Journal and News Scan

In this publication, the authors aimed to identify methodological differences that led to varied recommendations between the current American College of Cardiology (ACC)/American Heart Association (AHA) and the European Society of Cardiology (ESC)/European Association for Cardio-Thoracic Surgery (EACTS) valvular heart disease (VHD) guidelines. They also aimed to suggest improvements toward standardizing guideline development. To this end, an in-depth analysis was conducted to evaluate the methodologies used in developing both guidelines. The evaluation was benchmarked against the standards proposed by the Institute of Medicine. Considerable discrepancies were noted in the methodologies utilized in development processes, including writing committee composition, evidence evaluation, conflict of interest management, and voting processes. Furthermore, both methodologies also demonstrated notable deviations from the Institute of Medicine standards in several essential areas, like literature review and evidence grading. These variances likely influenced treatment recommendations, thus significantly impacting global practice patterns. The authors concluded that standardization of essential processes is vital to increase the uniformity and credibility of clinical practice guidelines.

Valve sparing aortic root replacement has recently emerged as the preferred procedure, when feasible, for patients undergoing aortic root surgery. Two main options are available to achieve this: the Yacoub procedure (remodeling) and the David procedure (reimplantation). With these techniques differing considerably, the authors completed a meta-analysis of available outcome data to evaluate overall survival and need for reintervention.

In his presidential address to the AATS annual congregation, Dr. Lars Svensson shared ideas and insights into CT surgeons’ purpose as physicians, what it takes to become a master surgeon (40,000 hours), how surgery is similar to car racing, and what it takes to push the limits of what is possible to drive progress and innovation. He discusses the values of vision and leadership, shares a mantra for success and attaining the highest quality patient care possible, and discusses ways to reach such a lofty goal. He also touches on the importance of building a great team, and how to lead such a team, devise a strategy, and measure progress along the way. This is a thorough, elaborate, and eloquent address that is thought provoking and inspirational.

For hypoplastic left heart syndrome patients undergoing staged reconstruction, the neoaortic root can dilate so that the incidence of neoaortic valve insufficiency increases over time. This article aims to evaluate the outcomes of neoaortic root geometries and valvular function after chimney reconstruction in the Norwood operation in 20 patients. Researchers found that chimney reconstruction did allow patients to avoid significant neoaortic valve regurgitation and preserve conical configuration in the mid-term. However, further studies are needed to evaluate long term outcomes of this form of reconstruction.