Journal and News Scan

This study compared radical vs partial pericardiectomy in 534 consecutive adults with constrictive pericarditis from 2000 to 2022, using propensity-score matching to create 89 well-matched pairs. The authors found that radical pericardiectomy produced superior postoperative hemodynamics compared to partial resection, with cardiac index increases of 1.2 vs 0.5 liters per minute per square meter and central venous pressure decreases of 12 vs 4.8 mmHg (p<0.001). Operative mortality was significantly lower after radical pericardiectomy (3.4 percent vs 17 percent, p<0.05), with markedly improved 10-year survival (62 percent vs 23 percent). Cardiopulmonary bypass facilitated complete resection without increasing mortality risk, although there were increased transfusion requirements and bleeding complications noted. The authors concluded that radical pericardiectomy should be the preferred approach for constrictive pericarditis, as it can be performed safely with cardiopulmonary bypass support while providing superior short- and long-term outcomes. 

This 10-year, single-center, propensity-matched study compared the outcomes of resident-led operations with those of consultant-led operations at a high-volume UK center. This study investigated index adult cardiac surgical procedures as defined in the UK training curriculum, specifically isolated coronary artery bypass grafting (CABG), isolated aortic valve replacement (AVR), and combined CABG and AVR. Of a total of 11,372 such procedures performed between 2015 and 2024, propensity matching yielded 4,259 pairs for analysis (n = 8,518). 
 
Despite longer cardiopulmonary bypass and aortic cross-clamp times in resident-led cases, the groups had a higher incidence of deep sternal wound infection (1.2 percent vs 0.7 percent, p = 0.033) and a one-day longer median hospital stay (seven vs six days, p < 0.001). However, they exhibited comparable in-hospital mortality and rates of other postoperative complications, as well as comparable long-term survival extending to 10 years. Subgroup analyses demonstrated comparable morbidity, mortality, and long-term survival across each index procedure type. 
 
These findings provide reassurance for current cardiac surgical training models, indicating that a supervised, stepwise increase in residents’ operative responsibility can be implemented safely despite persistent scrutiny of outcomes and ongoing constraints on training time and operative exposure. By focusing on curriculum-defined index procedures, the study supports the safe incorporation of progressive operative autonomy within structured training programs without adversely affecting patient outcomes. 

In this article from the British Medical Journal, the author examines AI-generated images of doctors using OpenAI’s ChatGPT, comparing these depictions with real-world medical workforce data. A total of 24 images were generated, with eight images each for NHS, UK, and US doctors across different specialties. The results showed that only 25 percent of the generated images depicted female doctors, with women appearing in specialties such as obstetrics and pediatrics. In terms of ethnicity, 75 percent of US doctors were shown as white. Notably, images generated with the NHS prompt predominantly featured ethnic minority doctors, while those with the UK prompt depicted white doctors. 

This novel study examined tricuspid annular (TA) remodeling in conscious, awake sheep with functional tricuspid regurgitation (FTR) using tachycardia-induced cardiomyopathy. Fifteen sheep underwent thoracotomy with sonomicrometry crystal implantation around the TA and right ventricular epicardium. Eight surviving animals had baseline measurements acquired while awake, then underwent pacing (180-240 bpm for 18±2 days) until developing FTR. The model produced moderate-severe FTR, with a 48 percent increase in right ventricular (RV) volume, a 57 percent enlargement of the TA area, and a 24 percent perimeter expansion. Critically, all annular segments dilated significantly: the anterior perimeter increased by 27 percent, the posterior perimeter increased by 17 percent, and the septal perimeter by 25 percent (all p<0.01), with the TA area contraction decreasing from 16.6 percent to 4.5 percent. The authors conclude that septal annular dilation, which has traditionally been unsupported by partial rings, may explain high annuloplasty failure rates, suggesting that complete annular support could improve surgical durability in severe FTR.