Journal and News Scan

A large RCT concluding that 'surgical occlusion of the left atrial appendage provides additional protection against stroke when added to anticoagulation.' A number of limitations are briefly discussed. Findings are interesting in that absolute absence of surgical complications has been declared.

The updated version of an expert viewpoint on resources for management of acute aortic syndrome in the United States is presented. The esteemed authors advance the position of positive volume–outcome relationship for surgery for acute De Bakey I and II (ATAAD). They provide a historical perspective in favor of specialization and they comment on data on transferring the victims of ATAAD to aortic centers. The primary outcome measure is that of operative mortality rather than stroke. The case made is also relevant to European and global trends, although the geography, telecommunication, transport and health systems vary considerably from country to country.

The AATS expert consensus document was recently released and focused on surgical treatment of acute type A aortic dissection. The documents provides evidence-based recommendations, including initial medical therapy, interhospital transfer, surgical triage, cannulation and perfusion strategy, aortic root management, ascending aorta and distal anastomosis, aortic arch management, malperfusion management, and postoperative considerations.