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Journal and News Scan
September 23, 2022
Submitted by: Cameron Lind
As robotic surgery continues to advance and become a more established method in cardiothoracic and other surgical specialties, concerns have arisen surrounding cybersecurity. Healthcare systems are particularly vulnerable to cybersecurity attacks, and the complex nature of robotic surgery systems creates additional risk. To mitigate that risk, it is important to recognize system complexity, regularly update software, follow cybersecurity best practices, and increase transparency with robotic surgery patients.
September 20, 2022
Submitted by: Aristotle Protopapas
Plasma metabolomic profiles were examined to determine differences in social determinants of health between Black and white women. This observational study paves the groundwork for further investigation of social disparity in atheromatous disease. The historical hereditary effect of renin aldosterone axis regulation may be proven to reflect such disparities (related to slave trade and water deprivation) concerning people with African heritage. In fact, the study concluded that the significant difference in metabolomic profiles between Black and white women may be associated with coronary heart disease risk and racial disparities in the US.
September 15, 2022
Submitted by: Cameron Lind
Over the past three decades, more than 76,000 heart transplantations have been performed. This study evaluated trends and outcomes of patients who underwent the procedure to treat peripartum cardiomyopathy (PPCM)—a disease limited to female patients—the frequency of which increased over the study period. The analysis found that the ten-, fifteen-, and twenty-year survival rates were significantly lower among PPCM heart transplant patients than other female heart transplant patients. Additionally, survival rates were even lower among Black and Hispanic patients. However, the survival rate among PPCM patients did improve over the last decade, particularly for Black transplant patients.
September 9, 2022
Submitted by: Wei-Guo Ma
The authors of this study reported the safety and one-year clinical outcomes of the Thoraflex Hybrid frozen elephant trunk prosthesis from the US Investigational Device Exemption trial. Follow-up was available in 63 of 65 patients from twelve centers at one-year, when the mortality was 11 percent (7/65), and freedom was 81 percent (51/63) from major adverse events, including permanent stroke (n = 3), permanent paraplegia/paraparesis (n = 3), unanticipated aortic-related reoperation, or all-cause mortality (n = 7); planned extension procedures were performed in twenty-six (41%), including twenty-two endovascular procedures by a median of four months. While one-year results are acceptable, long-term data are needed to assess durability of the repairs.
September 9, 2022
Submitted by: Cameron Lind
While transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic stenosis, a new study in the American Journal of Cardiology showed that there may be a high risk of in-hospital mortality for patients who undergo surgical aortic valve replacement (SAVR) after TAVR. Because of questions surrounding the long-term durability of TAVR, future cardiac surgery often has to be considered. In patients who underwent SAVR after TAVR because of various complications, the mortality rate after one year was 53 percent. This number is higher than past studies and must be monitored as TAVR becomes a more common procedure. Read the full study here.
September 8, 2022
Submitted by: Cameron Lind
According to Duke University Health, a team of its surgeons has completed the first partial heart transplant, with living arteries and valves from a donated heart fused onto the heart of the existing newborn patient. This method allows the entire heart to grow as one, which could eliminate the need for multiple heart surgeries in a child’s lifetime and potentially extend the life of the child by decades. The patient has shown remarkable growth since the procedure and will provide insight for future children born with congenital heart diseases.
Clinical Outcomes Using Freestyle Valve–Valsalva Graft Composite Conduit for Aortic Root Replacement
September 8, 2022
Submitted by: Cameron Lind
From 2005 to 2020, 523 patients were treated using a novel method of aortic root replacement that used a self-constructed tissue valve conduit involving a Freestyle subcoronary valve sewn into a Valsalva graft. This study aimed to review the clinical outcomes of the method. Over the fifteen-year period, the five-year survival rate was 83 percent and the ten-year survival rate was 71 percent. Overall, the novel method produced excellent operative and ten-year outcomes, and valve durability was outstanding with low incidence for valve reintervention.
September 4, 2022
Submitted by: Wei-Guo Ma
This is the most recent data on the early mortality of acute type A aortic dissection within the first forty-eight hours from onset. Prior to this study, there was a lack of contemporary data that characterized the positive effects of timely surgery.
Based on 5611 patients enrolled between January 1996 and November 2018, the IRAD investigators have found an overall mortality of 5.8% over the first forty-eight hours. In medically managed patients, mortality was 23.7% at forty-eight hours (0.5% per hour). For patients intended for surgical treatment, forty-eight-hour mortality was 4.4% (0.09% per hour), and 1% died before the operation. Surgical patients were more likely to die of multiorgan failure and bleeding complications, while medically managed patients were more likely to die of aortic rupture and cardiac tamponade.
September 2, 2022
Submitted by: Cameron Lind
Recently, there has been an increase in infective endocarditis cases among people who inject drugs. As a result, the American Heart Association has sponsored a writing group of recognized experts to produce a more in-depth article on the management of infective endocarditis among this unique population. The writing group concluded that management of infective endocarditis in people who inject drugs requires a unique and wholistic approach to care, including the involvement of addiction-trained clinicians and measures taken to prevent an infection recurrence. The study also emphasizes that, regardless of current drug use, people with infective endocarditis who inject drugs should be considered for heart valve repair or replacement surgery if needed.
September 2, 2022
Submitted by: Cameron Lind
In the past, there has not been an accurate way to calculate mortality risk for patients with atrial fibrillation (AF) who have undergone a successful transcatheter aortic valve implantation (TAVI) and have been discharged home. Now, researchers with the ENVISAGE-TAVI AF trial have developed a risk score to more accurately predict mortality in TAVI patients. George Dangas, of The Zena and Michael A. Wiener Cardiovascular Institute, presented the trial’s findings at the European Society of Cardiology Congress 2022, highlighting that the new risk assessment score focuses on improving outcomes by determining how to categorize patients after a successful TAVI and discharge. Dangas added that the analysis will continue to enhance the understanding of patient risk after TAVI.