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Journal and News Scan
July 14, 2016
Submitted by: Tom C. Nguyen
This article explores the controversial topic of TAVR versus surgical AVR in low-risk patients. The primary outcome was 3-year survival. The authors report 3-year survival for TAVR and surgical AVR as 72% and 83.4%, respective (p=0.0015). Although TAVR is an exciting technology, there should be caution in adopting it in lower risk patients.
July 13, 2016
Submitted by: Joseph Basha
This retrospective study evaluated the effects of high-dose nitroglycerine (NTG) on glucose metabolism, tissue oxygenation and postoperative recovery in cardiac surgical patients. Two groups were classified: NTG group (iv loading of NTG starting at rewarming of cardiopulmonary bypass; n=101), NON-NTG group (n=151). Authors found that the the plasma glucose was significantly lower in the NTG group during and after CPB, the total consumption of regular insulin was significantly lower in the NTG group, there was a significantly lower incidence of hyperlactatemia in the NTG group during CPB, and the mixed venous oxygen saturation in the intensive care unit was higher in the NTG group.
July 13, 2016
Submitted by: Arie Blitz
The authors enrolled 149 patients on DAPT undergoing urgent cardiac surgery in a prospective study analyzing the association between platelet reactivity and postoperative bleeding. They found that decreasing platelet reactivity correlated with an increase in calculated red blood cell loss after surgery. Their findings support the use of objective measures of platelet function prior to proceeding with cardiac surgery.
July 5, 2016
Submitted by: Rakesh Arora
With the rapid expansion of mechanical circulatory support (MCS) in various contexts (CVICU, in-hospital cardiac arrest (E-CPR) and the ED), the authors have provided a very nice overview of the general principles of MCS options and management to assist the broader healthcare team involved with these complex patients.
July 5, 2016
Submitted by: Rakesh Arora
Acute kidney injury (AKI) complicates recovery from cardiac surgery in up to 30% of patients, injures and impairs the function of the brain, lungs, and gut, and places patients at a 5-fold increased risk of death during hospitalization. The authors have provided a nice general overview of the key determinants, outcomes and treatments for AKI in the cardiac surgery patient.
June 30, 2016
Submitted by: Mark Ferguson
The multi-institutional prospective study evaluated the behavior of pure GGOs (85%), heterogeneous GGOs (part solid only on CT lung windows; 7%), and part-solid GGOs on soft-tissue windows. Among pure GGOs, 6.6% advanced to one of the other categories during a mean follow-up period of 4.3 years. Of the 35 pure GGOs that were resected, none was an invasive cancer. Invasive adenocarcinoma was identified in only 1% of all nodules, and only among the part solid nodules.
June 28, 2016
Submitted by: Aamir Shah
This article investigates the effects of varying degrees of aortic regurgitation (AR) on survival after transcatheter aortic valve replacement (TAVR). They retrospectively evaluated a cohort of 237 patients undergoing TAVR from 2006 to 2012 with echocardiogram performed within 30 days of the procedure. Using a Cox proportional multivariable regression model, they found each 1+ increase in AR (on a scale of none to 4+) was associated with a unit hazard ratio of 2.26. After TAVR, patients with no paravalvular aortic regurgitation (15% of patients) had 0% mortality at 1 year, trivial to 1+ AR (29.5% of patiens) had 7.1% mortality at 1 year, and 1+ AR (32.5% of patients) had 16.9% mortality at 1 year. The authors conclude that even a mild degree of AR is associated with significant prognostic value after TAVR and that more discriminating grading scales of AR will be important in evaluating TAVR as it is applied to intermediate and low risk patient populations.
June 27, 2016
Submitted by: CTSNet Staff
The paper provides a comprehensive overview of current and developing applications of nanotechnologies for diagnostics, surveillance and therapy of thoracic cancer.
June 27, 2016
Submitted by: CTSNet Staff
The paper reports on the first experience in 14 consecutive patients who underwent elective one-stage frozen elephant trunk procedures via minimally invasive approach. There was no 30-day mortality and no permanent neurologic complication.
June 25, 2016
Submitted by: Aristotle Protopapas
A large retrospective study of the UNOS database advances that elevated troponin I in selected cardiac donors is NOT associated with various adverse events. The conclusion is likely to stimulate heated discussions. A number of limitations of the study are discussed, and the POST-OPERATIVE values of this important biomarker are not included in the study.