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Journal and News Scan

Source: The New England Journal of Medicine
Author(s): Duk-Hyun Kang, Sung-Ji Park, Seung-Ah Lee, Sahmin Lee, Dae-Hee Kim, Hyung-Kwan Kim, Sung-Cheol Yun, Ph.D., Geu-Ru Hong, Jong-Min Song, Cheol-Hyun Chung, Jae-Kwan Song, Jae-Won Lee, Seung-Woo Park

A medium size RCTwith encouraging surgical outcomes in the era of TAVI expansion.....

Source: JAMA
Author(s): Rahul Bhatnagar, Hania E. G. Piotrowska, Magda Laskawiec-Szkonter, Brennan C. Kahan, Ramon Luengo-Fernandez, Justin C. T. Pepperell, Matthew D. Evison, Jayne Holme, Mohamed Al-Aloul, Ioannis Psallidas, Wei Shen Lim, Kevin G. Blyth, Mark E. Roberts, Giles Cox, Nicola J. Downer, Jurgen Herre, Pasupathy Sivasothy, Daniel Menzies, Mohammed Munavvar, Moe M. Kyi, Liju Ahmed, Alex G. West, Richard N. Harrison, Benjamin Prudon, Gihan Hettiarachchi, Biswajit Chakrabarti, Ajikumar Kavidasan, Benjamin P. Sutton, Natalie J. Zahan-Evans, Jack L. Quaddy, Anthony J. Edey, Amelia O. Clive, Steven P. Walker, Matthew H. R. Little, Xue W. Mei, John E. Harvey, Clare E. Hooper, Helen E. Davies, Mark Slade, Merle Sivier, Robert F. Miller, Najib M. Rahman, Nick A. Maskell

In this randomized trial including 330 pts with MPE, talc slurry and VATS talc insufflation under local anesthesia had similar failure rates (24% vs 22%) at 90 days.

Source: The Annals of Thoracic Surgery
Author(s): Eric Zimmermann, Roger Zhu, Takuya Ogami, Anthony Lamonica, John A. Petrie III, Charles Mack, Samuel Lang, Dimitrios V. Avgerinos

Using a standardized intraoperative autologous blood donation protocol,  surgical complications, postoperative transfusions, and transfusion volumes were all reduced.  

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Thierry A Folliguet, Emmanuel Teiger, Sylvain Beurtheret, Thomas Modine, Thierry Lefevre, Eric Van Belle, Martine Gilard, Helene Eltchaninoff, René Koning, Bernard Iung, Jean Philippe Verhoye, Pascal Leprince, Hervé Le Breton, Antoine Lafont, Alessandro Parolari, Fabio Barili

The authors aimed to analyze the outcome of transcatheter aortic valve implantation (TAVI) via carotid arteries. Included are more than 10,000 patients. The study showed a similar two-year outcome regardless of access. Transcarotid TAVI was associated with higher risk of stroke but lower rate of access site complications.

Source: The Annals of Thoracic Surgery
Author(s): Vignesh Raman, Oliver K. Jawitz, Soraya L. Voigt, Norma E. Farrow, Shi-Fu J. Yang, Thomas A D’Amico, David H. Harpole Jr.

Using the NCDB, the authors evaluated outcomes for patients with T4a esophageal adenocarcinoma. Receipt of surgery, compared to definitive chemoradiotherapy, offered a significant benefit to overall survival (HR 0.26).  

Source: TCT MD
Author(s): David Taggart

In the ongoing debate about the results of the EXCEL trial in which Professor Taggart withdrew his authorship and EACTS withdrew their support for the recommendations regarding PCI versus CABG, we previously posted the response from the EXCEL remaining coauthors : 

https://www.tctmd.com/slide/official-response-excel-leadership

This posting is Professor Taggart's response to this document.

