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Journal and News Scan
The Nationwide Inpatient Sample was interrogated for all patients undergoing either CABG, valve replacement, or both from 2008 to 2011, and a total of 1,078,036 patients were included in the analysis. The authors discovered that, overall, 9.8% of patients developed acute kidney injury (AKI) postoperatively. Other important discoveries were:
Outcome non-AKI AKI p
- Death 1.3% 13.9% <0.001
- Mean hospital cost $38,820 $77,178 <0.001
The authors calculate that the net effect of AKI after cardiac surgery at a national level in the United States is over $1 billion annually.
The authors participated in a multi-institutional prospective study to evaluate the frequency, risk factors, and outcomes of patients who suffer mediastinal infection after cardiac surgery. A total of 5,158 patients were enrolled, and there were 43 infections in 41 patients (0.79 cumulative incidence) occurring at a median time of 20 days after surgery. The authors discovered the following risk factors for the development of mediastinitis:
- higher body mass index
- higher creatinine
- peripheral vascular disease
- preoperative steroids
- ventricular assist device or transplant surgery
- postoperative hyperglycemia in nondiabetics
Readmission rates and mortality were five times higher in patients who developed mediastinitis.
This randomized trial compared chemoradiotherapy alone to chemoradiotherapy followed by consolidation therapy with the PDL-1 antibody durvalumab in patients with stage III NSCLC. The treatment group had significantly improved progression-free survival, response rate, and overall survival, with clinically meaningful differences between the groups. The findings suggest that such regimens may be the new standard of care in these patients.
Several charities provided free surgeries to 15 Kashmiri children with congenital heart defects at the Fortis Memorial Research Institute in Gurgaon, India.
A man in his 40s discovered that he had a rare congenital heart defect after doctors were unable to access his left coronary system via angiography.
Newborns around the US are being adorned with red hats to raise heart disease awareness during February, which is considered American Heart Month.
Drugs and Devices
The PureFlex™ line of adult arterial cannulae from LivaNova has received the CE Mark.
Research, Trials, and Funding
The first patient has been enrolled in the BELIEVE trial, a postmarket prospective study sponsored by LivaNova to evaluate leaflet motion in patients who have received a commercially approved LivaNova bioprosthetic aortic valve.
Baylor College of Medicine in Texas and the University of Kentucky recently joined the American Heart Association’s Strategically Focused Vascular Disease Research Network as part of a collaborative effort to better understand the differences in aortic disease between men and women.
This review included 55 publications covering 141 cohort studies. The authors found that the relative risk of stroke associated with smoking just one cigarette a day was 1.25 to 1.31, and for coronary artery disease it was 1.48 to 1.57. There is no safe level of smoking.
An editorial from an influential source discussing the recent robust results of the CASTLE-AF RCT trial. It is likely that interventions for atrial fibrillation will be boosted by these results, in terms of insurance, industry, and clinical guideline support.
A brief note on the feasibility (or not) of RCT on surgery for mitral fibroelastic prolapse.
Decaluwé and colleagues prospectively tested the capacity of preoperative staging by video-assisted mediastinoscopy (VAM) or VAM-lymphadenectomy (VAM-LA) to detect hidden mediastinal lymph node involvement in patients with non-small cell lung cancer (NSCLC). Of 105 patients with clinical N1 disease based on PET-CT imaging, one quarter eventually developed N2 disease. Patients underwent either VAM or VAM-LA, which were able to detect mediastinal node involvement with a sensitivity of 73% and accuracy of 93%. The authors suggest that VAM or VAM-LA could be a good staging approach for this group of patients.
In a prospective cross-sectional analysis of 37 adult patients palliated with a Fontan procedure, Buendía-Fuentes and colleagues assessed liver disease by three techniques: hepatic magnetic resonance imaging (MRI), acoustic radiation force impulse (ARFI) imaging, and hepatic ultrasound. They authors compared the prevalence of disease and the diagnostic conclusion between different techniques. They also evaluated the association between the diagnosis from noninvasive imaging and clinical variables such as liver disease biomarkers. Signs of liver disease were observed in most patients by both hepatic MRI and ARFI elastography, but not by ultrasound imaging. Increased liver stiffness did not identify specific disease patterns from MRI, supporting the need for multimodality imaging to characterize liver disease in Fontan patients.
A playful chocolate Labrador retriever puppy named Shamus is one lucky dog after having thoracic surgery to cure a fatal abnormality of blood vessels in his heart.
Not only did veterinarians at Hyannis Animal Hospital perform the surgery that saved the pup for free, veterinarian Kevin Smith studied up on the surgical procedure for two weeks and even enlisted the operating room assistance of a Cape Cod Hospital heart surgeon.