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Journal and News Scan
July 30, 2015
Submitted by: Mark Ferguson
The ESMO Guidelines Committee provides an update to its guidelines for evaluation and management of malignant pleural mesothelioma. They recommend against screening. A biopsy demonstrating tissue invasion is required for a definitive diagnosis. Definitions for different extents of surgical radicality are provided. No specific recommendations for the extent of surgery are provided, indicating the presence of equipoise at this time.
July 29, 2015
Submitted by: Arie Blitz
The University of Virginia group retrospectively analyzed all non-emergent cardiac cases performed at their center from 2008 to 2013, and separated the nonemergent cases into two groups: "Early start" cases had an incision time before 3 PM, and "late start" cases, after 3 PM. After controlling for case type, surgeon, year, and risk, late cases resulted in greater than double the operative mortality of early cases.
July 28, 2015
Submitted by: Jill Ley
This article offers a much needed comprehensive overview of temporary pacing strategies specific to cardiac surgical patients. In addition to discussing standard pacing content such as device settings and connections, it offers strategies and rationale for epicardial pacing unique to this population, as well as clear depictions of unipolar versus bipolar lead systems and an introduction to biventricular temporary pacing. Content regarding use of atrial pacing wires for performing atrial ECG's and rapid atrial pacing of arrhythmias are well described. This paper is an excellent resource for both basic and advanced cardiac surgical providers that will be widely reviewed.
July 27, 2015
Submitted by: Stuart Head
Clinical trials evaluating transcatheter mitral valve interventions for severe mitral regurgitation (MR) are complex. The Mitral Valve Academic Research Consortium has provided a 2-part document with recommendations related to diagnosis of MR, patient selection for trials, trial designs and endpoint definitions that are instrumental for the evaluation of all treatments related to severe MR.
July 23, 2015
Submitted by: Mark Ferguson
This multicenter retrospective study evaluated the efficacy of salvage esophagectomy after definitive chemoradiotherapy compared to planned esophagectomy after induction chemoradiotherapy. Operative mortality was similarly high in both groups (8.4% vs 9.3%). Anastomotic leak was higher after salvage esophagectomy (17.2% vs 10.7%). 3-year survival was similar between the groups. Salvage esophagectomy for persistent disease resulted in lower survival than when performed for recurrent disease.
July 23, 2015
Submitted by: Joel Dunning
Authors describe a technique allowing excellent exposure of the mitral valve while more safely performing cut-and-sew Cox-Maze III.
July 23, 2015
Submitted by: Joel Dunning
The paper presents the guidelines for authors on statistical and data reporting for the European Journal of Cardio-Thoracic Surgery (EJCTS) and the Interactive CardioVascular and Thoracic Surgery (ICVTS). It focusses on issues which are most frequently commented on by the statistical reviewers.
July 23, 2015
Submitted by: Joel Dunning
Transoesophageal stimulation for motor-evoked potentials monitoring was evaluated in dogs. The method was feasible with technical ease and small interindividual variability and therefore warrants further studies. The project won the 2014 EACTS Hans G. Borst Award.
July 23, 2015
Submitted by: Joel Dunning
Among 4680 TEVAR procedures of the European Registry of Endovascular Aortic Repair Complications, 26 patients suffered from either central airway (aorto-bronchial) or pulmonary parenchymal (aorto-pulmonary) fistulation. A radical surgical approach was superior to any other treatment strategy with regard to overall survival.
July 22, 2015
Submitted by: CTSNet Staff
Mayo Clinic surgeons describe and illustrate the techniques they utilize to relieve obstruction in hypertrophic cardiomyopathy in those circumstances where it is difficult to adequately expose the basal and midventricular septum through the aortic root. In selected patients, either at primary myectomy or at redo myectomy, septal excision can be approached through a left ventricular transapical incision. This important alternative should be considered in cases where successful relief of dynamic basal or midventricular obstruction cannot be accomplished through the aorta.