Journal and News Scan

Current intraoperative methods for evaluating aortic valve repair often fail to predict the final echocardiographic outcome. The authors developed an aortic valve visualization and pressurization (AVP) device for use during cardioplegia and present results from its use in 24 patients undergoing valve sparing root replacement. The authors conclude that the AVP device can be a useful tool for intraoperative evaluation of the aortic valve, helping to make the result of surgery more predictable.

The incidence, predictors, and prognostic impact of rehospitalization following transcatheter aortic valve implantation (TAVI) has not been widely investigated and reported. This information is especially missing based on real-world practice data. Hence, the authors retrospectively analyzed a total of 1,397 patients who underwent TAVI between 2016 and 2020 in East Denmark. The medical records of all patients were reviewed to validate rehospitalizations up to one year after discharge from the index TAVI. A total of 615 patients (44 percent) had an unplanned rehospitalization within the first year after TAVI. The incidence of unplanned rehospitalization rate was three times higher in the early post-TAVI period (i.e., within 30 days) compared with the late post-TAVI period (i.e., 30 days to 1 year; 2.5 vs. 0.8 per patient-year, respectively; P < 0.001). Early rehospitalization was most frequently procedure related, whereas late rehospitalization was mostly related to baseline comorbidities. Early and late heart failure related rehospitalization was associated with a considerably higher one and five-year mortality risk (hazard ratio (HR) of 4.3 and 3.2 for 1-year mortality and HR of 3.2 and 2.9 for 5-year mortality, respectively; P < 0.001). Given the elevated frequency of rehospitalization following TAVI and the poor long-term survival associated with heart failure related rehospitalization, the authors conclude that TAVI trials should include rehospitalization as a major study endpoint.

This article looks at the application of prognostic models within cardiothoracic surgery, and medicine in general, using a televised UK dance competition where professional dancers are paired with celebrities as an illustration. The authors use available data from previous series to make predictions about the outcome of the competition and highlight the pitfalls of misapplication of prognostic models, particularly when extrapolating conclusions from demographic data alone.

This article is a registry review form an international voluntary registry. The retrospective historical data can be juxtaposed favorably with the recently published article on acute dissection in Denmark from a compulsory national registry. The main strength of the paper is the succinct discussion.