Journal and News Scan

Patient Care and General Interest

Surgeons at the Cleveland Clinic Abu Dhabi in the UAE used a metal stent for an emergency repair of a patient’s windpipe, which had been completely severed in a traffic accident.

A report from the UK Lung Cancer Coalition says that geographic variation persists despite improvements in 5-year survival rates for lung cancer in the UK.

Drugs and Devices

Medtronic has received the CE Mark for its Valiant Navion™ thoracic stent graft system, a low-profile thoracic stent for patients with small iliac arteries and other anatomic variations.

Research, Trials, and Funding

Physicians in Ontario, Canada, evaluate in-hospital counseling and surgery for injection drug users with endocarditis, finding that both reduce mortality in these patients.

Researchers at Stanford University in California are matching donor and pediatric recipient heart volumes using CT scans, rather than relying on height and weight to determine if a child could accept a particular donor heart.

At the recent meeting of the American Heart Association, researchers from Germany reported similar rates of major adverse cardiovascular events and major bleeding for patients taking either ticagrelor or aspirin after coronary artery bypass.

Patent descending aortic false lumen in type A dissection is associated with limited long-term outcomes. Inoue and colleagues aimed to evaluate the efficacy of their group’s strategy for these patients. Among 290 patients with type A aortic dissection and patent false lumen at the descending aorta, 124 underwent ascending aortic replacement and 166 additional total aortic arch replacement. Total aortic arch replacement was associated with better freedom from descending aortic aneurysm. There was no difference in in-hospital mortality between the groups.

On November 26, 2018, FDA Commissioner Scott Gottlieb, MD, and Director of the Center for Devices and Radiological Health Jeff Shuren, MD,  announced proposed changes intended to modernize the 510(k) clearance pathway to keep pace with the increasing complexity of rapidly evolving technology. The FDA is planning to rename this new approach the “Safety and Performance Based Pathway” to reflect its focus on advancing improved safety and performance of new low-risk to moderate-risk products. It is an alternative pathway to substantial equivalence that will provide more direct evidence of the safety and performance of a device and better information for patients and providers to make well-informed health care decisions. This new approach may also drive greater market competition to develop safer devices. 

Saito and colleagues evaluated the idea that anastomosis assist devices reduced complications for patients undergoing off-pump coronary artery bypass grafting. Their study is a one-to-one propensity scores matched analysis including 7,348 pairs of patients comparing the outcomes of anastomosis assist devices with a side-biting clamp. The authors found no difference in 30-day mortality or stroke. However, transient ischemic attack occurred more frequently in the side-clamp group.