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Journal and News Scan

Source: VUMEDI
Author(s): Ahmed Ouda, Utz Kappert

This video shows you how to take down a skeletonised LIMA. 

Very nice 

Source: JAMA Cardiology
Author(s): Rohan Khera, Ambarish Pandey, Thomas Koshy, Colby Ayers, Brahmajee K. Nallamothu, Sandeep R. Das, Mark H. Drazner, Michael E. Jessen, Ajay J. Kirtane, Timothy J. Gardner, James A. de Lemos, Deepak L. Bhatt, Dharam J. Kumbhani

Using a data set from 682 US hospitals during a 10-year period, the relationship of hospital procedure volume for AVR and MVR to adjusted mortality rate was evaluated.  Using terciles of volume to classify hospitals according to quality resulted in misclassification of 305 hospitals.  Hospital volume has only a modest association with quality as judged by adjusted mortality rates. 

Source: New England Journal of Medicine
Author(s): Andrew B. Goldstone, Peter Chiu, Michael Baiocchi, Bharathi Lingala, William L. Patrick, Michael P. Fischbein,and Y. Joseph Woo

Trends in the use of bioprosthetic versus mechanical valves for AVR and MVR were assessed using a California-based surgical population from 1996-2013.  During this period the use of bioprosthetic devices increased from 12% to 52% for AVR and from 17% to 54% for MVR.  Bioprostheses were associated with substantially increased 15-year mortality in younger patients and had a higher rate of reoperation.  Mechanical valves were associated with higher rates of bleeding and stroke.

Source: JAMA Surgery
Author(s): Amelia W. Maiga, Stephen A. Deppen, Sarah Fletcher Mercaldo, Jeffrey D. Blume, Chandler Montgomery, Laszlo T. Vaszar, Christina Williamson, James M. Isbell, Otis B. Rickman, Rhonda Pinkerman, Eric S. Lambright, Jonathan C. Nesbitt, Eric L. Grogan

This multicenter retrospective study sought to assess the utility of PET in the diagnosis of pulmonary nodules.  It emphasized the inclusion of patient cohorts from different geographic regions and who underwent PET for different indications such as lung cancer screening or surgical evaluation.  Among 1188 patients the positive predicted value was 86% and the negative predictive value was 49%.  The authors conclude that aggressive tissue acquisition needs to be emphasized in a population of patients with a high rate of false-positive scans and unreliable utility from negative scans.

Source: Journal of Visualized Surgery
Author(s): Edited by Marcello Migliore, Alan Sihoe, and Diego Gonzalez-Rivas

Uniportal VATS and uniportal lobectomy have been developed over the last few years as valuable tools in modern thoracic surgery. This special issue of JOVS, with the aid of multimedia materials,  gives insights regarding the procedures performed with a uniportal technique.  The articles are also useful in order to understand the history, the difinitions, and the future possible applications of this revolutionary step for general thoracic surgery.

Source: Annals of Cardiothoracic Surgery
Author(s): Matthias Thielmann, Konstantinos Tsagakis, Mohamad El Gabry, Heinz Jakob, Daniel Wendt

Severe aortic regurgitation without calcification of the aortic annulus cannot be treated with transcatheter implantation of a balloon-expandable valve, however, self-expandable valves can be successfully anchored in the absence of annulus calcification. In this narrated video, Thielmann and colleagues present a case of transapical transcatheter aortic valve implantation in a 75-year-old man with pure aortic regurgitation grade II/III.

Source: News from around the web.
Author(s): Claire Vernon

Patient Care

Ambulances specially tailored to respond to cardiac emergencies will go into service in Goa, India, at the beginning of 2018.

The cardiac team at the University of the Free State in Bloemfontein, South Africa, has launched a research project focused on improving treatment of idiopathic dilating cardiomyopathy.

Getting into the Halloween spirit and showing off their gourd-slicing skills, surgeons competitively carved pumpkins in Phoenix, Arizona.


Drugs and Devices

Doctors at the General Hospital of Mexico in Mexico City have safely reused sterilized donated pacemakers for 33 patients who could not afford a new device.

The US Food and Drug Administration will now recognize good manufacturing practice inspections done by eight European Union drug regulators, the most recent move to strengthen regulatory collaboration between the US and EU.

Trastuzumab did not worsen cardiac function when added to chemotherapy for HER2-positive breast cancer.


Research, Trials, and Funding

Pediatric cardiac surgery patients receiving intermittent postsurgical dosing of morphine and midazolam show similar pain relief and shorter length of stay when compared to patients receiving continuous analgesics.

Neuromuscular blockade might not always be necessary during cardiac surgery, and researchers at the University of Chicago are seeking to determine if avoiding it reduces postsurgical pulmonary complications.

Ventricular assist devices might provide better survival than extracorporeal membrane oxygenation for children awaiting heart transplantation.

A randomized trial published in The Lancet finds that 230 patients with stable angina had similar symptom relief whether they received a percutaneous coronary intervention or a placebo procedure.

Source: The Annals of Thoracic Surgery
Author(s): Vasileios Kamperidis, Suzanne E. van Wijngaarden, Philippe J. van Rosendael, William KF Kong, Melissa Leung, Georgios Sianos, Nina Ajmone Marsan, Victoria Delgado, Jeroen J. Bax

Kamperidis and colleagues report that left ventricular (LV) functional recovery after mitral valve (MV) repair for severe secondary mitral regurgitation is associated with improved patient outcomes. Their retrospective analysis of 130 patient records found increased LV forward ejection fraction and LV forward stroke volume after MV annuloplasty, despite no observed change in LV ejection fraction. The authors found that LV forward stroke volume after repair independently associated with overall survival and survival without major adverse cardiac-related events by multivariable analysis.

Source: Annals of Thoracic Surgery
Author(s): Bryan M. Burt, Hyun-Sung Lee, Veronica Lenge De Rosen, Masatsugu Hamaji, Shawn S. Groth, Thomas M. Wheeler, David J. Sugarbaker

In this single institution study, the prognostic role of soluble mesothelin-related peptides (SMRP) was evaluated in patients with pleural mesothelioma.  Preoperative levels of SMRP were related to tumor volume and disease-free survival.  Percent change in postoperative SMRP was predictive of tumor recurrence. 

Source: The Annals of Thoracic Surgery
Author(s): Christopher W. Seder, Andrew T. Arndt, Lia Jordano, Sanjib Basu, Cristina L. Fhied, Selina Sayidine, Gary W. Chmielewski, Kelsey Gallo, Michael J. Liptay, Jeffrey A. Borgia

In this single institution study, the authors screened biorepository materials obtained from patients undergoing resection for early stage cancer.  They wished to identify serum markers related to early recurrence.   A 7-component panel was developed that had a negative predictive value of 83% and an accuracy of  78%.  The accuracy was 70%.