Background: Aortic Valve Neocuspidization using glutaraldehyde-treated autologous pericardium was first performed by Ozaki et al. in 2007. This technique has become an alternative to tissue and mechanical valve as long-term anticoagulation is not required and shows promising midterm results and durability. Method: A comprehensive search was performed on the major database using search terms “Ozaki technique” AND “Aortic Valve Neocuspidization” AND “AV Neocuspidization” AND “Autologous pericardium” AND “glutaraldehyde-treated autologous pericardium”. Articles up to 1st of August 2020 were included in this study. Results: A total of 9 studies with a total of 1342 patients were included. The mean age was 67.36 and 54.23% were male. 66.32% and 23.92% of patients had aortic stenosis and aortic regurgitation, respectively. 66% of patients had a native tricuspid aortic valve and 31.37 % patients’ native aortic valve was bicuspid. Three studies reported their experience performing Aortic Valve Neocuspidization via mini sternotomy. Conclusion: Aortic Valve Neocuspidization is an alternative to biological and mechanical prostheses for surgical aortic valve replacement. The short and mid-term outcome are comparable without the need for long term oral anticoagulation. Long term follow-up data is required for this novel approach to be widely adopted.

Background: Subxiphoid incisional hernias are one of the complications following a median sternotomy, a surgical procedure to provide access to the mediastinum. Incidence has been reported between 1-4%, although the true incidence is not well known due to its asymptomatic nature. Method: A comprehensive search was performed on multiple sites. Keywords included “incisional hernia OR Subxiphoid hernia” AND “Median sternotomy OR Cardiac Surgery OR Coronary artery bypass graft OR Transplant OR Valve replacement”. Articles up to 1st of August 2020 were included in this study. Results: 8 articles were included in the study, with a total number of 132 patient identified. The incidence ranged from 0.81% to 3.44%. There was a mixture of repair method and follow up period reported. Recurrence post-repair ranged from 10% to 43%. Conclusion: Subxiphoid incisional hernias remains challenging to manage. We have discussed the incidence, risk factors, preventions, and management of subxiphoid incisional hernias including both the open and laparoscopic technique.

Background: This bibliometric analysis is used to identify publications and highlights the key areas that have significantly shaped modern clinical practice for aortic valve replacement (AVR), which is becoming increasingly relevant. The top 100 most cited manuscripts for AVR were analysed. Method: The Thomson Reuters Web of Science database was searched using the terms ‘aortic valve replacement’, ‘replacement’, ‘aortic valve’ and/or ‘AVR’ for full manuscripts in English Language. The results were ranked by citation number and the top 100 articles were further analysed by subject, author, journal, year of publication, institution and country of origin. Results: 26,782 eligible papers were returned and accumulated 76,680 citations in total, with a mean citation of 767 per manuscript (350-3667). The New England Journal of Medicine accumulated the most citations whereas Circulation published the most papers. Majority of manuscripts examined patients with aortic stenosis, of which half also included aortic regurgitation. The United States of America contributed 51 manuscripts, accumulating 43629 citations. Conclusion: The most cited manuscript, by Leon et al., assessed the outcomes of transcatheter aortic valve implantation in patients with severe aortic stenosis who were unfit for surgical replacement. By providing the most influential references this work serves as a guide to topics of interest in the field of AVR.