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Journal and News Scan

Source: NEJM Catalyst
Author(s): Michael McWilliams

Video and a readable digest of a talk in a Harvard meeting, especially interesting in its scepticism on prevention.

Source: JAMA
Author(s): Ted E. Feldman, Michael J. Reardon, Vivek Rajagopal, Raj R. Makkar, Tanvir K. Bajwa, Neal S. Kleiman, Axel Linke, Dean J. Kereiakes, Ron Waksman, Vinod H. Thourani, Robert C. Stoler, Gregory J. Mishkel, David G. Rizik, Vijay S. Iyer, Thomas G. Gleason, Didier Tchétché, Joshua D. Rovin, Maurice Buchbinder, Ian T. Meredith, Matthias Götberg, Henrik Bjursten, Christopher Meduri, Michael H. Salinger, Dominic J. Allocco, Keith D. Dawkins

The authors compared mechanically expanded TAVR to self-expanding TAVR in a randomized non-inferiority trial.  Major adverse events occurred in 20% and 17% of patients, respectively (safety measure).  The one-year rates of mortality, stroke, or paravalvular leak for the valves were 15.4% and 25.5%, respectively (effectiveness measure).  Mechanically expanded valves are not inferior to self-expanding valves and broaden the options available for high risk patients.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): John W.C. Entwistle III

A sobering editorial, read last May at the AATS, that discusses at length the ethics of ventricular assist as a super expensive therapy seen from the principle of fairness.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Martin Czerny

A dense but short and readable editorial arguing for the complexity of risk stratification of aortic pathology.

Source: AHA, YouTube
Author(s): American Heart Association

Incredible story about how American Heart Association President Dr John Warner suffered a cardiac arrest after his presidential address and was subsequently saved by two bystanders.  This story emphasizes the fortune of being in the right place at the right time, but more importantly, the public value of knowing CPR.

Source: Journal of the American Heart Association
Author(s): Fahad Alqahtani, Chalak O. Berzingi, Sami Aljohani, Mohamad Hijazi, Ahmad Al‐Hallak, Mohamad Alkhouli

The Nationwide Inpatient Sample was evaluated to assess tricupsid valve surgery. Isolated and concurrent tricuspid surgery outcomes are analyzed.  The authors conclude that "surgical treatment of TR remains underused and is associated with high operative morbidity and mortality, prolonged hospitalizations, and considerable cost."

Source: JAMA
Author(s): Andreas Claesson, Anders Bäckman, Mattias Ringh, Leif Svensson, Per Nordberg, Therese Djärv, Jacob Hollenberg

Using a simulated out-of-hospital cardiac arrest scenario, the authors compared the time from an emergency call to resource deployment and arrival for drone-delivered automatic external defibrillator (AED) and ground vehicle-based emergency medical services (EMS).  Mean time to dispatch was 3 sec for the drone and 3 min for EMS.  Over a median flight distance of 3.2 km, mean time to arrival was 5:21 min for the drone vs 22:00 min for EMS.

Source: MedPage Today
Author(s): Skeptical Scalpel

Sure, we all receive emergency calls that potentially could interrupt an operation.  This surgeon, however, was taking a Spanish language proficiency test on his cell phone while performing varicose vein surgery on an awake patient.  Common sense appears to have failed in this case.

Source: European Journal of Cardio-Thoracic Surgery & European Heart Journal
Author(s): Volkmar Falk, Helmut Baumgartner, Jeroen J. Bax, Michele De Bonis, Christian Hamm, Per Johan Holm, Bernard Lung, Patrizio Lancellotti, Emmanuel Lansac, Daniel Rodriguez Mun~oz, Raphael Rosenhek, Johan Sjögren, Pilar Tornos Mas, Alec Vahanian, Thomas Walther, Olaf Wendler, Stephan Windecker, Jose Luis Zamorano, ESC Scientific Document Group

The Task Force for the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) copublished the 2017 guidelines for the management of valvular disease in the European Heart Journal and in the European Journal of Cardio-Thoracic Surgery. In this comprehensive paper, there are many new and strong classes of recommendations since the previous 2012 guidelines.

Source: Annals of Thoracic Surgery
Author(s): Samuel St-Onge, Louis P. Perrault, Philippe Demers, Edward M. Boyle, A. Marc Gillinov, James Cox, Spencer Melby

This review article explores the association between postoperative mediastinal blood and atrial fibrillation.

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