Journal and News Scan

This meta-analysis of eight randomized clinical trials (RCT) compared no-touch (NT) vs conventional (CON) saphenous vein (SV) harvesting in coronary bypass surgery. At a 3.7-year follow-up, NT-SV harvesting showed significantly lower graft failure rates compared to CON-SV. However, mortality and major adverse cardiac events were similar between groups. NT-SV harvesting was associated with higher leg wound complications. The author’s conclusion was that NT-SV harvesting reduces graft failure but increases wound complications; thus, strategies to mitigate harvest-site complications are needed. 

This article examines both preclinical and clinical results in cardiac xenotransplantation, highlighting the ongoing challenges in achieving consistent and durable clinical graft survival. The authors discuss the relative value of preclinical nonhuman primate and human decedent transplant models to optimize patient cross-matching, immune suppression, postoperative monitoring, and graft survival. 

While seasonal patterns suggest that cold weather influences the incidence of acute type A aortic dissection, the impact of subjective thermal stress on dissection risk remains poorly characterized. This retrospective multicenter study examined environmental triggers of acute type A aortic dissection in 548 German patients between 1996 and 2016. Subjective cold exposure, particularly perceived as windchill, significantly increased dissection odds by up to 50 percent, peaking three to four days before events. Elevated atmospheric pressure and low dew point also increased risk, while lower humidity showed modest protection. The acute temporal pattern suggests that cold-induced sympathetic activation, vasoconstriction, and blood pressure surges may precipitate dissection in vulnerable individuals. These interesting findings emphasize that perceived environmental stress outweighs ambient temperature in triggering acute aortic events, highlighting opportunities for targeted prevention during adverse weather conditions.  

This 10-year, single institution propensity-matched study investigated the outcomes of supervised resident-led emergency cardiac surgery compared to consultant-led procedures. Among 1,241 emergency cases, 364 matched pairs were analyzed, and overall outcomes were noted to be similar. Despite longer cardiopulmonary bypass times in consultant-led cases—possibly suggesting greater complexity—there were no significant differences in in-hospital mortality (13.7 percent vs 13.5 percent), major complications, or long-term survival up to 10 years. Subgroup analyses focusing on high-risk cases, emergent revascularization, infective endocarditis, and acute aortic syndromes confirmed comparable outcomes. The authors suggest that these findings validate structured training programs that progressively increase resident autonomy under supervision, addressing concerns about reduced training duration and working-hour restrictions. The study supports the safety and efficacy of resident involvement in high-stakes emergency cardiac surgery, demonstrating that appropriate supervision enables skill development without compromising patient outcomes.