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Journal and News Scan
July 13, 2018
Submitted by: Claire Vernon
Buratto and colleagues retrospectively analyzed the outcomes of 68 patients with atrioventricular septal defects (AVSD) who underwent pulmonary artery banding between 1983 and 2016. Of these, 40 patients had balanced AVSD and 28 patients had unbalanced AVSD. Pulmonary arterial banding was not associated with a short-term increase in atrioventricular valve regurgitation for either group. Patients with unbalanced AVSD did not have a higher rate of atrioventricular valve reoperation than in previous series of patients without pulmonary artery banding. Patients with balanced AVSD did have a higher rate of valve reoperation than reported in previous series, though the authors speculate that the higher rate of reoperation might have been due to an increased severity of disease. The authors conclude that pulmonary artery banding can be used in patients with AVSD without affecting early survival or compromising atrioventricular valve function.
July 13, 2018
Submitted by: Claire Vernon
Patient Care and General Interest
A 7-year-old girl who received a heart transplant as an infant is now competing in the Canadian Transplant Games, which are underway at the University of British Columbia in Vancouver, Canada.
The Lung Cancer Alliance held its National Advocacy Summit in the US capitol, working to increase awareness of the disease and support for research. Thoracic surgeons in the US also join the call for increased funding for lung cancer research.
A surgical team from Dubai, UAE, performs free heart surgery for children in Mumbai, India, as part of the Nabadat initiative of the Mohamed bin Rashid Charity and Humanitarian Establishment.
England’s National Health Service has approved routine funding for percutaneous left atrial appendage occlusion for patients with atrial fibrillation who cannot take blood thinning medication.
Drugs and Devices
The US Food and Drug Administration has approved the next-generation MitraClip® from Abbott. The device received the CE Mark earlier this year.
Research, Trials, and Funding
Working in pigs, researchers have demonstrated the feasibility of a micropacemaker, a leadless pacemaker that is percutaneously inserted into the pericardial space.
July 11, 2018
Submitted by: Claire Vernon
Papageorgiou and colleagues discuss dealing with missing data, a common challenge in clinical research. Although the best approach is to minimize the amount of missing data through good study design and data collection protocols, missing data cannot always be avoided and they must be treated appropriately to maintain the validity of the statistical inferences from a study. The authors outline the different reasons that data may be missing and they discuss the methods for handling these types of missing data, including limitations of such methods. Finally, they provide an example using the scenario of a study of congenital heart disease patients receiving an aortic allograft.
July 9, 2018
Submitted by: Claire Vernon
In this illustrated article, Esposito and colleagues outline the Lupiae technique for hybrid three-stage repair of mega aorta. The technique includes initial surgical replacement of the ascending aorta and proximal rerouting of the aortic arch vessels, followed by delayed surgical replacement of the infrarenal aorta with distal rerouting of the visceral and renal vessels, which then facilitates an endovascular approach for subsequent complete exclusion of the residual diseased aorta between the surgically shaped proximal and distal Dacron landing zone. The authors describe the outcomes for 27 patients treated with this approach, and they discuss tips for a safe and effective procedure.
July 7, 2018
Submitted by: Mark Ferguson
In an announcement entitled "Retraction—Tracheobronchial transplantation with a stem-cell-seeded bioartificial nanocomposite: a proof-of-concept study," the results of an investigation by the Karolinska Institute were shared with The Lancet, resulting in retraction of what had appeared to be an exciting new development in transplantation and airway reconstruction. Hopefully this puts to rest this long and disturbing saga of scientific and ethical misconduct.
July 6, 2018
Submitted by: Claire Vernon
Patient Care and General Interest
The Israeli nonprofit organization Save a Child’s Heart received the United Nations’ Population Award, in recognition of its work providing congenital cardiac surgery to children in developing countries.
Several hospitals in the UAE have added pulse CO-oximeters with technology that integrates with a patient’s electronic health record to improve screening for critical congenital heart defects.
Drugs and Devices
The US Food and Drug Administration has approved the Zephyr Endobronchial Valve from Pulmonx Corp to treat severe emphysema.
Research, Trials, and Funding
Researchers in Boston, USA, and Xi’an, China, find that nitric oxide administration during and after cardiopulmonary bypass might reduce postoperative kidney injury.
A team of medical anthropologists evaluated cooperation and conflict in the operating rooms of different surgical specialties, and they report their observations in the journal PNAS.
JenaValve Technology has launched a study of its JenaValve transcatheter aortic valve for the treatment of severe aortic regurgitation, which the company hopes will inform its anticipated application for CE mark approval in 2019.
Facilities voluntarily participating in the US Medicare’s Bundled Payments for Care Improvement programs for cardiac care are more likely to be large, high-resource centers, which may limit the generalizability of these models.
July 6, 2018
Submitted by: Mark Ferguson
This retrospective study of 328 patients undergoing resection for non-small cell lung cancer demonstrated that sarcopenia determined by psoas muscle mass on computed tomography was associated with increased postoperative complications and was an independent predictor of survival.
July 6, 2018
Submitted by: Aristotle Protopapas
A detailed and somewhat disheartening analysis of stem cell therapy for cardiac failure.
July 3, 2018
Submitted by: Claire Vernon
Joseph Dearani, Chair of the Department of Cardiovascular Surgery at the Mayo Clinic in Rochester, Minnesota, graciously shares a copy of the letter with which he welcomes cardiothoracic surgery residents as they embark on their rotation on his service. Dr Dearani’s letter describes the importance of professionalism, preparedness, responsibility, introspection, and honesty to both self and others. It would be equally appropriate as an essay defining the key elements of a successful and productive relationship between a trainee and mentor in any surgical subspecialty.
The Incidence and Consequence of Prosthesis-Patient Mismatch After Surgical Aortic Valve Replacement
July 3, 2018
Submitted by: Claire Vernon
Fallon and colleagues evaluated patient-prosthesis mismatch (PPM) following isolated aortic valve replacement reported in the STS Adult Cardiac Surgery Database. They found that both moderate and severe PPM were associated with worse outcomes compared to no PPM over the 10-year study period. Readmission for congestive heart failure and aortic valve rereplacement were both more likely in patients with moderate or severe PPM, and overall survival was lower. The incidences of moderate and severe PPM were reduced over the study period, from 60.1% to 46.8% and from 13.8% to 6.2%, respectively. Because of the worse outcomes with even moderate PPM, the authors emphasize that continued efforts to avoid implantation of too small a prosthesis remain necessary.