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Journal and News Scan
Appropriate conduit selection for right ventricle (RV)-to-pulmonary artery (PA) connection has been studied extensively, with older implantation age, pulmonary (vs aortic) homografts, and true sizing associated with increased longevity. Notably, patients with PA arborization abnormalities (ie, major aortopulmonary collateral arteries [MAPCAs]) are reported to need earlier and more frequent conduit interventions. We aim to understand the behavior of large-diameter aortic homografts in patients with MAPCAs, which are programmatically utilized at our institution.
Non–Vitamin K Antagonist Oral Anticoagulant vs Warfarin for Post Cardiac Surgery Atrial Fibrillation
Treatment guidelines for nonvalvular atrial fibrillation (AF) recommend use of non–vitamin K antagonist oral anticoagulants (NOACs) over warfarin. However, clinical trials did not include individuals with post cardiac surgery AF. We sought to compare outcomes with NOACs vs warfarin for new onset post cardiac surgery AF.
A good-size Terumo-sponsored RCT that is set to impact on decisions to discontinue DAPT early after PCI with absorbable stent, a change that will somehow decrease the surgical risk of bleeding in the event of salvage CABG.
Patients with three-vessel coronary artery disease have been known to have better outcomes with coronary-artery bypass grafting (CABG) than patients with percutaneous coronary intervention (PCI). However, studies in which PCI is guided by measurement of fractional flow reserve (FFR) have been lacking.
In this multicenter, international, noninferiority trial, patients with three-vessel coronary artery disease were randomly assigned to undergo CABG or FFR-guided PCI with current-generation zotarolimus-eluting stents. The primary end point was the occurrence within 1 year of a major adverse cardiac or cerebrovascular event, defined as death from any cause, myocardial infarction, stroke, or repeat revascularization.
An extremely useful and free-access update on a major vascular entity. The 'Areas of Uncertainty' is a particularly useful chapter, discussing the available technology and its current supra-renal limitations and the emerging solutions.
In this large series, Dr. Chung and associates performed a study on completeness of guideline-directed imaging surveillance (GDIS) and its association with long-term outcomes. In 888 patients with acute type A dissection who survived surgical repair, 14% received GDIS throughout a median follow-up of 5.2 years, and GDIS was available in 3.4% at 6 years. Intriguingly, greater adherence to GDIS was associated with mortality (hazard ratio: 1.08; 95% confidence interval: 1.05-1.11) and reintervention (hazard ratio: 1.04; 95% confidence interval: 1.01-1.07).
Pediatric heart transplant (HTx) recipients with congenital heart defects need complex concomitant surgical procedures with the risk of prolonging the allograft’s ischemic time. Ex vivo allograft perfusion with the Organ Care System (OCS; Transmedics, Andover, MA) may improve survival of these challenging patients.
A Retrospective Study of Infection in Patients Requiring Extracorporeal Membrane Oxygenation Support
Healthcare-associated infections (HAIs) in critically ill patients are a public health issue. Extracorporeal membrane oxygenation (ECMO) has been increasingly used for patients with severe cardiac or respiratory failure, but it may increase HAI risk. This study's goal was to characterize HAIs in ECMO patients at an ECMO referral center.
This is a commentary on the article, "Residual Lesions and ECMO: Seek and You Shall Find Ways to Narrow the ECMO Gap"
This study aims to assess the impact of diagnostic procedures in identifying residual lesions during extracorporeal membrane oxygenation (ECMO) on survival after pediatric cardiac surgery.