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Journal and News Scan
July 8, 2020
Submitted by: Wei-Guo Ma
Upchurch and coauthors have recently published the practice guidelines on thoracic endovascular aneurysm repair (TEVAR) in the mangement of thoracic aortic aneurysms.
July 8, 2020
Submitted by: Wei-Guo Ma
Upchurch and coauthors have recently published the practice guidelines on thoracic endovascular aneurysm repair (TEVAR) in the mangement of thoracic aortic aneurysms.
July 3, 2020
Submitted by: Wei-Guo Ma
The authors make a brief overview of tricuspid regurgitation associated with congenital heart defects, including morphology, incidence and echocardiographic evaluation. The status quo of medical and surgical managements and outcomes are also comprehensively reviewed.
July 1, 2020
Submitted by: Emily Robinson
The authors consider simultaneous vs. staged repair of comorbid congenital tracheal stenosis in the surgical approach to these patients.
June 30, 2020
Submitted by: Wei-Guo Ma
Researchers from the UK reported a novel polymeric heart valve, PoliValve, which is made entirely from styrenic block copolymers.
The unique feature of PoliValve is that it is made of a self-assembling polymer with a microstructure conferring mechanical anisotropy analogous to that of natural valve tissue. Its prototype substantially exceeds ISO standards for in-vitro testing and shows encouraging preliminary results in acute in-vivo feasibility/safety testing in sheep without anticoagulation. Postmortem confirmed intact structure of the PHV with no evidence of any acute valvular clot/thrombus. Its durability exceeded 1.2 billion cycles in accelerated in-vitro tests, equivalent to 30 patient years.
These results show that PoliValve is a promising alternative to traditional biological and mechanical valve prostheses, which lasts up to 30 years and does not need anticoagulation.
June 27, 2020
Submitted by: Mark Ferguson
The previous randomized study of minimally invasive esophagectomy vs open esophagectomy (TIME trial) conducted in the Netherlands demonstrated reduced pulmonary complications and LOS with MIE. Compared to the benefits of MIE in those selected high volume centers, national use of MIE was associated with increased overall complications, increased pulmonary complications, and increased reoperation rates.
June 26, 2020
Submitted by: Emily Robinson
This original article retrospectively analyzed the outcome of 200 patients after implantation of HeartMate 3 and HeartWare LVAD respectively. The baseline characteristics of both groups, containing 100 patients each, were comparable, despite a higher percentage of INTERMACS I and II patients implanted with the HeartWare device. While the overall survival was not different, patients receiving HeartWare LVAD had more intracranial bleeding, while the total fraction of patients with cerebrovascular accidents was not different. The authors conclude that the devices show a different complication profile, but comparable intermediate survival.
June 22, 2020
Submitted by: Thomas Theologou
Over the years, frozen elephant trunk (FET) has become the treatment of choice for multisegmental thoracic aortic disease. This multicenter study presents the evolution of FET results using the E-vita Open hybrid graft with respect to institutional experience and time.The data of International E-vita Open registry were studied according to the institutional experience of the participating centers (high- versus low-volume centers) and according to the evolution of FET treatment during time (1st period, 2005–2011 versus 2nd period, 2012–2018). Overall, 1,165 patients were enrolled in the study with a wide variety of multisegmental thoracic aortic pathologies and aortic emergencies. Participating centers determined their own surgical protocol.The overall 30-day mortality was 12%. Short- and long-term survival were higher in high- versus low-volume centers (P=0.048 and P=0.013, respectively). In the 2nd time period, cerebral complications were reduced significantly (P=0.015). Incidence of permanent spinal cord-related symptoms was reduced to 3% in the 2nd time period, but did not reach statistical significance. Hypothermic circulatory arrest time (P<0.001) and incidence of postoperative temporary renal replacement therapy (P=0.008) were significantly reduced in the 2nd time period. Ten-year survival and freedom from aortic-related death rates were 46.6% and 85.7%, respectively, for the entire group. The freedom from distal aortic re-interventions for a new or progressive residual aortic disease was 76.0%. In conclusion, this study shows that the evolution of FET arch repair techniques with the E-vita Open graft and increasing institutional experience were associated with improved results. Progression of residual aortic disease makes close follow-up with aortic imaging mandatory in such patients.
June 19, 2020
Submitted by: Aristotle Protopapas
A large retrospective review of almost three decades of extensive thoracoabdominal aortic surgery, with considerable educational value especially on the anatomicoclinical correlations of the spinal vasculature.
June 12, 2020
Submitted by: Emily Robinson
The authors analyzed the volumes of thoracic endovascular aneurysm repair (TEVAR) for the treatment of descending thoracic aneurysms for Medicare patients over five years, comparing the proportion of cases to 30-day mortality.