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Journal and News Scan

Source: JAMA Surgery
Author(s): Chandima Divithotawela; Marcelo Cypel; Tereza Martinu; Lianne G. Singer; Matthew Binnie; Chung-Wai Chow; Cecilia Chaparro; Thomas K. Waddell; Marc de Perrot; Andrew Pierre; Kazuhiro Yasufuku; Jonathan C. Yeung; Laura Donahoe; Shaf Keshavjee; Jussi M. Tikkanen

Ex vivo lung perfusion was used in 25% of transplanted lungs in the Toronto program since 2008. This resulted in an increase in the number of transplanted patients without any degradation of long-term outcomes, including survival and freedom from chronic dysfunction.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Tatsuhiko Komiya, Takeshi Shimamoto, Michihito Nonaka, Takehiko Matsuo

The authors investigated cusp size in patients undergoing aortic valve repair for valve regurgitation. They found that most patients with small cusps have annulus cusp mismatch. They suggested that small cusp size is not a contraindication in aortic valve repair and recommended to secure annulus by plications to correct annulus cusp mismatch.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Paraskevi Theocharis, Nicola Viola, Nikolaos D Papamichael, Markku Kaarne, Tara Bharucha

In this paper, the objective was to find out the echocardiographic predictors of reoperation for subaortic stenosis. Among 82 patients who initially underwent subaortic stenosis corrective surgery, 30 patients required reoperation. The risk factors were young age, unfavorable left ventricular geometry, interrupted aortic arch, and higher residual left ventricular outflow tract gradient.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Daniel Grinberg, Pierre-Jean Cottinet, Sophie Thivolet, David Audigier, Jean-Fabien Capsal, Minh-Quyen Le, Jean-Francois Obadia

An interesting pilot experiment on attempting to quantify the optimum disposition of neochordae in transapical intervention for severe mitral regurgitation.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Nicola Buzzatti, Mathias Van Hemelrijck, Paolo Denti, Stefania Ruggeri, Davide Schiavi, Iside Stella Scarfò, Diana Reser, Maurizio Taramasso, Alberto Weber, Giovanni La Canna, Michele De Bonis, Francesco Maisano, Ottavio Alfieri

The authors address appropriate use of the transcatheter clip to treat degenerative mitral regurgitation in elderly low to moderate risk patients. Their analysis shows that the transcatheter approach had slightly higher one year survival (97.6% vs 95.3%) than the surgical group but long-term survival was much worse than the surgical group at five years (34.5% vs 82.2%). This is likely related to a much higher incidence of recurrent >3+ mitral regurgitation in the clip group, 36.9% vs 3.9%. The one caveat was that the STS PROM (interquartile range) was higher in the clip group, 2.99 (2.29 to 4.38) vs 1.64(1.3 to 2.41), which has been shown to correlate with long-term survival.

Source: European Journal of Vascular and Endovascular Surgery
Author(s): GVG Writing Group for the Joint Guidelines of the Society for Vascular Surgery (SVS), European Society for Vascular Surgery (ESVS), and World Federation of Vascular Societies (WFVS)

An important and recent consensus update.

Source: Interactive Cardio-Vascular and Thoracic Surgery
Author(s): Jinlin Wu, Yan Huang, Juntao Qiu, Bilal Saeed, Cuntao Yu

In this systemic review and meta-analysis, the authors compared outcomes of valve-sparing root replacement vs. the Bentall procedure in patients with acute aortic dissection type A. Valve-sparing root replacement was associated with lower risk of early and late mortality compared with the Bentall procedure. However, there was an increased risk of reintervention after valve-sparing root replacement. The authors concluded that valve-sparing root replacement can be performed safely in experienced centers and should be performed especially in young active patients.

Source: World Journal for Pediatric and Congenital Heart Surgery
Author(s): Yue-Hin Loke, Jason Mandell, Russell R. Cross, Ileen Cronin, Paige Mass, Elias Balaras, Laura J. Olivieri

Abnormal pulmonary artery bending in the setting of the Lecompte maneuver may affect right ventricular afterload in the absence of stenosis. The authors identified novel measurements related to the curvature of the pulmonary artery branches, and found that they correlated with right ventricular systolic pressures, as measured by contributions of curvature in the pulmonary arteries.

Source: MassDevice Network
Author(s): Chris Newmarker

The Hugo system includes a tower, surgeon console, surgical end effectors, and robotic arm carts.

Key aspects of the Hugo system include:

  • Modularity — The arms and other parts of the system are modular — and they’re on wheels — allowing for flexibility when it comes to placement and swapping around parts of the system. A surgeon could complete a procedure with an arm, push it out of the way, and start a laparoscopic procedure still using the tower, for example. After the surgery, hospital staff could undrape the system and roll it into a second sterilized and prepped OR so that the surgeon could quickly start a new surgery after a break. Because the arms are modular, a hospital could split up the arms for use in different procedures at the same time.
  • Universal use — The tower and its visualization system, generator, processors and endoscope are meant to support both robot-assisted surgery and laparoscopic applications, and even open surgery. The endoscope, for example, is a standard length. The FT10 generator powering the robotic system is the same type of generator powering laparoscopic and open surgery devices.
  • Upgradeable — Medtronic designed the system so that health providers can swap in new systems, generators, etc. as they become available, without having to buy an entirely new system. The company also has a pipeline of software applications and features that it will continually roll out.
  • An open console — The surgical console design boasts an open architecture with foot pedals so that surgeons can still interact with the patient and OR staff during procedures. At the same time, three-dimensional, high-definition glasses provide an immersive situation.
  • Drawing on existing surgical tool expertise — Medtronic is taking advantage of the expertise, know-how, and IP from its existing surgical instrumentation portfolio, which makes sense because the system’s instruments could be a big revenue source for the company. Doctors consulting for the company said today that they also like that the surgical tools are familiar.
Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Kenji Suzuki, Kenji Suzukik Kenji Suzuki, Hisashi Saji, Keiju Aokage, Shun-ichi Watanabe, Morihito Okada, Junki Mizusawa, Ryu Nakajima, Masahiro Tsuboi, Shinichiro Nakamura, , Kenichi Nakamura, Tetsuya Mitsudomi, Hisao Asamura

Interesting to see the long term curative results of this randomized controlled trial.