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Journal and News Scan

Source: Annals of Thoracic Surgery
Author(s): Vincent Chan, Elsayed Elmistekawy, Marc Ruel, Mark Hynes, Thierry G. Mesana

This single institution study explored the frequency and time course of failure of mitral valve repair for MR caused by prolapse using longitudinal echocardiography.   Recurrent MR developed in 49 (5.7%) patients at a mean of 3.1 years; 6 had prolapse and 43 did not.   Severe MS occurred in 3.  Reoperation was performed in 21 patients, and was most commonly valve replacement. 

Source: Annals of Thoracic Surgery
Author(s): Julius I. Ejiofor, Maroun Yammine, Morgan T. Harloff, Siobhan McGurk, Jochen D. Muehlschlegel, Prem S. Shekar, Lawrence H. Cohn, Pinak Shah, Tsuyoshi Kaneko

This single institution retrospective study evaluated outcomes of valve replacement for degenerated bioprosthetic aortic valves comparing surgical AVR (SAVR) to transcatheter valve-in-valve procedures (TViV).  Patients were matched into 2 groups of 22 according to STS risk scores.   Operative mortality, stroke rate, and 3-year survival were similar between the groups. 

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): Rio Nomoto, Lynn A. Sleeper, Michele J. Borisuk, Lisa Bergerson, Frank A. Pigula, Sitaram Emani, Francis Fynn-Thompson, John E. Mayer, Pedro J. del Nido, Christopher W. Baird

This single center review assessed the need for reintervention after pulmonary valve replacement with bioprostheses for congenital heart disease.  Most patients had TOF, and most were in their teens or twenties.  After correction for age, the Sorin Mitroflow valve required reintervention sooner and more often than the other two valves (Carpentier-Edwards Magna and MagnaEase, Carpentier-Edwards Perimount).  Valve type was the only independent predictor of reintervention. 

See also: Pulmonary valve replacement for congenital heart disease: What valve substitute should we be using?

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): Brooks V. Udelsman, Jessica Eaton, Ashok Muniappan, Christopher R. Morse, Cameron D. Wright and Douglas J. Mathisen

This retrospective single institution report examined outcomes of repair of large airway defects with bioprothetic materials.  8 patients underwent repair with aortic homograft or acellular dermal matrix, 5 of whom suffered from airway-enteric fistulae.   Most repairs were buttressed with muscle or omentum.   All airways healed; 2 required debridement of granulation tissue and 1 required dilation.

See also: The search for a long-lasting circumferential tracheal conduit: Belsy's problem and ours

 

 

Source: Eur J Cardiothorac Surg
Author(s): Marianna Buonocore, Cristiano Amarelli, Michelangelo Scardone, Angelo Caiazzo, Giuseppe Petrone, Luigi Majello, Pasquale Santé, Gianantonio Nappi, and Alessandro Della Corte

One-hundred eleven patients who underwent surgical repair of acute type A aortic dissection without preoperative malperfusion are analyzed for outcome with regard to arterial cannulation site, route of cerebral perfusion and surgeon’s specific experience. Potential biases are discussed.

Source: Eur J Cardiothorac Surg
Author(s): Masamichi Ono, Jelena Kasnar-Samprec, Alfred Hager, Julie Cleuziou, Melchior Burri, Constantin Langenbach, Alessia Callegari, Martina Strbad, Manfred Vogt, Jürgen Hörer, Christian Schreiber, and Rüdiger Lange

The retrospective study includes 434 patients with total cavopulmonary connection. Clinical results and factors influencing the outcome are analyzed.

Source: Eur J Cardiothorac Surg
Author(s): Benjamin Bierbach, Claudia Arenz, Phillip Suchowerskyj, Sylvia Schroth, Jadwiga Blaschczok, Boulos Asfour, Martin Schneider, and Viktor Hraška

This retrospective monocenter analysis compares 30 patients with intraventricular rerouting and 29 patients with repair on arterial level for transposition of the great arteries associated with ventricular septal defect and left ventricular outflow tract (LVOT) obstruction. The strategy was chosen according to the individual anatomical situation. Freedom from reoperations on the right ventricular outflow tract was lower for patients with intraventricular rerouting whereas survival at 5, 10 and 15 years and LVOT reoperation rates were similar for both groups.

Source: Annals of Surgery
Author(s): Pasquer, Arnaud; Renaud, Florence; Hec, Flora; Gandon, Anne; Vanderbeken, Marguerite; Drubay, Vincent; Caranhac, Gilbert; Piessen, Guillaume; Mariette, Christophe; On behalf of the FREGAT Working GroupFRENCH

All patients undergoing surgical therapy for esophageal or gastric cancer in France 2010-2012 were evaluated for postoperative mortality stratified by comorbidity score and assessed by medical center volume (low, medium, high, very high).  Most operations were performed in low volume centers.  Mortality decreased linearly with increasing center volume.  The linear decrease was present regardless of comorbidity score.  Comparing low to very high volume centers, a 70% reduction in relative risk was present. 

Source: Annals of Surgery
Author(s): Anderegg, Maarten C. J.; Lagarde, Sjoerd M.; Jagadesham, Vamshi P.; Gisbertz, Suzanne S.; Immanuel, Arul; Meijer, Sybren L.; Hulshof, Maarten C. C. M.; Bergman, Jacques J. G. H. M.; van Laarhoven, Hanneke W. M.; Griffin, S. Michael; van Berge Henegouwen, Mark I.

The authors explored the relationship of nodal region and survival from adenocarcinoma of the esophagus/GEJ in patients undergoing induction therapy and transthoracic resection.  Survival diminished related to nodal status/region:  highest for no nodes, followed in order by: local/regional, truncal, upper thoracic, and combined truncal and upper thoracic.  They suggest that nodal location should be considered in future staging systems.

Source: Annals of Surgery
Author(s): Gandon, Anne; Gronnier, Caroline; Renaud, Florence; Borde, Paul; Vanderbeken, Marguerite; Hec, Flora; Piessen, Guillaume; Adenis, Antoine; Mirabel, Xavier; Mariette, Christophe

In this retrospective review, the authors queried whether a hiatal hernia (HH; >5cm) was associated with adverse outcomes after esophagectomy for cancer.  After adjustment, they found that HH patients had a lower rate of complete resection and  lower median survival.  They also found that in patients with HH who received induction therapy the rate of perioperative mortality was higher than those without HH who underwent induction therapy, largely due to increased cardiopulmonary complications.

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