Also see here for EACTS response: 

https://www.eacts.org/changing-evidence-changing-practice/

A full list of all the documents relevant to this discussion provided by the SCTS will also be available on the SCTS website. As more information becomes available, SCTS will endeavour to post it online and communicate with members directly, as appropriate. Please use the following link for items that are included as separate PDFs. Thank you. (https://www.dropbox.com/sh/9bq984evzqzkky5/AAAGTLyNYcUCiagA4dYkJ8Npa?dl=0)

  1. EXCEL trial (8th December 2016)


    https://www.nejm.org/doi/full/10.1056/NEJMoa1610227

  2. EXCEL trial 5-year outcomes (28th September 2019)  
    https://www.nejm.org/doi/full/10.1056/NEJMoa1909406
    https://solaci.org/_files/tct-2019/excel-5yearpdf.pdf

  3. TCTMD commentary (7th October 2019)


    https://www.tctmd.com/news/former-excel-investigator-alleges-trial-manipulation-prompting-vehement-denials

  4. BBC news story (9th December 2019)
    https://www.bbc.co.uk/news/health-50715156

  5. EACTS initial response to Newsnight article (9th December 2019)


    https://www.eacts.org/eacts-responds-to-bbc-newsnights-investigation-on-the-excel-trial/

  6. Cardiovascular news commentary (9th December 2019)


    https://cardiovascularnews.com/eacts-issues-response-to-bbc-newsnight-investigation-of-excel-trial/

  7. TCTMD commentary (10th December 2019)


    https://www.tctmd.com/news/eacts-pulls-out-left-main-guidelines-after-bbc-bombshell-alleging-excel-trial-cover

  8. British Cardiovascular Intervention Society (BCIS) statement (11th December 2019)


    https://www.bcis.org.uk/wp-content/uploads/2019/12/The-Excel-controversy-finalab.pdf

  9. Society for Cardiothoracic Surgery in Great Britain & Ireland (SCTS) joint statement with BCS & BCIS  (12th December 2019)

  10. Official response of EXCEL Leadership (12th December 2019)


    https://www.tctmd.com/slide/official-response-excel-leadership

  11. Medscape commentary & podcast (13th December 2019)


    https://www.medscape.com/viewarticle/922528

  12. SCTS second statement (18th December 2019)

  13. Taggart response to EXCEL rebuttal (19th December 2019)


    https://www.tctmd.com/slide/response-david-taggart-md-phd-excel-statement

  14. EACTS subsequent statement (19th December 2019)


    https://www.eacts.org/changing-evidence-changing-practice/

  15. ATTS statement (21st December 2019)


    https://www.aats.org/aatsimis/AATSWeb/Association/About/Statement%20ESC-EACTS.aspx

Source: Aorta
Author(s): Thais Faggion Vinholo, Adam J. Brownstein, Bulat A. Ziganshin, Mohammad A. Zafar, Helena Kuivaniemi, Simon C. Body, Allen E. Bale and John A. Elefteriades

This is an updated list of genes associated with thoracic aortic aneurysm and dissection. Dr Elefteriades and associates published the first version in 2017 and made an update in 2018. During the last year, six new genes were reported to be associated with thoracic aortic aneurysm and dissection.

Source: Fox News
Author(s): Hollie McKay

As a new political crisis for the United States evolves in Iraq, this is a timely glimpse at the impact of medical diplomacy. "In conflict zones, I enter each operation knowing that each surgery - mostly open-heart - is saving a life while all around us people are dying for mere thought differences. This frequently is my first thought in the morning and last at night." - Dr. William Novick 

Source: JAMA Oncology
Author(s): Yihan He, Xinfeng Guo, Brian H. May, Anthony Lin Zhang, Yihong Liu, Chuanjian Lu, Jun J. Mao, Charlie Changli Xue, Haibo Zhang

In this analysis of randomized controlled studies, accupuncture and/or accupressure significantly reduced cancer-associated pain compared to sham procedures.  

Source: The Annals of Thoracic Surgery
Author(s): Nicholas J. Goel, Amit Iyengar, John J. Kelly, Chase R. Brown, Fabliha Kurshan, Pavan Atluri, Michael A. Acker, Zehang Chen, Nimesh D. Desai

The readmission rate after mitral valve surgery was 17% among over 75,000 patients in the National Readmissions Database. Predictors included extended initial LOS, chronic lung or renal disease, and low hospital procedural volume for mitral surgery. The mean cost of readmission was over $15,000.

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