ALERT!
This site is not optimized for Internet Explorer 8 (or older).
Please upgrade to a newer version of Internet Explorer or use an alternate browser such as Chrome or Firefox.
Journal and News Scan
The investigators report a novel technology to predict VAD thrombosis. This approach records and measures acustic signature characteristics. Using annalysis of spectral tracings the investigators suggest their exists an acoustic patern associated with thrombosis.
Anomalous origins of coronary arteries from the pulmonary artery are rare malformations in which the coronary arteries originate from pulmonary artery sinuses or branches. The consequences are variable although, in most cases, these anomalies lead to severe coronary hypoperfusion and ventricular dysfunction. Surgical correction is indicated once the diagnosis is established. In nearly all cases, the anomalous artery can be excised from its pulmonary origin, mobilized, and reimplanted directly into the ascending aorta using different surgical techniques. In rare circumstances, technical modifications must be used to restore a normal dual coronary perfusion.
Doctors in the U.S. are committing suicide at an alarming rate. This article focuses on the suicide of a 29-year-old oncology fellow, and examines the role a physicians health program (PHP) may have played in his death.
Here is a nice video of an extrapleuralpneumonectomy
Heart transplantation still remains the gold standard therapy for end-stage heart failure, although several other approaches have emerged, such as biventricular pacing, left ventricular assist devices (LVADs) and total artificial heart. Moreover, the increasing use of LVADs as a bridge to transplant is posing the technical challenge of LVAD removal during the procedure. We in this paper describe the bicaval technique, which currently represents the routine approach for orthotopic heart transplantation.
Since the 1990s, minimally invasive cardiac surgery has gained wide acceptance due to patient and economic demand. The advantages are less trauma, less bleeding, less wound infections, less pain and faster recovery. Many studies showed that the outcomes are comparable with those of conventional sternotomy. Right lateral mini-thoracotomy evolved into a routine and safe access in specialized centres for minimally invasive mitral valve surgery. The 6-cm incision is performed over the fifth intercostal space in the inframammary groove. With a double-lumen tube, the right lung is deflated before entering the pleural cavity. A soft tissue retractor is used to minimize rib spreading. The stab incisions for the endoscopic camera and the transthoracic clamp are performed in the right anterior and posterior axillary line in the third intercostal space. Surgery on the mitral valve is performed in a standard fashion under a direct vision with video assistance. One chest tube is inserted. The intercostal space is adapted with braided sutures to prevent lung herniation. Ropivacaine is used for local infiltration. The pectoral muscle, subcutaneous tissue and skin are adapted with running sutures. Complications of a right lateral mini-thoracotomy are rare (conversion to sternotomy, rethoracotomy, phrenic nerve palsy, wound infection and thoracic wall hernia) and well manageable.
Surgeons will soon be able to plan heart operations using 3D models of patients’ organs with revolutionary software that recreates working versions of human body parts.
The technology, which also allows companies that make artificial valves and stents to assess exact measurements and simulate the performance of their proposed implants, is part of Paris-based 3D software specialist Dassault Systemes’ ambition to harness the 3D revolution for medicine.
Apart from cardiac health, Dassault Systemes is also exploring opportunities to implement the technology in prenatal care, modelling a mother’s uterus and foetus to identify whether a natural birth is viable or not by simulating the birth process.
Dassault Systemes’ chief strategy officer Steve Levine said the simulations could supply critical data about the likelihood of problems.
“The technology can be used to understand how much strain it would put on the foetus and the mother,” Dr Levine said.
It turns out that marriage may actually mend broken hearts.
A new study published in the Journal of the American Medical Association found that married patients recovered better after heart surgery than single or divorced patients.
After studying 1,576 adults over age 50 who had serious cardiac surgery, the researchers found that unmarried patients had a 40% greater chance of dying or developing complications two years after the surgery.
Using University of Michigan Health and Retirement Study data, the authors evaluated marital status at the time of cardiac surgery and subsequent survival or deterioration in the ability to perform activities of daily living (ADLs) independently. At follow-up, those who were married had a 19.4% incidence of death or new disability, which was similar to outcomes for never married individuals. In contrast, those who were divorced, separated, or widowed had a 32% incidence of adverse outcomes.
Initial Surgical versus Conservative Strategies in Patients with Asymptomatic Severe Aortic Stenosis
The investigators in this registry study enrolled 3815 patients with asymptomatic aortic stenosis. Patients underwent either surgical aortic valve replacement (AVR) or conservative therapy. In order to increase comparability, they used propensity score matching to create two more similar groups. The cumulative 5-year incidences of all-cause death and heart failure hospitalization were significantly lower in the initial AVR group compared to the conservative group (15.4% vs. 26.4%, p=0.009 and 3.8% vs. 19.9%, p<0.001). Moreover, 41% of the patients in the conservative treatment group received AVR during follow-up. These results indicate that initial AVR in patients asymptomic severe aortic stenosis might be substantially improved by initial AVR.