Journal and News Scan

Surgical mitral valve repair is the gold standard treatment for mitral regurgitation due to degenerative disease. Repair is performed on the arrested heart, meaning that assessments of success can only be made after removal of cardiopulmonary bypass. The saline test remains an integral part of repair, however, its hemodynamics have not been evaluated. The authors present a simple technique to quantify the saline test. The authors note that the saline test may be less informative in cases where the maximum left ventricle diastolic pressure is low.

In 2018, the United States network for organ sharing modified its heart allocation policy. Against a background of declining heart-lung transplantation, the authors investigated the effect of the new policy on outcomes for combined heart-lung transplant patients. A total of 511 adult patients were included between 2012 and 2021. Procedures at high-volume centers were associated with decreased mortality. The authors concluded that the policy change has improved waitlist outcomes. Despite increases in both ischemic times and ECMO use, early survival post-transplant was unchanged.

A retrospective study found that women continue to have a higher mortality and morbidity rate after CABG compared with men. This has historically been the case, as women are often referred to surgery later than men and have more cardiovascular risk factors. Researchers emphasize that since this trend has not changed, there needs to be greater action to increase the quality of care for women who require CABG surgery. Read the original study, published in JAMA Surgery.

Neointimal hyperplasia may affect systemic-to-pulmonary shunt failure in this group of infants. The histopathology of removed shunts was analyzed. Neointimal hyperplasia and shunt stenosis were correlated and significantly greater in the group with early interventions and shunt revision. Smaller shunt sizes and lower aspirin dosage were associated with increased neointimal proliferation.