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Journal and News Scan
On July 22, The Annals of Thoracic Surgery published this consensus statement on nomenclature and classification of the congenital bicuspid aortic valve (BAV) and Its aortopathy.
This consensus statement divides BAV into 3 types: 1) Cusp-fused type (right-left, right-non and left-non-coronary cusp fusion ); 2) Two-sinus type (latero-lateral and antero-posterior ); and 3) Partial-fusion (forme fruste) type.
BAV-associated aortopathy are categorized into 3 types: 1) Ascending type; 2) Root type; and 3) Extended type.
This study assessed cognitive involved in cardiac surgical procedures from the perspective of three different specialty groups: surgeons, anesthesiologists, and perfusionists. The 137 unique processes that were identified were classified as: decision points, critical communications, pitfalls, and strategies. Understanding these processes and the different perspectives each team member brings to the operation may help improve patient safety and outcomes.
In this article, Dr. Sandhu et al. review their 22-year experience in managing patients with thoracic aortic graft infection. They demonstrate that this infection is highly morbid and requires prompt antimicrobial coverage, debridement, graft replacement, and vascularized graft coverage to prevent morbidity and mortality.
In this article, Dr. Farber et al. describe the acceptable five year outcomes of using the Conformable GORE® TAG® thoracic endoprosthesis (CTAG) device (W.L. Gore and Associates, Flagstaff, AZ) for thoracic endovascular repair (TEVAR) of blunt aortic injuries in a prospective, single-arm study among 111 patients.
In this article, Dr. Skelhorne-Gross et al. discuss the utility of a standardized minimal opioid pain prescription post minimally invasive thoracic surgery to limit postoperative opioid prescriptions. They provided patients with a standardized prescription of Hydromorphine (2mg x 15 tabs), Acetaminophen (1g tid x 7 days), and Ibuprofen (400mg po tid x 3 days), and demonstrate that the pain was successfully controlled in the majority of patients.
In this article, Jacobs et al. provide a multi-institutional outcomes review of 200 consecutive patients with confirmed COVID-19 supported with ECMO. The mean time on ECMO was 15 days with survival on VV-ECMO of 46.3% and survival on VA-ECMO of 25%. Predictors of survival included a lower median age and shorter median time from COVID-19 diagnosis to ECMO initiation.
This registry, involving multiple centers, aims to provide conclusive results reflecting the importance of critical preoperative conditions and different treatment strategies to reduce the risk of early adverse events after surgery for acute TAAD.
Based on data of patients with acute aortic dissection in a hospital of Nobeoka City from 2016-2018, Yamaguchi and associates found the incidence of acute aortic dissection was 17.6 per 100,000 (11.3 for type A, 6.2 for type B). This incidence is 4 times higher than reported in the Olmsted County study (3.5 per 100,000).
The Society of Thoracic Surgeons (STS), the Society of Cardiovascular Anesthesiologists (SCA), the American Society of ExtraCorporeal Technology (AmSECT), and the Society for the Advancement of Blood Management (SABM) published an update to the "2011 Update to The Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists Blood Conservation Clinical Practice Guidelines."