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Journal and News Scan

Source: JAMA Surgery
Submitted by: Mark Ferguson
June 25, 2015
Author(s): Wayne S. Lee; Vincent E. Chong; Gregory P. Victorino
The authors reviewed their experience with patients suffering blunt trauma who had evidence of a pneumomediastinum on CT.  Among over 3,000 pts, 2.7% had pneumomediastinum.  Those affected had higher injury scores and a higher mortality rate (12.5% vs 3.6%).  Increased risk of mortality was associated with posterior mediastinal air, air in all mediastinal spaces, and an associated hemothorax.
Source: Journal of Thoracic Oncology
Submitted by: Mark Ferguson
June 25, 2015
Author(s): Iida, Tomohiko; Shiba, Mitsutoshi; Yoshino, Ichiro; Miyaoka, Etsuo; Asamura, Hisao; Date, Hiroshi; Okumura, Meinoshin; Tada, Hirohito; Nakanishi, Yoichi; Dosaka-Akita, Hirotoshi; Kobayashi, Hideo; Takahashi, Kazuhisa; Inoue, Masayoshi; Yokoi, Kohei; for the Japanese Joint Committee of Lung Cancer Registry
This study evaluated outcomes in patients undergoing resection for lung cancer who were found at surgery to have pleural carcinomatosis.  2.9% of registry patients were identified, of whom 49% had a macroscopic complete resection.  5-year survival in those without other metastatic disease was 29%.  5-year survival in those undergoing macroscopic complete resection was 37%. 
Source: New England Journal of Medicine
Submitted by: Mark Ferguson
June 24, 2015
Author(s): James D. Douketis, Alex C. Spyropoulos, Scott Kaatz, Richard C. Becker, Joseph A. Caprini, Andrew S. Dunn, David A. Garcia, Alan Jacobson, Amir K. Jaffer, David F. Kong, Sam Schulman, Alexander G.G. Turpie, Vic Hasselblad, and Thomas L. Ortel for the BRIDGE Investigators
Patients with afib undergoing elective surgery or invasive procedure who were on coumadin were randomized to bridging with low molecular weight heparin or placebo preoperatively.  The incidence of arterial thromboembolism was .03% in the bridge group and 0.4% in the placebo group, demonstrating non-inferiority of placebo.  The bleeding complication rates were higher in the bridge group, 3.2% vs 1.3%.  Not bridging was non-inferior to bridging and reduced the risk of bleeding complications.
Source: Radiology
Submitted by: Mark Ferguson
June 24, 2015
Author(s): David F. Yankelevitz, Rowena Yip, James P. Smith, Mingzhu Liang, Ying Liu, Dong Ming Xu, Mary M. Salvatore, Andrea S. Wolf, Raja M. Flores, Claudia I. Henschke, As the Writing Committee for The International Early Lung Cancer Action Program Investigators Group
The ELCAP data set was evaluated for pts identified with non-solid nodules at baseline or during follow-up.  2392  (4.2%) pts had nonsolid nodules at baseline, of which 73 were diagnosed as adenocarcinoma.  A new nodule was identified in an additional 485 (0.7%) pts, of whom 11 were diagnosed with adenocarcinoma.  Nonsolid nodules improved in 66% of pts.  Median time to cancer treatment was 19 mos, and survival was 100% at a median follow-up of 78 mos.  22 of these pts had a solid component develop during f/u and prior to therapy. The group recommends that nonsolid nodules can be safely followed with CT at intervals of 12 months. 
Source: Journal of Cardiac Surgery
Submitted by: CTSNet Staff
June 22, 2015
Author(s): Suvitesh Luthra, Omar Ramady, Mary Monge, Michael G. Fitzsimons, Terry R. Kaleta, and Thoralf M. Sundt
Using a regression analysis, researchers determined that procedure times are better indicators of OR efficiency in cardiac surgery than knife to skin times. 
Source: Annals of Thoracic Surgery
Submitted by: Arie Blitz
June 20, 2015
Author(s): Shahab A. Akhter, Abbasali Badami, Margaret Murray, Takushi Kohmoto, Lucian Lozonschi, Satoru Osaki, Entela B. Lushaj
The University of Wisconsin group analyzed the etiology, costs, and effect on survival of unplanned readmissions after LVAD surgery.  At a median follow-up of 11 months, 68 of the 103 patients (66%) were readmitted.  The top 3 causes of readmission were GI bleeding, driveline infection, and stroke.  Thirty patients (44%) were readmitted within 30 days of discharge.  The median direct cost of each readmission was $7,546.  Survival was not significantly affected by hospital readmission.     
Source: MMCTS
Submitted by: CTSNet Staff
June 19, 2015
Author(s): Juan Carlos Trujillo-Reyes, Ramón Rami-Porta, Sergi Call Caja and Josep Belda-Sanchis
Through a subxiphoid approach, the pericardium is incised and a rigid (usually a video-mediastinoscope) or a flexible endoscope (flexible bronchoscope or flexible choledoscope) is inserted into the pericardial cavity. The inner surface of the parietal pericardium and the epicardium can be explored and biopsies can be taken under visual control. In addition, a subxiphoid pericardial window can be developed, and sclerosing agents instilled for pericardiodesis, if a malignant aetiology is confirmed.
Source: MedPage Today
Submitted by: Mark Ferguson
June 19, 2015
Author(s): C. Phend
The FDA approved Edwards' Sapien third generation transcatheter aortic valve, designed to limit paravalvular leakage by incorporating a skirt at the base of the valve.  The approval was based on results of the PARTNER II S3 study, which demonstrated improved rates of paravalvular leakage at 30 days (<4%) compared to 10% to 20% rates for other valves.
Source: JAMA Surgery
Submitted by: Mark Ferguson
June 18, 2015
Author(s): Joshua C. Grimm; Vicente Valero III; Arman Kilic; Jonathan T. Magruder; Christian A. Merlo; Pali D. Shah; Ashish S. Shah
Using UNOS data, the authors evaluated long-term survival and primary graft failure (PGF) comparing cohorts with less than and more than 6 hours of graft ischemia.  31% of patients had prolonged ischemia.  There was no association between prolonged ischemia and PGF or survival at 1 and 5 years.
Source: Journal of the American College of Cardiology
Submitted by: J. Rafael Sadaba
June 17, 2015
Author(s): Reardon MJ, Adams DH, Kleiman NS, Yakubov SJ, Coselli JS, Deeb GM, Gleason TG, Lee JS, Hermiller JB Jr, Chetcuti S, Heiser J, Merhi W, Zorn GL 3rd, Tadros P, Robinson N, Petrossian G, Hughes GC, Harrison JK, Maini B, Mumtaz M, Conte JV, Resar JR, Aharonian V, Pfeffer T, Oh JK, Qiao H, Popma JJ.
In this paper the authors report on the 2-year results of the randomized US pivotal trial for surgical and self-expanding percutaneous aortic prosthetic valves. The survival  benefit observed at 1 year in the transcatheter group were sustained at two years. This was also the case for the significant reduction in major adverse clinical and cerebrovascular events. These results lead the authors to suggest that self-expanding transcatheter valve therapy should be considered the standard of care and preferred over surgery in the study population.