Journal and News Scan

The device manufacturer Abiomed has issued a recall, issued Class I by the FDA, for its left-sided heart pumps due to cases in which the pump catheter has perforated the left ventricle wall. In its letter, Abiomed advised clinicians to carefully position the pump catheter, use imaging to aid in positioning, and to use caution in high-risk patients. It also specified that the recall is a correction, not a total product removal.

The frequency of minimally invasive mitral valve (MV) surgery has increased over the last decade. Hence, the number of patients requiring MV reoperations post-minimally invasive MV surgery is increasing. This study analyzed the outcomes of patients undergoing MV reoperation after previous minimally invasive MV surgery during a twenty-year period in a high volume heart valve center. A total of 187 patients were included in the analysis (34 [18.2 percent] patients repeat MV repair; 153 [81.8 percent] MV replacement). Redo MV surgery was performed through median sternotomy in 169 (90.4 percent) patients. The median intensive care unit stay was 1 day (1-5 days). The thirty-day mortality was 6.4 percent, and actuarial survival at 5 and 12 years was 61.8 percent and 38.3 percent, respectively. Endocarditis and preoperative stroke were identified as predictors of late mortality.

This study aimed to evaluate the percentage of solitary fibrous pleural tumors presenting unfavorable clinical behavior to predict negative long-term outcomes. Although they are historically considered benign neoplasms, this retrospective review identified 25 percent of 74 patients displayed histological evidence of malignancy as per England criteria and the recurrence rate was 21 percent. The authors recommended the pathological differentiation of these tumors into pedunculated, well circumscribed, and sessile growth patterns. They also recommend that all nonpedunculated lesions should be classified as potentially aggressive.

Heart transplantation (HT) is the only life extending option in adults with congenital heart disease (CHD) and end stage heart failure. This study evaluated outcomes after heart transplantation in adults with univentricular versus biventricular CHD. One-hundred-forty-nine patients were included, 55 of whom (36.9 percent) had univentricular CHD. Follow up was for a mean of 10.1 years. Sixty-four patients died during follow up, including 47 before discharge from hospital. Multivariable analysis showed univentricular physiology (odds ratio (OR) 2.99, 95 percent CI 1.33–6.74) and female recipient gender (OR 2.76, 95 percent CI 1.23–6.74) carried higher risk of early mortality. For patients who survived the early period, long-term survival was excellent and did not differ between the groups.