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Journal and News Scan
Techniques of unifocalization and pulmonary artery reconstructions have been developed to treat complex disorders of pulmonary artery development. The objective of this study was to document the prevalence of complications in these patients. The data demonstrate that the median value for duration of cardiopulmonary bypass (CPB) was 473 minutes, number of complications was five, and length of stay was 24 days. Major adverse cardiac events occurred in 11% of patients. Notably, while complications were relatively frequent, the overall outcomes were generally favorable. Importantly, CPB time had a poor correlation with total number of complications and hospital length of stay; a finding that is different from what has been observed in relation to other complex congenital or adult cardiac operations.
This article examines the use of lungs from older donors and associated survival of recipients.
The initial experience from Ann Arbor throughout a quarter of a century in malperfusion syndrome from type B (De Bakey III) aortic dissection is presented in this paper, juxtaposing early fenestrating and adjunct endovascular techniques to conservative treatments.
Half of the relatively young patients were not alive after ten years, although radiological success was claimed in more than nine out of ten cases.
The growing interest in early intervention for type B, and the advances in endovascular and hybrid solutions for aortic disease will rend this retrospective manuscript an interesting read.
In a press release early this morning, Pfizer and BioNTech accounced the results of their vaccine candidate against SARS-CoV-2 in the first interim efficacy analysis of its Phase 3 clinical study.
This vaccine candiate, BNT162b2, was found to be more than 90% effective in preventing COVID-19 in 94 participants without evidence of prior SARS-CoV-2 infection.
This original article by Linardi et al. analysis the outcome of slow versus fast rewarming after hypothermic circulatory arrest in a rat model. They observed reduced inflammatory and oxidative stress and also a higher cerebral blood flow within the slow rewarming group compared to the fast rewarming group. Therefore they suspect slow rewarming might be superior regarding neurologic outcome after hypothermic circulatory arrest.
This hard hitting article summarises the current situation with the Excel trial and the situation regarding the evidence of PCI vs CABG in left main stem disease.
It exposes a legion of errors and scandals which were first exposed by Professor David Taggart then the BBC then EACTS.
It lists the 30% of the writing taskforces declaration of interest with stent manufacturers
It finally reports the possible resolution by a change in the guidelines which is now being planned.
This joint consensus document aims to facilitate triage and management of patients with aortic dissection, rupture, and malperfusion syndromes during the COVID-19 pandemic. The following issues have been addressed in the care of COVID-19–positive or status unknown patients with aortic emergencies:
1. Management and triage
2. Management of interfacility transfers
3. Preoperative considerations to minimize risk to health care personnel
4. Important anesthetic considerations
5. Precautions to be taken by surgical personnel during the procedure
6. Postoperative considerations
Within the limitations of a meta-analysis, a useful work advancing that PCI may have a hitherto masked or hidden mortality
Depypere et al. report on a survey among members of the European Society of Thoracic Surgeons (ESTS) regarding the impact of coronarvirus disease 2019 on thoracic oncology surgery. They recorded an almost universal impact on surgical practice regardless of the country and the numbers of COVID-19 infected patients. Furthermore, there was no consensus regarding surgical priorities in lung cancer patients, which represents the need of further guideline work within this area.
Kawamura et al. present a retrospective multicenter study of 84 patients who underwent concomitant CABG to aortic surgery and anastomosis of the 109 CABG graft anastomosed either to the native aorta or to the vascular prosthesis. The patency evaluated by CT angiography or coronary angiography was significantly worse for those grafts anastomosed to the vascular graft compared to the native aorta.