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Journal and News Scan
October 9, 2014
Submitted by: Joel Dunning
This paper presents an update on diagnostic and prognostic biomarkers in malignant pleural mesothelioma considering also recent molecular biologic achievements as microRNA and genomic sequencing.
October 9, 2014
Submitted by: Joel Dunning
This prospective observational study compares patients with coronary artery bypass grafting on aspirin and ticagrelor (n = 173) or on aspirin and clopidogrel (n = 232). Major bleeding complications occurred in 14.5% with ticagrelor and 13.8% with clopidogrel (p=0.89).
No significant differences were observed, too, when the drugs were discontinued ≥5 or 2-4 days before surgery. A strong tendency to more bleeding complications in the ticagrelor group was found, however, when the drugs were given until 0–1 day before surgery.
October 9, 2014
Submitted by: Joel Dunning
The authors compare 3 groups of patients undergoing aortic root replacement for ascending aorta aneurysm: valve-sparing root replacement (VSRR, n = 178), Bentall procedure with biological conduit (n = 91) or mechanical conduit (n = 101). Patients with VSRR had the best 5-year survival and low incidence of bleeding complications. The authors suggest the VSRR procedure as first choice for patients with ascending aortic aneurysms.
October 9, 2014
Submitted by: Joel Dunning
This exiting paper describes current achievements and open questions on the way to the manufacturing of heart valves using 3D printing.
October 9, 2014
Submitted by: Joel Dunning
Fifty years after the first coronary artery bypass grafting, the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) issued together guidelines for myocardial revascularization. In this document ESC and EACTS provide recommendations for revascularization of stable coronary artery disease, non-ST-segment elevation acute coronary syndrome, ST-segment elevation myocardial infarction and revascularization in patients with different risk factors. The authors underline the importance of interaction between cardiologists, cardiac surgeons and referring physicians for choosing the best possible revascularization approach.
October 9, 2014
Submitted by: Mark Ferguson
A well done video describing radial artery line placement aided by US.
October 9, 2014
Submitted by: Mark Ferguson
This randomized trial investigated two different thresholds for triggering transfusion in patients with septic shock: 9 g/dL or 7 g/dL. The lower threshold group received a median of 1 unit of blood compared to 4 in the higher threshold group. 90 day mortality rates and other morbidity were similar between the groups.
October 8, 2014
Submitted by: Stuart Grant
This study utilised data form the UK National Adult Cardiac Surgery Audit to compare re-intervention free survival between porcine and bovine pericardial aortic valves. All elective or urgent aortic valve replacements with or without coronary artery surgery between 2003 and 2013 were included with a median follow-up time of 3.6 years. There was no difference in in-hospital mortality, survival (10-year survival of 49.0% and 50.3% in the bovine pericardial and porcine groups respectively) or re-intervention free survival between the groups. After adjustment there was a trend towards improved re-intervention free survival in younger patients (<60) who received porcine valves.
October 8, 2014
Submitted by: Mark Ferguson
This multicenter prospective trial evaluated the impact of induction therapy on anastomotic leak (AL) and other complications after esophagectomy. Of 2944 included pts, 593 had induction chemoradiotherapy. AL occurred in 8.8% of induction therapy pts compared to 10.6% of surgery only patients. 90 day postoperative morbidity and mortality rates were similar between the groups. Chylothorax, cardiovascular complications, and VTE events were more common after induction therapy.
October 8, 2014
Submitted by: Mark Ferguson
The authors investigated the impact of new onset a-fib after esophagectomy in 437 pts. Risk factors included age, diabetes, induction therapy, and cardiac history. A-fib was associated with postoperative pneumonia, symptomatic pleural effusions, and an increase in C-reactive protein. It was not associated with anastomotic leak or mortality. 92% of affected pts were discharged in sinus rhythm. Long-term survival was not related to the development of a-fib.