Journal and News Scan

Lung cancer screening with low-dose CT is being introduced in several European countries. The management of incidental findings, both pulmonary and extrapulmonary, is an important component of the clinical and cost effectiveness of screening programs. A multi-society European group was convened to discuss the issue. Of twenty-three topics identified, the nine that were considered to be the most important and frequent were reviewed as standalone topics. These included interstitial lung abnormalities, emphysema, bronchiectasis, consolidation, coronary calcification, aortic valve disease, mediastinal mass, mediastinal lymph nodes and thyroid abnormalities. The remainder were grouped in generic categories. Following the group's recommendations will ensure an evidence-based approach is used and that harms are minimized.

Recently, the Tricuspid Valve Academic Research Consortium (TVARC) released its first document, a consensus statement aimed at bridging the current knowledge gaps in the study of tricuspid regurgitation (TR). The current classification of TR is not uniform, and as such it is challenging to stratify and study disease outcomes, especially in a growing field where transcatheter alternates to surgery are also being studied. This first document by the consortium aims to address these knowledge gaps and standardize the terminology and gives general endpoints for trials to allow for better study of the disease and promote research. The authors report that a second paper is underway, which will go into more granular detail to characterize this disease even further.Recently, the Tricuspid Valve Academic Research Consortium (TVARC) released its first document, a consensus statement aimed at bridging the current knowledge gaps in the study of tricuspid regurgitation (TR). The current classification of TR is not uniform, and as such it is challenging to stratify and study disease outcomes, especially in a growing field where transcatheter alternates to surgery are also being studied. This first document by the consortium aims to address these knowledge gaps and standardize the terminology and gives general endpoints for trials to allow for better study of the disease and promote research. The authors report that a second paper is underway, which will go into more granular detail to characterize this disease even further.

Patients younger than nineteen years old were included in a study developed to gain a better understanding of pediatric patients supported with ventricular assist devices (VADs). The authors found that illness at VAD implantation, diagnosis, and strategy of support affect survival and differ by device type. The study can act as a predictive tool to help providers make informed decisions.

ECMOSARS registry data was used to describe the characteristics and outcomes of COVID-19 patients undergoing either veno-arterial (VA) or veno-arterial venous (VAV) extracorporeal membrane oxygenation (ECMO). The authors concentrated on forty-seven patients, with a median age of forty-nine years, supported with VA or VAV-ECMO for refractory cardiogenic shock. Fourteen percent had a previous heart failure diagnosis. The two most common causes of cardiogenic shock were acute pulmonary embolism (30 percent) and myocarditis (28 percent). Thirty-eight percent of the patients underwent extracorporeal cardiopulmonary resuscitation (eCPR). In-hospital survival in the whole group was 28 percent (43 percent if eCPR patients were excluded). One day after ECMO cannulation, nonsurvivors had significantly more severe acidosis and higher FiO2. Several other factors were associated with death.
 
The authors concluded that VA-ECMO is a viable rescue therapy in carefully selected patients and suggested that eCPR is not a reasonable indication for ECMO in this group.