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Journal and News Scan

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Valentino Bianco, Arman Kilic, Thomas G. Gleason, Edgar Aranda-Michel, Yisi Wang, Forozan Navid, Ibrahim Sultan

Fascinating confirmation of null hypotheses including bleeding complications and survival in a Pennsylvanian cohort study, despite the easily predictable previous PCI, hock, and IABP prevalence in the emergency group. The statistical model is elaborate and complex. Perhaps a randomized trial could now be justified!

Source: Circulation Research
Author(s): Joshua A. Beckman, Peter A. Schneider, Michael S. Conte

A useful detailed review (or state-of-the-art article) on revascularisation in extracardiac vascular stenoocclusive atheromatosis.

Source: The New England Journal of Medicine
Author(s): Jan A. Deprest, Kypros H. Nicolaides, Alexandra Benachi, Eduard Gratacos, Greg Ryan, Nicola Persico, Haruhiko Sago, Anthony Johnson, Mirosław Wielgoś, Christoph Berg, Ben Van Calster, and Francesca M. Russo for the TOTAL Trial for Severe Hypoplasia Investigators

A glimpse of what could be a future for surgery..........

Source: Annals of Surgery
Author(s): Brown LM, Thibault DP, Kosinski AS, Cooke DT, Onaitis MW, Gaissert HA, Romano PS

This examination of readmission rates is based on data from nearly 40,000 patients from the STS Database having undergone elective pulmonary lobectomy.   Readmission was driven by complications during the index operation, notably pulmonary embolism, empyema, pleural effusion, and pneumothorax.  Improved pleural space management may offer a means to mitigate readmission rates.

Source: Annals of Thoracic Surgery
Author(s): Subramanian MP, Sahrmann JM, Nickel KB, Olsen MA, Bottros M, Heiden B, Semenkovich TR, Meyers BF, Kozower BD, Patterson GA, Nava RG, Kreisel D, Puri V.

Over 30% of lung resection patients in the STS Database had prior exposure to opioid use.  They experienced longer length of postoperative stay, more frequent visits to the ED, and a higher incidence of readmission within 90 days.  Athough there is growing interest in standardized enhanced recovery pathways after lung resection, this challenging subset of patients appears to require unique targeted postoperative interventions.

Source: Annals of Surgical Oncology
Author(s): Pamela Milito, Jakub Chmelo, Lorna Dunn, Sivesh K. Kamarajah, Anantha Madhavan, Shajahan Wahed, Arul Immanuel, S. Michael Griffin, Alexander W. Phillips

Chyle leak remains a challenging postoperative complication to manage, and avoidance is always easier than mitigation.  The only predisposing factor identified in this study was low BMI.  Although ICU stay was longer in affected patients, operative mortality, hospital LOS, and survival were not negatively impacted by the presence of a leak. 

Source: Journal of Thoracic and Cardiovascular Surgery Techniques
Author(s): Abigail White, MD; Sabin J. Bozso, MD; Maral Ouzounian, MD, PhD; Michael W. A. Chu, MD; Michael C. Moon, MD; on behalf of Canadian Thoracic Aortic Collaborative

A good discussion on the concepts of:

1. aortic true lumen and false lumen behavior after repair of acute Type A aortic dissection
2. distal anastomotic new entry tear after hemiarch repair
3. impact of above on clinical outcomes
4. strategies on preventing distal anastomotic entry tear

The authors communicate that improved understanding of these hemodynamic conditions may serve to improve surgical technique, guide creation of novel devices toward new therapeutic targets, reduce surgical risk, and ultimately improve patient outcomes.

Source: Foldax news and events
Author(s): Foldax Inc

On May 25, 2021, Dr. David Heimansohn successfully performed the first surgical implantation of biopolymer Tria™ heart valve in a patient with mitral valve disease at Ascension St. Vincent Hospital, Indianapolis, IN. 

Foldax’s Tria valve is fabricated with a polymeric, silicone-rich polyurethane material intended to resist calcification, improve valve durability, and, most importantly, avoid the need for lifelong anticoagulation. 

Source: The Annals of Thoracic Surgery
Author(s): Christopher Ibarra, MD, Zachary Spigel, MD, MPH, Rija John, RN, MSN, Ziyad M. Binsalamah, MD, Iki Adachi, MD, Jeffrey S. Heinle, MD, Christopher A. Caldarone, MD, E. Dean McKenzie, MD, and Michiaki Imamura, MD, PhD
There are multiple techniques for the repair of supravalvular aortic stenosis (SVAS), but given the rarity of the lesion, analyses comparing the efficacy of each repair is limited.
Source: The Annals of Thoracic Surgery
Author(s): Anita Nguyen, MBBS, Hartzell V. Schaff, MD, Steve R. Ommen, MD, Bernard J. Gersh, MBChB, DPhil, Joseph A. Dearani, MD, Jeffrey B. Geske, MD, Brian D. Lahr, MS, Rick A. Nishimura, MD
Septal myectomy leads to excellent symptomatic relief in most patients, and more than 80% report subjective improvement in health status. Important predictors of worsening health included coronary artery disease and poor preoperative health status.