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Journal and News Scan
December 16, 2015
Submitted by: Arie Blitz
PREVENT IV trial participants who had undergone either a RIMA or LIMA to LAD anastomosis and underwent an angiogram at 1 to 1.5 years (n=1539) were analyzed for mammary graft failure (defined as >75% stenosis). Mammary graft failure occurred in 8.6% of patients, and independent predictors of graft failure were an LAD stenosis < 75% and the presence of a graft to the diagonal. These associations suggest competitive flow may play an important role in mammary graft failure and raise the question of whether LAD stenoses < 75% without evidence of ischemia should be bypassed and whether diagonal grafts should be more selectively performed.
December 13, 2015
Submitted by: J. Rafael Sadaba
In this prospective study on 377 patients, the authors evaluate the effect of the application of a patient-specific transcatheter heart valve (THV) selection algorithm, which suggests the use of a specific THV (CoreValve or SAPIEN XT) for specific anatomical subsets, on procedural outcomes. Among the 377 patients, 184 consecutive patients underwent TAVR with the THV selection algorithm (study group) and 193 consecutive patients without the algorithm (control group). The main finding of the study is that the application of the algorithm resulted in a reduction of the incidence of moderate/severe paravalvular regurgitation and the composite of aortic annular rupture, coronary occlusion and THV embolization after TAVR and provided higher device success.
December 10, 2015
Submitted by: Tom C. Nguyen
A growing body of evidence demonstrates improved short, mid, and long term outcomes with the use of arterial conduits for coronary revascularization. Despite this, less than 10% of patients receive more than 2 arterial grafts. This is the first set of guidelines by the STS focused on arterial revascularization with supporting levels of evidence.
December 10, 2015
Submitted by: J. Rafael Sadaba
The study was a single-arm, multicentre, prospective study enrolling 31 high-risk adult individuals with symptomatic mitral regurgitation despite optimal medical therapy from five institutions in Europe. The primary efficacy endpoints included: (a) Technical success rate of the device implantation; (b) Technical feasibility of Cardioband adjustment; and (c) Cardioband ability to reduce the annular septolateral dimension and MR. The technical success rate of implantation was 93.6%. Cardioband adjustment was successful in 29 of 31 subjects. At 30 days, 22 of 25 patients had MR ≤2+. Procedural mortality was zero and in-hospital mortality was 6.5%. The authors conclude that the initial experience with the Cardioband system shows that transfemoral implantation of a surgical-like direct annuloplasty device is feasible, safe, and effective.
December 8, 2015
Submitted by: Joel Dunning
This is an edition of the annals of Cardiothoracic Surgery dedicated to minimally invasive cardiothoracic surgery. It contains many approaches for thymectomy and mediastinal masses including VATS, uniportal VATS, subxiphoid approaches and robotic approaches.
December 3, 2015
Submitted by: Aamir Shah
Patients with bicuspid aortic valves have a significantly increased incidence of aortic complications including type A aortic dissection. The authors studied 1181 patients with bicuspid aortic valves and sinus of valsalva or ascending aortic aneurysms with diameter greater than or equal to 4.7 cm on CT scan or MRI. The prevalence of type A dissection identified by initial imaging or detected at operation or during surveillance follow up was 5.3%. The probability of surgical intervention for aortic expansion or dissection among patients undergoing surveillance was 16% at 1 year and 50% at 6 years follow up. The authors found the cross-sectional area of the ascending aorta or sinuses of Valsalva to height ratio to be the best predictor of type A dissection, and recommend aortic replacement in patients with bicuspid aortic valves and aortic diameter greater than 5 cm or cross sectional area to height ratio greater than 10 cm2/m.
November 30, 2015
Submitted by: Joel Dunning
This is an interesting document adding the proposals for the next edition of lung cancer staging. the changes are going to be quite significant :
Recommended changes are as follows: to subclassify T1 into T1a (≤1 cm), T1b (>1 to ≤2 cm), and T1c (>2 to ≤3 cm); to subclassify T2 into T2a (>3 to ≤4 cm) and T2b (>4 to ≤5 cm); to reclassify tumors greater than 5 to less than or equal to 7 cm as T3; to reclassify tumors greater than 7 cm as T4; to group involvement of main bronchus as T2 regardless of distance from carina; to group partial and total atelectasis/pneumonitis as T2; to reclassify diaphragm invasion as T4; and to delete mediastinal pleura invasion as a T descriptor.
November 30, 2015
Submitted by: Joel Dunning
This is an expert commentary on the state of the art in this field together with an audio commentary also available on this link
November 25, 2015
Submitted by: CTSNet Staff
This article reports on the long-term (up to 15 year) survival of patients who participated in the COURAGE trial.
November 24, 2015
Submitted by: Joel Dunning
A nice short demonstration from Michael Mack of his cannulation technique for minimally invasive AVR with femoral vein cannulation