-eight (85.7%) patients underwent R0 resection and 10 (17.9%) had a complete pathological response (CPR). Thirty-day mortality rate was 5.4%, major surgical complications occurred in 6 (10.7%) patients. At the end of the follow-up, 17 (30.4%) patients were alive and 39 (69.6%) died (29 for cancer-related causes), with an overall 5-year survival of 38%. At statistical analysis, stage IIB (P = 0.003), R0 resection (P = 0.03), T3 tumour (P = 0.002) and CPR (P = 0.01) were significant independent predictors of better prognosis. This combined approach is feasible, and allows for a good rate of complete resection. Long-term survival rates are acceptable, especially for early stage tumours radically resected. Systemic control of disease still remains poor, with distant recurrence being the most common cause of death. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    Interactive Cardiovascular and Thoracic Surgery 03/2015; 20(6). DOI:10.1093/icvts/ivv032
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    ABSTRACT: A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether transcatheter aortic valve-in-valve replacement (viv-TAVR) or redo aortic valve replacement (rAVR) is the best strategy in a patient with a degenerative bioprosthetic aortic valve. Altogether, 162 papers were found using the reported search, of which 12 represented the best evidence to answer the question. The authors, journal, date, country of publication, patient group, study type, outcomes and results of papers are tabulated. The results of the studies provided interesting results. All the studies are retrospective. Four papers reported the results of redo aortic valve replacement in patients with failed aortic bioprosthetic valve, six papers demonstrated their results with transcatheter aortic valve-in-valve replacement for the same indication and two papers reported their propensity-matched analysis of outcomes between viv-TAVR and rAVR in patients with previous cardiac surgery. Thirty-day mortality for rAVR was 2.3-15.5% and 0-17% for viv-TAVR. For rAVR, survival rate at 30 days was 83.6%, 76.1% at 1 year, 70.8% at 3 years, at 51.3-66% at 5 years, 61% at 8 years and 61.5% at 10 years. For viv-TAVR, the overall Kaplan-Meier survival rate at 1 year was 83.2%. After viv-TAVR at 1 year, 86.2% of surviving patients were at New York Heart Association (NYHA) class I/II. The complications after rAVR were stroke (4.6-5.8%), reoperation for bleeding (6.9-9.7%), low-cardiac output syndrome (9.9%) whereas complications after viv-TAVR at 30 days were major stroke (1.7%), aortic regurgitation of at least moderate degree (25%), new permanent pacemaker implantation rate (0-11%), ostial coronary obstruction (2%), need for implantation of a second device (5.7%) and major vascular complications (9.2%). It is noteworthy to mention that there is a valve-in-valve application that provides information to surgeons for choosing the correct size of the TAVR valve. Transcatheter aortic valve-in-valve procedures are clinically effective, at least in the short term, and could be an acceptable approach in selected high-risk patients with degenerative bioprosthetic valves. Redo AVR achieves acceptable medium and long-term results. Both techniques could be seen as complementary approaches for high-risk patients. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    Interactive Cardiovascular and Thoracic Surgery 03/2015; 20(6). DOI:10.1093/icvts/ivv037
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    ABSTRACT: A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was ‘Do thymic malignancies respond to target therapies?’ Altogether, 347 papers were found using the reported search, of which, in our opinion, 16 papers represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated. We did not find any randomized controlled trials on target therapies for the thymic malignancies, due to the very small incidence of this tumour, and it seems unlikely that there will be any such trials in the foreseeable future. Three studies on target therapies showed that several cases of thymic malignancies were reported to have partial response (PR) to epidermal growth factor receptor tyrosine kinase inhibitors such as cetuximab and erlotinib, whereas, one study on erlotinib and another on gefitinib showed no activity. Proto-oncogene c-KIT (KIT) mutant thymic carcinomas were noted to benefit from target therapies, implying that systematic sequencing of KIT in thymic carcinoma tumours may be warranted for optimal patient selection. A study that investigated the efficacy of cixutumumab, a fully human IgG1 monoclonal antibody that binds to insulin-like growth factor 1 receptor, indicated that relapsed thymomas tended to respond, whereas thymic carcinoma did not. The antiangiogenesis agent belinostat had modest antitumour activity in heavily pretreated thymoma, but no response to thymic carcinoma was found. Several cases with metastatic thymic carcinoma showed that multitargeted kinase inhibitors, such as sunitinib and sorafenib, were effective. We concluded that, as the side-effects of the agents were tolerable in almost all reported cases, target therapies can be an option for patients with heavily pretreated thymoma.
