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Journal and News Scan
January 23, 2019
Submitted by: Claire Vernon
Vergnat and colleagues retrospectively evaluated long-term outcomes for neonates who underwent either balloon valvotomy or open valvoplasty between 1989 and 2015 (51 and 52 patients, respectively). Although both methods offer good survival benefits, open valvoplasty was associated with a higher freedom from operation during the follow-up period.
January 23, 2019
Submitted by: Claire Vernon
Stiles and colleagues evaluated outcomes for patients with esophageal cancer undergoing surgical resection after either neoadjuvant chemoradiation or preoperative chemotherapy without radiation. The authors evaluated disease-free and cancer-specific survival from prospective data collected from 338 patients, 112 who underwent neoadjuvant chemoradiation and 226 receiving chemotherapy. Nearly all patients underwent transthoracic esophagectomy for their surgical procedure. Patients with adenocarcinoma showed an increased local tumor response but no difference in survival with neoadjuvant chemoradiation, whereas patient with squamous cell carcinoma had improved cancer-specific survival.
January 22, 2019
Submitted by: Wei-Guo Ma
The medical therapies for thoracic aortic aneurysm comprise of β-adrenergic blocking agents and angiotensin II type I receptor. Several large randomized trials of pediatric and adult patients with Marfan syndrome have yielded no evidence that antagonism of angiotensin II type I receptor by losartan slows aortic enlargement more effectively than conventional treatment with β-blockers. Studies in mouse models have begun to resolve the complex molecular pathophysiology underlying onset and progression of aortic disease and have emphasized the need to preserve the transformation growth factor-β signaling to prevent aneurysm formation.
This review describes critical experiments that have influenced the evolution of our understanding of thoracic aortic disease, in addition to discussing old controversies and identifying new therapeutic opportunities.
January 18, 2019
Submitted by: Claire Vernon
Patient Care and General Interest
Air pollution tops the World Health Organization’s list of Top 10 threats to global health.
A US woman had an aortic dissection while simultaneously going into premature labor, requiring emergency coordination of two procedures.
An Indian man receives a heart transplant, with the cost of the procedure covered by the Tamil Nadu Chief Minister’s comprehensive Health Insurance Scheme.
Drugs and Devices
Abbott receives US Food and Drug Administration approval for a tiny patent ductus arteriosus occlusion device for premature infants, and it also acquires Cephea Valve Technologies, a company that develops transcatheter mitral valve technologies.
Research, Trials, and Funding
Providing vouchers to reduce the cost of antiplatelet therapy after a heart attack only marginally improved adherence and did not affect outcomes, report researchers from Durham, North Carolina.
Patients reap postoperative benefits from quitting smoking before lung cancer surgery, say researchers from Tokyo, Japan.
Researchers from New Hampshire, US, report on the growth of medical marketing in the US over last two decades.
January 18, 2019
Submitted by: Claire Vernon
David and colleagues prospectively examined long-term results of the Ross procedure, following a cohort of 212 patients over a median 18.0 years (interquartile range, 14.6-21.2). They report 10.8% cumulative mortality and 16.8% cumulative probability of Ross-related reoperations at 20 years. Postoperative aortic insufficiency increased with time and was associated with the presence of preoperative aortic insufficiency. The authors conclude that the Ross procedure should be part of the surgical armamentarium for treating aortic stenosis in young adults.
January 18, 2019
Submitted by: Claire Vernon
Mariette and colleagues randomly assigned 207 patients with resectable esophageal cancer to undergo either transthoracic open esophagectomy or hybrid minimally invasive esophagectomy. The hybrid procedure resulted in a lower incidence of major intraoperative or postoperative complications (odds ratio, 0.31; 95% confidence interval, 0.18 – 0.55; p<0.001). Both groups had similar survival over three years.
January 18, 2019
Submitted by: Aristotle Protopapas
A good attempt to shed some light into the somewhat challenging concept of heart failure with preserved ejection fraction, on the occasion of a small randomized controlled trial on albuterol.
January 17, 2019
Submitted by: Aristotle Protopapas
A succinct handy comment on a small series of left ventricular assist devices (LVAD) that is quite useful for a fast read on LVAD for surgeons and nonsurgeons.
January 16, 2019
Submitted by: Claire Vernon
The European Association for Cardio-Thoracic Surgery and the European Society of Cardiology have, for the third time, brought together cardiac surgeons and cardiologists to draft a document on the treatment of coronary heart disease. These guidelines provide new information and recommendations on calculation of the Syntax score, radial access as standard approach for coronary angiography, drug-eluting stents for any percutaneous coronary intervention, preferred surgical myocardial revascularisation if left ventricular ejection fraction is less than 35%, among other updates.
January 15, 2019
Submitted by: Claire Vernon
Ibezim and colleagues examined outcomes for patients undergoing their first mechanical mitral valve replacement (M-MVR) before 21 years of age. Using information from the Pediatric Cardiac Care Consortium database, the authors performed a retrospective analysis of 441 children from 36 centers in the United States. Nearly 60% of patients were less than 6 years old when they underwent their first M-MVR, and the most common diagnoses were complete and partial atrioventricular canal defects. Mortality within 90 days was 11.1%, and 76% of patients who survived more than 90 days were still alive and transplant-free after 20 years. Early risk factors were age younger than 2 years and concurrent mechanical valve replacement of another valve.