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Journal and News Scan

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Mateo Marin-Cuartas, Suzanne de Waha, Stefanie Naumann, Salil V Deo, Jagdip Kang, Thilo Noack, Alexandro Hoyer, David Holzhey, Sergey Leontyev, Diyar Saeed, Martin Misfeld, Massimiliano Meineri, Joerg Ender, Mohamed Abdel-Wahab, Steffen Desch, Holger Thiele, Michael A Borger, Philipp Kiefer

During some transcatheter aortic valve implant (TAVI) procedures, complications require conversion to emergency open heart surgery (E-OHS). This study evaluated early and midterm outcomes in a large center over fifteen years. Patients were grouped by surgical risk and the study time was divided into three five-year periods. In the entire study period, 1.1 percent of TAVI patients (74/6903) required E-OHS. The rate of E-OHS decreased over the three periods, from 3.5 percent to 0.4 percent. However, the proportion of patients from the study with low or intermediate risk increased considerably, from 1 percent to 26 percent. In-hospital mortality was 62 percent in high-risk and 12.5 percent in low and intermediate-risk patients. One-year survival was 31.8 percent in high-risk and 87.5 percent in low/intermediate risk patients.

Source: JTCVS Open
Author(s): Ashiq Abdul Khader, Aina Pons, Abigail Palmares, Sarah Booth, Chiara Proli, Paulo De Sousa, Eric Lim

This study reports outcomes of protocolized management of chest drain removal on-table for patients undergoing wedge resections and minor thoracic procedures. Chest drains were removed at the end of the operation if air leak was < 20 ml/min. Between 2016 and 2021, 107 patients underwent on-table chest drain removal with a 0.9 percent reintervention rate. Safe on-table chest drain removal using digital drainage in select cases challenges the need for routine drain insertion in thoracic surgery.

Source: JAMA Cardiology
Author(s): Jeremy P. Brown, Kevin Wing, Clémence Leyrat, Stephen J. Evans, Kathryn E. Mansfield, Angel Y. S. Wong, Liam Smeeth, Nicholas W. Galwey, Ian J. Douglas

The risk of dissection associated with fluoroquinolone use has gained wide acceptance, but recent data indicate there’s more to the story. Pasternak and colleagues report a Swedish, multicenter, propensity-matched study of one million treatment episodes examining the relationship between fluoroquinolone use and aneurysm or dissection. Interestingly, after adjustment for confounders, the absolute risk of aneurysm or dissection associated with fluoroquinolone use was smaller than previously reported, risk was found to be driven by aneurysm rather than dissection, and greatest risk was identified in the first ten days during treatment. 

Source: The Annals of Thoracic Surgery Short Reports
Author(s): Jacob N. Schroder, Sharon L. McCartney, Piet Jansen, Ryan Plichta, Jason N. Katz, David M. Smadja, Krish C. Dewan, Carmelo A. Milano

The authors present the first autoregulated total artificial heart implant in the United States. The Aeson total artificial heart provides biventricular support with improvements in hemocompatibility and autoregulation in response to higher filling pressures, when compared to previous generations. The authors present the case of a patient who was successfully bridged to transplant using this improved total artificial heart implant.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Sinha S, Dong T, Dimagli A, Vohra HA, Holmes C, Benedetto U, Angelini GD

This study compared in-hospital mortality risk prediction after cardiac surgery using the EuroSCORE II system with results generated by several machine-learning techniques. The dataset contained 227,087 adult patients, among whom there were 6,258 deaths (2.76 percent). Machine learning techniques showed some statistical improvements over EuroSCORE II, but the clinical impact of this was modest. The addition of other risk factors in future studies may result in further improvements.

Source: Journal of the American College of Cardiology
Author(s): Jing Fang MD, Yani Liu MD, Ying Zhu MD Rui Li MD, Rui Wang MD, Dao Wen Wang, Yunhu Song, Chenhe Li, Yue Chen MD, Lin Cheng, Kangchao Zheng, Yun Zhao, Shiliang Li, Cai Cheng, Liming Xia, Xiaoping Chen, Song Wan, Xiang Wei

This paper reports the first in-human trial exploring surgical reduction therapy for hypertrophic obstructive cardiomyopathy (HOCM). Patients recruited to the trial were those who presented with refractory HOCM with disabling symptoms despite best medical management. The authors reported on the procedural success of a novel transapical beating heart septal myectomy via a minithoracotomy under echocardiographic guidance.

Source: Circulation
Author(s): Laurie J. Morrison, Claudio Sandroni, Brian Grunau, Michael Parr, Finlay Macneil, Gavin D. Perkins, Mayuki Aibiki, Eileen Censullo, Steve Lin, Robert W. Neumar, Steven C. Brooks and on behalf of the International Liaison Committee on Resuscitation

Can we increase the rate and consistency of organ donation from donors experiencing out-of-hospital arrest? What are the challenges and opportunities associated with procurement from this population? The International Liaison Committee on Resuscitation released a scientific statement defining a protocol for organ donation after cardiac arrest, designed for applicability to all health systems. Read the full statement from Circulation journal ahead of print.

Source: The National Institute for Health and Care Excellence (NICE)
Author(s): The National Institute for Health and Care Excellence (NICE) Staff

Recently, NICE released guidance from the British regulatory body limiting the Ozaki operation to research until further review, which is scheduled in three calendar years. The overarching concern appears to be the durability of the autoprosthesis. NICE guidelines have the strongest influence in healthcare in the United Kingdom and often abroad.

Source: NBC News
Author(s): Megan Holohan

The first domino transplant procedure performed on infants was successfully completed recently in New York City. One patient needed a heart transplant because of cardiomyopathy and was able to donate a heart valve to another infant, who was only born with one. 

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Kate L. Brown, MPH, MD, Qi Huang, PhD, Elena Hadjicosta, PhD, Anna N. Seale, MD, MRCP, Victor Tsang, FRCS, David Anderson, FRCS, David Barron, MD, FRCS, Hannah Bellsham-Revell, MD, Christina Pagel, PhD, Sonya Crowe, PhD, Ferran Espuny-Pujol, PhD, Rodney Franklin, MD, FRCP, Deborah Ridout, MSc

This study reported long term outcomes of over three thousand single ventricle patients in the United Kingdom, with a median of 7.6 years. The most significant predictor of long-term survival was single ventricle subtype, with the worst outcomes observed among patients with hypoplastic left heart syndrome or unbalanced AVSD. Other negative outcome predictors were low weight at time of first procedure and acquired comorbidities. Although center volume was not a major predictor of long-term outcomes in this study, it is important to note that congenital care in the UK is highly centralized; thus, no low volume centers were captured in this study.

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