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Journal and News Scan
May 5, 2016
Submitted by: Mark Ferguson
This article summarizes the current status of robotic approaches to mitral valve repair. The technique is suitable to all types of degenerative mitral valve disease, and the outcomes are similar to those for open repair.
May 5, 2016
Submitted by: Mark Ferguson
The author summarizes the challenges but tremendous potential of mechanical circulatory support for infants and children undergoing heart surgery.
April 29, 2016
Submitted by: CTSNet Staff
This article examined the impact of gait speed, as a marker of frailty, on surgical outcomes in a group of 167 cardiac patients aged 65 years or older. The authors concluded that there was no relation between gait speed and outcome.
April 28, 2016
Submitted by: Joel Dunning
A hospital has agreed to pay a $2.2 million penalty for permitting the video-taping of two patients who did not consent to the filming. U.S. Federal regulators have also used the opportunity to clarify stipulations governing the filming of patients.
April 28, 2016
Submitted by: Stuart Head
In a large multi-center, propensity-matched study, Paparella et al found that antiplatelet therapy as opposed to oral anticoagulation therapy initiated after mitral valve repair as antithrombotic prophylaxis caused significantly less major bleeding, which also caused mortality to be less by a 5-fold than with anticoagulation therapy.
April 23, 2016
Submitted by: Aristotle Protopapas
An editorial discussion of the impressive 10-year benefits of CABG for ischemic cardiomyopathy as found in the STICH trial.
April 21, 2016
Submitted by: Arie Blitz
These authors analyzed retrospectively the effect of postoperative fibrinogen level on bleeding after heart surgery in their database of 2,800 patients. They found that serum fibrinogen levels lower than 220 mg/dl more than doubled the risk of postoperative bleeding.
Is it time to standardize the measurement of postop fibrinogen in cardiac surgery?
April 12, 2016
Submitted by: Mark Ferguson
Results of an audit of the National Congenital Heart Disease database were evaluted to determine characteristics of patients undergoing reoperation within 30 days of their primary procedure. Among over 18,000 patients, 3.5% had early reoperations. The reoperations were most commonly arterial shunt, PA band, and VSD procedures. 60 day mortality was 5-fold higher than among patients who did not have an early reoperation.
April 12, 2016
Submitted by: Mark Ferguson
The association of acute kidney injury (AKI) with adverse outcomes after cardiac surgery is well known. This study compared the association of AKI and the elevation of cystatin C, another filtration marker, with long-term survival after cardiac surgery. 30% of patients experienced an abnormal increase in creatinine postop compared to 15% who had an abnormal rise in cystatin C. A rise in cystatin C was better predictive of decreased long-term survival than was creatinine.
April 12, 2016
Submitted by: Mark Ferguson
The authors used a single institution data base to assess very long-term outcomes after AVR to determine the effects of prosthesis-patient mismatch. Among 673 pts, 24% had mismatch. Mean follow-up was nearly 18 years. On multivariable analysis, mismatch was not a significant determinant of long-term survival.