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Journal and News Scan
The CSP 474 trial challenges some of the conventional knowledge around graft choice in CABG surgery, as was presented at the European Association for Cardiothoracic Surgery (EACTS) conference. The trial results showed that when an adjunctive graft was needed in patients with coronary disease, use of the radial artery instead of a saphenous vein did not give any survival advantage. However, multiarterial grafts remain the best option when performed by an experienced surgeon.
Postoperative bleeding in patients undergoing cardiac surgery is a frequent problem, and this study aimed to test the contribution of metabolic perturbations to platelet dysfunction after cardiac surgery. Patients undergoing elective surgical aortic valve replacement were included in the study. The results suggested that preoperative levels of arachidonic acid may be more relevant than platelet count to anticipate and prevent postoperative blood loss in these patients.
With the aim to compare the pain medicines bupivacaine and liposomal bupivacaine, minimally invasive lobectomy patients were randomly assigned to either medicine and monitored after surgery. Both postoperative pain level and treatment cost were compared. The study concluded that the morphine use, long-term narcotic use, and overall cost metrics between bupivacaine and LipoB were similar.
This retrospective review compares the outcomes of heart failure patients who used continuous-flow left ventricular device (CF-LVAD) support with patients listed as primary transplant candidates at the same center. The results showed that CF-LVAD patients had excellent outcomes regardless of how long they were on the waitlist. This change of risk should be taken into account when considering CF-LVAD support as a bridge to transplant.
This editorial describes the evolving pathway of diagnosing a disease that is predicted to augment the indication for orthotopic cardiac transplantation. Cardiac involvement of sarcoidosis accounts for the majority of deaths in sarcoidosis patients, so it is important to better understand its symptoms. The differential diagnosis with giant cell myocarditis will certainly be of importance in providing nuance to the decisions of the transplant meeting.