Journal and News Scan

Fuhrman and colleagues investigated the occurrence of acute kidney injury (AKI) in young adults with congenital heart disease undergoing a surgical procedure, a group of patients that is increasing in number. They retrospectively analyzed data for 699 patients between 18 and 40 years of age who were admitted to a children’s hospital's cardiac intensive care unit over an 11 year time period. AKI occurred in 13.2% of these patients. Suspected sepsis, exposure to calcineurin inhibitors, vancomycin, and piperacillin-tazobactam increased the odds of injury, even after controlling for several factors including repeat cardiopulmonary bypass.

The authors conclude that postoperative AKI is common in young adults with congenital heart disease and is associated with adverse outcomes. They also suggest that care be taken in the use of potentially nephrotoxic medications.

Patient Care and General Interest

A roadside thoracotomy was performed in the UK to control severe bleeding for a man who was stabbed, and the procedure was captured on video.

The 30-day public comment period for the US national coverage decision for transcatheter aortic valve replacement has closed, and this brief Cardiovascular Business article summarizes the public response.

Public health officials in the UK call for greater awareness of lung cancer in individuals who have never smoked tobacco.

Several health associations have voiced support for the Tobacco to 21 Act, legislation that was introduced in the US Congress that would raise the minimum federal age to purchase tobacco products.

Drugs and Devices

The US Food and Drug Administration (FDA) has categorized a recall of Miller Balloon and Fogartey Dilation Atrioseptostomy Catheters, issued in March by Edwards Lifesciences, as a Class I recall.

An active fixation lead for quadripolar cardiac resynchronization therapy defibrillators and pacemakers, the Attain Stability Quad left heart lead from Medtronic, is approved by the US FDA.

Research, Trials, and Funding

Lung cancer presents differently in patients with idiopathic pulmonary fibrosis, say researchers in New York City, New York, USA.

Researchers in London, UK, report that the addition of an informational video to a brochure on lung cancer screening improved patients’ understanding and reduced conflicted feelings about whether to undergo the screening.

A study in piglets found that adding hydrogen to ventilation gasses during and after arrested blood flow improved neuroprotection, and the researchers from Boston, Massachusetts, USA, are now aiming to translate these results to people.

Thourani and colleagues used data from The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry to develop a risk model for in-hospital stroke after transcatheter aortic valve replacement (TAVR), a serious complication. Of the 97,600 TAVR procedures performed between 2014 and 2017 that were included in the analysis, 1,839 patients experienced in-hospital stroke. The authors limited covariate selection to patient demographics and baseline characteristics—with the one exception being access strategy—to increase the usefulness of the model prior to a procedure. Predictors for increased stroke risk included alternative access, prior stroke, procedural acuity, smoking, porcelain aorta, peripheral artery disease, and advanced age.

Additionally, the authors report that patients at 10 of the 521 participating sites were found to have significantly higher odds ratios for stroke than the other sites. They note that the model thus serves as a resource for quality improvement as well as for clinical decision making and patient counseling.

Melfi and colleagues present a keynote lecture outlining the evolution of robotic thoracic surgery. The robotic technique in thoracic surgery has progressively become widespread, particularly for the treatment of mediastinal and pulmonary lesions. The authors discuss the development of technology in the robotic system that has been associated with the improvement of intraoperative and postoperative results.