Journal and News Scan

The Cleveland Clinic group performed a randomized clinical trial comparing transfusion triggers of 24% vs. 28% from 2007-2014.  The study included 722 patients who underwent either CABG or valve surgery.  While the lower trigger group received fewer transfusions, adverse outcomes did not differ between the groups.  Because the lower trigger group had equivalent outcomes but fewer transfusions, the authors recommend using a lower trigger perioperatively.

Patient Care

A heart team at Kingston Health Sciences Centre in Ontario performs the first hybrid cardiac ablation for atrial fibrillation in Canada.

A five-year-old boy from Newcastle, South Africa, is among the youngest and smallest people to receive a heart ventricular assist device.

Surgical teams in Armenia already use minimally invasive procedures in the abdominal cavity, and they will soon add them to their arsenal of tools for treating lung cancer.

A cardiac surgery resident in Edmonton, Canada, has designed paper toys that help teach pediatric patients about their hearts and hospital stays.

News outlets highlight athletic successes of transplant patients including a cyclist from Fairlie, United Kingdom, and a swimmer from Michigan, USA, who medaled in the World Transplant Games in Málaga, Spain.

Two paramedics in New York, USA, responded immediately when a nurse suffered a cardiac arrest in their home during a postsurgical follow-up visit.

Drugs and Devices

Surgeons have implanted the first Biostage Cellspan esophageal implant, in which a patient’s stem cells are seeded onto an esophageal scaffold.

Research, Trials, and Funding

Physicians from the Cleveland Clinic in Ohio wrote a letter to the New England Journal of Medicine where they report a decrease in nitroprusside and isoproterenol usage at 47 US hospitals following price hikes in the cost of each drug.

A highly-detailed, 3D representation of the cardiac conduction system in the intact human heart is published in Scientific Reports.

The University of Maryland School of Medicine has received a grant to establish the first cardiac xenotransplantation research center in the USA.

Hraska and colleagues present a retrospective study of outcomes following congenitally corrected transposition of the great arteries using the morphologically left ventricle as the systemic pumping chamber. Patients were followed for a median of 5 years, with a range up to 20 years. Overall survival and event-free survival were good, and only one of the 63 patients had worse than mild dysfunction of the morphologically left ventricle.

This research was presented at the 2017 Annual Meeting of The Society of Thoracic Surgeons, and the audio discussion that followed the presentation accompanies the article.

Ghoneim and colleagues retrospectively evaluated surgical risk caused by prior mediastinal radiation therapy (MRT) in patients undergoing aortic valve replacement (AVR). The authors found that operative mortality was higher than predicted when AVR was performed with concomitant procedures, and they speculate this is in part related to the longer cardiopulmonary bypass time required. Despite good short-term outcomes in the isolated AVR group, MRT patients undergoing both isolated and concomitant AVR had reduced midterm survival. The authors suggest this should be considered when weighing the choice of device, the invasiveness of the AVR procedure, and the inclusion of concomitant procedures for this population of patients.