ALERT!
This site is not optimized for Internet Explorer 8 (or older).
Please upgrade to a newer version of Internet Explorer or use an alternate browser such as Chrome or Firefox.
Journal and News Scan
June 29, 2018
Submitted by: Claire Vernon
Patient Care and General Interest
A guideline for the number of opioid pills that should be prescribed after different surgeries, from cochlear implantation to coronary artery bypass grafting, is self-published by an expert group of health professionals as part of the effort to reduce overprescribing these drugs in the US.
A webcam in the operating room allows cardiothoracic surgeons in Pennsylvania, US, to update a patient’s family on a successful procedure earlier than usual.
After a baby’s heart transplant, her parents—a pediatrician and a school district trustee—are writing a children’s book for the kids and families who face this type of procedure.
The first double-lung transplant in the UAE is performed at the Cleveland Clinic Abu Dhabi using a minimally invasive approach.
Drugs and Devices
The Incraft Stent Graft System for endovascular abdominal aortic aneurysm repair, from Cardinal Health/Cordis, has received a vote of approval from a US Food and Drug Administration advisory panel.
Research, Trials, and Funding
A trial has begun to evaluate the first biological heart valve made in India. If shown to be a good therapeutic option, it is hoped that this locally-manufactured bioprosthesis will help bring down the cost of valve implantation for patients.
A VATS approach to early-stage lung cancer resection leads to survival outcomes similar to thoracotomy, say researchers from Yale University in Connecticut, US.
June 28, 2018
Submitted by: Claire Vernon
Chan and colleagues describe a stepwise approach to reducing the time to extubation after cardiac surgery, driven primarily by bedside providers as opposed to a conventional physician-directed approach. The authors demonstrate that this fast-track extubation protocol increased the rate of early extubation and decreased the median time to extubation without altering reintubation or early mortality rates.
June 27, 2018
Submitted by: Aristotle Protopapas
A brief, readable, sensibly balanced, and well-referenced editorial on the occasion of the retrospective Austrian paper on venoarterial extracorporeal membrane oxygenation (ECMO). Taken in the context of the recent New England Journal of Medicine paper on venovenous ECMO for acute respiratory distress syndrome and the relevant ATS presentations on the EOLIA trial, the editorial raises questions on the utility of the expensive innovation of ECMO.
June 26, 2018
Submitted by: Claire Vernon
Sample size calculations are a necessary prerequisite in the design of clinical studies. Most often, they are encountered in randomized controlled trials. Hickey and colleagues describe the reasoning behind determinations of sample size and illustrate some basic calculations. The authors also discuss estimation and sample size for nonrandomized studies.
June 25, 2018
Submitted by: Claire Vernon
This written and video case review from Osho and colleagues centers on a 54-year-old woman who suffered smoke inhalation injury as a result of a house fire. Following prolonged intubation, mechanical ventilation, open tracheostomy tube placement, and recurrent pneumonia, the patient was diagnosed with a tracheoesophageal fistula (TEF). The authors prefer to manage TEF via an anterior cervical approach with division of the trachea, though a right thoracotomy may be used in the setting of highly distal TEFs. They emphasize that careful operative technique and the interposition of a robust muscle flap are the most important safeguards in surgical management of TEF.
June 22, 2018
Submitted by: Claire Vernon
Patient Care and General Interest
Screening infants for critical congenital heart disease at birth is becoming mandatory in the US state of Idaho and the Indian state of Kerala.
Tufts Medical Center in Boston, Massachusetts, USA, has completed its 500th heart transplant.
Drugs and Devices
The Venus P-Valve self-expanding pulmonary valve from Venus Medtech has been launched in Canada. The valve was developed for percutaneous implantation in native right ventricular outflow tracts.
The US Food and Drug Administration has issued a Class I recall for the HeartWare Ventricular Assist Device from Medtronic due to the possibility of an interrupted connection between the power source and the device controller.
Research, Trials, and Funding
A cardiac surgery team in Japan has approval to test induced pluripotent stem cell grafts in patients with damaged heart tissue to determine the safety of this regenerative medicine approach.
Interim data from a phase II trial from Leading BioSciences suggests that the company’s serine protease inhibitor, which targets postoperative ileus, reduces the length of intensive care and hospital stay for patients undergoing cardiac procedures on cardiopulmonary bypass.
An analysis from a European registry determined that mortality prediction models for heart failure patients have relatively poor reliability and are not used often in clinical practice.
June 21, 2018
Submitted by: Claire Vernon
Park and Kim describe the construction and use of semimanufactured eight-branched aortic graft for open repair of thoracoabdominal aortic aneurysm. The authors review the results of open repair using this graft in 12 patients, eight of whom had Marfan syndrome.
June 20, 2018
Submitted by: Claire Vernon
Chen and colleagues present their experience closing ventricular septal defects with a device using a minimally invasive surgical approach that does not require cardiopulmonary bypass. This approach relies on transthoracic echocardiography for device guidance and was substantially cheaper than transcatheter approaches. The authors conclude that intraoperative device closure of ventricular septal defects is a reasonable alternative to transcatheter approaches, particularly in developing countries.
June 17, 2018
Submitted by: Tom C. Nguyen
Controversial and revisited topic of dual-antiplatelet therapy (DAPT) (aspirin and clopidogrel) versus low dose warfarin after On-X mechanical aortic valve replacement. There were two arms to the study: low and high risk for thromboembolism. The low-risk arm was terminated secondary to higher thromboembolic events in the DAPT group. For the high-risk groups, patients receiving low dose warfarin with an international normalized ratio goal of 1.5 to 2.0 experienced no difference in mortality or thromboembolic complications compared to the standard dose warfarin group.
June 15, 2018
Submitted by: Claire Vernon
Patient Care and General Interest
Cardiac arrest survivors gathered at Basildon Hospital in the UK to share their stories and raise awareness, while attempting to set a world record for most cardiac arrest survivors at one gathering.
The University of Washington in the US joins a growing list of institutions that offer hearts from hepatitis C-positive donors to patients on the transplant waiting list, as evidence accumulates that the virus can be safely treated in organ recipients.
Drugs and Devices
Japan’s Ministry of Health, Labor, and Welfare has approved the Perceval sutureless valve from LivaNova for treating aortic valve disease.
Research, Trials, and Funding
Researchers from the University of California Los Angeles in the US and from Edwards Lifesciences trained a machine-learning algorithm to predict intraoperative hypotension using physiological data that is routinely collected during surgery.
Swedish researchers have found an association between invasive procedures such as coronary artery bypass grafting and infective endocarditis, and the accompanying editorial postulated that improving sterile technique and procedures for infection control when possible may prove more beneficial than administering prophylactic antibiotics.
Research presented at the recent American Thoracic Society meeting in San Diego, California, evaluated patient refusal of lung cancer treatment, finding that US patients with early stage disease were more likely to refuse surgical treatment if they did not have insurance or if they were covered by Medicaid.