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Journal and News Scan
An interesting dilemma posed by a tattoo providing advanced care directives.
Newspaper and prime time TV advertisements are beginning in the US today that detail the medical toll that smoking exacts on its victims. The ads are paid for by big tobacco based on a court order from 2006 that has finally survived the appeal process. A spokesperson for one of the companies stated that they hope to "develop less risky tobacco products." The ads emphasize that smoking causes nearly 500,000 deaths annually in the US.
The medical care oversight committee for Hertfordshire County, England, has banned elective surgery for the obese and for those who are actively smoking. Obese patients must lose 10% to 15% of their body weight within 9 months to qualify, and smokers must abstain for at least 8 weeks if elective surgery is to be performed. Free counseling to achieve these goals is provided.
Preventza and colleagues present their experience with aortic repair, analyzing prospectively collected data from 129 patients who underwent either a traditional elephant trunk (t-ET) procedure or a modified frozen elephant trunk (FET) procedure that does not use a hybrid graft. The authors found no statistically significant difference in mortality or persistent spinal cord ischemia between patients undergoing a t-ET and those undergoing a modified FET.
This is the kind of video that patients are going to in large numbers. It is a nice description of a CABG case performed at MedStar Union Memorial Hospital in Maryland, USA. Nearly a million hits makes these guys YouTube stars!
The authors review their first 1000 robotically assisted mitral valve surgery, demonstrating excellent repair rates and low operative mortality and morbidity.
Del Nido cardioplegia has been used in congenital heart surgery but the data for adult cardiac surgery has been lacking. This randomized trial compares del Nido to whole blood cardioplegia for patients undergoing either a CABG, valve, or CABG/valve. The results suggest that the use of del Nido is safe and may streamline the workflow.
This is a lecture about the treatment of massive pulmonary embolus.
Heart patients in Malaysia seem to be successfully reducing their cholesterol levels, though cholesterol levels are still on the rise in the general population.
A lung surgeon discusses the immediate and long-term effects of air pollution in Delhi, India.
Drugs and Devices
Medtronic presented 30-day outcomes from the pilot study for its Intrepid™ transcatheter mitral valve replacement system, which indicate successful implantation in nearly all patients and reduced regurgitation.
Four cardiac health monitoring apps and devices received recent approval from the US Food and Drug Administration (FDA).
The US FDA will now permit an electric stimulation device to be marketed for opioid withdrawal, though the device is contraindicated in patients with cardiac pacemakers.
Research, Trials, and Funding
Lungs from donors over 60 years old might be suitable for patients who need double lung transplants.
Researchers from the University of the Witwatersrand in Johannesburg, South Africa, highlight the importance of psychosocial factors in health as they report high financial stress is associated with 13-fold higher odds of having a heart attack.
Dr. John Warner, President of the AHA, suffered a minor heart attack during the AHA congress in California. The day prior he had delivered an address describing the impact that coronary artery disease has had on his extended family. He was treated with stent placement and is recovering well.