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Journal and News Scan
Outcomes of surgery for congenital heart defects in children with trisomy 13 or 18 were evaluated in 98 pts the Pediatric Cardiac Care Consortium 1982-2008. Hospital mortality was 28% and 13%, respectively. Median survival was 15 years and 16 years, primarily related to cardiac and respiratory causes.
A statewide quality initiative database that included over 11,500 pts undergoing surgical AVR (SAVR) who were assessed for outcomes based on pre-TAVR and post-TAVR time periods (divided into early TAVR and commercial TAVR). SAVR rates increased with each time period, wheres predicted mortality rates decreased, observed mortality was lowest during the commercial era, and major morbidity decreased throughout the time periods. SAVR outcomes are improving, possibly because the highest risk patients are undergoing TAVR.
Data from the Centers for Medicare and Medicaid Services related to patients aged 65 and older who underwent TAVR during a 2 year period were evaluated, stratified into older (age 90 or greater; 19.3%) and younger cohorts. Nonagenarians had fewer comorbidities. Mortality was higher in nonagenarians (8.4% vs 5.9%) as was morbidity (25.4% vs 21.5%). Among nonagenarians, the transfemoral approach was associated with lower mortality, higher rates of discharge to home, and lower readmission rates.
In this single site retrospective review, outcomes of repair of giant paraesophageal hiatal hernia were reviewed with respect to the effects of patient age. Patients aged 80 or greater had greater comorbidity at the time of surgery, more often had Type IV hernias, and underwent emergency intervention more often. The incidence of postoperative complications was higher in this group. Recurrence rates were similar between the older and younger groups.
May 23, 2017
Submitted by: Arie Blitz
The authors conducted a retrospective cohort study of 88 patients that received methylene blue (MB) for refractory vasoplegia following cardiopulmonary bypass. Administration of MB was associated with an 8 mmHg increase in mean arterial pressure, with the peak response occurring at 2 hours after completion of dose.
May 22, 2017
Submitted by: CTSNet Staff
The purpose of this study was to evaluate differences in long-term survival without the influence of early mortality, and to identify factors associated with one-year conditional ten-year survival after heart transplantation across different age and diagnostic groups using the UNOS database. Predictors of one-year conditional ten-year survival for infants were: recipient’s Caucasian race (odds ratio [OR]: 1.9, 95% confidence interval [CI]: 1.3-2.7) and donor–recipient weight ratio (OR: 0.8, 95% CI: 0.6-1); for children: Caucasian race (OR: 1.6, 95% CI: 1.2-2.1), retransplantation (OR: 0.4, 95% CI: 0.2-0.6), and transplantation after the year 2000 (OR: 1.5, 95% CI: 1.1-2.1); for adolescents: only Caucasian race (OR: 2.5, 95% CI: 1.9-2.3). In both congenital heart disease (CHD) and cardiomyopathy groups, adolescents had worse survival compared to infants and children. There was an era effect with improved survival after 2000. Male gender was a predictor of survival in cardiomyopathy group.
May 22, 2017
Submitted by: Aristotle Protopapas
A surprisingly readable Australasian manuscript on risk prediction models for cardiac surgery. Interesting that the class of dyspnoea was not captured in 5.28% of the operated patients.
May 18, 2017
Submitted by: Emily Farkas
Following a charitable initiative launched in 2014 to impact one million underserved people by 2020, Edwards provides a current update on progress toward that goal. Dr. David Adams and other specialists comment on the magnitude and importance of the effort, and a request for proposals announces the beginning of the foundation's 2017 grant cycle.
May 18, 2017
Submitted by: Joel Dunning
He weighed merely 470 grams at birth and was just the size of a palm. He was born prematurely after 28 weeks (5.5 months). His eyes hadn't opened, lungs weren't developed, skin resembled parchment paper, too fragile and delicate to touch, and he had heart complications. After 15 days of birth, he underwent a heart surgery and has now become the tiniest miracle baby to have undergone a PDA (patent ductus arteriosus) corrective operation.
May 17, 2017
An assessment of regional lung resection outcomes relative to compliance with NCCN resection guidelines was performed. Negative margins 94%, 91% anatomic, 51% hilar nodes sampled, 26% 3 mediastinal nodal stations sampled. On average, 17% of resections met all criteria, although the trend was upward over time. Survival was better for pts who met all four criteria.