Journal and News Scan

This study assessed nonfatal outcomes comparing CABG to PCI for pts with multivessel CAD identified in national registries.  The outcome was the composite of death, MI, or stroke.  Registry data were linked to Medicare data to obtain outcomes and pts were propensity score matched.  The authors identified a total of 86,244 CABG and 103,549 PCI pts.  At 4 yrs in matched cohorts, MI incidence was 3.2% after CABG and 6.6% after PCI.  Stroke incidence was 4.5% in CABG and 3.1% in PCI pts; the difference was primarily due to the 30-day stroke rate after CABG.  The composite index incidence was 21.6% for CABG and 26.7 % for PCI.

This multicenter retrospective review included 518 pts from 9 centers who underwent EPP from 2000 to 2010.  Half the pts received induction chemotherapy, and nearly three-quarters of the patients received postoperative adjuvant therapy, primarily chemotherapy.  The major surgical complication rate was 26% and 90 day mortality was 6.9%.  3-year survival was 27%.  Factors negatively influencing survival were male sex and non-epithelial histology.  Trimodality treatment with induction therapy was favorably associated with survival. 

Extracapsular spread of cancer cells is associated with poorer outcome compared to intracapsular limitation in positive lymphnodes in patients with adenocarcinoma of the oesophagus and gastro-oesophageal junction. This finding is not reflected by the current tumour staging system.  

The aims of this study were, in patients with MVP undergoing MV repair, to describe the prevalence and characteristics of MAC, to correlate MAC with clinical risk factors, coronary involvement, and aortic valve disease, and to describe prevalence, site, and extension of MAC in fibroelastic deficiency (FED) versus Barlow's disease (BD) and correlate MAC to surgical outcomes. Despite very high percentage of repairability, MAC influences surgical outcomes and very detailed echo evaluation is advocated.