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Journal and News Scan
July 6, 2018
Submitted by: Claire Vernon
Patient Care and General Interest
The Israeli nonprofit organization Save a Child’s Heart received the United Nations’ Population Award, in recognition of its work providing congenital cardiac surgery to children in developing countries.
Several hospitals in the UAE have added pulse CO-oximeters with technology that integrates with a patient’s electronic health record to improve screening for critical congenital heart defects.
Drugs and Devices
The US Food and Drug Administration has approved the Zephyr Endobronchial Valve from Pulmonx Corp to treat severe emphysema.
Research, Trials, and Funding
Researchers in Boston, USA, and Xi’an, China, find that nitric oxide administration during and after cardiopulmonary bypass might reduce postoperative kidney injury.
A team of medical anthropologists evaluated cooperation and conflict in the operating rooms of different surgical specialties, and they report their observations in the journal PNAS.
JenaValve Technology has launched a study of its JenaValve transcatheter aortic valve for the treatment of severe aortic regurgitation, which the company hopes will inform its anticipated application for CE mark approval in 2019.
Facilities voluntarily participating in the US Medicare’s Bundled Payments for Care Improvement programs for cardiac care are more likely to be large, high-resource centers, which may limit the generalizability of these models.
July 6, 2018
Submitted by: Mark Ferguson
This retrospective study of 328 patients undergoing resection for non-small cell lung cancer demonstrated that sarcopenia determined by psoas muscle mass on computed tomography was associated with increased postoperative complications and was an independent predictor of survival.
July 6, 2018
Submitted by: Aristotle Protopapas
A detailed and somewhat disheartening analysis of stem cell therapy for cardiac failure.
July 3, 2018
Submitted by: Claire Vernon
Joseph Dearani, Chair of the Department of Cardiovascular Surgery at the Mayo Clinic in Rochester, Minnesota, graciously shares a copy of the letter with which he welcomes cardiothoracic surgery residents as they embark on their rotation on his service. Dr Dearani’s letter describes the importance of professionalism, preparedness, responsibility, introspection, and honesty to both self and others. It would be equally appropriate as an essay defining the key elements of a successful and productive relationship between a trainee and mentor in any surgical subspecialty.
The Incidence and Consequence of Prosthesis-Patient Mismatch After Surgical Aortic Valve Replacement
July 3, 2018
Submitted by: Claire Vernon
Fallon and colleagues evaluated patient-prosthesis mismatch (PPM) following isolated aortic valve replacement reported in the STS Adult Cardiac Surgery Database. They found that both moderate and severe PPM were associated with worse outcomes compared to no PPM over the 10-year study period. Readmission for congestive heart failure and aortic valve rereplacement were both more likely in patients with moderate or severe PPM, and overall survival was lower. The incidences of moderate and severe PPM were reduced over the study period, from 60.1% to 46.8% and from 13.8% to 6.2%, respectively. Because of the worse outcomes with even moderate PPM, the authors emphasize that continued efforts to avoid implantation of too small a prosthesis remain necessary.
July 2, 2018
Submitted by: Claire Vernon
Yoshioka and colleagues evaluated the artery of Adamkiewicz using multidetector row computed tomography in 64 patients. These patients had descending thoracic or thoracoabdominal aortic aneurysms that were associated with the occlusion of the segmental artery from which the artery of Adamkiewicz originated. Seventy-five collateral pathways were identified in 53 patients, and these were more frequently located around the spinal column than in the thoracic wall.
June 29, 2018
Submitted by: Claire Vernon
Patient Care and General Interest
A guideline for the number of opioid pills that should be prescribed after different surgeries, from cochlear implantation to coronary artery bypass grafting, is self-published by an expert group of health professionals as part of the effort to reduce overprescribing these drugs in the US.
A webcam in the operating room allows cardiothoracic surgeons in Pennsylvania, US, to update a patient’s family on a successful procedure earlier than usual.
After a baby’s heart transplant, her parents—a pediatrician and a school district trustee—are writing a children’s book for the kids and families who face this type of procedure.
The first double-lung transplant in the UAE is performed at the Cleveland Clinic Abu Dhabi using a minimally invasive approach.
Drugs and Devices
The Incraft Stent Graft System for endovascular abdominal aortic aneurysm repair, from Cardinal Health/Cordis, has received a vote of approval from a US Food and Drug Administration advisory panel.
Research, Trials, and Funding
A trial has begun to evaluate the first biological heart valve made in India. If shown to be a good therapeutic option, it is hoped that this locally-manufactured bioprosthesis will help bring down the cost of valve implantation for patients.
A VATS approach to early-stage lung cancer resection leads to survival outcomes similar to thoracotomy, say researchers from Yale University in Connecticut, US.
June 28, 2018
Submitted by: Claire Vernon
Chan and colleagues describe a stepwise approach to reducing the time to extubation after cardiac surgery, driven primarily by bedside providers as opposed to a conventional physician-directed approach. The authors demonstrate that this fast-track extubation protocol increased the rate of early extubation and decreased the median time to extubation without altering reintubation or early mortality rates.
June 27, 2018
Submitted by: Aristotle Protopapas
A brief, readable, sensibly balanced, and well-referenced editorial on the occasion of the retrospective Austrian paper on venoarterial extracorporeal membrane oxygenation (ECMO). Taken in the context of the recent New England Journal of Medicine paper on venovenous ECMO for acute respiratory distress syndrome and the relevant ATS presentations on the EOLIA trial, the editorial raises questions on the utility of the expensive innovation of ECMO.
June 26, 2018
Submitted by: Claire Vernon
Sample size calculations are a necessary prerequisite in the design of clinical studies. Most often, they are encountered in randomized controlled trials. Hickey and colleagues describe the reasoning behind determinations of sample size and illustrate some basic calculations. The authors also discuss estimation and sample size for nonrandomized studies.