Journal and News Scan

Endospan announced that it has received European CE Mark approval for its Nexus stent graft system for the endovascular repair of aortic arch disease comprising both aneurysms and dissections.

Nexus is a low-profile branched stent-graft designed and engineered specifically for the aortic arch to allow ease of deployment while achieving a durable effective repair and importantly minimizing the risk of stroke and other cardiovascular complications.  It represents a major milestone being the first low-profile branched endovascular stent-graft to be available off-the-shelf in Europe for endovascular repair of the aortic arch, especially for high-risk partients with complex arch pathologies.

Yanagawa and colleagues evaluated the experience of 10 centers in Ontario, Canada, participating in the Ontario Transfusion Coordinator (ONTraC) program to determine if red blood cell transfusion rates were reduced by patient participation in the program and optimization of hemoglobin prior to coronary artery bypass grafting (CABG). The authors discuss the ONTraC program, noting that the first 60 consecutive patients undergoing CABG at each center each year were referred for assessment. After this, patients were referred only upon physician request. Over the 10 years following the start of the program, overall transfusion rates fell from 40.1% to 26.2%. Patients who were assessed by an ONTraC coordinator were more likely to be older, to be women, and to be anemic, but despite this, no differences were found in overall transfusion rates between patients who were and were not assessed. When patients were stratified by World Health Organization Anemia Classification, patients with both mild and moderate-to-severe anemia who were assessed prior to CABG had lower transfusion rates than patients with anemia who were not assessed.

This review summarizes recent promising applications of artificial intelligence (AI) in cardiology and cardiac imaging, which potentially add value to patient care.

Problems with timing, efficiency, and missed diagnoses occur at all stages of the imaging chain. The application of AI may reduce cost and improve value at all stages of image acquisition, interpretation, and decision-making. The main fields of AI for imaging will pertain to disease phenotyping, diagnostic support, and image interpretation. Grouping of relevant clinical and imaging information with cluster analysis may provide opportunities to better characterize disease. Diagnostic support will be provided by automated image segmentation and automated measurements. The initial steps are being taken towards automated image acquisition and analysis. “Big data” from imaging will interface with high volumes of data from the electronic health record and pathology to provide new insights and opportunities to personalize therapy.

The American College of Cardiology's 68th Annual Scientific Session has released the 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. This guideline includes newly generated recommendations for control of blood presssure, cholesterol and type II diabetes, aspirin use, regular exercise and physical activity, heathier diet, and tobacco use, in addition to recommendations related to team-based care, shared decision-making, and assessment of social determinants of health, to create a comprehensive yet targeted ACC/AHA guideline on the prevention of atherosclertoic cardiovascular disease.