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Journal and News Scan

Source: Critical Care Explorations
Author(s): Velho, Tiago R. MD; Ferreira, Ricardo MD; Willmann, Katharina PhD; Pedroso, Dora PhD; Paixão, Tiago PhD; Pereira, Rafael Maniés CLP; Junqueira, Nádia MD; Guerra, Nuno Carvalho MD; Brito, Dulce PhD; Almeida, Ana G. PhD; Nobre, Ângelo MD; Köcher, Thomas PhD; Pinto, Fausto PhD; Moita, Luís Ferreira PhD

Postoperative bleeding in patients undergoing cardiac surgery is a frequent problem, and this study aimed to test the contribution of metabolic perturbations to platelet dysfunction after cardiac surgery. Patients undergoing elective surgical aortic valve replacement were included in the study. The results suggested that preoperative levels of arachidonic acid may be more relevant than platelet count to anticipate and prevent postoperative blood loss in these patients.

Source: The Annals of Cardiothoracic Surgery
Author(s): Sowmyanarayanan Thuppal, MD, PhD; Anthony Sleiman, BA; Kanika Chawla, MD; Danuta Dynda, MD; Quadis Evans, BS; Stephen Markwell, MA; Stephen Hazelrigg, MD; Traves Crabtree, MD

With the aim to compare the pain medicines bupivacaine and liposomal bupivacaine, minimally invasive lobectomy patients were randomly assigned to either medicine and monitored after surgery. Both postoperative pain level and treatment cost were compared. The study concluded that the morphine use, long-term narcotic use, and overall cost metrics between bupivacaine and LipoB were similar.

Source: Scientific Reports
Author(s): Mercedes Fernández-Castro, José-María Jiménez, Belén Martín-Gil, María-Fe Muñoz-Moreno, Ana-Belén Martín-Santos, Isaías del Río-García, Natán Redondo-Pérez & María López
One of the main causes for concern in patients undergoing cardiac surgery is postoperative pain. This study focused on levels of preoperative anxiety, one driver of postoperative pain. After updated guidelines recommended incorporating anxiety assessment into the preoperative process, this study was performed to gauge the effectiveness of that process in evaluating postoperative pain. The results found that patients with higher preoperative anxiety experienced increased postoperative pain and needed more medication for pain management, reinforcing the updated guidelines.
Source: JAMA Cardiology
Author(s): Matthew D. Solomon, MD, PhD; Thomas Leong, MPH; Sue Hee Sung, MPH; Catherine Lee, PhD; J. Geoff Allen, MD; Joseph Huh, MD; Paul LaPunzina, MD; Hon Lee, MD; Duncan Mason, MD; Vicken Melikian, MD; Daniel Pellegrini, MD; David Scoville, MD, PhD; Ahmad Y. Sheikh, MD; Dorinna Mendoza, MD; Sahar Naderi, MD; Ann Sheridan, MD; Xinge Hu, MD, PhD; Wendy Cirimele, BSN, MPA; Anne Gisslow, RN, MSN; Sandy Leung, RN; Kristine Padilla, RN; Michael Bloom, MA; Josh Chung, MD; Adrienne Topic, MD; Paniz Vafaei, MD; Robert Chang, MD; D. Craig Miller, MD; David H. Liang, MD, PhD; Alan S. Go, MD
In conducting the largest study to date supporting the current medical consensus that recommends surgery only for patients with a thoracic aneurysm that is 5.5 centimeters or larger, the authors found that the overall risk for patients below that standard is low. This conclusion adds vital information to a circumstance that is underexplored but drives clinical decision-making.
Source: The Annals of Thoracic Surgery
Author(s): Jennie H. Kwon, MD, Sarah Chen, MD, Srujan Ganta, MD, Khaled Shorbaji, MD, T. Konrad Rajab, MD, Scott M. Bradley, MD, Minoo N. Kavarana, MD
One method for performing a critical step of the arterial switch operation (ASO), closed coronary artery transfer, was observed in a retrospective analysis and the results reported in this study. The overall survival rate for patients undergoing the procedure after a median follow-up period of 5.8 years was 97.4 percent, with a reoperation-free survival rate of 83.6 percent. The study concluded that closed coronary transfer for ASO has excellent short and mid-term results, even in more complex cases.
Source: Dovepress
Author(s): Wu XD, Zeng FF, Yu XX, Yang PP, Wu JP, Xv P, Wang HT, Pei YM
Chronic post-surgical pain (CPSP) is especially prevalent after thoracotomy but is not well-studied in elderly adults. The authors of this study surveyed thoracotomy and video-assisted thoracoscopic surgery patients to establish a prediction model for CPSP in those sixty-five and older. Advanced age, BMI, blood loss, longer hospital stays, and higher pre-operative neutrophil count were all associated with CPSP, establishing information on the condition in older adults.
Source: Annals of Thoracic Surgery
Author(s): Nadia H. Bakir, BS; Michael J. Finnan, MS; Akinobu Itoh, MD, PhD; Michael K. Pasque, MD; Gregory A. Ewald, MD; Kunal D. Kotkar, MD; Ralph J. Damiano Jr., MD; Marc R. Moon, MD; Justin C. Hartupee, MD, PhD; Joel D. Schilling, MD, PhD; Muhammad F. Masood, MD

This retrospective review compares the outcomes of heart failure patients who used continuous-flow left ventricular device (CF-LVAD) support with patients listed as primary transplant candidates at the same center. The results showed that CF-LVAD patients had excellent outcomes regardless of how long they were on the waitlist. This change of risk should be taken into account when considering CF-LVAD support as a bridge to transplant.

Source: National Heart, Lung, and Blood Institute
Author(s): N/A
Since the human genome was fully sequenced, new methods of screening, diagnosing, and treating patients for heart conditions have emerged. Researchers have found that genetic variations can help to predict sudden cardiac death and thoracic aortic events. Some scientists are even developing a gene therapy treatment to prevent atrial fibrillation after surgery. These accomplishments in genetics could prevent numerous cardiac related mortalities.
Source: Circulation Research
Author(s): Hayat S, Kramann R

This editorial describes the evolving pathway of diagnosing a disease that is predicted to augment the indication for orthotopic cardiac transplantation. Cardiac involvement of sarcoidosis accounts for the majority of deaths in sarcoidosis patients, so it is important to better understand its symptoms. The differential diagnosis with giant cell myocarditis will certainly be of importance in providing nuance to the decisions of the transplant meeting.

Source: The Annals of Cardiothoracic Surgery
Author(s): Gileh-Gol Akhtar-Danesh, MD, Noori Akhtar-Danesh, PhD, and Yaron Shargall, MD
This study aimed to establish risk factors for venous thromboembolism (VTE), a significant cause of mortality in lung cancer surgical patients. Unlike in surgical specialties that have adopted postdischarge VTE prophylaxis, in thoracic surgery the evidence is scarce. The study concluded that patients undergoing more extensive procedures and patients with advance stage lung cancer have an increased VTE risk. Strategies to reduce VTE risk should be considered in these patients.