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Journal and News Scan
Cohort study from the UK, fuelling the escalating debate on blood management in perioperative cardiovascular care.
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.
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.
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.
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.
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.
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.
Many surgeons remain skeptical navigating the intersection of professionalism and social media presence. Utilizing CTSNet.org profiles in Canada and the United States, these authors hypothesized that thoracic surgeons who are active on Twitter have a higher research citation index (h-index) than their nonactive counterparts.
Sixty-five children who underwent biventricular repair were extubated early (immediately after chest closure in the operating room) or were extubated later on intensive care unit (ICU). The results of these two different strategies were compared. Early extubation resulted in better cardiac output, fewer pleural effusion, and shorter stay in the ICU and hospital. The authors concluded that early extubation is safe and feasible and has a beneficial effect on the postoperative course.
In this study from the Mayo Clinic, outcomes of bioprosthetic valves placed in the pulmonary position in adults with congenital heart disease were evaluated. Cumulative prosthetic valve dysfunction at 15 years was 48%, raising the question of the efficacy of using such valves in this position.