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Journal and News Scan
August 10, 2017
Submitted by: Claire Vernon
Hraska and colleagues present a retrospective study of outcomes following congenitally corrected transposition of the great arteries using the morphologically left ventricle as the systemic pumping chamber. Patients were followed for a median of 5 years, with a range up to 20 years. Overall survival and event-free survival were good, and only one of the 63 patients had worse than mild dysfunction of the morphologically left ventricle.
This research was presented at the 2017 Annual Meeting of The Society of Thoracic Surgeons, and the audio discussion that followed the presentation accompanies the article.
August 8, 2017
Submitted by: Marco Nardini
Despite VATS lobectomy being 25 years old, we do need definitive results urgently and from large randomised clinical trials in order to demonstrate the remarkable advantage for the patients undergoing major lung resection by minimally invasive approach. Looking forward to seeing the results of this French multicentric trial and from the ongoing VIOLET trial from UK.
August 7, 2017
Submitted by: Claire Vernon
Ghoneim and colleagues retrospectively evaluated surgical risk caused by prior mediastinal radiation therapy (MRT) in patients undergoing aortic valve replacement (AVR). The authors found that operative mortality was higher than predicted when AVR was performed with concomitant procedures, and they speculate this is in part related to the longer cardiopulmonary bypass time required. Despite good short-term outcomes in the isolated AVR group, MRT patients undergoing both isolated and concomitant AVR had reduced midterm survival. The authors suggest this should be considered when weighing the choice of device, the invasiveness of the AVR procedure, and the inclusion of concomitant procedures for this population of patients.
August 4, 2017
Submitted by: Claire Vernon
Patient Care
An Iraqi boy from Mosul went from Jordan to Australia for surgery to correct the blood flow through his heart and repair a hole between his ventricles.
Transcatheter approaches continue growing as transcatheter aortic valve implantation (TAVI) is performed for the first time in Kenya at the Aga Khan University Hospital and in Bangladesh at the United Hospital Ltd.
The Palestinian Authority chief negotiator will need a lung transplant as medical treatment for his pulmonary fibrosis is no longer sufficient.
A professional basketball player in the USA talks about undergoing and recovering from open heart surgery.
Drugs and Devices
Mayo Clinic in Rochester, Minnesota, is partnering with AliveCor to improve early detection of long QT syndrome with AliveCor’s Kardia Mobile device.
The European Medicines Agency must relocate from its current London offices ahead of Brexit (the UK leaving the European Union), and 19 different cities are vying to be the agency’s new home.
The Avalus pericardial aortic surgical valve from Medtronic, an MRI-safe stented valve, is now CE (Conformité Européenne) marked and has received US Food and Drug Administration approval. Medtronic also announced CE mark and the European launch of the CoreValveTM EvolutTM PRO valve.
Research, Trials, and Funding
Researchers at Ohio State University in Columbus, Ohio, find that the human heart has multiple pacing mechanisms with redundancies in the sinoatrial node.
Researchers at the CSIR Institute of Genomics and Integrative Biology in New Delhi, India, will soon start a longitudinal study of the factors affecting lung function in children.
August 3, 2017
Submitted by: Claire Vernon
Grigor and colleagues investigated the relationship between self-reported patient experience and the incidence of adverse events or prolonged length of hospitalization after surgery. Patients with a prolonged length of stay rated their experience lower on more measures than patients with adverse events did. Notably, extended length of stay was associated with a lower rating of the comprehensiveness of information provided by surgeons.
August 2, 2017
Submitted by: Mark Ferguson
This retrospective study of the association of BMI to long-term survival after resection of NSCLC identified BMI > 30kg/m2 as an independent predictor of survival. In a propensity score matched set, patients with BMI >30 had better survival than those with a BMI of 25 (p=0.003). The reason for this relationship remains to be elucidated.
August 2, 2017
Submitted by: Mark Ferguson
This is an excellent summary of progress during the past year in all aspects of lung cancer, from prevention/detection through molecular therapies and future perspectives. Each section is written by a handful of international experts.
August 2, 2017
Submitted by: Ruben Osnabrugge
Frailty is an important factor in patients undergoing either Transcatheter or Surgical Aortic Valve Replacement. However, it is hard to assess. Multiple scoring systems have been proposed which are either underperforming or are cumbersome to calculate.
In the current study, the authors introduced and tested the Essential Frailty Toolset (EFT), consisting of four items: lower-extremity weakness, cognitive impairment, anemia, and hypoalbumenia. The EFT outperformed other frailty assesment tools in approximatly 1000 elderly patients undergoing either TAVR or SAVR.
Dr. Mack notes in the accompanying editorial that several conclusions can be drawn:
1. Frailty can be assessd using an easy tool
2. Frailty is predictive of 1-year mortality after either TAVR or SAVR
3. EFT improves the power of the STS-PROM to predict 1 year mortality
4. EFT is also predictive for 30-day mortality and 1-year mortality and disability
This important study shows that frailty can classified easily. This facilitates comparitive studies, heart team discussions and clinical decision-making in patients undertoing an invasive treatment for aortic stenosis.
August 1, 2017
Submitted by: Benjamin Bidstrup
The authors present an extensive experience with the Frozen Elephant Trunk procedure for aortic pathology of varying types. They provide useful tips for each type. The results justify the techniques. The authors also provide some insight into when results may not be so good.
August 1, 2017
Submitted by: Claire Vernon
Badhwar and colleagues analyzed the usage and outcomes of surgical ablation (SA) for atrial fibrillation reported in The Society of Thoracic Surgeons database. They found an incrementally increasing volume of SA procedures concomitant with cardiac operations like coronary artery bypass and valve repair/replacement over the 3-year period analyzed. Concomitant SA was associated with reduced risk of mortality and stroke but increased risk of renal failure and subsequent pacemaker implantation.
This research was presented at the 2016 Annual Meeting of the Southern Thoracic Surgical Association, and a brief discussion from that meeting follows the article.