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Journal and News Scan
August 4, 2016
Using a Taiwanese national database, the authors evaluated long-term survival after VATS vs open lobectomy for lung cancer using propensity matching and multvariate analyses. Among 5,222 patients, 2,164 (41%) had a VATS approach. Propensity matching yielded 1848 patients in each group. 5-year survival was similar for the VATS and open groups (68.7% vs 65.5%). Surgical resection was not an independent predictor of survival.
The authors compared the results of annuloplasty with flexible and rigid rings in patients with tricuspid valve regurgitation. This is a propensity score-matched analysis with 98 pairs. They concluded that both rings are equally effective, however the rigid one causes a more complete right heart reverse remodelling.
The authors describe their experience with radical resection by either extrapleural pneumonectomy or extended pleurectomy–decortication (EPD) for management of pleural mesothelioma. They present pathologic findings, progression and outcome and discuss the results with caution.
The propensity-score analysis compares minimized extent of repair with root replacement (RR). Results for mortality are similar; however, RR seems to be associated with fewer interventions.
The paper summarizes the opinions of cardiac surgeons on data collection and presentation for quality assessment on surgeon-specific and institutional level. The analysis is based on a questionnaire which was handed out at the EACTS Annual Meeting in 2015.
Proposed definitions for the 8th edition of the AJCC Cancer Staging Manual are presented.
This randomized trial evaluated the efficacy of postoperative metoprolol or losartan in preventing atrial fibrillation in patients with elevated N-terminal pro-brain natriuretic peptide who were undergoing lung resection for cancer. Among candidates, 29% (320) of patients had elevated NT-proBNP and were randomized. Both metoprolol and losartan reduced afib incidence compared to controls (6%, 12%, 40%).
The impact of radial artery vs saphenous vein in patients undergoing bilateral IMA grafting was evaluated in 275 and 489 pts, respectively, using propensity score matching. Operative mortality and survival at 5, 10, and 15 years were similar. There was no influence of patient age, R vs L coronary system grafting, diabetes, or ventricular dysfunction on outcomes comparing the two groups. Commentary: http://www.jtcvsonline.org/article/S0022-5223(16)30296-3/fulltext
This single institution study evaluated the accuracy of intraoperative TEE to identify residual intramural ventricular septal defects after repair of conotruncal defects. Intramural VSDs occurred in 10% of 337 pts; postoperative TTE identified all, intraoperative TEE identified 19. Of abnormalities requiring catheterization or reoperation, 6 of 7 were identified by TEE. Intraoperative TEE has most value in identfying defects that require reintervention. Commentary: http://www.jtcvsonline.org/article/S0022-5223(16)30272-0/fulltext
Physiologic effects of pulmonary endarterectomy (PEA) for chronic thromboembolic disease (CTED) were studied 1 year postop. PEA resulted in improved RV stroke volume response, heart rate response, and ventilatory efficiency related to exercise. Commentary: http://www.jtcvsonline.org/article/S0022-5223(16)30661-4/abstract