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Journal and News Scan

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Michel Pompeu Barros de Oliveira Sá, Martinha Millianny Barros de Carvalho, Dário Celestino Sobral Filho, Luiz Rafael Pereira Cavalcanti, Sérgio da Costa Rayol, Roberto Gouvea Silva Diniz, Alexandre Motta Menezes, Marie-Annick Clavel, Philippe Pibarot, Ricardo Carvalho Lima

This meta-analysis included 70 articles reporting on more than 100,000 patients who underwent surgical aortic valve replacement. The incidence of patient-prosthesis mismatch (PPM) was 53.7%. Moderate and severe PPM was associated with higher mortality, both early and late after surgery. The authors conclude that the implementation of surgical strategies to prevent PPM are important in order to reduce mortality rates.

Source: The New England Journal of Medicine
Author(s): David Harrington, Ralph B. D’Agostino, Sr, Constantine Gatsonis, Joseph W. Hogan, David J. Hunter, Sharon-Lise T. Normand, Jeffrey M. Drazen, Mary Beth Hamel

In this editorial, Harrington and coauthors introduce the updated guidelines for statistical reporting in the New England Journal of Medicine, which can be accessed at https://www.nejm.org/author-center/new-manuscripts.

The authors went into detail about the requirement to replace P values with estimates of effects or association and 95% confidence intervals when neither the protocol nor the statistical analysis plan has specified methods used to adjust for multiplicity.

Source: Abbott Press Release
Author(s): Abbott

Abbott announced that its fourth-generation MitraClip device, MitraClip G4, was approved by the US Food and Drug Administration on July 15, 2019, to treat mitral regurgitation (MR) in a wider population of patients.  The MitraClip G4 include new clip sizes and an enhanced leaflet grasping feature

  1. More flexibility with four unique clip sizes, including clips with a wider grasping area to provide additional treatment options
  2. Independently controlled grippers that better help with the grasp of one or both mitral leaflets during transcatheter mitral valve interventions
  3. Upgraded MitraClip catheter can be integrated with a commercially available pressure monitor to continuously track and confirm MR reduction during the implant procedure

 

Source: Innovations
Author(s): Hans-Joachim Schäfers

Aortic valve repair is complex, and techniques must be tailored to the pathology. With this in mind, the author summarizes his core philosophy on aortic valve repair in 10 points:

  1. Be prepared!
  2. Know the geometry of the aortic valve
  3. Understand the echocardiographic analysis of the aortic valve
  4. Do not trust looks!
  5. Identify suitable substrates
  6. Keep the repair simple and reproducible
  7. Assess the repair result systematically
  8. Carefully consider the alternatives
  9. Follow your patients/Learn from your failures
  10. Share your results

Each point is discussed in more depth in this editorial.

Source: International Journal of Cardiology
Author(s): Lidia R. Bons, Zahra Sedghi Gamechi, Carlijn G.E. Thijssen, Klaus F. Kofoed, Jesper H. Pedersen, Zaigham Saghir, Johanna J.M. Takkenberg, Isabella Kardys, Ricardo P.J. Budde, Marleen de Bruijne, Jolien W. Roos-Hesselink

Investigators reported the distribution of thoracic aortic growth in smokers based on longitudinal data of current and ex-smokers aged 50-70 years from the Danish Lung Cancer Screening Trial. Mean and 95th percentile of annual aortic growth of the ascending aortic and descending aortic diameters were calculated with the first and last noncontrast computed tomography scans during follow-up.

A total of 1,987 participants (56% male, mean age 57.4 ± 4.8 years) were included and followed for a median of 48 months. The ascending and descending aortic growth was approximately 0.1 mm/year and consistent with growth in the general population. The 95th percentile ranged from 0.42 to 0.47 mm/year, depending on sex and location. Larger aortic growth was associated with lower age, increased height, absence of medication for hypertension or hypercholesterolemia, and lower Agatston scores.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Patrick M. McCarthy, Charles J. Davidson, Jane Krusea, Daniel J. Lerner, Mary Jo Braid-Forbes, Michelle M. McCrea, Ahmed M. Elmouelhi, Michael A. Ferguson

An important update on the evolving landscape of surgery for atrial fibrillation.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Richard D. Weisel, Spencer McGrath

Later this year, AATS will launch two new open access journals, JTCVS Open and JTCVS Techniques, to provide authors with additional options to publish high-quality information of importance to thoracic and cardiovascular surgeons.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Maral Ouzounian, Christopher M. Feindel, Cedric Manlhiot, Carolyn David, Tirone E. David

Tirone David's experience on his operation, with interesting data on the durability of the re-implantation.

Source: The Annals of Thoracic Surgery
Author(s): Mohanad Hamandi, Robert L. Smith, William H. Ryan, Paul A. Grayburn, Anupama Vasudevan, Timothy J. George, J. Michael DiMaio, Kelley A. Hutcheson, William Brinkman, Molly Szerlip, David O. Moore, Michael J. Mack

Hamandi and colleagues reviewed outcomes for 95 patients who underwent isolated tricuspid valve (TV) surgery between 2007 and 2017 at their institution. For 41% of patients, the procedure was reoperative, following either prior coronary artery bypass grafting or prior valve surgery. Valve repair was performed in over 70% of patients. Operative mortality was low, being 3.2% overall and with no mortality in the last 6 years studied (73 patients). The authors conclude that careful patient selection and current periprocedural management have improved morbidity and mortality of isolated TV surgery, and they suggest that these outcomes can serve as a benchmark for catheter-based TV interventions.

Source: Interactive Cardiovascular and Thoracic Surgery
Author(s): Yuriko Terada, Tsuyoshi Takahashi, Shigeki Morita, Kosuke Kashiwabara, Kazuhiro Nagayama, Jun-Ichi Nitadori, Masaki Anraku, Masaaki Sato, Aya Shinozaki-Ushiku, Jun Nakajima

Spread through air space (STAS) is a pattern of lung adenocarcinoma invasion, and it is a predictor of recurrence in patients with early-stage lung adenocarcinoma. However, less is known about the role of STAS in advanced lung adenocarcinoma. In this retrospective study including 76 patients with stage III lung adenocarcinoma, the presence of a STAS invasion pattern was a significant risk factor for adenocarcinoma relapse.

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