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Journal and News Scan

Source: The New England Journal of Medicine
Author(s): Mandeep R. Mehra, Daniel J. Goldstein, Nir Uriel, Joseph C. Cleveland, Melana Yuzefpolskaya, Christopher Salerno, Mary N. Walsh, Carmelo A. Milano, Chetan B. Patel, Gregory A. Ewald, Akinobu Itoh, David Dean, Arun Krishnamoorthy, William G. Cotts, Antone J. Tatooles, Ulrich P. Jorde, Brian A. Bruckner, Jerry D. Estep, Valluvan Jeevanandam, Gabriel Sayer, Douglas Horstmanshof, James W. Long, Sanjeev Gulati, Eric R. Skipper, John B. O’Connell, Gerald Heatley, Poornima Sood, and Yoshifumi Naka, for the MOMENTUM 3 Investigators

An interesting two-year report from the MOMENTUM 3 randomized controlled trial comparison of HeartMate 3 and II, the analysis performed by Abbott. Although stroke and reoperation were clearly lower with the latest technology, reflected in the lower LDH measurements, there was bafflingly no improvement in survival.

 

Source: News from around the web.
Author(s): Claire Vernon

Patient Care

Carter Capps, a pitcher for professional baseball team the San Diego Padres, has made himself a necklace out of the rib surgeons removed during his thoracic outlet surgery.

A Connecticut, USA, man gets some experimental and synergistic help from a bacteriophage and antibiotic to treat a persistent infection in his aortic graft.

 

Drugs and Devices

The US Food and Drug Administration (FDA) has approved the world’s smallest mechanical heart valve for pediatric patients, a 15 mm Masters Series Heart Valve from Abbott.

Durvalumab from AstraZeneca has been approved by the US FDA for patients with unresectable stage III non-small cell lung cancer; this follows the publication of a randomized trial showing superiority of durvalumab over placebo following chemotherapy.

 

Research, Trials, and Funding

Researchers from Vancouver, Canada, presented their early experience with the Sapien M3, a transcatheter mitral valve replacement device that caught the attention of attendees at the recent Cardiovascular Research Technologies meeting.

The use of lung cancer treatment modalities varies by geographic region across the UK, according to research published in Thorax, and the researchers say this could be negatively affecting patient survival in regions with lower treatment rates.

In Indiana, USA, the first patient has been enrolled in the EVAS2 IDE Confirmatory Clinical Study of the Nellix EndoVascular Aneurysm Sealing System from Endologix.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Ilhan Inci, Ilker Iskender, Jonas Ehrsam, Claudio Caviezel, Sven Hillinger, Isabelle Opitz, Didier Schneiter, Walter Weder

Inci and colleagues reviewed prospectively collected data from 117 patients with end-stage emphysema undergoing lung transplantation. The authors found that short-term and long-term survival were equivalent in patients who did and did not undergo lung volume reduction surgery prior to their transplantation (107 versus 86 months, p = 0.6).

Source: Pediatric Pulmonology
Author(s): Elisabeth Dellon, Samuel B. Goldfarb, Don Hayes Jr, Gregory S. Sawicki, Joanne Wolfe, Debra Boyer

A handy view from the pediatric standpoint on an expanding indication for sequential pulmonary transplanation.

Source: Medical Economics
Author(s): Craig M. Wax

Physicians are at high risk for burnout, physical disability, and financial deprivation after investing time and money in obtaining their training.  This article highlights how physicians can maintain their health and positive outlook to enable them to continue helping others.

Source: The Lancet
Author(s): David L Brown, Rita F Redberg

A few months after its publication, the ORBITA trial results do not seem to have filtered adequately to cardiac multidisciplinary teams worldwide.

Source: Science
Author(s): Seth Thomas Scanlon

This brief synopsis of an article published in Cell describes how certain skin microorganisms interact beneficially with the host to accelerate wound healing.

Source: The Annals of Thoracic Surgery
Author(s): Tyler J. Beute, Matthew D. Orem, Timothy M. Schiller, Matthew Goehler, Jessica Parker, Charles L. Willekes, Tomasz Timek

The authors retrospectively reviewed their minimally invasive aortic valve replacement experience over a three-year period to assess the outcomes in patients undergoing conventional knot tying (n = 39) versus automated knot tying with the Cor-Knot device (n = 53).  Aortic cross-clamp time was approximately 10 minutes shorter in the latter group.  Postoperative mortality and morbidity were comparable, as was valve function at one year.

Source: The Annals of Thoracic Surgery
Author(s): Fenton H. McCarth, Sreekanth Vemulapalli, Zhuokai Li, Vinod Thourani, Roland A. Matsouaka, Nimesh D. Desai, Ajay Kirtane, Saif Anwaruddin, Matthew L. Williams, Jay Giri, Prashanth Vallabhajosyula, Robert H. Li, Howard C. Herrmann, Joseph E. Bavaria, Wilson Y. Szeto

The STS/ACC TAVR Registry  was analyzed to determine the effect of tricuspid regurgitation (TR) on outcomes after transcatheter aortic valve replacement (TAVR).  The authors found that TR, of any severity, is quite common in TAVR patients (80%).  The breakup of TR severity was as follows:

  • Mild TR:             56%
  • Moderate TR: 19%
  • Severe TR:         5%

Findings:  Along with higher predicted risk, increasing TR severity was associated with increased mortality and readmission.

Should the TR of a certain severity be addressed at the time of TAVR?  How?

Source: News from around the web.
Author(s): Claire Vernon

Patient Care

The first deceased donor lung transplant in the UAE was performed at the Cleveland Clinic Abu Dhabi’s Heart and Vascular Institute, making the hospital the first in the country to offer heart, liver, and lung transplants.

The king of Morocco underwent surgery for an arrhythmia in Paris, France.

Malaysia hosted the first Joint Surgical Colleges Fellowship Examination in Cardiothoracic Surgery to be held outside the UK.

 

Drugs and Devices

AtriCure, Inc, has launched the AtriClip Flex-V™ Left Atrial Appendage Exclusion System in the United States, the newest design to be added to the AtriClip line of devices.

The US Food and Drug Administration has issued a warning about the use of clarithromycin in patients with heart disease.

 

Research, Trials, and Funding

Children with congenital heart disease are considered well-connected to health care regardless of socioeconomic background, however researchers from New York City found that neighborhood health disparities for these patients were similar to those observed in general pediatric patients.

The American Lung Association has released its first Lung Force “State of Lung Cancer” report, which evaluates cancer incidence, survival, and treatment around the US.

Researchers from California have identified iron as a key element to Aspergillus invasion in transplanted lungs of mice.

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