Journal and News Scan

This study addressed midterm outcomes with the hemispherical aortic annuloplasty reconstructive technology (HAART) ring used for aortic valve repair (AVr). Seventy-one patients had AVr using the HAART ring—53 had a trileaflet valve and 18 had a bicuspid valve. Their median age was 54 years old and 79 percent were male. Many patients needed concomitant interventions such as arch repair (77 percent) or a root procedure (46 percent). At a mean follow up time of 3.9 ± 1.1 years, freedom from reoperation was 96 percent. Eleven patients had moderate or higher aortic insufficiency (AI) during surveillance, and all of these patients had a trileaflet valve. Three patients suffered ring dehiscence. The authors recommend caution when using the subannular approach for stabilization in patients with trileaflet aortic valves.

This study addressed the long-term results of the réparation à l’étage ventriculaire (REV) procedure for double outlet right ventricle (DORV) and transposition of the great arteries (TGA) with pulmonary stenosis (PS). From 1980 to 2021, 157 patients underwent an REV procedure. Thirteen patients died (8.3 percent), including four in the first postoperative month and two after heart transplants. Survival at 40 years was 89.3 percent. 37 patients required 68 reinterventions on the right ventricular outflow tract (RVOT) including 49 reoperations with a median delay of nine years (8 months to 27 years). The authors concluded that the REV procedure is a good alternative for patients with TGA and double outlet right ventricle with PS, with only a quarter of patients needing redo RVOT surgery.

The benefits of early extubation in the operating room (OR) following cardiac surgery remain unproven. In this study, the authors evaluated perioperative outcomes after extubation in the OR versus extubation in the intensive care unit (ICU) in patients who underwent nonemergency isolated coronary artery bypass grafting (CABG). A total of 1,397 patients who underwent nonemergency isolated CABG during a six-year period were analyzed. Among them, 891 (63.8 percent) patients were extubated in the ICU, and 506 (36.2 percent) were extubated in the OR. After propensity score matching, 414 patient pairs were compared. Adjusted comparison did not show differences between the two groups in the incidence of major early postoperative complications such as reintubation, re-exploration for bleeding, stroke, renal failure, or thirty-day mortality. Furthermore, patients extubated in the OR had shorter ICU (P < 0.0001) and hospital stays (P < 0.0001), were more frequently discharged directly home (P < 0.0001), and presented with a lower thirty-day readmission rate (P = 0.04). Based on these results, the authors suggest a wider adoption of routine OR extubation for nonemergency CABG.

A recently published article showed the benefit of TEER compared to mitral valve surgery in older, sicker patients with a high risk in surgery. Based on the French administrative hospital discharge database, the study collected information from all consecutive patients treated for primary or secondary mitral regurgitation with isolated TEER or isolated mitral valve surgery (repair or replacement) between 2012 and 2022. A total of 57,030 patients were found in the database, and after propensity score matching, a total of 2,160 patients were included for analysis in each arm. This study has led to controversy and a heated discussion within the cardiovascular community. In his article, Michael O'Riordan from TCTMD interviews the study's primary author and other experts in the field, providing insights into this issue and a comprehensive overview of the topic.