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Journal and News Scan
February 15, 2014
Submitted by: Mark Ferguson
Pts undergoing aortic root replacement who moderate MR preoperatively were evaluated for outcomes after mitral repair vs no repair. Mitral repair was associated with longer crossclamp times, and postoperative renal failure. Root replacement improved MR without mitral repair, but mitral repair further improved the degree of regurgitation. There was no difference in long-term survival.
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.
February 15, 2014
Submitted by: Mark Ferguson
The authors performed VSD closure in children using a 3-port technique and compared the outcomes to patients undergoing open repair. The MIS approach was associated with shorter ICU stay, shorter hospital stay, fewer blood transfusions, and less opioid use.
February 15, 2014
Submitted by: Mark Ferguson
Over 700 lung cancer patients were surveyed at diagnosis and a mean of 54 months later regarding smoking status. 56% of those smoking at the time of diagnosis and stopped smoking 1 year later. Smoking cessation was adversely affected by second hand smoke exposure from housemates, spouses, and peers; these effects were cumulative.
February 10, 2014
Submitted by: Mark Ferguson
The CROSS trials randomized pts with esophageal cancer or GEJ cancer to surgery vs induction chemoradiotherapy (CRT) followed by surgery. Prior studies reported a significant improvement in survival and freedom from recurrence associated with induction therapy. In this report, CRT reduced locoregional recurrence from 34% to 14% and reduced peritoneal carcinomatosis from 14% to 4%. Local recurrence within the RT field occurred in only 5% of patients.
February 8, 2014
Submitted by: Stuart Head
Di Giammarco and colleagues reported that intraoperative graft verification was significantly improved if a combination of transit-time flow measurement and epicardial echocardiography was used in comparison with transit-time flow measurement alone. The positive predictive value increased from 10% to almost 100% in an analysis of 678 grafts in 333 patients undergoing isolated CABG, reducing the rate of unnecessary graft revisions.
February 8, 2014
Submitted by: Mark Ferguson
The authors performed a population-based study to determine the extent to which mesothelioma occurs absent occupational asbestos exposure. A clear dose-response relationship between degree of exposure and risk of mesothelioma was identified. Occupational exposure to asbestos carried a much higher risk of mesothelioma than did non-occupational exposure, and non-occupational exposure carried a higher risk than did no exposure. Non-occupational exposure to asbestos carried a substantially higher mesothelioma risk in women than it did in men.
February 7, 2014
Submitted by: Joel Dunning
Redmond Burke MD, Chief of Pediatric Cardiovascular Surgery at Miami Children's Hospital demonstrates the operative repair and postoperative recovery for a child with VSD.
February 7, 2014
Submitted by: Joel Dunning
Transcatheter aortic valve replacement (TAVR) has, without a doubt, brought an unprecedented excitement to the field of interventional cardiology. The avoidance of a sternotomy by transfemoral or transapical aortic-valve implantation appears to come at the price of some serious complications, including an increased risk of embolic stroke and paravalvular leakage. The technical challenges of the procedure and the complex nature of the high-risk patient cohort make the learning curve for this procedure a steep one, with the potential for unexpected complications always looming.
February 7, 2014
Submitted by: Joel Dunning
Chest drainage following cardiac surgery is used to avoid complications related to the accumulation of blood and serous fluid in the chest. We aimed to determine the incidence of chest tube clogging and the role of bedside assessment in identifying the potential for failure to drain.
CONCLUSIONS:
The chest tubes can become clogged at any time after their placement. The status of urgency, reoperations and use of blood products can be contributing factors increasing the incidence of chest tube clogging. Clinicians likely underestimate the prevalence of this failure to drain, as most clogging occurs in the internal portion of the tube.