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Journal and News Scan
September 12, 2017
Submitted by: Joel Dunning
This is a summary of the literature as to the prevalence of seizures in patients who have had tranexamic acid during their cardiac surgery.
September 9, 2017
Submitted by: Arie Blitz
The STS Adult Cardiac Surgery database data that had been submitted to a regional quality initiative were compared to a hospital claims database to assess what effect, if any, would supplying missing data provided by the latter affect the reported STS 30-day mortality rates. The STS database currently counts as "alive" any patient that has unknown status at 30 days.
Findings:
- An excessive 22% of patients had unknown 30-day mortality status.
- The missing data was able to be reduced down to 7% by incorporating the data from the hospital claims database.
- Finally, the study found that, if the external data for CABG patients were included for these hospitals, the true 30-day mortality observed/expected ratio would be increased to 1.30 from 1.27. Thus, at present, the current method for reporting STS data underestimates the true 30-day mortality.
Should centers make an effort to include missing data provided from external administrative databases in order to improve the accuracy of STS reported outcomes? Should STS mandate such an inclusion of data?
September 9, 2017
Submitted by: Benjamin Bidstrup
The authors have concluded from a meta-analysis of over 45,000 patients, mitral regurgitation in the presence of LV dysfunction (either ischaemic cardiomyopathy or idiopathic causes) is, not surprisingly, associated with reduced survival. Whether this is due to the underlying myopathic process or the MR per se is not clear. Likely MR is a marker of LV dysfunction. The authors refer to the lack of proof that correction of MR improves outcomes in this subset of patients.
September 8, 2017
Submitted by: Claire Vernon
Patient Care
Natural disasters, such as hurricanes and earthquakes, disrupt many aspects of daily life. How do medical teams respond to the disruption of cardiac care?
Pediatric surgeons at Jehangir Hospital in Pune, India, removed a pleuropulmonary blastoma type-II tumor from a toddler.
Drugs and Devices
The US Food and Drug Administration approved a new, lower dose of the endothelin receptor antagonist bosentan for congenital pulmonary arterial hypertension in pediatric patients.
NaviGate reported the investigational implantation of its size-52 mm Gate tricuspid atrioventricular valved stent into a patient’s transplanted heart at the University of Padua, Italy.
Research, Trials, and Funding
Researchers in Texas, USA, have developed a handheld mass spectrometry “pen” for rapid, nondestructive, intraoperative diagnosis of cancer tissues.
Protembis reported the first in-human use, as part of a European trial, of its next generation cerebral-focused embolic protection device, the ProtEmboTM System, at Galway University Hospital in Ireland.
September 8, 2017
Submitted by: Claire Vernon
The authors describe a new technique for localization of very small, non-visible, and non-palpable pulmonary lesions for video-assisted thoracoscopic sublobular resection.
September 7, 2017
Submitted by: Claire Vernon
Murashita and colleagues reviewed the surgical outcomes of patients with intraoperatively-confirmed constrictive pericarditis. The authors divided patients into a historical group (1936- 1990) and a contemporary group (1990-2013) to compare patient presentation and analyze risk factors for negative outcomes. The etiology of pericarditis was known in nearly half of contemporary cases, as opposed to fewer than 20% of historical cases. Long-term outcomes were similar between the groups when patient characteristics were controlled for.
CME activity related to this article is available online.
September 5, 2017
Submitted by: Claire Vernon
The last four days matter: larger changes in atmospheric pressure correlate with primary spontaneous pneumothorax. This paper matches two hospital databases with meteorologic data of a geographic area in Japan over more than five years.
September 4, 2017
Submitted by: Marco Nardini
A wide experience, from the Euorpean Institute of Oncology, on Pancoast tumors' treatment confirms that surgery is still the most important step of the multimodality approach for the patients affected by this condition.
August 25, 2017
Submitted by: Claire Vernon
Dr Magdi H. Yacoub and colleagues explore the major approaches, pearls, and pitfalls of septal myectomy, which represents the contemporary gold standard for treating symptomatic hypertrophic cardiomyopathy patients without significant comorbidities. The authors further cover key components of the preoperative workup for this procedure, as well as current evidence for short- and long-term outcomes in these patients. They emphasize that surgical techniques for relief of left ventricular outflow obstruction are still significantly underused, despite consistent demonstrations of safety and efficacy.
August 25, 2017
Submitted by: Claire Vernon
Patient Care
Two critically ill patients receive heart transplants within 4 hours in a hospital in Mumbai, India, thanks to efficient and quick transport of the organs.
A report in the World Journal of Surgery says that the primary skills of US surgeons, being ever more specialized, don’t align with the procedures that comprise the majority of work performed by groups like Médecins Sans Frontières.
Drugs and Devices
A confidentiality commitment has been signed as part of ongoing increased information exchange between the European Medicines Agency and the US Food and Drug Administration.
Research, Trials, and Funding
Researchers at the Mayo Clinic in Minnesota, USA, find that women have a better outcomes than men following chemotherapy and radiation prior to surgery for advanced esophageal cancer.
Surgeons in New York City, USA, find evidence that questions prophylactic insertion of inferior vena cava filters in patients with traumatic spinal cord injury.