Journal and News Scan

This propensity matched single institution study compared conventional aortic valve replacement via a full sternotomy (CAVR) to minimal access aortic valve replacement (MAAVR) via an upper hemisternotomy. Over the eleven year study period a total of 2103 patients underwent isolated aortic valve replacement. After propensity matching, 585 patients were included in each group. Patient characteristics were well balanced between the two groups. There was no difference between the groups with respect to cross-clamp time although the MAAVR group had a longer average bypass time. The MAAVR group had a lower average volume of autologous blood transfusion, intubation time, post-operative renal complications and rate of respiratory insufficiency. There was no difference between the groups with regards to re-exploration for bleeding, ICU or hospital length of stay, early mortality of survival. The authors conclude that MAAVR is their procedure of choice for isolated aortic valve replacement.  

This meta-analysis compares short-term mortality, neurological dysfunction and malperfusion in patients who underwent acute type A aortic dissection (AAD) repair with axillary artery cannulation (AXC) compared to femoral artery cannulation (FAC).

412 Fontan patients were evaluated retrospectively for long-term correlations between postoperative haemodynamics and anticoagulant regimens with haemostatic events. Thrombo-embolic events were observed in 2.7% and haemorrhagic events in 4.4% of patients. Risk factors are analysed for both short- and long-term complications.

This study examined the utility/accuracy of an administrative database compared to the STS Congenital Database for the outcome of mortality, which is used to rank quality.  The administrative database had substantially lower volume and mortality numbers than the STS Database, resulting in ranking differences of 5 or more places for 24% of hospitals.