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Journal and News Scan
March 13, 2016
Submitted by: Arie Blitz
This Belgian study prospectively analyzed the predictors of long-term mortality in a group of 107 consecutive CABG patients with an LV EF < 35%. All patients underwent preoperative Cardiac MR to assess both LV and RV EF. Right ventricular systolic dysfunction (RVSD), defined as an RV EF < 35%, was a strong independent predictor of mortality at a median follow-up of 4.7 years. The presence of RVSD more than doubled long-term mortality.
March 13, 2016
Submitted by: Arie Blitz
The authors reviewed the Medicare database to analyze the trends in CABG surgery within this population over a 12-year period. Trends in the Medicare population included the following:
- CABG volume decreased by 46%.
- An increasing percentage of CABGs were with fewer grafts (<2).
- ITA use increased from 76% to 89%.
- Comorbidites increased over time.
- The risk-adjusted mortality decreased by 27%.
March 11, 2016
Submitted by: Arie Blitz
The authors provide an excellent overview of the rationale for screening all patients with a new diagnosis of cardiomyopathy for coronary artery disease. This rationale includes the following:
- Two-thirds of patients with HF and reduced EF have CAD.
- Patients with CAD may deny angina, especially diabetics and females.
- Even without risk factors, more than 10% of HF patients have CAD.
- The important benefit of revascularization and secondary prevention in patients with CAD.
March 7, 2016
Submitted by: Joseph Basha
This is a very interesting and provocative article that discusses Exracorporeal Cardiac Life Support (ECLS) as an adjunct to CPR. ECLS has gained in popularity with new tools and techniques, ECLS guidelines, protocols and better understanding of the importance of early initiation.
March 7, 2016
Submitted by: CTSNet Staff
The authors report on the transplantation of allogeneic bone graft in 10 patients with massive post-sternotomy defects. There were no further complications in 6 patients. In 3 patients additional re-suture of the soft tissue was necessary and one patient died 6 months later. Allogeneic bone graft transplantation seems to be a promising method in patients with serious tissue loss after sternotomy.
March 7, 2016
Submitted by: CTSNet Staff
607 consecutive patients with non-small-cell lung cancer who had undergone pulmonary resection were analyzed according to the distance from their home to the hospital: 0 < 10, 10–30 and >30 km. The mean postoperative hospital stay differed between the groups, but there were no significant differences in the median length of follow-up, disease-free survival.
March 7, 2016
Submitted by: CTSNet Staff
The analysis compares 1478 patients who underwent CABG and received no red blood cell (RBC) transfusion to 1528 CABG patients with 1–2 units of RBCs. The 30-day mortality rate was 0.3% and 0.2%, respectively. The propensity score-adjusted odds ratio (OR) in the RBC+ group was 0.29 [95% confidence interval (CI): 0.06–1.50; P = 0.14]. Major clinical complications did not differ significantly between groups.
March 7, 2016
Submitted by: CTSNet Staff
Approximately 3800 patients who underwent elective cardiac surgery were analyzed for post-surgical acute kidney injury (AKI). AKI occurred in 21% of patients who initiated a statin within 100 days prior to surgery compared with 29% of patients without prior statin use. The adjusted relative risk for the effect of statin initiation on AKI was RR = 0.86 (95% CI: 0.74, 0.98). Thus, presurgical statin initiation is associated with a reduction in AKI risk after cardiac surgery.
March 7, 2016
Submitted by: Mark Ferguson
Using data from the National Cancer Data Base, the surgical and oncologic efficacy of minimally invasive (VATS, robotic) lobectomy were compared to open lobectomy. Groups were created for comparison using propensity score matching techniques. VATS compared to open was associated with shorter LOS, higher readmission rates, and slightly better 2-year survival. Nodal upstaging and 30-day mortality were similar. No differences were identified comparing VATS to robotic resections for nodal upstaging, 30-day mortality, or 2-year survival.
March 7, 2016
Submitted by: Mark Ferguson
This retrospective study of 434 infants and children undergoing TOF repair focused on how methods of handling hypoplastic pulmonary arteries affects long-term outcomes. The most agressive patching technique resulted in the highest incidence of reintervention, whereas patients who had no intervention for hypoplastic pulmonary arterties had the lowest incidence of reintervention. This suggests that patching restricts the growth potential of the native vessels, and indicates that patients generally do better without intervention.