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Journal and News Scan
October 24, 2017
Submitted by: Joel Dunning
The authors present a step-by-step description of mitral valve annuloplasty ring implantation that takes into account not only the surgical technique, including positioning of annular stitches and correct sizing, but also mitral annulus anatomy and its close relationship with surrounding structures.
October 24, 2017
Submitted by: Mark Ferguson
From one of the few relatively unbiased sources of information regarding surgical treatment of pleural mesothelioma, the authors describe populations of patients undergoing EPP or P/D and their outcomes. Survival was compared between propensity matched cohorts, demonstrating no difference in OS.
October 24, 2017
Submitted by: Mark Ferguson
Surgical treatment of metastatic disease, particularly lung cancer metastases, is often controversial. This article reviews the literature on therapeutic surgical interventions, and comments on diagnostic, palliative, and consolidation roles for surgery in patients with stage IV NSCLC.
October 24, 2017
Submitted by: Mark Ferguson
A useful reminder of the substantial progress that has been made and the continuing challenges that we face in fighting this terrible disease.
October 20, 2017
Submitted by: Joel Dunning
Many answers need to be addressed before transcatheter aortic valve implantation (TAVI) is adopted in lower risk patients. This paper highlights the pros and cons of TAVI based mostly on randomized clinical trials involving the two device platforms approved in the United States. The authors focused their analysis on metrics that will play a key role in expanding TAVR indication in healthier individuals. They review the significance and give a perspective on paravalvular leak (PVL), valve performance, valve durability, leaflet thrombosis, stroke and pacemaker requirement.
October 20, 2017
Submitted by: Claire Vernon
Helminen and colleagues employ near-infrared imaging as a novel technique for lymphatic mapping in minimally invasive esophagectomy of distal esophageal cancer. Indocyanine green dye was injected endoscopically and used to identify nodal stations outside of the en bloc resection area.
October 20, 2017
Submitted by: Claire Vernon
Patient Care
The “I Love Life” campaign to raise awareness of heart failure in Egypt launched this week.
Pollution was determined to contribute to over 9 million deaths worldwide in 2015, with over 70% of these being heart-related and lung-related deaths linked to air pollution.
Surgical teams from Komfo Anokye Teaching Hospital in Kumasi, Ghana, and Boston Children’s Hospital in the US collaborated to provide congenital heart surgery free of charge for 140 Ghanaian children.
Drugs and Devices
Alectinib (Alecensatm, Roche) was recommended by the European Medicine Agency CHMP as a first-line treatment for ALK-positive non-small cell lung cancer.
The Phase 3 JUNIPER trial evaluating abemaciclib (Verzeniotm, Eli Lilly) as monotherapy for KRAS-mutated non-small cell lung cancer did not meet the primary endpoint of overall survival, but secondary endpoints suggested efficacy.
Research, Trials, and Funding
A review published in JAMA: Internal Medicine highlights what the authors determined to be the 10 most notable studies examining medical overuse published in 2016.
Heart surgery might provide useful benefits to patients with trisomy 13 and trisomy 18.
October 20, 2017
Submitted by: Mark Ferguson
Physicians are sometimes at risk related to services they provide for patients. This study describes the effects of low dose radiation in the cath lab on the brains of interventional cardiologists. This is something for CT surgeons to be aware of as they become more involved in catheter-based techniques.
October 19, 2017
Submitted by: Mark Ferguson
The authors review cybersecurity issues related to newer generations of pacemakers. Telemetric capabilities providing patient data to health care workers can be co-opted, enabling malicious software to endanger patients. Risks include intentional battery depletion and malicious reprogramming.
October 18, 2017
Submitted by: Claire Vernon
This study evaluates 1028 octogenarians who underwent isolated aortic valve replacement (AVR, 306 TAVR and 722 SAVR) between 2002 and 2015 at Brigham and Women’s Hospital in the US. The mean age of patients was 84.4 ± 3.4 years old, with overall STS-PROM score of 5.96 ± 3.87. After adjusting for confounders, both of these elderly cohorts had similar operative mortality and short-term outcomes. No difference in mid-term survival was seen when comparing transfemoral TAVR, transsubclavian or transaortic TAVR, minimally invasive AVR, and sternotomy AVR. The authors suggest that these results indicate a continued role for SAVR in treating aortic stenosis in this patient population.