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Journal and News Scan
March 27, 2024
Submitted by: Mateo Marin-Cuartas
The frequency of minimally invasive mitral valve (MV) surgery has increased over the last decade. Hence, the number of patients requiring MV reoperations post-minimally invasive MV surgery is increasing. This study analyzed the outcomes of patients undergoing MV reoperation after previous minimally invasive MV surgery during a twenty-year period in a high volume heart valve center. A total of 187 patients were included in the analysis (34 [18.2 percent] patients repeat MV repair; 153 [81.8 percent] MV replacement). Redo MV surgery was performed through median sternotomy in 169 (90.4 percent) patients. The median intensive care unit stay was 1 day (1-5 days). The thirty-day mortality was 6.4 percent, and actuarial survival at 5 and 12 years was 61.8 percent and 38.3 percent, respectively. Endocarditis and preoperative stroke were identified as predictors of late mortality.
March 27, 2024
Submitted by: Francesco Pollari
Overall, 4,365 patients were diagnosed and operated on for infective endocarditis (IE) from 2000 to 2021. Long-term survival was significantly higher among patients receiving a mechanical prosthesis than those receiving a biological prosthesis (hazard ratio [HR] 0.546, 95 percent CI: 0.322-0.926, p= 0.025). Mechanical prostheses were associated with significantly less recurrent endocarditis after AVR than biological prostheses (HR 0.268, 95 percent CI: 0.077-0.933, p= 0.039). The present analysis of the INFECT-REGISTRY shows increased survival and reduced recurrence of endocarditis after a mechanical aortic valve prosthesis implant for IE in middle-aged patients.
March 27, 2024
Submitted by: Javeria Tariq
This study aimed to evaluate the percentage of solitary fibrous pleural tumors presenting unfavorable clinical behavior to predict negative long-term outcomes. Although they are historically considered benign neoplasms, this retrospective review identified 25 percent of 74 patients displayed histological evidence of malignancy as per England criteria and the recurrence rate was 21 percent. The authors recommended the pathological differentiation of these tumors into pedunculated, well circumscribed, and sessile growth patterns. They also recommend that all nonpedunculated lesions should be classified as potentially aggressive.
March 19, 2024
Submitted by: Jo Chikwe
Many obstacles challenge cardiac surgery in low- and middle-income countries, despite unmet cardiac surgical needs. One challenge has been providing adequate follow up care to monitor anticoagulation, manage morbidity, and prevent mortality. This systematic review of 67 articles published between 2012 and 2022 describes outcomes after valvular cardiac surgery and focuses on strategies for prolonged follow up care in resource constrained settings.
March 19, 2024
Submitted by: EACTS Staff
Heart transplantation (HT) is the only life extending option in adults with congenital heart disease (CHD) and end stage heart failure. This study evaluated outcomes after heart transplantation in adults with univentricular versus biventricular CHD. One-hundred-forty-nine patients were included, 55 of whom (36.9 percent) had univentricular CHD. Follow up was for a mean of 10.1 years. Sixty-four patients died during follow up, including 47 before discharge from hospital. Multivariable analysis showed univentricular physiology (odds ratio (OR) 2.99, 95 percent CI 1.33–6.74) and female recipient gender (OR 2.76, 95 percent CI 1.23–6.74) carried higher risk of early mortality. For patients who survived the early period, long-term survival was excellent and did not differ between the groups.
March 19, 2024
Submitted by: Mateo Marin-Cuartas
In this brief review article, the authors discuss the pros and cons of early intervention in patients with moderate aortic valve stenosis.
March 14, 2024
Submitted by: Jo Chikwe
Between 2001 and 2021, 51 percent (n = 28,012) of US pediatric heart donors underwent cardiopulmonary resuscitation (CPR). Donor acceptance was lower after CPR (54 percent versus 66 percent; P < .001) and across successive quartiles of CPR duration (P < .001). Posttransplant survival was worse in donors who received more than 55 minutes of CPR (11.1 years vs 9.2 years; P = .025). There was no survival difference between the recipients of donors who received less than 55 minutes of CPR and no CPR (11.1 years vs 11.2 years; P = .571).
March 14, 2024
Submitted by: Jo Chikwe
To assess whether seeking care at multiple Commission on Cancer hospitals is associated with different rates of guideline-concordant care, 44,531 patients undergoing treatment for non-small cell lung cancer between 2004 and 2018 were analyzed. Visiting more than one Commission on Cancer hospital was associated with higher rates of guideline-concordant care for individuals with pN1 to pN2 lung cancer and higher overall survival at five years (54.35 percent vs 45.62 percent, P < .001).
March 14, 2024
Submitted by: Mateo Marin-Cuartas
This commentary refers to “PCI or CABG for left main coronary artery disease: the SWEDEHEART registry,” by J. Persson et al. In their commentary, the authors discuss the evidence that shows lower rates of major adverse events at five years in patients who underwent CABG compared with PCI for the treatment of left main disease.
March 14, 2024
Submitted by: Francesco Pollari
In the last decades, four different scores for the prediction of mortality following surgery for type A acute aortic dissection (TAAD) were proposed. Researchers aimed to validate these scores in a large external multicenter cohort. The study retrospectively analyzed patients who underwent surgery for TAAD between 2000 and 2020. Patients were enrolled from ten centers in two European countries. Outcomes were determined for early (30-day and/or in-hospital) and one-year mortality. Discrimination, calibration, and observed/expected (O/E) ratio were evaluated for the GERAADA, the UK Aortic, Centofanti's, and IRAD's score. The GERAADA score showed the best performance in comparison with other scores. However, none of them achieved both a fair discrimination and good calibration for predicting either the early or the one-year mortality.