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Journal and News Scan
The Pulmonary Autograft After the Ross Operation: Results of 25-Year Follow-Up in a Pediatric Cohort
This study investigates the need for follow-up and reoperation after the Ross procudure over 25 years.
Froede et al. present a new simplified technique to determine commissural orientation in bicuspid aortic valves using echocardiography. Their technique using a line between the center of the nonfused and fused sinuses led to reproducible results, whereas the use of the coaptation center led to misleading results.
Montgomery et al. report on untreated infectious aneurysms of native coronary artery and aortocoronary bypass grafts are associated with high mortality. Early diagnosis proves difficult given non-specific presenting symptoms, however once recognized, early intervention is essential to mitigate complications such as myocardial ischemia or pericardial tamponade. The successful surgical management of a patient who presented two months after diagnosis of Staphylococcus aureus bacteremia is described in this report.
A scholarly metanalytic review on training by surgical simulators. The authors submit that low-fidelity is acceptable, balancing affordable basic inanimate models against the higher cost (and ethics) of zootomy and cadaceric dissection.
Morimura et al. report on mechanical circulatory support bridging prior to repair of ventricular septal rupture. In eight patients, the use of intraaortic balloon pump +/- extracorporeal life support led to avoidance of emergency operation. Survival was 7/8 perioperative and 5/8 after one year. Delayed surgery of ventricular septal rupture by mechanical circulatory support bridging constitutes a safe strategy.
Benedetto et al. looked into machine learning as a tool to predict mortality after cardiac surgery. They analyzed single-center data using prediction models, which were developed based on a neural network technique. They demonstrated in their cohort of more than 28.000 surgeries that machine learning methods did not result in improved prediction of mortality following cardiac surgery.
Celik et al. present a meta-analysis regarding the outcome of TAVI implantation with respect to the survival six years after the implantation and compared it to the outcome of surgical aortic valve replacement. In their reconstructed individual patient data analysis, they found a significant higher 5-year mortality rate in TAVI patients compared to surgical aortic valve replacement.
This is brief informative review that aids in decision making and provides criteria for early surgery for infective endocarditis in the setting of a neurologic event.
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.