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Journal and News Scan
November 20, 2019
Submitted by: Emily Robinson
Sixty-five children who underwent biventricular repair were extubated early (immediately after chest closure in the operating room) or were extubated later on intensive care unit (ICU). The results of these two different strategies were compared. Early extubation resulted in better cardiac output, fewer pleural effusion, and shorter stay in the ICU and hospital. The authors concluded that early extubation is safe and feasible and has a beneficial effect on the postoperative course.
November 20, 2019
Submitted by: Emily Robinson
In this study from the Mayo Clinic, outcomes of bioprosthetic valves placed in the pulmonary position in adults with congenital heart disease were evaluated. Cumulative prosthetic valve dysfunction at 15 years was 48%, raising the question of the efficacy of using such valves in this position.
November 18, 2019
Submitted by: Aristotle Protopapas
An editorial related to a recent randomized controlled trial suggesting a striking benefit of anti-inflammatory secondary prevention after recent myocardial events.
November 15, 2019
Submitted by: Wei-Guo Ma
The International Registry of Acute Aortic Dissection investigators analyzed the impact of cerebral malperfusion (CM) on the surgical outcomes of acute type A dissection in 2402 patients. The incidence of CM and neurologic deficit was 15.1% (362/2402). While patients with CM were less likely to present with chest pain and back pain, they had a significantly higher incidence of syncope, peripheral malperfusion, and shock and were more likely to have Debakey type I dissection and pericardial effusion on presentation. In-hospital mortality and the incidences of cerebrovascular accident and acute kidney injury were significantly higher in patients with CM. The authors conclude that surgeons may continue to offer lifesaving surgery for acute type A dissection to this critically ill cohort of patients with acceptable morbidity and mortality.
November 15, 2019
Submitted by: Emily Robinson
The authors investigated the influence of hypothermic circulatory arrest on renal function. This study includes 191 patients who underwent surgery for acute aortic dissection type A. Postoperative acute kidney injury was observed in 49 patients. Lower body ischemic time was one of the risk factors for postoperative kidney injury.
November 15, 2019
Submitted by: Emily Robinson
The authors evaluated outcomes of empyema management in over 9,000 patients in Ontario, Canada, from 1996-2015. Mortality was higher for nonoperative management at all time points assessed up to one year.
November 15, 2019
Submitted by: Emily Robinson
This study examines the way in which risk is perceived by parents of children undergoing congenital cardiac surgery. The findings demonstrate differences in the way mothers and fathers perceive risk, with mothers reporting statistically significantly higher scores than their partners. In particular, parents of children who experience postoperative complications presented a persistent rise in risk perception following discharge, emphasizing the need for flexible levels of support and information as parents navigate uncertainty.
November 14, 2019
Submitted by: Aristotle Protopapas
Interesting succinct note on a major issue, noting a possible association between cardiopulmonary bypass and this common complication.
November 11, 2019
Submitted by: Aristotle Protopapas
A useful narrative on pharmacology and metabolomics for surgeons caring for the diabetic population; the vast majority of the CTSNet membership.
November 11, 2019
Submitted by: Aristotle Protopapas
A succinct analysis of a challenging problem, with a discussion on the 'magic diameter' of 55 mm.