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Journal and News Scan
March 20, 2017
Submitted by: Arie Blitz
The authors randomized 68 patients undergoing CABG to three treatment groups: ASA 81 mg QD ASA 325 mg QD ASA 162 mg BID On the 4th day following CABG, the authors measured serum thromboxane B2 (TXB2) as an inverse surrogate for ASA effect. The order of TXB2 levels were as follows: 162 mg BID << 81 mg BID ≈ 81 mg QD. Thus, the optimal regimen, according to this small study, would be ASA 162 mg BID.
March 17, 2017
Submitted by: Aristotle Protopapas
Three quarters of a century in caring for patients with congenital heart disease are summarized well in this brief viewpoint article, with the big data issue discussed.
March 9, 2017
Submitted by: CTSNet Staff
According to BBC Tyne & Wear, a patient died after surgeons inserted a heart valve upside down causing irreversible damage to her heart. The procedure was performed at the Freeman Hospital in Newcastle upon Tyne. NHS Foundation Trust has admitted the error, and the family has begun legal action.
The authors report the use of ECMO in 8 pts who suffered ARDS after pneumonectomy. Predicted mortality was 80% prior to ECMO institution. ECMO was weaned in 7 pts and overall hospital survival was 50%.
31 pts who underwent arterial switch at a weight of 2.5 kg or less were evaluated for outcomes. Surgery was performed at an average of 16 days of life. Mortality was 2.8% for those weighing 2.0-2.5 kg, and was 50% for those under 2 kg. At a mean follow-up of 13 years, 8% had required late reoperation. There were no late deaths, and all pts were NYHA Class I at last follow-up.
Changes in end organ function were assessed in 59 pts having a continuous flow LVAD in place for more than 3 years. Renal and hepatic function improved initially, but renal function deteriorated to preoperative levels during the follow-up period.
The authors describe a 10-year experience with extended arteriotomy for endarterectomy of a diffusely diseased LAD, using an internal mammary artery for reconstruction. Perioperative mortality was 1.1% and postoperative MI occurred in 9%. Survival at 5 years was 89% and freedom from acute cardiovascular events was 74%.
March 5, 2017
Submitted by: Tom C. Nguyen
This trial randomly assigned 4,752 patients from 19 countries to either on-pump or off-pump CABG with a mean follow-up of 4.8 years. The authors report no difference in death, stroke, myocardial infarction, renal failure or repeat revascularization at 5 years between the two groups.
March 2, 2017
Submitted by: CTSNet Staff
The webinar will be presented by one of the UK’s most senior general thoracic surgeons, Mr. Pala B. Rajesh, and will entail a one-hour interactive session on “everything you need to know” about the thymus. The session, aimed at trainees and surgeons alike, will be broadcast on March 6 at 2:00 p.m., Central Time (8:00 p.m., GMT), and will be repeated on March 7 at 2:30 a.m., Central Time (8:30 a.m., GMT). Visit https://www.rcsed.ac.uk/professional-support-development-resources/learning-resources/webinars to register.
February 26, 2017
Submitted by: J. Rafael Sadaba
In this manuscript, the authors describe their findings in an observational prospective study of 52 patients who had tentative diagnoses of bioprosthetic valve thrombosis (BPVT) of surgically implanted valves over a 3-year period. All patients underwent a trial of anticoagulation therapy with warfarin, and follow-up transthoracic or transesophageal echocardiography performed at least 4 weeks after the initiation of anticoagulation therapy. The authors found that an echocardiographic diagnostic score predicted the response to warfarin anticoagulation in BPVT with excellent accuracy, that warfarin significantly reduced prosthetic gradients in 83% of the patients; and that this diagnostic and therapeutic strategy was associated with minimal side effects and no mortality.