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Journal and News Scan
Abe and associates reported the trends in the early outcomes of surgical repair for acute type A aortic dissection in 11,843 patients from the Japan Cardiovascular Surgery Database between 2008 and 2015. Operative mortality was 9.5% and 30-day mortality was 7.6%. The number of surgically treated cases increased by 45% during the interval. A signficant upward trend was found in patient age and the incidences of preoperative renal failure. Unadjusted operative mortality rate with arch replacement showed a significant downward trend (P = 0.01). Risk-adjusted mortality rate showed a downward trend both in ascending aortic or hemiarch and arch replacement, which did not reach statistical signficance.
In this multi-institutional randomized trial comparing talc slurry through a chest tube to talc pudrage during VATS, success rates at 90 days were similar.
Succinct commentary on the challenge of vascular access in ECMO circuits on the occasion of a manuscript on a novel design of a multi-access adaptor.
In this study, the authors report on the outcome of mitral valve repair, applying subannular repair for functional mitral valve regurgitation. Included are 108 patients who underwent annuloplasty with subannular repair (n=60) versus patients with annuloplasty only (n=48). Repositioning of the papillary muscle lead to excellent outcomes with less mitral valve regurgitation recurrence.
Higher case volumes (>10 annually) were associated with decreased mortality for surgical treatment of aortic dissection. This relationship was not evident for thoracic endovascular aortic repair.
Well-presented Canadian prospective study juxtaposing a combination of Wells scoring and dimers to the imaging gold standard.
It was particularly fascinating to read the referenced assertion that:
.....the prevalence of pulmonary embolism among patients who undergo diagnostic testing is substantially higher in Europe than in North America.. (Penultimate paragraph): We wonder what would be the robust causes of such disparity........
Cohort study from the UK, fuelling the escalating debate on blood management in perioperative cardiovascular care.
High-Throughput, Contact-Free Detection of Atrial Fibrillation From Video With Deep Learning
In this study, one-minute videos including multiple individuals were analyzed for their facial photoplethysmographic signals, permitting accurate detection of atrial fibrillation. It is an example of how biometric data may be collected with high throughput in the future.
A deep-learning computer aided detection (CAD) system was trained to recognize neoplasia using nearly 500,000 endoscopic images. In head-to-head testing against experienced gastroenterologists using additional images, the accuracy of CAD in diagnosing neoplasia was 88% vs 73% for the gastroenterologists.
The authors analyzed what is the best management for tricuspid valve disease in adults. This is a retrospective study with 1,735 patients who received tricuspid valve repair and 806 patients who underwent replacement. Replacement was associated with increased late mortality. Tricuspid valve repair did not result in a higher risk of reoperation. The authors concluded that tricuspid valve repair should be preferred whenever feasible.