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Journal and News Scan
April 2, 2015
Submitted by: Mark Ferguson
The authors retrospectively reviewed their institutional database to assess outcomes for VATS lobectomy vs SBRT for stage I NSCLC, comparing propensity score-matched groups (41 pairs). Survival, cancer-specific survival, local recurrence, and distant recurrence were significantly better in the surgical group.
April 2, 2015
Submitted by: CTSNet Staff
This video demonstrates aortic valve bypass surgery on an 83-year-old male patient. This surgery was offered to the patient as an alternative to conventional aortic valve replacement.
April 2, 2015
Submitted by: CTSNet Staff
This article takes an in-depth look at robotic-assisted thymectomy. The technique is described and data from over 100 centers is analyzed.
March 30, 2015
Submitted by: Joseph Basha
The authors describe a kinetic modeling tool to safely regulate the osmotic changes that can occur when treating severe metabolic alkalosis and concurent hypernatremia. The authors discuss disequilibrium syndrome and brain edema, a potential occurence when intermittant dialisis is used versus a longer, slower, and potentially more easily regulable therapy such as CRRT.
March 29, 2015
Submitted by: Ruben Osnabrugge
The authors of this article compared CABG and PCI with second generation drug eluting stents (DES-PCI) in patients with multivessel coronary artery disease. They used data from a large observational registry and applied propensity score matching to create groups with similar baseline characteristics. They found that, at a mean follow-up of almost 3 years, DES-PCI and CABG had a similar risk of all-cause death (3.1% per year versus 2.9% per year, p=0.50), but a higher risk of myocardial infarction (1.9% per year vs. 1.1% per year; p<0.001) and repeat revascularization (7.2% per year vs. 3.1% per year, p<0.001). The risk of stroke was lower with DES-PCI (0.7% per year vs. 1.0% per year, p<0.001). The higher risk of myocardial infarction seemed to be restricted to those DES-PCI patients in whom there was incomplete revascularization. The authors conclude that the 3-year mortality risk between second generation DES-PCI and CABG was similar. DES-PCI was associatied with higher risk of myocadial infarction and repeat revascularization, but had a lower risk of stroke.
March 28, 2015
Submitted by: Stuart Head
Benedetto and co-authors analyzed propensity-matched groups of patients who underwent CABG or PCI (n= 1097 pairs) for multivessel disease, and found that outcomes were comparable at 1-year follow-up, while CABG did significantly better during follow-up to 5 years and Kaplan-Meier curves continued to diverge even further after 5 years.
March 28, 2015
Submitted by: Stuart Head
In a prospective study using MRI before and within 14 days after AVR and TAVI, Crouch and co-authors demonstrated that postoperative aortic regurgitation that was higher in the TAVI group had a significant impact on increasing left atrial size and declining right ventricular function.
March 27, 2015
Submitted by: Mark Ferguson
The authors evaluated a simple scoring system for assessing sternal healing after sternotomy. Observers had close agreement as to how CT findings matched the scoring system. There was no attempt at correlating CT findings with clinical results. Healing scores increased over time, indicating some correlation with biologic behavior.
March 21, 2015
Submitted by: Marcelo Jimenez
Concerns remain about the definition of a high risk population who can benefit from low-dose computed tomography screening programs. In this paper, the authors present a promising tool to optimize lung cancer screening in a high-risk population using a serum microRNA signature (miR-Test). The area under the ROC curve of test is 0.85 (95% CI = 0.78 to 0.92).
March 21, 2015
Submitted by: J. Rafael Sadaba
The authors describe the one-year results of a randomized trial comparing outcomes between transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) among an all-comers cohort of 280 patients. Patients 70 years of age or older with severe degenerative aortic valve stenosis referred for SAVR but also a candidate for TAVR were eligible for inclusion regardless of their predicted risk of death after surgery. The primary hypothesis was that the rate of the composite outcome of death from any cause, stroke, or myocardial infarction after 1 year would be lower for patients receiving TAVR versus SAVR. In the intent-to-treat analysis, the primary outcome was similar in the two groups (13.1% vs.16.3% for TAVR and SAVR). The need for permanent pacemaker implantation was higher in TAVR patients (38.0% vs. 2.4%), while the rate of new-onset or worsening atrial fibrillation was lower (21.2% vs. 59.4%). After 1 year, patients undergoing TAVR had more dyspnea compared to SAVR patients (29.5% vs. 15.0%; P=0.01). There was more improvement in effective orifice area relative to baseline in SAVR patients, but TAVR patients experienced a higher rate of significant aortic valve regurgitation. The authors conclude that based on their findings, they are not able to recommend one procedure over the other in lower risk patients.