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Journal and News Scan
The authors present the first autoregulated total artificial heart implant in the United States. The Aeson total artificial heart provides biventricular support with improvements in hemocompatibility and autoregulation in response to higher filling pressures, when compared to previous generations. The authors present the case of a patient who was successfully bridged to transplant using this improved total artificial heart implant.
This study compared in-hospital mortality risk prediction after cardiac surgery using the EuroSCORE II system with results generated by several machine-learning techniques. The dataset contained 227,087 adult patients, among whom there were 6,258 deaths (2.76 percent). Machine learning techniques showed some statistical improvements over EuroSCORE II, but the clinical impact of this was modest. The addition of other risk factors in future studies may result in further improvements.
This paper reports the first in-human trial exploring surgical reduction therapy for hypertrophic obstructive cardiomyopathy (HOCM). Patients recruited to the trial were those who presented with refractory HOCM with disabling symptoms despite best medical management. The authors reported on the procedural success of a novel transapical beating heart septal myectomy via a minithoracotomy under echocardiographic guidance.
Can we increase the rate and consistency of organ donation from donors experiencing out-of-hospital arrest? What are the challenges and opportunities associated with procurement from this population? The International Liaison Committee on Resuscitation released a scientific statement defining a protocol for organ donation after cardiac arrest, designed for applicability to all health systems. Read the full statement from Circulation journal ahead of print.
Recently, NICE released guidance from the British regulatory body limiting the Ozaki operation to research until further review, which is scheduled in three calendar years. The overarching concern appears to be the durability of the autoprosthesis. NICE guidelines have the strongest influence in healthcare in the United Kingdom and often abroad.
The first domino transplant procedure performed on infants was successfully completed recently in New York City. One patient needed a heart transplant because of cardiomyopathy and was able to donate a heart valve to another infant, who was only born with one.
This study reported long term outcomes of over three thousand single ventricle patients in the United Kingdom, with a median of 7.6 years. The most significant predictor of long-term survival was single ventricle subtype, with the worst outcomes observed among patients with hypoplastic left heart syndrome or unbalanced AVSD. Other negative outcome predictors were low weight at time of first procedure and acquired comorbidities. Although center volume was not a major predictor of long-term outcomes in this study, it is important to note that congenital care in the UK is highly centralized; thus, no low volume centers were captured in this study.
This article provides a systematic review of the choice of conduits for coronary artery bypass grafting and has been endorsed by both the STS and EACTS. The review reports on a variety of factors related to specific conduits, from patency and clinical outcomes to harvesting and target vessel selection.
In a research letter on a small pilot genomic study of sampling coronary atheroma, the authors offer a brief explanation on how their technique can be applied to detect stability of coronary plaque.
Because of the potential risk of early structural valve deterioration, the FDA has sent notice about Abbott’s decision to stop selling and distributing Trifecta aortic surgical heart valves in the United States. The FDA recommends that healthcare providers be aware of the risk of SVD with Trifecta valves, discuss risk with patients, and monitor patients who have undergone implantation with Trifecta valves.Because of the potential risk of early structural valve deterioration, the FDA has sent notice about Abbott’s decision to stop selling and distributing Trifecta aortic surgical heart valves in the United States. The FDA recommends that healthcare providers be aware of the risk of SVD with Trifecta valves, discuss risk with patients, and monitor patients who have undergone implantation with Trifecta valves.