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Journal and News Scan
August 30, 2023
Submitted by: EACTS Staff
Survival of diabetics after single or multiple coronary artery bypass grafting was compared in a national database over twenty years with 69,224 patients. End points were long-term all-cause mortality and thirty-day clinical outcomes. 17,474 nondiabetic and 10,989 diabetic matched pairs were generated. At a median of 5.9 years after grafting, mortality was statistically significantly lower after multiple arterial grafting in both diabetic and nondiabetic cohorts. The incidence of myocardial infarction was significantly higher in single rather than multiple grafting for both cohorts. Multiple arterial grafting was associated with improved survival for both diabetic and nondiabetic patients.
August 30, 2023
Submitted by: Mujtaba Mubashir
While much research is ongoing regarding the safety of transcatheter aortic valve replacement (TAVR) compared to surgical aortic valve replacement (SAVR) after prior coronary artery bypass (CABG), there is limited data on morbidity outcomes and discharge locations among these two procedures. This article looked into a single center experience over fifteen years and found shorter length of stay, less new-onset atrial fibrillation, and more discharges home in the TAVR group compared to the SAVR group, with an overall improved morbidity profile.
August 24, 2023
Submitted by: EACTS Staff
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.
August 24, 2023
Submitted by: Ashiq Abdul Khader
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.
August 24, 2023
Submitted by: Malak Elbatarny
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.
August 24, 2023
Submitted by: Jason Trevis
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.
August 17, 2023
Submitted by: EACTS Staff
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.
August 17, 2023
Submitted by: Jason Trevis
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.
August 17, 2023
Submitted by: Malak Elbatarny
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.
August 16, 2023
Submitted by: Aristotle Protopapas
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.