    Interactive Cardiovascular and Thoracic Surgery 03/2015; 20(6). DOI:10.1093/icvts/ivv040
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    ABSTRACT: Acute aortic dissection type A (AADA) is still an emergency operation with high morbidity and mortality. In this acute situation quick cannulation to the heart-lung machine and systemic cooling is often life-saving. However, the often easy access to the femoral vessels for cannulation leads to an arterial backflow in the descending aorta with the likelihood of plaque rupture and cerebral embolism. We analysed the outcome after initial femoral versus central cannulation for AADA. All patients with acute aortic dissection type A operated between January 2003 and December 2012 were evaluated for the type of arterial cannulation (femoral vs central) for initial bypass. Demographic data and outcome parameters were accessed. No patient was excluded. One hundred and seventy-seven patients were operated on with acute type A dissection in the last 10 years; 94 (53.1%) were initially cannulated in the central aortic vessels and 83 (46.9%) in the femoral artery. The patients were comparable with regard to age (61.1 ± 14.9 vs 62.2 ± 15.0 years, P = 0.607), gender (male, 62 vs 69%, P = 0.348), EuroSCORE (11.5 ± 4.0 vs 12.8 ± 4.3, P = 0.057) and previous sternotomy (17% in both groups). Bypass (243 ± 105 vs 233 ± 83 min, P = 0.471), cross-clamp (160 ± 86 vs 150 ± 66 min, P = 0.381) and circulatory arrest times (47.8 ± 24.7 vs 42.5 ± 21.7 min, P = 0.130) were similar as were lowest temperatures (17.7 ± 1.8 vs 17.6 ± 1.3, P = 0.652). Postoperative cerebral infarction and 30-day mortality were comparable between the cannulation groups (13 vs 9%, P = 0.449 and 20 vs 17%, P = 0.699, central vs peripheral cannulation). Only postoperative need for dialysis was borderline significantly higher in the femoral cannulation group (28 vs 40%, P = 0.073). This single-centre study with 177 patients could show that an acute aortic dissection type A can be operated on with central and peripheral cannulation with similar results. Risk for early mortality was driven by the preoperative clinical and haemodynamic status before operation rather than the cannulation technique. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    Interactive Cardiovascular and Thoracic Surgery 03/2015; 20(6). DOI:10.1093/icvts/ivv041
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    ABSTRACT: Patients with respiratory failure may benefit from veno-venous and veno-arterial extracorporeal membrane oxygenation (ECMO) support. We report on our initial experience of veno-veno-arterial (v-v-a) ECMO in patients with respiratory failure. Between January 2012 and February 2014, 406 patients required ECMO support at our institution. Here, we retrospectively analysed the characteristics and outcomes of patients commenced on either veno-venous or veno-arterial ECMO due to respiratory failure, and then switched to v-v-a ECMO. Ten (2%) patients proceeded to v-v-a ECMO. The underlying conditions were acute respiratory distress syndrome (n = 3), end-stage pulmonary fibrosis (n = 5) and respiratory failure after major thoracic surgery (n = 1) and Caesarean section (n = 1). In all of these patients, ECMO was initially started as veno-venous (n = 9) or veno-arterial (n = 1) ECMO but was switched to a veno-veno-arterial (v-v-a) approach after a mean of 2 (range, 0-7) days. Reasons for switching were: haemodynamic instability (right heart failure, n = 5; pericardial tamponade, n = 1; severe mitral valve regurgitation, n = 1; haemodynamic instability following cardiopulmonary resuscitation, n = 1 and evidence of previously unknown atrial septal defect with pulmonary hypertension and Eisenmenger syndrome, n = 1) and upper-body hypoxaemia (n = 1). ECMO-related complications were bleeding (n = 3) and leg ischaemia (n = 2). Seven patients were successfully taken off ECMO with 4 being bridged to recovery and a further 3 to lung transplantation after a mean of 11 (range, 9-18) days. Five patients survived until hospital discharge and all of them were alive at the end of the follow-up. Veno-veno-arterial ECMO is a technically feasible rescue strategy in treating patients presenting with combined respiratory and haemodynamic failure. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    Interactive Cardiovascular and Thoracic Surgery 03/2015; 20(6). DOI:10.1093/icvts/ivv035
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    ABSTRACT: Non-transplant surgery for dilated cardiomyopathy (DCM) has been in the process of development. We performed posterior restoration for dilated akinetic or dyskinetic lesions in patients with DCM and obtained favourable outcomes. The early and long-term results of the procedures are discussed. Between 2005 and 2013, posterior restoration procedures (PRPs) for DCM were electively performed in 58 patients (17 with ischaemic and 41 with non-ischaemic DCM). There were 45 men and 13 women with a mean age of 56 ± 12 years old. The mean preoperative ejection fraction was 24% and the preoperative New York Heart Association functional class was Class III in 24 and Class IV in 34 patients with intravenous inotrope support. Indications for PRPs were determined by using speckle-tracking echocardiography of the posterior region of the left ventricle before surgery (GE ultrasound machine, Vivid 7 or Vivid E9). After cardioplegic arrest, mitral surgery or coronary artery bypass grafting (CABG) was performed and the posterior left ventricular (LV) muscle between bilateral papillary muscles was incised or resected. The LV apex was preserved and cryoablation was applied between the cut edge and the posterior mitral annulus. All patients were followed up by transthoracic echocardiography. In addition to PRP, mitral surgery was performed in 56 (plasty 51, replacement 5), tricuspid annuloplasty in 21, CABG in 17, cardiac resynchronization therapy in 6 and LV lead implantation in 27 patients. Perioperative intra-aortic balloon pumping was used in 9 patients and there was no hospital mortality. After the operation, 35 patients (60%) improved their functional class to Class I or II. In the late follow-up, there were 14 cardiac deaths (congestive heart failure 10, ventricular arrhythmia 4). The 3- and 8-year survival rates were 77 or 66%, respectively. DCM with posterior akinesis or dyskinesis indicated by speckle-tracking echocardiography can be surgically treated with PRP. Our results demonstrated that 60% of the selected patients could avoid heart transplantation with relief of their symptoms. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
    Interactive Cardiovascular and Thoracic Surgery 03/2015; 20(6). DOI:10.1093/icvts/ivv019