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Journal and News Scan

Source: The Guardian
Author(s): Stephen Buranyi and Hannah Devlin

Dozens of recent clinical trials contain suspicious statistical patterns that could indicate incorrect or falsified data, according to a review of thousands of papers published in leading medical journals.

The analysis was carried out by John Carlisle, a consultant anaesthetist at Torbay Hospital, who previously used similar statistical tools to expose one of the most egregious cases of scientific fraud on record, involving a Japanese anaesthesiologist who was found to have fabricated data in many of his 183 retracted scientific papers. 

The latest study identified 90 trials that had skewed baseline statistics, 43 of which with measurements that had about a one in a quadrillion probability of occurring by chance.

 

This study is published in Anaesthesia and it names the papers concerned - go here to read the paper 

http://onlinelibrary.wiley.com/doi/10.1111/anae.13938/full

 

 

 

 

 

Source: Annals of Cardiothoracic Surgery
Author(s): Dale Adler, Jamahal Luxford, Rebecca Hahn, Gosta Pettersson, Irving Kron, Marisa Cevasco

This special issue of the ACS is focused on Tricuspid Valve Surgery. With Guest Editors Dr Bettina Pfannmuller and the late Dr Lawrence Cohn, topics of interest include non-functional tricuspid valve disease, innovative solutions for tricuspid leaflet repair, management of Ebstein’s Anomaly, minimal access surgery and much more. Contributors include Dale Adler, Jamahal Luxford, Rebecca Hahn, Gosta Pettersson, Irving Kron, Marisa Cevasco and many more.

Source: Annals of Thoracic Surgery
Author(s): Jennifer K. Peterson, Lazaros K. Kochilas, Kirsti G. Catton, James H. Moller, Shaun P. Setty

Outcomes of surgery for congenital heart defects in children with trisomy 13 or 18 were evaluated in 98 pts the Pediatric Cardiac Care Consortium 1982-2008.  Hospital mortality was 28% and 13%, respectively.  Median survival was 15 years and 16 years, primarily related to cardiac  and respiratory causes. 

Source: Annals of Thoracic Surgery
Author(s): Robert B. Hawkins, Emily A. Downs, Lily E. Johnston, J. Hunter Mehaffey, Clifford E. Fonner, Ravi K. Ghanta, Alan M. Speir, Jeffrey B. Rich, Mohammed A. Quader, Leora T. Yarboro, Gorav Ailawadi for the Investigators for the Virginia Cardiac Services Quality Initiative

A statewide quality initiative database that included over 11,500 pts undergoing surgical AVR (SAVR) who were assessed for outcomes based on pre-TAVR and post-TAVR time periods (divided into early TAVR and commercial TAVR).  SAVR rates increased with each time period, wheres predicted mortality rates decreased, observed mortality was lowest during the commercial era, and major morbidity decreased throughout the time periods.   SAVR outcomes are improving, possibly because the highest risk patients are undergoing TAVR. 

Source: Annals of Thoracic Surgery
Author(s): Christian McNeely, Alan Zajarias, Randall Robbs, Stephen Markwell, Christina M. Vassileva

Data from the Centers for Medicare and Medicaid Services related to patients aged 65 and older who underwent TAVR during a 2 year period were evaluated, stratified into older (age 90 or greater; 19.3%) and younger cohorts.  Nonagenarians had fewer comorbidities.  Mortality was higher in nonagenarians (8.4% vs 5.9%) as was morbidity (25.4% vs 21.5%).   Among nonagenarians, the transfemoral approach was associated with lower mortality, higher rates of discharge to home, and lower readmission rates. 

Source: Annals of Thoracic Surgery
Author(s): Mustapha A. El Lakis, Stephen J. Kaplan, Michal Hubka, Kamran Mohiuddin, Donald E. Low

In this single site retrospective review, outcomes of repair of giant paraesophageal hiatal hernia were reviewed with respect to the effects of patient age.  Patients aged 80 or greater had greater comorbidity at the time of surgery, more often had Type IV hernias, and underwent emergency intervention more often.  The incidence of postoperative complications was higher in this group.  Recurrence rates were similar between the older and younger groups. 

Source: Annals of Cardiac Anesthesia
Author(s): Michael Mazzeffi1, Benjamin Hammer2, Edward Chen3, Mark Caridi-Scheible4, James Ramsay5, Christopher Paciullo6

The authors conducted a retrospective cohort study of 88 patients that received methylene blue (MB) for refractory vasoplegia following cardiopulmonary bypass.  Administration of MB was associated with an 8 mmHg increase in mean arterial pressure, with the peak response occurring at 2 hours after completion of dose.  

Source: World Journal for Pediatric and Congenital Heart Surgery
Author(s): Tarek Alsaied, MD, Muhammad S. Khan, MD, Raheel Rizwan, MD, Farhan Zafar, MD, Chesney D. Castleberry, MD, Roosevelt Bryant III, MD, Ivan Wilmot, MD, Clifford Chin, MD, John L. Jefferies, MD, David L. Morales, MD

The purpose of this study was to evaluate differences in long-term survival without the influence of early mortality, and to identify factors associated with one-year conditional ten-year survival after heart transplantation across different age and diagnostic groups using the UNOS database.

Predictors of one-year conditional ten-year survival for infants were: recipient’s Caucasian race (odds ratio [OR]: 1.9, 95% confidence interval [CI]: 1.3-2.7) and donor–recipient weight ratio (OR: 0.8, 95% CI: 0.6-1); for children: Caucasian race (OR: 1.6, 95% CI: 1.2-2.1), retransplantation (OR: 0.4, 95% CI: 0.2-0.6), and transplantation after the year 2000 (OR: 1.5, 95% CI: 1.1-2.1); for adolescents: only Caucasian race (OR: 2.5, 95% CI: 1.9-2.3). In both congenital heart disease (CHD) and cardiomyopathy groups, adolescents had worse survival compared to infants and children. There was an era effect with improved survival after 2000. Male gender was a predictor of survival in cardiomyopathy group.

 

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Md Nazmul Karim, Christopher M. Reid, Lavinia Tran, Andrew Cochrane, Baki Billah

A surprisingly readable Australasian manuscript on risk prediction models for cardiac surgery. Interesting that the class of dyspnoea was not captured in 5.28% of the operated patients.

Source: PR Newswire
Author(s): Amanda C. Fowler

Following a charitable initiative launched in 2014 to impact one million underserved people by 2020, Edwards provides a current update on progress toward that goal.   Dr. David Adams and other specialists comment on the magnitude and importance of the effort, and a request for proposals announces the beginning of the foundation's 2017 grant cycle.

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