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Journal and News Scan

Source: The Annals of Thoracic Surgery
Author(s): Faisal G. Bakaeen MD , Marc Ruel MD , John H. Calhoon MD , Leonard N. Girardi MD, Robert Guyton MD, Dawn Hui MD, Rosemary F. Kelly MD, Thomas E. MacGillivray MD, S. Christopher Malaisrie MD, Marc R. Moon MD, Joseph F. Sabik 3rd MD, Peter K. Smith MD, Lars G. Svensson MD, PhD, Wilson Y. Szeto MD for the American Association for Thoracic Surgery and The Society of Thoracic Surgeons

Authors representing the American Association for Thoracic Surgery and The Society of Thoracic Surgeons published a rebuttal to the Chronic Coronary Disease Guidelines. The authors explain their stance on the revised guidelines, stating their belief that the new recommendations on revascularization are flawed adaptations of the 2021 guidelines. The rebuttal points out contradicting evidence, missing information, selection biases, and more within the revised guidelines.

For more on the societies’ reaction to the new guidelines, read this article from tctMD.

Source: Edmonton Journal
Author(s): Edmonton Journal Staff

Alberta’s first minimally invasive direct coronary artery bypass (MIDCAB) surgery was performed at one of the few sites in Canada offering the procedure. The procedure is less invasive than traditional bypass surgery and provides patients with a faster recovery time. Since the first procedure, the multidisciplinary team at the center have performed ten more, a big step for Canadian cardiac surgical care.

Source: The Annals of Thoracic Surgery
Author(s): Fukuhara, Deeb, et. Al.

In forty-eight consecutive patients undergoing explants of transcatheter aortic valve replacement (TAVR) at a single center between 2011 and 2021, at a median of 2.3 years after TAVR, the most common indications for surgery were nonstructural valve dysfunction (patient-prosthesis mismatch or paravalvular leak) in 35 percent, structural valve deterioration in 29 percent, and mitral valve disease in 29 percent. The authors describe that TAVR valves were typically easily removed; however, unplanned aortic root replacement because of aortic root trauma during explantation was required in four patients, and root enlargement was required in four patients. Overall operative mortality was 15 percent.

Source: Circulation
Author(s): Salim S. Virani, L. Kristin Newby, Suzanne V. Arnold, Vera Bittner, LaPrincess C. Brewer, Susan Halli Demeter, Dave L. Dixon, William F. Fearon, Beverly Hess, Heather M. Johnson, Dhruv S. Kazi, Dhaval Kolte, Dharam J. Kumbhani, Jim LoFaso, Dhruv Mahtta, Daniel B. Mark, Margo Minissian, Ann Marie Navar, Amit R. Patel, Mariann R. Piano, Fatima Rodriguez, Amy W. Talbot, Viviany R. Taqueti, Randal J. Thomas, Sean van Diepen, Barbara Wiggins and Marlene S. Williams

These new guidelines contain wide-ranging recommendations on the use of beta-blockers, sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1, and other medical therapies to treat chronic coronary disease. They also contain recommendations on how to evaluate, diagnose, and risk stratify patients, as well as the role of coronary revascularization when medical therapy does not work. 

Visit this article from tctMD for a summary of the guidelines, including additional observations from the authors.Visit this article from tctMD for a summary of the guidelines, including additional observations from the authors.

Source: The Annals of Thoracic Surgery
Author(s): Tyler M. Bauer, Jessica M. Yaser, Temilolaoluwa Daramola, Alexandra I. Mansour, Gorav Ailawadi, Francis D. Pagani, Patricia Theurer, Donald S. Likosky, Steven J. Keteyian, Michael P. Thompson

To measure the effectiveness of cardiac rehabilitation for CABG patients, researchers used mortality within two years of discharge as the primary outcome. They found that use of cardiac rehabilitation is associated with a lower two-year mortality rate compared with non-CR users. In an article about the study, researchers also stated that “minority and underserved populations face many barriers to cardiac rehab, but improving referral, attendance, and adherence in these populations may be an effective strategy to mitigating longstanding disparities in cardiovascular outcomes.”

Source: JAMA Network Open
Author(s): Carli J. Lehr, MD, Maryam Valapour, MD, Paul R. Gunsalus, Warren T. McKinney, Kristen A. Berg, Johnie Rose, Jarrod E. Dalton

This study aimed to determine if socioeconomic status and region had any effect on post-transplant outcomes across different races and ethnicities. After another study found that transplant outcomes varied greatly based on multiple factors, researchers wanted to know if socioeconomic factors played into differences based on race. They found that socioeconomic position did not explain most of the difference in posttransplant outcomes among racial groups. These findings highlight the presence of a complex social reality that warrants further study to increase equity among transplant recipients.

Source: Interdisciplinary Cardiovascular and Thoracic Surgery
Author(s): Shoji Kuriyama, Kazuhiro Imai, Hajime Saito, Shinogu Takashima, Nobuyasu Kurihara, Ryo Demura, Haruka Suzuki, Yuzu Harata, Yusuke Sato, Katsutoshi Nakayama, Kyoko Nomura, Yoshihiro Minamiya

This study aimed to determine whether inferior pulmonary ligament (IPL) division leads to pulmonary dysfunction in 213 upper lobectomy (UL) patients divided into two groups with division or preservation of the IPL. The authors found no difference in complication rate, dead space area, forced vital capacity, or forced expiratory volume in 1 s. However, after left UL, pulmonary function was significantly better in the IPL preservation group. IPL division during left UL caused pulmonary dysfunction and limited airflow due to bronchial kinking.

Source: The Annals of Thoracic Surgery
Author(s): Tanaka, Estrera et. Al.

This expert single-center series analyzes 1,429 ascending aorta and arch replacements performed between 1991 and 2020 with circulatory arrest at nadir temperatures of 14 to 20°C with retrograde cerebral perfusion, including 464 acute type A dissections. The authors report overall operative mortality of 8.9 percent and stroke rate of 8.4 percent. The incidence of stroke was less than 5 percent when retrograde perfusion lasted less than twenty minutes and 11.5 percent at sixty minutes, with a linear relationship. The authors recommend other adjuncts for cerebral protection if circulatory arrest is anticipated to be more than sixty minutes.

Source: Northwestern Now
Author(s): Amanda Morris

To help prevent premature death after a major cardiac event, researchers have developed a new device to monitor heart disease in the following weeks and months. The device is soft, flexible, and the size of a postage stamp, using sensors to provide functions beyond those of a traditional pacemaker. When the device is no longer needed, it dissolves inside the patient’s body. The device can be placed on different areas of the heart, allowing for customizable real-time tracking of heart functions.

This article includes summary and dialogue with head researchers, but the original study is available for open access viewing.

Source: Diagnostic and Interventional Cardiology
Author(s): Diagnostic and Interventional Cardiology Staff

The Côte d’Ivoire Health Ministry has announced a local capacity building initiative to establish the country’s local congenital cardiac surgery capabilities and enable Côte d’Ivoire to become a model for other African countries to build similar programs. In order to develop the program and treat the one out of every hundred babies born with congenital heart disease, local medical staff will undergo advanced training from French and Israeli surgical teams, who will travel throughout the year to perform operations and provide training.

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