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Cardiac Guidelines

April 24, 2018
The authors report on a randomized, multicenter, open-label, clinical trial involving 500 patients with 1460 saphenous vein grafts (SVG) who were assigned to three groups: (1) ticagrelor + asprin (ASA), (2) ticagrelor alone, or (3) ASA alone.  Neither patients nor physicians were blinded to the allocation.  The primary outcome was SVG patency at one
March 19, 2018
A medium-size RCT comparing full sternotomy to limited sternotomy for conventional aortic valve replacement, presented at the SCTS Annual Meeting in Glasgow. The 7-10% one year attrition rate seems quite disappointing, and will most probably be discussed. We will await the full paper to see what was the learning curve for the innovative approach.
March 1, 2018
The authors present a thorough expert consensus review on the prevention—preoperative, intraoperative, and postoperative—and the postoperative management of sternal wound infections.  The authors conclude with a guideline with class recommendations and levels of evidence. This article should be in every cardiac surgeon's armamentarium.
February 28, 2018
A retrospective Mount Sinai small series on selective emergent implantation of long-term ventricular assist devices  in cardiogenic shock. It challenges the traditional concept of short-term stabilisation with ECMO or short-term support, and is likely to generate criticism and discussions.
February 2, 2018
An editorial from an influential source discussing the recent robust results of the CASTLE-AF RCT trial. It is likely that interventions for atrial fibrillation will be boosted by these results, in terms of insurance, industry, and clinical guideline support.
February 2, 2018
A brief note on the feasibility (or not) of RCT on surgery for mitral fibroelastic prolapse.
January 25, 2018
A large follow-up study comparing repair and replacement results and trends. Of particular interest to the UK and European readership is the page 113 discussion on the center of mitral excellence principle.
January 17, 2018
The new EACTS Guidelines on perioperative medication in adult cardiac surgery address antithrombotic management, atrial fibrillation, renin–angiotensin–aldosterone system inhibitors, beta-blockers, dyslipidaemia, ulcer prevention and steroids, antibiotic prophylaxis, anaesthesia and postoperative analgesia, and blood glucose management.
January 8, 2018
A very brief editorial on frailty as a risk factor. In the time of weighing transcatheter interventions versus variable access surgical options, quantifying this physiological concept is of major importance for the cardiac teams and, importantly, the autonomy of the patient.
January 3, 2018
Video and a readable digest of a talk in a Harvard meeting, especially interesting in its scepticism on prevention.

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