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Journal and News Scan
Patients undergoing tracheobronchoplasty for diffuse tracheobronchial malacia were retrospectively stratified as severely frail or other based on a cumulative deficits model score. Severe frailty was associated with an increased risk of respiratory failure (OR 13.1), pneumonia (OR 20.1), and overall respiratory complications (OR 17.4).
There are several different strategies for arterial cannulation in patients with acute aortic dissection type A. Kitamura and colleagues compared results of direct true-lumen cannulation (Samurai cannulation) with other cannulation options. The retrospective review includes 100 patients undergoing surgery for acute type A aortic dissection, 61 of whom underwent Samurai cannulation. Samurai and other cannulation site patients had in-hospital mortality rates of 5% and 7%, respectively. Seven percent of Samurai cannulation patients and 10% of other cannulation site patients experienced disabling stroke. There was no difference between the groups regarding survival and freedom from aorta-related death at follow-up. The authors conclude that Samurai cannulation is a safe and reasonable option in patients with type A dissection.
Will await the full paper to test the titular preliminary assertion.
Patient Care and General Interest
Saturday, September 29 is World Heart Day! This year’s theme is “My Heart, Your Heart.”
Gerald D. Buckberg, MD, a renowned heart surgeon who made a major contribution in the field of myocardial protection, recently passed away.
Team Heart, a group of medical volunteers, visits Rwanda once a year to perform life-saving valve replacement procedures caused by rheumatic heart disease, which is prevalent in many African and Asian countries.
An atrial fibrillation procedure performed on a keen Hong Kong-based marathon runner saved him from a life-threatening abnormal heart rhythm and gave him renewed energy when training.
Data presented at the recent TCT 2018 conference indicates that patients with severe symptomatic aortic stenosis and high risk of operative mortality who underwent TAVR had similar 5-year survival and stroke rates compared with those who underwent SAVR.
A study published in Pediatric Research indicates that neonates with congenital heart disease tend to have enlarged kidneys.
The BMI journal Heart has published research suggesting a link between mitral valve prolapse – a common condition – and sudden cardiac death.
This single institution summary of treatment of failed stenting for esophageal perforation included 26 patients over an eight year period. Management included primary closure, esophagectomy, and observation. The overall prognosis was very good, supporting the use of stents as initial therapy for esophageal perforation in appropriate patients.
Using the National Cancer Database, the effect of the timing of computed tomography (CT) surveillance after resection of non-small cell lung cancer on survival was investigated. Survival was similar for patients undergoing CTs every three months or every six months compared to those undergoing annual surveillance CTs. More frequent imaging also had no impact on survival after recurrence.
Data in the STS Database indicate that invasive mediastinal staging is underused in patients undergoing resection for non-small cell lung cancer, and that the pattern of use varies widely among the participants. Use of guidelines outlining indications for invasive mediastinal staging should be encouraged.
This objective, well-researched, and well presented article summarizes the importance of gender inclusion in cardiothoracic surgery as a means for improving institutional culture, patient safety, patient outcomes, and gender equality.
A seismic shift occurred today when the NELSON screening trial results were presented at the IASLC 19th World Conference on Lung Cancer (#WCLC2018). Hear from the CEO, Dr. Fred R. Hirsch, as he comments on these results. Men have a 24% survival advantage in the screening programme. This is a very large shift to earlier stage cancer detection. There can be no doubt that lung cancer screening is a lifesaving intervention in lung cancer.
Meta-analysis of composite death/myocardial infarction/stroke/repeat revascularization outcome in 4700 patients across six randomized controlled trials is presented. Percutaneous coronary intervention was associated with a higher risk of the composite outcome in all SYNTAX score tertiles as well as increased risk of repeat revascularization. Additionally, no difference was shown between bare metal stent and drug eluting stents on a sub-group analysis.