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Journal and News Scan
April 23, 2015
Submitted by: Mark Ferguson
The authors reviewed patients with small resected stage I lung adenocarcinoma to determine the frequency of tumor cells spreading through airway spaces (STAS) and their relationship to recurrent cancer. Nearly 40% of patients had tumor cells in the airways beyond the edge of the main tumor. In patients undergoing parenchymal-sparing operations, the recurrence rate was much higher in patients with tumor STAS (43% vs 11%). This relationship was not identified in patients undergoing lobectomy. Tumor STAS should be recognized as a pattern of invasive spread among patients with lung adenocarcinoma.
April 19, 2015
Submitted by: Arie Blitz
The Mayo Clinic reviewed its series using VA ECMO for postcardiotomy support in patients older than the age of 70 years. Not surprisingly, only a quarter of patients were able to be discharged alive. Preop atrial fibrillation, chronic kidney disease, lactic acidosis on support, and persistent coagulopathy were each associated with a higher mortality.
April 19, 2015
Submitted by: Arie Blitz
The authors retrospectively analyzed the causes of death and their temporal relationship to surgery for close to 500 patients undergoing LVAD implantation at their institutions. The most common causes by time period were as follows: (1) early→cardiac (62%) and neurologic (21%); (2) between hospital dismissal and 6 months→neurologic (31%), cardiac (17%), and device-related (11%); (3) between 6 months and 1 year→neurologic (43%) and cardiac (22%); and (4) later than 1 year→neurologic (35%), cardiac (20%), and infection (15%). Identifying the predominant causes during each time interval may allow better honing of strategies to further improve outcomes.
April 16, 2015
Submitted by: CTSNet Staff
This feature length documentary takes an in-depth look at uniportal VATS, the relatively new procedure created by Diego Gonzalez Rivas. The film chronicles the development of the procedure, and follows Dr. Gonzalez Rivas as he introduces the minimally invasive technique to hospitals from the UK to China. Patients who have undergone the uniportal procedure also share their stories.
April 15, 2015
Submitted by: Lisa Brown
Propensity score-matched analysis of surgical ligation versus medical management of clinically significant patent ductus arteriosus in premature (<37 weeks), extremely low birth weight infants (<1000 g). Infants undergoing surgical ligation had lower mortality (15% vs 26%) and a higher rate of routine disposition from the hospital (48% vs 41%) as opposed to transferring care or requiring home health services. However, in the surgical ligation group, the length of stay was longer (88.5 days vs 65.6 days) and total cost was higher ($209,829 vs $139,446). Necrotizing enterocolitis and sepsis were independent predictors of mortality in both groups of infants.
April 13, 2015
Submitted by: Marcelo Jimenez
This retrospective case-control study involving 1852 Hodgkin lymphoma 5-year survivors found that radiation to the heart valves tend to increase the risk for clinically significant valvular heart disease. The rate increased 3.1-fold in patients receiving 31-35 Gy and 11.8-fold in those who received > 40 Gy.
April 12, 2015
Submitted by: J. Rafael Sadaba
In this manuscript the authors describe their findings in a meta-analysis of 12 randomized placebo-controlled clinical trials involving 2,980 patients undergoing isolated CABG. They found that statin therapy, particularly atorvastatin, initiated before CABG, was associated with a 58% reduction in the risk of postoperative AF. Unfortunately, the optimal dose of statin therapy to achieve this effect was not addressed in the study. Other interesting findings were that the length of hospital stay was lower, and there was a lower number of strokes with preoperative statin therapy. The risk of postoperative MI and renal failure were not significantly decreased with statins.
April 10, 2015
Submitted by: CTSNet Staff
The authors analysed 621 reliefs, sculptures and paintings from Ancient Egypt looking for anatomical defects of the chest. They found a relief dated back to 2400 BC, depicting a man with an abnormal shape of the chest similar to a pectus excavatum. The authors opened the debate on the occurrence of this deformity in ancient times.
April 10, 2015
Submitted by: CTSNet Staff
Westaby and coworkers analyzed the demographic changes of cardiothoracic surgeons in the UK between 1999 and 2014. There was an increase in appointments from overseas and from other European countries which complemented a decrease of UK graduates entering the specialty. Only 5% are females. The authors attribute this to several public discussions in the last years that shed a negative light on cardiothoracic surgery and call to action to restore attractiveness of the specialty.
April 10, 2015
Submitted by: CTSNet Staff
False-negative results of endobronchial ultrasound-guided transbronchial needle aspiration in non-small-cell lung cancer staging were identified in 14% of 165 patients. Prevalence of false-negative results was low, when three satisfactory samples from mediastinal stations could be obtained and rose, when fewer adequate samples were available. Further, false-negative results were more frequent for left-sided tumors.