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Journal and News Scan
This position statement recapitulates the role of the clinical perfusionist in Germany. The needed qualifications to accomplish the complex tasks are described and responsibilities defined. This consensus statement is an important step to emphasize the clinical perfusionist as an important partner for cardiac surgery and cardiology.
In this small series of propensity score matched patients, two methods of administering cardioplegia, each using a different agent, were assessed for outcomes of isolated CABG. A repeated infusion with Basel Microplegia was superior to a single shot of Cardioplexol® for troponin release, creatinine kinase, and ICU stay. Major adverse events did not differ.
Another refreshing change of pace with an interesting pre-translational contibution to the genetics of atrial dysrhythmias.
A tribute to a pioneer and humanitarian in our field, Dr Francis Robicsek.
In the ISCHEMIA Trial, 5179 patients with moderate or severe myocardial ischemia were randomized equally into two groups based on initial management strategy: initial invasive strategy (angiography and revascularization when feasible) and medical therapy, or initial conservative strategy (medical therapy alone and angiography if medical therapy failed). Primary endpoint was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. After a median follow-up of 3.2 years, primary outcome events occurred in 318 of the invasive-strategy group and in 352 of the conservative-strategy group, the respective numbers of death were 145 and 144 in two groups.
These results did not show that an initial invasive strategy of angiography and revascularization reduced the risk of ischemic cardiovascular events or all- cause death over a median of 3.2 years, as compared to an initial conservative strategy.
Quite refreshing well-written experimental paper leaving promises of artificial organoids.
Former AATS President Dr. Craig Smith updates his 'Department of Surgery family' at Columbia University each day, highlighted as "Winston Churchill's radio speeches of this war."
Short but promising follow-up: the intervention appears again to trade off short-term peripheral vascular complications for hitherto semi-qualified MAJOR bleed in patients undergoing revascularization for peripheral vascular disease, for an assumed considerable financial cost.
Useful series from the Pacific North West, main questions:
-Why four patients who had a do-not-resuscitate order on admission were included in the dead and, ultimately, why been admitted in an ITU/ICU setting?
-How come no sputum samples from nine fatalities were ever sent for bacterial culture in an ITU/ICU setting?
It has been highlighted by experts such as Ioannides of Stanford that, since we cannot/will not screen for this elusive SARS-associated virus, we cannot computate mortality nor ultimately ascribe CAUSATION.
Interesting to follow up the translational potential of this rodent-model of carotid intimal re-hyperplasia/stenosis.