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Journal and News Scan
March 31, 2018
Submitted by: Joel Dunning
70-year-old Arnold Schwarzenegger has undergone successful redo heart surgery at Ceders-Sinai Hospital, after an initial attempt to replace his pulmonic valve percutaneously. He famously underwent an attempted Ross Procedure in 1997, and the pulmonic valve left from that operation now required repeat surgery.
Apparently everything went well, and his first words were "I'm back!"
March 30, 2018
Submitted by: Grahame Rush
Patient Care
Higher risk of death from coronary artery disease was noted for Americans who drank higher quantities of sugary beverages but not for those who ate more sugary foods.
Drugs and Devices
Aymara craftswomen in Bolivia weave textile-art-based patterns into percutaneous devices for occluding structural heart defects in children.
Several groups, including the American Lung Association and the American Heart Association, have sued the US Food and Drug Administration over their decision to delay implementation of a rule that would regulate e-cigarette marketing like marketing of tobacco products.
Research, Trials, and Funding
A study of data from the German Aortic Valve Registry suggests that rapid deployment valves lead to shorter surgery duration but not to better outcomes than conventional biological valves.
An observational study from Denmark, published in JAMA Cardiology, found that the risk of thromboembolism from atrial fibrillation (AFib) that began after coronary artery bypass grafting was lower than that seen with nonsurgical, nonvalvular AFib, despite a lower rate of oral anticoagulation therapy.
Researchers in South Africa find that silver-based anticancer drugs show promise in preclinical studies, potentially representing an opportunity to design chemotherapeutic drugs on a less expensive starting material than the current platinum-based drugs.
March 28, 2018
Submitted by: Claire Vernon
Freemantle and colleagues discuss evidence evaluating myocardial revascularization strategies, focusing in particular on conclusions that can and cannot be drawn from subgroup analyses. The authors detail the benefits and limitations inherent to meta-analyses, and they comment on dividing left main coronary artery stenosis and multivessel coronary artery disease into subgroups when comparing outcomes between surgical and percutaneous interventions.
March 27, 2018
Submitted by: Aristotle Protopapas
A brief readable editorial on a retrospective analysis of the costs of coronary artery bypass grafting in Virginia, USA, which suggests the value of enhanced recovery in coronopathy.
March 27, 2018
Submitted by: Aristotle Protopapas
A succinct balanced editorial advancing, amongst other things, the position for initial nonintervention for submassive pulmonary embolism.
Bleeding Complications After Use of Novel Oral Anticoagulants in Patients Undergoing Cardiac Surgery
March 26, 2018
Submitted by: Claire Vernon
Hassan and colleagues performed a retrospective analysis of 81 patients who presented for open cardiac surgery while receiving novel oral anticoagulant (NOAC) therapy. Patients were off NOACs for a median of 4 days (IQR, 3 - 6 days) prior to surgery. The authors found the length of the NOAC withdrawal period was significantly related to the postoperative 24-hour drainage volume, which was 480 ml (IQR, 350 - 600 ml). Additionally, 6.2% of patients required rethoracotomy to investigate bleeding. The authors suggest that 10 days of NOAC withdrawal might be preferable prior to elective cardiac surgery.
March 24, 2018
Submitted by: Mark Ferguson
This survey of general surgeons in the US who had a pregnancy during surgical training identified a number of challenges that may influence career satisfaction. These included inadequate scheduling support, lactation facilities, and mentoring. 30% of participants would advise a female medical student not to pursue a surgical career.
March 23, 2018
Submitted by: Benjamin Bidstrup
This article examines an interesting concept for preparing for mitral repair. This may have useful assistance in complex valve repairs and in the early stages of training of young surgeons.
March 23, 2018
Submitted by: Claire Vernon
Patient Care
A teen in Chicago, Illinois, USA, awaiting a heart transplant received the news that a heart was available from his pediatric cardiologist, who dressed up as Chewbacca from Star Wars just for the occasion.
Surgeons in the UAE replaced all four heart valves in a man with infective endocarditis.
A hospital system based in Delaware, USA, plans to launch an app to help monitor infants born with a single ventricle when they are discharged from the hospital after surgery.
Drugs and Devices
Japan’s Ministry of Health, Labor, and Welfare has granted national reimbursement for the MitraClip™ from Abbott, a move that will make the technology more accessible through the country’s health insurance system.
Research, Trials, and Funding
Researchers from the Netherlands presented a proof-of-concept study at the recent European Heart Rhythm Association meeting, showing that putting light-sensitive ion channels into the heart allows it to terminate arrhythmias itself in response to a pulse of light.
Reports of severe myocarditis after cancer treatment with immune checkpoint inhibitors are increasing, say researchers from the US and France, and they speculate that this is due both to increased use of these drugs and heightened awareness of this complication.
March 23, 2018
Submitted by: Mark Ferguson
Surgery for cancer is known to suppress immune response and facilitate the development of metastases. In this study in mice, a scaffold designed to release agonists of innate immunity over time was placed in the bed of resected tumors. The treatment reduced local recurrence and improved survival.