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Journal and News Scan
Bjerregaard and colleagues evaluated methylprednisolone as an analgesic strategy following video-assisted thoracoscopic surgery (VATS) in a randomized controlled trial with 96 patients. Patients received either methylprednisolone or placebo prior to their VATS lobectomy. High-dose methylprednisolone reduced pain at rest and while sitting on the day of the procedure.
A handy free, short, good quality video on an open valve-in valve procedure.
A large cadaveric study of the scalloping of normal mitral valve leaflets. As the accompanying editorial points out, it would be useful to correlate the cadaveric observations to imaging and surgical anatomy.
This article from the BBC highlights two different artificial intelligence (AI) diagnostic systems, one that evaluates coronary artery disease (CAD) and another that determines whether a lung nodule is cancerous. The systems are being trialed around the UK, and they show promise for improved accuracy of imaging-based diagnoses. The software that evaluates CAD could be available throughout the UK as early as summer of 2018.
Video and a readable digest of a talk in a Harvard meeting, especially interesting in its scepticism on prevention.
The authors compared mechanically expanded TAVR to self-expanding TAVR in a randomized non-inferiority trial. Major adverse events occurred in 20% and 17% of patients, respectively (safety measure). The one-year rates of mortality, stroke, or paravalvular leak for the valves were 15.4% and 25.5%, respectively (effectiveness measure). Mechanically expanded valves are not inferior to self-expanding valves and broaden the options available for high risk patients.
A sobering editorial, read last May at the AATS, that discusses at length the ethics of ventricular assist as a super expensive therapy seen from the principle of fairness.
A dense but short and readable editorial arguing for the complexity of risk stratification of aortic pathology.
Incredible story about how American Heart Association President Dr John Warner suffered a cardiac arrest after his presidential address and was subsequently saved by two bystanders. This story emphasizes the fortune of being in the right place at the right time, but more importantly, the public value of knowing CPR.
The Nationwide Inpatient Sample was evaluated to assess tricupsid valve surgery. Isolated and concurrent tricuspid surgery outcomes are analyzed. The authors conclude that "surgical treatment of TR remains underused and is associated with high operative morbidity and mortality, prolonged hospitalizations, and considerable cost."