Journal and News Scan

The authors aimed to analyze the impact of preoperative septic cerebral embolism on early and late postoperative outcomes in patients with infective endocarditis (IE) undergoing valve surgery. This study utilized data from the Clinical Multicentric Project for Analysis of Infective Endocarditis in Germany (CAMPAIGN) registry, which includes patients with IE who underwent valve surgery between 1994 and 2018 at six German centers. Patients were categorized based on the presence or absence of preoperative septic cerebral embolism. A total of 4,917 patients were included in the analysis, with 3,909 (79.5 percent) without preoperative septic cerebral embolism and 1,008 (20.5 percent) patients with preoperative septic cerebral embolism. Among patients with preoperative cerebral embolism, 286 (28.4 percent) patients had no stroke signs (silent stroke). There were no statistically significant differences in 30-day mortality (20.1 percent vs. 22.8 percent; p = 0.14) or 5-year survival (47.8 percent vs. 49.1 percent; stratified log-rank p = 0.77) between patients with and without preoperative cerebral embolism. Therefore, the authors conclude that preoperative septic cerebral embolism should not be a major factor in deciding whether to perform surgery in patients with IE requiring heart valve surgery. 

This article provides a comprehensive guide for students aiming to enter the field of cardiothoracic surgery, by addressing challenges from premedical stages to residency. This article helps students make informed decisions by detailing various training pathways, including the traditional path, the integrated six-year program, and the fast-track 4+3 pathway. Emphasizing the importance of mentorship, networking, and extracurricular activities such as research and volunteering, the article offers practical advice to build a competitive application. It also discusses future opportunities within the specialty, such as super-fellowships and diverse career paths. This guide is crucial for aspiring cardiothoracic surgeons, demystifying the path to a demanding field and addressing workforce shortages. It is particularly relevant to CTSNet’s global audience, highlighting strategies for success in a competitive and evolving specialty. 

The optimal revascularization strategy after extracorporeal cardiopulmonary resuscitation (ECPR) remains unclear, with limited existing data. This study compared outcomes for patients who underwent coronary artery bypass grafting (CABG) and those who received percutaneous coronary intervention (PCI) after ECPR using databases from two referral centers. Forty patients in each category were compared. Researchers found that the CABG group had better early outcomes (hospital survival- 56.4 percent vs 32.4 percent, p = 0.04 and success of ECPR weaning: 71.1 percent vs 48.7 percent, p = 0.05) compared to the PCI group. Late outcomes were similar among groups, although the PCI group appeared to have more endovascular interventions.

Minimally-invasive pulmonary segmentectomy is an effective method for treating selective cases while preserving lung parenchyma and minimizing perioperative morbidity and length of hospital stay. A fully thoracoscopic multiport approach is often preferred due to its straightforwardness and flexibility, allowing adaptation to unexpected intraoperative findings.  

The S1 (apical) segment of the right upper lobe poses challenges for a conventional anterior approach due to its complex vascular anatomy. A posterior approach may address these challenges by providing direct access to the segmental bronchus and better alignment for dissection for the apical artery, however, success depends on individual anatomy.