Journal and News Scan

A medium-size RCT comparing full sternotomy to limited sternotomy for conventional aortic valve replacement, presented at the SCTS Annual Meeting in Glasgow. The 7-10% one year attrition rate seems quite disappointing, and will most probably be discussed. We will await the full paper to see what was the learning curve for the innovative approach.

Please scroll to page 14 in the link provided to read the presentation summary.

The authors studied 852 adults with bicuspid aortic valves.  The prevelance of three morphotypes was tallied.  Relative fusion rates were: RL 72.9%, RN 24.1% and LN 3%.  Additionally, 18.3% had no raphe.  Aortic regurgitation was unrelated to morphotype.  Aortic stenosis was more common in the RN fusion group and in the presence of a raphe.  Seventy-six percent had ascending aortic dilation unrelated to morphotype but associated with valve dysfunction.  Aortic root dilation was present in 34% and was more commonly associated with male sex and aortic regurgitation.

Patient Care

Some Syrian refugee children have received surgery for congenital heart defects in Jordan, however many refugees in need of complex medical care are unable to receive such care.

A hospital in Philadelphia, Pennsylvania, is working to increase the rate of patient referral for cardiac rehab after surgery.

Several Rwandan heart patients will receive surgical treatment as part of a free surgery camp at King Faisal Hospital in Kigali, Rwanda, an initiative sponsored by the Rwandan Ministry of Health, King Faisal Hospital, and the non-profit organization Team Heart.

Drugs and Devices

The US Food and Drug Administration took the first formal step toward a major policy change that would reduce the amount of nicotine allowed in cigarettes.

The UK Medicines and Healthcare Products Regulatory Agency announced plans to review anticoagulant usage after a study published in the BMJ suggested increased risk for atrial fibrillation patients with chronic kidney disease.

Research, Trials, and Funding

Japanese researchers have received approval from Osaka University to test the ability of iPS cell-derived sheets of cardiac muscle to treat ischemic cardiomyopathy. The team must now gain approval from the Japanese Health, Labor, and Welfare Ministry.

Researchers from the US and Canada find that COPD patients selected for lung transplant have better survival than one would expect based on their BODE score, potentially because the transplant qualification process reduces comorbid conditions that are unrelated to lung function in this group of patients.

Early studies on wearable devices for atrial fibrillation screening were presented at the recent meeting of the American College of Cardiology, but the findings don’t yet address whether the increased screening results in improved patient outcomes.

The EJCTS and ICVTS are publishing a series of Statistical Primers to help clinicians perform and interpret research. Although Kaplan-Meier analyses are standard in the cardiothoracic surgical literature, there are several pitfalls that should be kept in mind. In this primer, Thuijs and coauthors describe the fundamental concepts of analyzing survival data.