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Journal and News Scan

Source: The Annals of Thoracic Surgery
Author(s): Hector I. Michelena, Alessandro Della Corte, Arturo Evangelista, Joseph J. Maleszewski, William D. Edwards, Mary J. Roman, Richard B. Devereux, Borja Fernández, Federico M. Asch, Alex J. Barker, Lilia M. Sierra-Galan, Laurent De Kerchove, Susan M. Fernandes, Paul W.M. Fedak, Evaldas Girdauskas, Victoria Delgado, Suhny Abbara, Emmanuel Lansac, Siddharth K. Prakash, Malenka M. Bissell, Bogdan A. Popescu, Michael D. Hope, Marta Sitges, Vinod H. Thourani, Phillippe Pibarot, Krishnaswamy Chandrasekaran, Patrizio Lancellotti, Michael A. Borger, John K. Forrest, John Webb, Dianna M. Milewicz, Raj Makkar, Martin B. Leon, Stephen P. Sanders, Michael Markl, Victor A. Ferrari, William C. Roberts, Jae-Kwan Song, Philipp Blanke, Charles S. White, Samuel Siu, Lars G. Svensson, Alan C. Braverman, Joseph Bavaria, Thoralf M. Sundt, Gebrine El Khoury, Ruggero De Paulis, Maurice Enriquez-Sarano, Jeroen J. Bax, Catherine M. Otto, Hans-Joachim Schäfers

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.

Source: Annals of Surgery
Author(s): Dias RD, Zenati MA, Conboy HM, Clarke LA, Osterweil LJ, Avrunin GS, Yule SJ.

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.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Harleen K. Sandhu, MD, MPH, Alexander P. Nissen, MD, Harith Mushtaq, MD, Charles C. Miller III, PhD, Hazim J. Safi, MD, FACS, Anthony L. Estrera, MD, FACS, Kristofer M. Charlton-Ouw, MD, FACS

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. 

Source: The Annals of Thoracic Surgery
Author(s): Mark A. Farber, M.D., Kambhampaty V. Krishnasastry, M.D., Nimesh Desai, M.D., Ph.D., Benjamin W. Starnes, M.D., Jon S. Matsumura, M.D., Beth C. Tohill, M.S.P.H., Ph.D., on behalf of the TAG 08-02 clinical trial investigators

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. 

 

Source: The Annals of Thoracic Surgery
Author(s): Graham Skelhorne-Gross, MD PhD, Carmine Simone, MD FRCSC, Sayf Gazala, MD FRCSC, Robert Allan Zeldin, MD FRCSC, Najib Safieddine, MD FRCSC

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. 

 

 

Source: The Annals of Thoracic Surgery
Author(s): Jeffrey P. Jacobs, MD, Alfred H. Stammers, MSA, James D. St. Louis, MD, J.W. Awori Hayanga, MD, Michael S. Firstenberg, MD, Linda B. Mongero, CCP, Eric A. Tesdahl, PhD, Keshava Rajagopal, MD, PhD, Faisal H. Cheema, MD, Kirti Patel, CCP, Tom Coley, CCP, Anthony K. Sestokas, PhD, Marvin J. Slepian, MD, Vinay Badhwar, MD

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.

Source: Journal of Cardiothoracic Surgery
Author(s): Fausto Biancari, Giovanni Mariscalco, Hakeem Yusuff, Geoffrey Tsang, Suvitesh Luthra, Francesco Onorati,Alessandra Francica, Cecilia Rossetti,Andrea Perrotti, Sidney Chocron, Antonio Fiore, Thierry Folliguet, Matteo Pettinari, Angelo M. Dell’Aquila, Till Demal, Lenard Conradi, Christian Detter, Marek Pol, Peter Ivak, Filip Schlosser, Stefano Forlani, Govind Chetty, Amer Harky, Manoj Kuduvalli, Mark Field, Igor Vendramin, Ugolino Livi, Mauro Rinaldi, Luisa Ferrante, Christian Etz, Thilo Noack, Stefano Mastrobuoni, Laurent De Kerchove, Mikko Jormalainen, Steven Laga, Bart Meuris, Marc Schepens, Zein El Dean, Antti Vento, Peter Raivio, Michael Borger and Tatu Juvonen

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.

Source: European Heart Journal Acute Cardiovascular Care
Author(s): Tetsuo Yamaguchi, Michikazu Nakai, Takao Yano, Masakazu Matsuyama, Hideaki Yoshino, Yoshihiro Miyamoto, Yoko Sumita, Hitoshi Matsuda, Yousuke Inoue, Yutaka Okita, Kenji Minatoya, Yuichi Ueda, Hitoshi Ogino

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).

Source: The Annals of Thoracic Surgery
Author(s): Chris J. Bond, MB ChB, Milan Milojevic, MD, PhD, Chang He, MS, Patricia F. Theurer, MSN, Melissa Clark, MSN, Andrew L. Pruitt, MD, Divyakant Gandhi, MD, Alphonse DeLucia, MD, Robert N. Jones, MD, MHA, Reza Dabir, MD, and Richard L. Prager, MD
This article outlines a statewide collaborative-based approach to improving utilization of arterial conduits in the United States.
Source: The Annals of Thoracic Surgery
Author(s): Pierre Tibi, R. Scott McClure, FRCSC, Jiapeng Huang, Robert A. Baker, David Fitzgerald, C. David Mazer, Marc Stone, Danny Chu, Alfred H. Stammers, Tim Dickinson, Linda Shore-Lesserson, Victor Ferraris, Scott Firestone, Kalie Kissoon, and Susan Moffatt-Bruce

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."

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