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Journal and News Scan
Chemtob et al. present data from the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD). They database out of eight hospitals the recorded data of 1,128 patients. This analysis focused on perioperative stroke, which occurred in 15.7% of all patients and was higher in patients with preoperative cerebral malperfusion, impaired hemodynamics, and in patients who underwent arch replacement. However, as many patients with prior cerebral malperfusion did not develop stroke, this should never be judged as contra-indication for surgery.
This retrospective observational study of patients undergoing surgical repair for TOF-APV between 2006 and 2018 evaluated the safety of pulmonary artery replacement and aggressive direct airway management at initial definitive repair of cardiac TOF-APV.
An ad hoc interim analysis pursuant to previous publications raising concerns on Paclitaxel DCS in chronic critical and not-critical lower limb ischaemia. The short manuscript requires careful reading to form an individual opinion beyond the relatively simple arithmetics: slightly more deaths in the intervention group. The vasculopathic cohort had a 75% crude overall survival after only 2.5 years.
A brief and readable editorial on the United Kingdom prespective on the global impact of the pandemic to the delivery of cardiovascular care, attempting a semi-quantitative economic appraisal of the problem.
A large RCT with results somewhat supportive of considering a NOAC in the place of warfarin for post operative surgical patients. The study will be weighed against healthcare economical aspects. One question will arise: Why, if there was a subgroup ( the cohort had an average age below 60 years) eceiving lifelong warfarin or equivalent anticoagulation prior to surgery, they did not have a mechanical prosthesis? It is of course possible that local financial constrains impede access to such devices, and bioprostheses were more affordable.
A relatively recent, open-access, brief viewpoint on the utility of screening for thoracic aortic pathologies. Although the negative opinion expressed by the author may not be universally accepted, a debate fuelled by data and especially patient-centered cerebrospinal outcomes will certainly be of benefit; evem more so with the spreading of metrics for prediction of acute complications of aortic disease.
This is a comprehensive review of current strategies for monitoring and protection of the brain during aortic arch surgery under hypothermic circulatory arrest.
Hoyos Mejia et al. present a single center report regarding the outcome of thoracic surgery during the COVID-19 pandemic. They recorded a significant reduction in thoracic surgical cases. They observed five cases of coronarvirus infection in 101 surgical patients within 14 days after surgery. Two of these patients needed inpatient treatment and none died due to the infection. They conclude that it is safe to perform selected surgical procedures during the pandemic if managed properly.
This study evaluated preoperative cerebrospinal fluid drainage (CSFD) In patients undergoing isolated descending TEVAR with or without arch involvement (+/− arch TEVAR).
A scholarly and sober narrative review on , as the authors state, a ' hot topic' that is already being debated in Multidisciplinary Meetings and Lung Cnacer Boards.