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Journal and News Scan

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Jonas Pausch, Eva Harmel, Christoph Sinning, Hermann Reichenspurner, Evaldas Girdauskas

In this study, the authors report on the outcome of mitral valve repair, applying subannular repair for functional mitral valve regurgitation. Included are 108 patients who underwent annuloplasty with subannular repair (n=60) versus patients with annuloplasty only (n=48). Repositioning of the papillary muscle lead to excellent outcomes with less mitral valve regurgitation recurrence.

Source: The Annals of Thoracic Surgery
Author(s): Alexander A. Brescia, Himanshu J. Patel, Donald S. Likosky, Tessa M.F. Watt, Xiaoting Wu, Raymond J. Strobel, Karen M. Kim, Shinichi Fukuhara, Bo Yang, G. Michael Deeb, Michael P. Thompson

Higher case volumes (>10 annually) were associated with  decreased mortality for surgical treatment of aortic dissection. This relationship was not evident for thoracic endovascular aortic repair.  

Source: The New England Journal of Medicine
Author(s): Clive Kearon, Kerstin de Wit, Sameer Parpia, Sam Schulman, Marc Afilalo, Andrew Hirsch, Frederick A. Spencer, Sangita Sharma, Frédérick D’Aragon, Jean-François Deshaies, Gregoire Le Gal, Alejandro Lazo-Langner, Cynthia Wu, Lisa Rudd-Scott, Shannon M. Bates, and Jim A. Julian, M.Math. for the PEGeD Study Investigators

Well-presented Canadian prospective study juxtaposing a combination of Wells scoring and dimers to the imaging gold standard.

It was particularly fascinating to read the referenced assertion that:

.....the prevalence of pulmonary embolism among patients who undergo diagnostic testing is substantially higher in Europe than in North America.. (Penultimate paragraph): We wonder what would be the robust causes of such disparity........

Source: Journal of Cardiothoracic and Vascular Anesthesia
Author(s): Vasileios Zochios, Joht Singh Chandan, Marcus J. Schultz, Andrew Conway Morris, Ken Kuljit Parhar, Marc Gimenez-Mila, Caroline Gerrard, Alain Vuylsteke, Andrew A. Klein

 Cohort study from the UK, fuelling the escalating debate on blood management in perioperative cardiovascular care.

Source: JAMA Cardiology
Author(s): Bryan P. Yan, William H. S. Lai, Christy K. Y. Chan, Alex C. K. Au, Ben Freedman, Yukkee C. Poh, Ming-Zher Poh

High-Throughput, Contact-Free Detection of Atrial Fibrillation From Video With Deep Learning

In this study, one-minute videos including multiple individuals were analyzed for their facial photoplethysmographic signals, permitting accurate detection of atrial fibrillation. It is an example of how biometric data may be collected with high throughput in the future.

Source: Gastroenterology
Author(s): A.J. de Groof, M.R. Struyvenberg, J. van der Putten, F. van der Sommen, K.N. Fockens, W.L. Curvers, S. Zinger, R.E. Pouw, E. Coron, F. Baldaque-Silva, O. Pech, B. Weusten, A. Meining, H. Neuhaus, R. Bisschops, J. Dent, E.J. Schoon, P.H. de With, J.J. Bergman

A deep-learning computer aided detection (CAD) system was trained to recognize neoplasia using nearly 500,000 endoscopic images.  In head-to-head testing against experienced gastroenterologists using additional images, the accuracy of CAD in diagnosing neoplasia was 88% vs 73% for the gastroenterologists.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Nishant Saran, Joseph A Dearani, Sameh M Said, Kevin L Greason, Alberto Pochettino, John M Stulak, Simon Maltais, Sertac Cicek, Juan Crestanello, Richard C Daly, Katherine S King, Hartzell V Schaff

The authors analyzed what is the best management for tricuspid valve disease in adults. This is a retrospective study with 1,735 patients who received tricuspid valve repair and 806 patients who underwent replacement. Replacement was associated with increased late mortality. Tricuspid valve repair did not result in a higher risk of reoperation. The authors concluded that tricuspid valve repair should be preferred whenever feasible.

Source: The Annals of Thoracic Surgery
Author(s): Kathleen C. Clement, Alejandro Suarez-Pierre, Krisztian Sebestyen, Diane Alejo, Joseph DiNatale, Glenn J.R. Whitman, Thomas L. Matthew, Jennifer S. Lawton

Variations in, and elevation of, serum glucose within 24 hours of isolated CABG were associated with a significantly increased risk of cardiovascular complications and mortality within 30 days.

Source: The New England Journal of Medicine
Author(s): Ole De Backer, George D. Dangas, Hasan Jilaihawi, Jonathon A. Leipsic, Christian J. Terkelsen, Raj Makkar, Annapoorna S. Kini, Karsten T. Veien, Mohamed Abdel-Wahab, Won-Keun Kim, Prakash Balan, Nicolas Van Mieghem, Ole N. Mathiassen, Raban V. Jeger, Martin Arnold, Roxana Mehran, Ana H.C. Guimarães, Bjarne L. Nørgaard, Klaus F. Kofoed, Philipp Blanke, Stephan Windecker, and Lars Søndergaard, M.D., D.M.Sc. for the GALILEO-4D Investigators Abstract

Puzzling subgroup from the GALILEO trial, which appears in the same issue of the periodical as an article that discredits the use of rivaroxaban as thromboprevention strategy :

https://www.nejm.org/doi/full/10.1056/NEJMoa1911425?query=recirc_curatedRelated_article,

And yet, in this particular subgroup, a subclinical benefit on leaflet mobility is being suggested!  It would appear that the GALILEO will be discussed at length and in detail in the months and years to come.

Source: The Annals of Thoracic Surgery
Author(s): Robbin G. Cohen, S. RamKumar, Jules Lin, Rishindra M. Reddy, Lauren Kane, Jennifer Bagley, Armando Juarez, Fernando Fleischman, Emily A. Farkas, Amy E. Hackmann, Kendra J. Grubb, Seenu Reddy, Loretta Erhunmwunsee, Nestor R. Villamizar, Muhammad F. Masood, Melissa Griffin, Natalie Boden

A growing number of patients consult online resources for medical information, not only to learn about their own health issues and therapeutic options, but also to evaluate the background and reputation of their physicians.  In 2015, the Workforce on Media Relations and Communications of The Society of Thoracic Surgeons (STS) created a Patient Information Task Force for the purpose of overhauling its patient information website into a comprehensive, multimedia, bilingual online education resource (ctsurgerypatients.org) for cardiothoracic surgical patients and their families. The website was also designed to be used as a reference tool to which STS member surgeons could refer their patients. The methodology and structure of the website are described, as well as an evaluation of its success using survey results both from patients utilizing the website and STS members.

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