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Journal and News Scan
August 27, 2022
Submitted by: Emily Farkas
Most surgeons practice in high income countries, even though the majority of the world’s population lives in low- or middle-income countries. There is a significant disparity between high-income and low-income countries in the number of both cardiac and pediatric cardiac surgeons. The number of nonsurgical cardiovascular surgeons—including interventional cardiologists, cardiac anesthesiologists, perfusionists, technicians, and other health workers—in low-income countries remains unclear, along with where they are distributed. A clear path exists to foster and uphold heart teams with a high socioeconomic return on investment across countries, but failing to take action means that millions of people will continue to suffer from preventable and treatable cardiac conditions each year.
August 26, 2022
Submitted by: Cameron Lind
In a recent study comparing modes of cardiac rehabilitation, the authors found that home-based cardiac rehabilitation results in fewer hospitalizations among patients. Because of accessibility issues, many patients who could benefit from cardiac rehabilitation to improve health after cardiac issues do not take advantage of these resources. To remedy this problem, home-based rehabilitation was developed in facilities such as Kaiser Permanente Southern California (KPSC), where this study was conducted. Although previous studies have concluded that home-based and center-based rehabilitation result in similar outcomes, this study encompasses previously unstudied diverse and medically complex populations, allowing for a more inclusive result.
August 26, 2022
Submitted by: Cameron Lind
Historically, investment in surgical care has been limited in low-income countries, where children are fourteen times more likely to die before age five than in high-income countries. The authors argue that with simple and affordable surgical care, children with treatable illnesses such as congenital anomalies, injuries, and infections could be saved. Networks of physicians funded by charitable donation and driven by commitments from the United Nations are integral to providing necessary surgical care, and the authors emphasize that the global health philanthropy community needs to pivot a larger portion of its focus to surgical programs in underserved countries.
August 26, 2022
Submitted by: Cameron Lind
As one of the most challenging medical emergencies, acute Type A aortic dissection (ATAAD) is associated with increased mortality even when recognized and treated early. This article from Zara Khachatryan, et. al—recently opened to nonsubscribers—describes the benefits of using valve-sparing aortic root replacement, or the David procedure, in patients with ATAAD. The authors found that, especially in younger patients and those with connective tissue disorders, the David procedure is associated with good preoperative safety and long-term efficacy. When performed effectively by experienced surgeons, valve-sparing aortic root replacement has become a desirable option in treating ATAAD in properly selected patients.
August 19, 2022
Submitted by: Mary Hammon
A new analysis by a team led by Dr. Mario Gaudino of Weill Cornell Medicine and NewYork-Presbyterian shows that a combination of two antiplatelets drugs can benefit patients after coronary artery bypass graft surgery but also increases the risk of potentially dangerous bleeding. Reported on August 9 in JAMA, the finding suggests physicians should carefully weigh the use of these medications after this procedure.
August 19, 2022
Submitted by: Mary Hammon
Surgical management for potentially resectable stage IIIA-N2 non-small cell lung cancer (NSCLC) is controversial. In this study, researchers examined outcomes of a well-selected surgical cohort of postinduction IIIA-N2 NSCLC patients with persistent N2 disease and found that overall survival for patients with non-R(un) or persistent N2 (true R0) was similar to those with mediastinal downstaging.
Authors say this study underscores the importance of classifying the extent of mediastinal involvement for persistent N2 patients, supporting the proposed International Association for the Study of Lung Cancer R(un) classification.
August 19, 2022
Submitted by: Mary Hammon
This study compared the development of de novo aortic insufficiency (AI), the a common adverse event after continuous-flow left ventricular assist device (LVAD) placement, between HeartMate 3 (Abbott) and HeartMate II LVAD recipients. Researchers ultimately concluded there is no significant difference in severity of AI between HeartMate II and HeartMate 3 patients.
August 12, 2022
Submitted by: Mary Hammon
Many congenital heart diseases are tied to genetic defects and can lead to heart failure that requires heart transplant. This paper outlines the outcomes of transplants performed in children with such genetic syndromes and disorders and finds that, despite more preoperative comorbidities, midterm outcomes after heart transplant are promising.
August 12, 2022
Submitted by: Mary Hammon
According to the authors of this paper, surgical risk stratified outcomes after contemporary revascularization strategies have not been well described. This study outlines such outcomes after PCI or CABG in patients with multivessel coronary disease, which the authors say can help guide the revascularization strategy choice for individual patients.
August 12, 2022
Submitted by: Mary Hammon
Investigators in the CALGB 140503 recently presented the results of phase 3 of the trial at the IACSLC World Conference on Lung Cancer 2022 in Vienna. The results show that sub-lobar resection is noninferior to lobectomy with respect to disease-free survival and overall survival in patients with clinical stage T1a N0 non-small-cell lung cancer and tumors no larger than 2 cm, among other findings.