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Journal and News Scan
September 5, 2018
Submitted by: Emily Robinson
This STS Database review included 255 neonates and 239 infants with Ebstein anomaly (EA). For neonates, repair was performed in 40%, shunt in 20%, and tricuspid valve closure in 9%; operative mortality was 27%. For infants, superior cavopulmonary anastomosis was performed in 38% and repair in 16%. Operative mortality was 9%. Optimal approach and timing for repair remain elusive.
August 31, 2018
Submitted by: Emily Robinson
Patient Care and General Interest
Late-breaking results from the VISION study just presented at the European Society of Cardiology’s 2018 annual Congress suggest that 75% of patient deaths after noncardiac surgery can be attributed to cardiovascular causes.
Access to the Affordable Care Act in the United States has seemingly made middle-aged stroke survivors less likely to skip prescribed medications due to cost.
A new study suggests that chemotherapy may lead to early menopause in young women with lung cancer.
Drugs and Devices
A new Astrazeneca drug called Tagrisso has been approved in Japan for patients with inoperable or recurrent epidermal growth factor receptor mutation-positive non-small-cell lung cancer.
The Duke Clinical Research Institute and Cerner have jointly developed an app that estimates patients’ cardiovascular disease risk.
Research, Trials, and Funding
A new study published in the Journal of the American Heart Association finds that a simplified cardiac magnetic resonance protocol can help developing nations diagnose heart ailments more quickly and cheaply.
A meta-analysis published in JAMA Cardiology finds that young and middle-aged adults with aortic valve disease have a higher survival rate when treated via the Ross procedure as opposed to mechanical aortic valve replacement.
New guidelines on clinical care for patients undergoing myocardial revascularization have been released by the European Society of Cardiology and European Association for Cardio-Thoracic Surgery.
August 31, 2018
Submitted by: Emily Robinson
Grimminger and colleagues present their technique for a four-armed robotic approach to esophageal cancer surgery. The authors note the improved control and dexterity offered by the addition of the fourth arm, leading to greater surgeon independence in this complex procedure.
August 31, 2018
Submitted by: Aristotle Protopapas
A balanced editorial discussing the relevant RCT from Britain. The esteemed authors are correct to highlight the overall discouraging survival from out-of-hospital cardiac arrest WITHOUT NEUROLOGICAL DEFICIT. What does need to be done to improve a 3% acceptable outcome? The 'non-superiority' of adrenaline (epinephrine) is, under the devastating primary outcome, a finding of secondary importance for the general public.
August 31, 2018
Submitted by: Aristotle Protopapas
Quite useful case-illustrated debate on a VERY hot topic!
August 30, 2018
Submitted by: Emily Robinson
Kiefer and colleagues report the outcomes of six patients who underwent transapical mitral valve repair for severe mitral regurgitation. Treatment was offered as part of the safety and feasibility trial for the NeoChord DS1000 system at the authors’ institution. One patient underwent intraoperative conversion to an open repair, two patients underwent reoperation for recurrent mitral regurgitation, and the remaining three patients had no cardiac symptoms throughout the five-year follow-up period.
August 29, 2018
Submitted by: Emily Robinson
Hickey and colleagues discuss the assumptions that underlie regression models, and they detail approaches to identifying deviations from these assumptions. They illustrate several points using linear regression as the basis but also discuss logistic regression and Cox regression models. The authors present both formal statistical tests and graphical diagnostics that should be used for assessing model assumptions.
August 27, 2018
Submitted by: Tom C. Nguyen
Patients with severe secondary mitral regurgitation with depressed ejection fraction were randomized to either MitraClip and medical therapy vs. medical therapy alone. There was no difference in primary outcomes (i.e. death and unplanned hospitalization) at one year.
August 24, 2018
Submitted by: Emily Robinson
Patient Care and General Interest
A new study finds that elderly heart surgery patients who exhibit postoperative delirium are sometimes given antipsychotic medications, which are ineffective and may even be dangerous.
A 5-month-old child in St. Louis, Missouri, becomes the youngest documented heart-lung transplant patient in more than a decade.
A 3-year-old boy from Germany with a rare congenital heart disease travelled all the way to Milwaukee, Wisconsin, to undergo a complex procedure.
Drugs and Devices
The first clinical use of FRAME external support technology for aneurysm repair in high flow arteriovenous (AV) fistulas took place in Germany.
Research, Trials, and Funding
A Harvard study regarding cardiothoracic surgery operating teams suggests that variations in interpersonal and leadership communication patterns may have a strong effect on teamwork.
A novel technique tested at Ohio State University’s Wexner Medical Center allows damaged lungs to be placed on a machine that keeps them alive at normal body temperature, allowing doctors to better assess whether they are viable.
August 24, 2018
Submitted by: Emily Robinson
Nguyen and colleagues evaluated whether left atrium (LA) enlargement in hypertrophic cardiomyopathy was reversed after septal myectomy. The authors retrospectively reviewed transthoracic echocardiographic measurements of LA volume index from 656 patients who underwent myectomy over eight years at their center. Only patients with both preoperative and postoperative measurements were included. The authors noted both early reduction in LA volume index prior to hospital discharge, and late reduction at two-year follow-up, which they suggest is indicative of continued reverse remodeling. The severity of preoperative mitral regurgitation and the risk of postoperative atrial fibrillation were associated with preoperative LA volume index, but the risks of postoperative stroke and survival were not.