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Journal and News Scan

Source: Critical Care
Author(s): Jason B. O’Neal, Andrew D. Shaw and Frederic T. Billings IV
Acute kidney injury (AKI) complicates recovery from cardiac surgery in up to 30% of patients, injures and impairs the function of the brain, lungs, and gut, and places patients at a 5-fold increased risk of death during hospitalization. The authors have provided a nice general overview of the key determinants, outcomes and treatments for AKI in the cardiac surgery patient.
Source: Journal of Thoracic Diseases
Author(s): Ryutaro Kakinuma, Masayuki Noguchi, Kazuto Ashizawa, Keiko Kuriyama, Akiko Miyagi Maeshima, Naoya Koizumi, Tetsuro Kondo, Haruhisa Matsuguma, Norihisa Nitta, Hironobu Ohmatsu, Jiro Okami, Hiroshi Suehisa, Taiki Yamaji, Ken Kodama, Kiyoshi Mori, Kouzo Yamada, Yoshihiro Matsuno, Sadayuki Murayama, Kiyoshi Murata
The multi-institutional prospective study evaluated the behavior of pure GGOs (85%), heterogeneous GGOs (part solid only on CT lung windows; 7%), and part-solid GGOs on soft-tissue windows.   Among pure GGOs, 6.6% advanced to one of the other categories during a mean follow-up period of 4.3 years.  Of the 35 pure GGOs that were resected, none was an invasive cancer.  Invasive adenocarcinoma was identified in only 1% of all nodules, and only among the part solid nodules. 
Source: J Thorac Cardiovasc Surg
Author(s): Brandon M. Jones, E. Murat Tuzcu, Amar Krishnaswamy, Zoran Popovic, Stephanie Mick, Eric E. Roselli, Sajjad Gul, Jasneet Devgun, Sohi Mistry, Wael A. Jaber, Lars G. Svensson, Samir R. Kapadia
This article investigates the effects of varying degrees of aortic regurgitation (AR) on survival after transcatheter aortic valve replacement (TAVR).  They retrospectively evaluated a cohort of 237 patients undergoing TAVR from 2006 to 2012 with echocardiogram performed within 30 days of the procedure.  Using a Cox proportional multivariable regression model, they found each 1+ increase in AR (on a scale of none to 4+) was associated with a unit hazard ratio of 2.26.   After TAVR, patients with no paravalvular aortic regurgitation (15% of patients) had 0% mortality at 1 year, trivial to 1+ AR (29.5% of patiens) had 7.1% mortality at 1 year, and 1+ AR (32.5% of patients) had 16.9% mortality at 1 year.   The authors conclude that even a mild degree of AR is associated with significant prognostic value after TAVR and that more discriminating grading scales of AR will be important in evaluating TAVR as it is applied to intermediate and low risk patient populations.
Source: Eur J Cardiothorac Surg
Author(s): Sophie C. Hofferberth, Mark W. Grinstaff, and Yolonda L. Colson
The paper provides a comprehensive overview of current and developing applications of nanotechnologies for diagnostics, surveillance and therapy of thoracic cancer.
Source: Eur J Cardiothorac Surg
Author(s): Ali El-Sayed Ahmad, Petar Risteski, Nestoras Papadopoulos, Medhat Radwan, Anton Moritz, and Andreas Zierer
The paper reports on the first experience in 14 consecutive patients who underwent elective one-stage frozen elephant trunk procedures via minimally invasive approach. There was no 30-day mortality and no permanent neurologic complication.
Source: Circulation: Heart Failure
Author(s): Shivank Madan; Omar Saeed; Jooyoung Shin; Daniel Sims; Daniel Goldstein; Ileana Piña; Ulrich Jorde, Snehal R. Patel
A large retrospective study of the UNOS database advances that elevated troponin I  in selected cardiac donors is NOT associated with various adverse events. The conclusion is likely to stimulate heated discussions. A number of limitations of the study are discussed, and the POST-OPERATIVE values of this important biomarker are not included in the study.
Source: Interact CardioVasc Thorac Surg
Author(s): Giuseppe Gatti, Luca Dell'Angela, Marco Morosin, Luca Maschietto, Bruno Pinamonti, Bernardo Benussi, Gabriella Forti, Gian Luigi Nicolosi, Gianfranco Sinagra, and Aniello Pappalardo
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. 
Source: Eur J Cardiothorac Surg
Author(s): Alexander Romanov, Kinga Goscinska-Bis, Jaroslaw Bis, Alexander Chernyavskiy, Darya Prokhorova, Yana Syrtseva, Vitaliy Shabanov, Sergey Alsov, Alexander Karaskov, Marek Deja, Michal Krejca, and Evgeny Pokushalov
The RESCUE study recruited 178 patients with heart failure and systolic dyssynchrony. Patients were randomized to CABG alone or to CABG with concomitant epicardial CRT implantation. Results for long-term survival (55 ± 10.7 months) were in favor of the CABG+RCT group.  
Source: The Telegraph
Author(s): Sarah Knapton
In his new book The Naked Surgeon: The Power and Peril of Transparency in Medicine, Samer Nashef of Papworth Hospital, Cambridge, UK reports that of the 115 specialists surveyed, 30% said that they had recommended non-surgical treatment to high risk patients to avoid a poor mortality rating. 
Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): Siva Raja, Jay J. Idrees, Eugene H. Blackstone, Jiayan He, Anish Badjatiya, Peter Mazzone, David P. Mason, Thomas W. Rice, Daniel P. Raymond, Sudish C. Murthy
The authors summarize findings in a single institution retrospective review of patients undergoing pre-discharge VTE screening after pneumonectomy for NSCLC and compare outcomes to an historic series of patients who did not have screening.  Rates of VTE in the screened group were 8.9% at discharge, an additional 3.4% within 30 days postop, and 5.4% >30 days postop.  These rates were significantly higher than in the non-screened cohort.  VTE was associated with decreased survival at 1 year. Commentary: http://www.jtcvsonline.org/article/S0022-5223%2816%2930070-8/fulltext  

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