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Journal and News Scan
June 29, 2023
Submitted by: Jessica Bogensberger
Transcatheter aortic valve implantation (TAVI) is now a standard procedure for the treatment of symptomatic aortic valve stenosis in many patients. In Germany, according to the annual reports from the German Institute for Quality Assurance and Transparency in Healthcare, the rate of serious intraprocedural complications, such as valve malpositioning or embolization, coronary obstruction, aortic dissection, annular rupture, pericardial tamponade, or severe aortic regurgitation requiring emergency cardiac surgery has decreased markedly in recent years from more than 5.5 percent in 2012 to 2 percent in 2019. However, with increased use, the total number of adverse events remains about 500 per year, about 100 of which require conversion to sternotomy. These sometimes fatal events can occur at any time and are still challenging. Therefore, the interdisciplinary TAVI heart team should be prepared and aware of possible rescue strategies.
June 23, 2023
Submitted by: Cameron Lind
This single-center study of 299 patients operated on for type-A aortic dissection between 1992 and 2020 reported lower ten-year mortality (32 percent) after prosthetic or valve-sparing root replacement compared with ascending aorta replacement (52 percent; hazard ratio, 1.38; 95 percent CI, 1.12-1.68) without resecting the coronary sinuses, and lower proximal aorta reoperation rates (14 percent vs 23 percent; hazard ratio, 2.08; 95 percent CI, 1.44-5.56). The authors conclude that aortic root replacement should be considered when the aortic root is partially dissected or pathologically dilated.
June 23, 2023
Submitted by: Cameron Lind
The first three cardiac catheterization surgeries at University of Ghana Medical Center were performed recently by a Ghanaian pediatric cardiac specialist. The procedures were performed on three children with three different heart conditions. Ghanaian surgeons and cardiologists emphasize that this minimally invasive surgery could be performed more often with increased medical facilities and logistics resources.
June 23, 2023
Submitted by: Cameron Lind
This study analyzed results of aortic valve repair in patients with tricuspid aortic valves and aortic regurgitation caused by prolapse, comparing the results in cases caused by cusp fermentation and myxomatous degeneration. Researchers concluded that repair of cusp prolapse in tricuspid aortic valves with preserved root dimensions can be performed successfully, even when there are fenestrations that must be repaired.
June 15, 2023
Submitted by: Jo Chikwe
In this analysis of 5,437 patients with clinical stage IA (cT1 N0) non-small cell lung cancer identified from the National Cancer Database, overall survival in patients pathologically upstaged to pN1 disease was greater after lobectomy (2,808 patients) than after wedge resection (128 patients). There was no difference in survival between wedge resection and lobectomy in patients upstaged to N2 disease. The authors conclude that their results highlight the importance of intraoperative detection of lymph node disease in lobectomy candidates.
June 15, 2023
Submitted by: EACTS Staff
The authors performed a systematic review to determine whether direct oral anticoagulants (DOACs) are as safe and effective as vitamin K antagonists in the three months after bioprosthetic valve replacement. They found no difference regarding thrombosis, major bleeding, or deaths, although the interpretation was limited by the small number of events and wide confidence intervals. Future studies should focus on DOACs in surgical valves and have long-term follow-up.
June 15, 2023
Submitted by: Cameron Lind
A new expert consensus on diagnosis, staging, and therapy for early-stage non-small cell lung cancer patients has been released. The experts recommend CT and PET imaging as a necessary part of the diagnosis and staging phase. Recommendations for chemotherapy, radiotherapy, and adjuvant systemic therapy before and after lung resection are also explained in this report. Overall, treatment paradigms have shifted significantly over the past few years and surgeons must be knowledgeable about different treatment options.
June 15, 2023
Submitted by: Joel Dunning
This is a groundbreaking article that, for the first time, compares port access mitral surgery with sternotomy in a randomized multicenter trial. It demonstrates benefits for surgery through a minimal access route and, most importantly, that it is as safe as open surgery. Finally, it demonstrates that expert surgeons are required, whatever the access, to maximize the repair rate for patients.
While this full report is behind a paywall, a detailed abstract is included through the link above.
June 8, 2023
Submitted by: Cameron Lind
Through the Palestine Children’s Relief Fund (PCRF), a group of Italian doctors and nurses traveled to the Gaza Strip to perform cardiac surgery on a group of ten children with congenital heart disease. Since advanced surgical procedures are not readily accessible in the occupied area because of lack of resources and a travel ban, the surgical team was crucial for treating these urgent cases and training local medical professionals.
June 8, 2023
Submitted by: Jo Chikwe
This analysis of 279 neonates with pulmonary atresia and intact ventricular septum who underwent surgical or catheter intervention between 2009 and 2019 in nineteen centers showed that seventy-nine (28 percent) underwent right ventricular decompression, 151 (54 percent) underwent systemic-to-pulmonary shunt or ductal shunt only, thirty-six (13 percent) underwent both, and eleven (4 percent) received transplants. Major adverse events—including in-hospital mortality (8 percent), cardiopulmonary resuscitation (13 percent), stroke (6 percent), and mechanical circulatory support (13 percent)—were reported in fifty-seven patients (20 percent). Lower weight and the presence of two major coronary stenoses predicted major adverse events, and the authors recommend vigilance in procedural planning in patients with these risk factors.