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Journal and News Scan
February 26, 2018
Submitted by: Claire Vernon
Weder and colleagues present a debate addressing surgery versus stereotactic body radiotherapy as the primary treatment of early-stage lung cancer. Arguments relating to outcome and the impact on further therapy are given by both surgeons and radiation oncologists.
February 26, 2018
Submitted by: Aristotle Protopapas
A succinct, readable, and well-referenced editorial on extending criteria for surgery on bicuspid aortopathy below the threshold of 4.5 cm diameter. It is even more interesting in the era of increasing industry pressure for transcatheter aortic valve replacement.
February 24, 2018
Submitted by: Mark Ferguson
An alarming list of some crazy things our colleagues have done in the recent past.
February 23, 2018
Submitted by: Claire Vernon
Patient Care
A woman in the northwest US who was thought to have drowned makes a surprising recovery, aided by a local hospital’s use of extracorporeal membrane oxygenation for traumatic heart and lung injuries.
An Indian man now has two hearts, as his surgical team performed a heterotopic heart transplant upon realizing that the donor heart could be too small for the patient.
Drugs and Devices
The SherpaPak™ and SherpaPerfusion™ Cardiac Transport Systems, heart and kidney transportation devices from Paragonix Technologies, have received the CE mark.
The US Food and Drug Administration has approved tezacaftor/ivacaftor and ivacaftor from Vertex Pharmaceuticals to treat cystic fibrosis in patients with particular CFTR mutations.
Research, Trials, and Funding
Researchers in Philadelphia, Pennsylvania, found that over 20% of children who underwent cardiac surgery as infants had hearing loss, a rate 20 times higher than in the general population.
Research from the Penn Atrial Fibrillation Free Study, based at the University of Pennsylvania, suggests that despite having a lower risk of developing atrial fibrillation, African Americans with atrial fibrillation have a higher risk of stroke when compared to Caucasian Americans.
February 23, 2018
Submitted by: Ruben Osnabrugge
In this patient level meta-analysis of 11 randomised trials, the authors compare PCI using stents with CABG. In total, almost 12,000 randomised patients were included.
They found that at a mean of 3.8 years of follow-up, mortality was higher after PCI versus CABG (11.2% versus 9.2%, hazard ratio 1.20, 95% confidence interval 1.06 - 1.37, p = 0.0038). The vast amount of data allowed meaningful analysis of subgroups. The mortality benefit was particularly clear in patients with multivessel disease and diabetes, whereas there was no difference between the two treatments in patients with left main disease or without diabetes.
February 23, 2018
Submitted by: Aristotle Protopapas
A comprehensive review of pleural diseases from the internists' viewpoint. Relevant to surgeons in the sense of referrals for empyema, pleural effusions, and other traditional surgical problems that are now often dealt with revitalised internist-led options such as office pleuroscopy/pleurodesis.
February 21, 2018
Submitted by: Aristotle Protopapas
A well-written, brief, pessimistic editorial on the loss of surgeon autonomy in innovation.
February 19, 2018
Submitted by: Joel Dunning
This great video documents the beginning of the first successful robotic mitral surgery program in the UK, by Paul Modi and proctored by Doug Murphy.
They use the LEAR technique–Lateral Endoscopic Approach for Robotics–which is a totally port-based approach to intracardiac robotic surgery. I am sure we will see many more videos from this group in the near future.
February 18, 2018
Submitted by: Mark Ferguson
An interesting article describing the interface between medical 3D printing and art. It briefly outlines current and future applications, and it also describes constraints to the use of this technology.
February 17, 2018
Submitted by: Mark Ferguson
An FDA advisory committee voted 6-4 against expanding approved indications for liposomal bupivicaine for regional pain control after surgery. This drug is a central element in many institutions' Enhanced Recovery After Surgery programs. They cited inconsistent results, failure to provide comparative results, and increased deaths associated with the drug. The official FDA will use this assessment as part of their deliberations.