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Journal and News Scan
February 24, 2014
Submitted by: Mark Ferguson
A group of 1365 pts from 6 institutions was retrospectively reviewed for outcomes after palliative treatment, chemotherapy alone, pleurectomy/decortication (P/D), or extrapleural pneumonectomy (EPP). Multivariable analysis identified age <70, epithelial histology, and chemotherapy as independent predictors of improved survival. In patients with all 3 favorable characteristics, median survival with or without P/D or EPP was similar.
February 24, 2014
Submitted by: Mark Ferguson
Using SEER data the authors compared open to VATS segmental resection in a population of pts >65 years old. Propensity score matching was used to adjust for baseline differences between the groups. VATS pts had lower complication rates, fewer ICU admissions, and shorter length of hospital stay. Outcomes did not appear to be surgeon-specific. Survival was similar between the groups.
February 24, 2014
Submitted by: Mark Ferguson
This study evaluated safety and efficacy of EBUS-TBNA in a population of pts 70 or older and compared their results to those of younger patients. Tolerance was better in the older group, and complication rates were similar. Overall accuracy was higher in the older group, possibly related to differences in the underlying diagnoses.
February 19, 2014
Submitted by: Joel Dunning
Systolic and diastolic myocardial motion was determined using magnetic resonance tissue phase mapping (n=27). Cold ischemic time of the transplanted heart >155 min is associated with decreased myocardial velocities whereas longer postoperative time has a positive influence. The future aim is to develop a non-invasive method to diagnose transplant rejection.
February 19, 2014
Submitted by: Joel Dunning
Computational models based on data from computed tomography show that maximal wall shear stress is associated with the maximal diameter in large aortic aneurysms whereas eccentricity of the bulge is more important in small aneurysms.
February 19, 2014
Submitted by: Joel Dunning
Aorto-oesophageal fistulation following thoracic endovascular aortic repair occurred in 36 of 2387 patients with a mean interval of 90 days according to the European Registry of Endovascular Aortic Repair Complications. Key symptoms included fever, haematemesis and shock. Aggressive therapy with radical oesophagectomy and aortic replacement achieved the best 1-year survival.
February 19, 2014
Submitted by: Joel Dunning
There is growing interest in reparative techniques that durably improve the mitral orifice while preserving the subvalvular apparatus. Many of these techniques are technically challenging and require complex resections with intricate chordal adjustments, which may have limited their global acceptance. In this report, a three-step technique is outlined that does not require significant resection or involve the use of neochords. This offers a potentially simplified approach to the repair of rheumatic mitral stenosis.
Two cases of acute bioprosthetic mitral valve thrombosis immediately after mitral valve replacement.
February 16, 2014
Submitted by: J. Rafael Sadaba
In this manuscript the authors present two cases of early thrombosis of biological prosthesis following mitral valve replacement. Both patients were on venous arterial extracorporeal membrane oxygenation (ECMO), which could be the factor responsible for this unusual event. The authors advocate the use of more aggressive anticoagulation on patients on ECMO and prosthetic cardiac valves.
February 16, 2014
Submitted by: J. Rafael Sadaba
This interesting study evaluates the hemodynamic effect of the residual ASD produced by the transeptal approach for MitraClip implantation. The new left to right shunt could contribute to the reduction in mitral regurgitation following MitraClip implantation
February 15, 2014
Submitted by: Mark Ferguson
Pts surviving esophagectomy longer than 10 years were queried as to QOL. Alimentary comfort rating was 9 out of 10. 33% experienced diarrhea, dumping, or regurgitation. 15% had aspiration requiring hospital care. Mean weight loss was 26 lbs. Median GI QOL score was 2.9 out of 4.