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Journal and News Scan
April 21, 2023
Submitted by: Cameron Lind
ROMA-Women is an offshoot of the original ROMA CABG trial designed to address the lack of women in surgical studies, and therefore the lack of guideline-directed surgical care for women patients. Women make up less than one third of participants in cardiac trials, yet they make up roughly half of annual cardiac deaths in the US annually. Researchers aim to alter this trend by creating a connected but separate trial for women to determine whether multiarterial grafts are better than single arterial grafts in CABG.
April 21, 2023
Submitted by: Cameron Lind
Mitral regurgitation (MR) is often seen in patients having a left ventricular assist device (LVAD) implanted. A comparison was done between LVAD patients from the EUROMACS registry with either none-to-mild or moderate-to-severe MR prior to implantation. Moderate-to-severe MR pre-LVAD was associated with better midterm survival and a lower incidence of major adverse events and complications.
April 19, 2023
Submitted by: Mark Ferguson
This study used lung cancer screening trial low dose CT scans to develop a model (Sybil) that predicts the likelihood of development of a lung cancer within the next year. The model was then tested using images from independent data sets totaling more than 27,000 patients. Areas under the receiver-operator curves were in the range of 0.85 to 0.95, indicating very good predictive value. The model may help individualize subsequent screening frequency or the need for diagnostic CT.
April 13, 2023
Submitted by: Cameron Lind
Models created using artificial intelligence can now be used to help identify patients who may need a permanent pacemaker after transcatheter valve surgery. This relatively common complication of TAVR can now be more easily and accurately determined by the AI model, which uses characteristics like age, presence of right bundle branch block, and other factors associated with PPM implantation. Read the original study in the World Journal of Cardiology.
April 13, 2023
Submitted by: Cameron Lind
By analyzing a cohort of patients with aortic aneurysms who were not undergoing surgery, this study aimed to determine the natural course of an aortic aneurysm. The patients’ ascending aortic aneurysms grew very slowly, and growth over 0.2 cm per year was rarely seen. The researchers concluded that aortic growth may not be a proper indicator for intervention, and that the criterial size for intervention should be changed from 5.5 cm to 5 cm.
April 13, 2023
Submitted by: Cameron Lind
This study aimed to measure the quality of life (QOL) as reported by patients after esophagectomy, a procedure which has a high rate of mortality. Researchers found that the one hundred and three patients in the study had declining QOL immediately following the procedure, which slowly rose back to baseline QOL in a one hundred day period, affirming important information for future esophagectomy patients.
April 6, 2023
Submitted by: Cameron Lind
This single center, open RCT compared patients’ satisfaction with local (LA) or general anesthesia (GA) for video-assisted thoracoscopy. Fifty patients were allocated to GA and 57 to LA. Patient satisfaction did not differ significantly for anesthesiology care, general perioperative care, or recovery after surgery. Surgeons and anesthesiologists were both less satisfied with feasibility in the LA group. LA patients had significantly shorter hospital stays, averaging 3.9 vs. 6.0 days, with P < 0.01. The authors conclude that patients should be offered LA as an alternative to GA whenever medically appropriate and feasible.
April 6, 2023
Submitted by: Cameron Lind
Although there are proportionate numbers of women and men in Canadian medical schools, women still only make up 33 percent of the surgeon population. The top paid specialties, cardiac and thoracic surgery, are only 9.4 and 10.9 percent women, respectively. This is despite the fact that surveys confirm more women are aspiring to become surgeons. The article details the microaggressions, pay differences, and other factors that may have led to this outcome, and ways that change can be made.
April 6, 2023
Submitted by: Cameron Lind
A strike by trainees in the UK is scheduled for April 11 through April 15 because of a pay dispute with the government and NHS. This ongoing conflict, which took junior doctors out of care settings in March as well, has caused a backup in appointments for patients. There has been no move by the government to settle pay disputes and a way forward remains up for discussion.
April 6, 2023
Submitted by: Cameron Lind
In the first analysis to validate observed clinical outcomes, two trials compared transcatheter aortic valve replacement (TAVR) to surgical aortic valve replacement (AVR). Valve dysfunction was found to be less common after five years in TAVR. Long-term performance is a critical consideration in patients who undergo TAVR, especially when they are younger and lower risk. These promising results were driven by lower rates of valve deterioration and prothesis-patient mismatch.