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Journal and News Scan
February 6, 2020
Submitted by: Emily Robinson
Among 7830 patients undergoing arch or hemiarch replacement with hypothermic circulatory arrest in the STS Database, risk factors for the composite of mortality or major permanent neurologic complications were assessed. The incidence of the outcome was 10.9%. The use of antegrade or retrograde cerebral perfusion was protective compared to no cerebral perfusion.
February 3, 2020
Submitted by: Mark Ferguson
Use of a novel decision aid for patients with symptomatic aortic stenosis resulted in greater patient knowledge and satisfaction, although decisional conflict was unchanged. Physicians, on the other hand, felt that the aid was not understood by elderly patients, and believed that they used shared decision-making in their usual practice, without the use of a decision aid.
February 3, 2020
Submitted by: Mark Ferguson
This interesting study compared bronchial epithelial mutation burden, the primary source of new lung cancers, among nonsmokers, former smokers, and current smokers. Smoking typically adds 1,000 to 10,000 mutations per cell. Smoking cessation in this study was associated with replenishment of the abnormal epithelium with cells that are typical of nonsmokers and have a normal mutagenic potential.
February 1, 2020
Submitted by: Mark Ferguson
Individuals at high risk for lung cancer were randomized to low dose CT screening (years 0, 1, 3, and 5.5) or observation. At 10 years the cumulative rate ratio for lung cancer death was 0.76 in the screened population of men (p=0.01) and 0.67 in the screened population of women, demonstrating a strong benefit for screening.
January 30, 2020
Submitted by: Emily Robinson
This study investigated whether the life expectancy of patients undergoing surgical aortic valve replacement was fully restored compared to the matched general population.
The authors investigated the long-term outcomes of 614 patients above the age of 75 years undergoing surgical aortic valve replacement and compared it to a set of 100 age and sex matched people from the general population.
Those patients who survived the initial postoperative period had life expectancies and survival rates comparable to the general population.
January 30, 2020
Submitted by: Wei-Guo Ma
The American Association for Thoracic Surgery and International Society for Heart and Lung Transplantation provide a consensus guidelines document on ten important aspects in mechanical circulatory support. These include:
1. Preoperative Evaluation and Optimization
2. Support Techniques in Cardiogenic Shock
3. Biventricular Support
4. Surgical Approach
5. Management of Postoperative Bleeding
6. Anticoagulation Management
7. Optimizing Pump Speed
8. Diagnosis and Management of Pump Malfunction
9. Management of Pump-Related Infections
10. Strategies to Promote Myocardial Recovery
January 29, 2020
Submitted by: Wei-Guo Ma
In this consensus statement, a new anatomic classfication system is proposed for thoracic aortic dissections. The acuity of aortic dissection and complicated vs uncomplicated dissections are clearly defined. Risk factors, presentations, management, and complications are expounded. Follow-up criteria are also discussed with nomenclature for false lumen status, in addition to measurement criteria and definitions of aortic remodeling. This expert consensus provides a comprehensive document that facilitates communcations and reporting of aortic dissection among the aortic community.
January 22, 2020
Submitted by: Emily Robinson
This study investigated the impact of preoperative levosimendan administration in patients undergoing LVAD implantation. The authors report on outcomes of patients who received preoperative optimization with levosimendan (n=58) versus patients optimized without a Calcium-sensitizer (n=27).
Although the patients’ characteristics have not been different at baseline, the end-organ function recovered to a greater extent within the levosimendan group. In this small group however, the mortality, as well as length of stay and ventilation, were not different within the two groups. The authors state that levosimendan administration prior to LVAD implantation is safe and well-tolerated.
January 17, 2020
Submitted by: Wei-Guo Ma
In this How-I-Teach-It tutorial, Dr Hermsen and associates from the the University of Wisconsin in Madison provide a step-by-step introduction to how they instituted their introductory CPB training course.
January 16, 2020
Submitted by: Emily Robinson
Two groups of Clinical Stage IA lung cancer patients were retrospectively investigated. Ninety-nine patients underwent complex segmentectomy, and 94 patients underwent location-adjusted lobectomy. The results of these two different strategies were compared. Outcomes have been comparable regarding mortality, morbidity, overall survival, and recurrence-free survival rates.
The authors concluded that complex segmentectomy can provide comparable outcomes in Stage IA lung cancer treatment.