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Journal and News Scan
A surgical team at Northwestern Medicine has successfully performed two double lung transplants in patients with stage 4 lung cancer. Their method evolved from treatment of COVID-19 patients who needed double lung transplants. This technique allows both lungs to be replaced at once to avoid the spread of cancer from the diseased lung to the donor lung.
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.
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.
This study aimed to determine risk factors that lead to hospital readmission after lobectomy. Researchers found that patients experiencing postoperative complications are at increased risk for readmission, while a shorter time between discharge and follow-up is associated with a decreased risk of readmission.
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.
Outcomes of Treatment for Infective Endocarditis Following Transcatheter Pulmonary Valve Replacement
Transcatheter pulmonary valve replacement (TPVR) carries an increased risk of infective endocarditis. This study used data from the Pediatric Health Information System for the period 2010–2020. Ninety-eight hospital admissions for infective endocarditis were identified for sixty-eight patients. For index admissions, 78 percent were treated medically and 22 percent surgically. The need for surgical intervention increased with increasing need for readmission. Mortality was 4.3 percent overall. Concern was expressed that reliance on medical therapy may delay surgery, which in this cohort was more successful overall.
A new study found that patients who undergo TAVR with concomitant chronic total occlusion lesions are more likely to experience complications from the procedure, but they do not have a higher risk of mortality. The results suggest that if a patient is otherwise a candidate for TAVR, their CTO status should not exclude them from the surgery.