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Journal and News Scan

Source: Annals of Cardiothoracic Surgery
Author(s): Giampiero Esposito, Antonio Pignatelli, Gaetano Contegiacomo, Giangiuseppe Cappabianca, Cesare Beghi, Carlo Lafranceschina, Fabio Tiecco, Francesco Bartolomucci, Matteo Miccoli, Massimiliano Conte

In this illustrated article, Esposito and colleagues outline the Lupiae technique for hybrid three-stage repair of mega aorta. The technique includes initial surgical replacement of the ascending aorta and proximal rerouting of the aortic arch vessels, followed by delayed surgical replacement of the infrarenal aorta with distal rerouting of the visceral and renal vessels, which then facilitates an endovascular approach for subsequent complete exclusion of the residual diseased aorta between the surgically shaped proximal and distal Dacron landing zone. The authors describe the outcomes for 27 patients treated with this approach, and they discuss tips for a safe and effective procedure.

Source: The Lancet
Author(s): The Lancet Editors

In an announcement entitled "Retraction—Tracheobronchial transplantation with a stem-cell-seeded bioartificial nanocomposite: a proof-of-concept study," the results of an investigation by the Karolinska Institute were shared with The Lancet, resulting in retraction of what had appeared to be an exciting new development in transplantation and airway reconstruction.  Hopefully this puts to rest this long and disturbing saga of scientific and ethical misconduct.

Source: News from around the web.
Author(s): Claire Vernon

Patient Care and General Interest

The Israeli nonprofit organization Save a Child’s Heart received the United Nations’ Population Award, in recognition of its work providing congenital cardiac surgery to children in developing countries.

Several hospitals in the UAE have added pulse CO-oximeters with technology that integrates with a patient’s electronic health record to improve screening for critical congenital heart defects.

 

Drugs and Devices

The US Food and Drug Administration has approved the Zephyr Endobronchial Valve from Pulmonx Corp to treat severe emphysema.

 

Research, Trials, and Funding

Researchers in Boston, USA, and Xi’an, China, find that nitric oxide administration during and after cardiopulmonary bypass might reduce postoperative kidney injury.

A team of medical anthropologists evaluated cooperation and conflict in the operating rooms of different surgical specialties, and they report their observations in the journal PNAS.

JenaValve Technology has launched a study of its JenaValve transcatheter aortic valve for the treatment of severe aortic regurgitation, which the company hopes will inform its anticipated application for CE mark approval in 2019.

Facilities voluntarily participating in the US Medicare’s Bundled Payments for Care Improvement programs for cardiac care are more likely to be large, high-resource centers, which may limit the generalizability of these models.

Source: Journal of Thoracic Oncology
Author(s): Ryota Nakamura, Yoshihisa Inage, Rika Tobita, Satoshi Yoneyama, Takeshi Numata, Kyoko Ota, Hidetoshi Yanai, Takeo Endo, Yukinori Inadome, Shingo Sakashita, Hiroaki Satoh, Kenji Yuzawa, Toru Terashima

This retrospective study of 328 patients undergoing resection for non-small cell lung cancer demonstrated that sarcopenia determined by psoas muscle mass on computed tomography was associated with increased postoperative complications and was an independent predictor of survival.

Source: Circulation Research
Author(s): Mariann Gyöngyösi, Paul M. Haller, Derek J. Blake, Enca Martin Rendon

A detailed and somewhat disheartening analysis of stem cell therapy for cardiac failure.

Source: World Journal for Pediatric and Congenital Heart Surgery
Author(s): Joseph A. Dearani

Joseph Dearani, Chair of the Department of Cardiovascular Surgery at the Mayo Clinic in Rochester, Minnesota, graciously shares a copy of the letter with which he welcomes cardiothoracic surgery residents as they embark on their rotation on his service. Dr Dearani’s letter describes the importance of professionalism, preparedness, responsibility, introspection, and honesty to both self and others. It would be equally appropriate as an essay defining the key elements of a successful and productive relationship between a trainee and mentor in any surgical subspecialty.

Source: The Annals of Thoracic Surgery
Author(s): John M. Fallon, Joseph P. DeSimone, J. Matthew Brennan, Sean O’Brien, Dylan P. Thibault, Anthony W. DiScipio, Philippe Pibarot, Jeffrey P. Jacobs, David J. Malenka

Fallon and colleagues evaluated patient-prosthesis mismatch (PPM) following isolated aortic valve replacement reported in the STS Adult Cardiac Surgery Database. They found that both moderate and severe PPM were associated with worse outcomes compared to no PPM over the 10-year study period. Readmission for congestive heart failure and aortic valve rereplacement were both more likely in patients with moderate or severe PPM, and overall survival was lower. The incidences of moderate and severe PPM were reduced over the study period, from 60.1% to 46.8% and from 13.8% to 6.2%, respectively. Because of the worse outcomes with even moderate PPM, the authors emphasize that continued efforts to avoid implantation of too small a prosthesis remain necessary.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Kunihiro Yoshioka, Ryoichi Tanaka, Hidenobu Takagi, Yuta Ueyama, Tsuyoshi Sugawara, Takuya Chiba, Kazumasa Arakita, Joanne D Schuijf

Yoshioka and colleagues evaluated the artery of Adamkiewicz using multidetector row computed tomography in 64 patients. These patients had descending thoracic or thoracoabdominal aortic aneurysms that were associated with the occlusion of the segmental artery from which the artery of Adamkiewicz originated. Seventy-five collateral pathways were identified in 53 patients, and these were more frequently located around the spinal column than in the thoracic wall.

Source: News from around the web.
Author(s): Claire Vernon

Patient Care and General Interest

A guideline for the number of opioid pills that should be prescribed after different surgeries, from cochlear implantation to coronary artery bypass grafting, is self-published by an expert group of health professionals as part of the effort to reduce overprescribing these drugs in the US.

A webcam in the operating room allows cardiothoracic surgeons in Pennsylvania, US, to update a patient’s family on a successful procedure earlier than usual.

After a baby’s heart transplant, her parents—a pediatrician and a school district trustee—are writing a children’s book for the kids and families who face this type of procedure.

The first double-lung transplant in the UAE is performed at the Cleveland Clinic Abu Dhabi using a minimally invasive approach.

 

Drugs and Devices

The Incraft Stent Graft System for endovascular abdominal aortic aneurysm repair, from Cardinal Health/Cordis, has received a vote of approval from a US Food and Drug Administration advisory panel.

 

Research, Trials, and Funding

A trial has begun to evaluate the first biological heart valve made in India. If shown to be a good therapeutic option, it is hoped that this locally-manufactured bioprosthesis will help bring down the cost of valve implantation for patients.

A VATS approach to early-stage lung cancer resection leads to survival outcomes similar to thoracotomy, say researchers from Yale University in Connecticut, US.

Source: The Annals of Thoracic Surgery
Author(s): Joshua L. Chan, Justin G. Miller, Mandy Murphy, Ann Greenberg, Margaret Iraola, Keith A. Horvath

Chan and colleagues describe a stepwise approach to reducing the time to extubation after cardiac surgery, driven primarily by bedside providers as opposed to a conventional physician-directed approach. The authors demonstrate that this fast-track extubation protocol increased the rate of early extubation and decreased the median time to extubation without altering reintubation or early mortality rates.

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