Journal and News Scan

Patient Care and General Interest

Cardiac surgical and cardiology societies weigh in as an advisory committee revisits the US Centers for Medicare and Medicaid Services procedure volume requirements for transcatheter aortic valve replacement programs.

As the Houston Methodist Hospital in Texas, USA, moves to new facility, it is closing historic operating rooms where renowned heart surgeon Dr Michael DeBakey developed the Dacron graft.

The LUNGevity Foundation has published recommendations to expand eligibility for lung cancer trial participation to more patients.

Drugs and Devices

Polares Medical has received venture capital funding to continue developing a transcatheter hemireplacement device that would replace only the posterior leaflet of the mitral valve.

Research, Trials, and Funding

Researchers from Johns Hopkins University in Baltimore, Maryland, explored surgeon decision-making and the factors that influence a surgeon’s decision to operate or not in a scenario where a patient has a likely nonsurvivable medical problem.

Palliative care support offered to families of infants with single-ventricle heart disease by health care teams at the University of Michigan may help them cope with and navigate their child’s medical care.

Researchers in Canada studied factors that influence hemodynamic valve deterioration after surgical aortic valve replacement.

Barbetta and colleagues retrospectively reviewed outcomes for 80 patients with T2N0 esophageal adenocarcinoma, staged by endoscopic ultrasound (EUS) and treated by surgery alone. EUS staging was inaccurate in the majority of patients, and final pathologic staging found nodal disease in 35% of patients. Vascular invasion was identified as an independent predictor of nodal involvement, and the authors suggest that its utility as a marker to select patients for induction therapy should be further explored.

Buratto and colleagues retrospectively analyzed the outcomes of 68 patients with atrioventricular septal defects (AVSD) who underwent pulmonary artery banding between 1983 and 2016. Of these, 40 patients had balanced AVSD and 28 patients had unbalanced AVSD. Pulmonary arterial banding was not associated with a short-term increase in atrioventricular valve regurgitation for either group. Patients with unbalanced AVSD did not have a higher rate of atrioventricular valve reoperation than in previous series of patients without pulmonary artery banding. Patients with balanced AVSD did have a higher rate of valve reoperation than reported in previous series, though the authors speculate that the higher rate of reoperation might have been due to an increased severity of disease. The authors conclude that pulmonary artery banding can be used in patients with AVSD without affecting early survival or compromising atrioventricular valve function.

Papageorgiou and colleagues discuss dealing with missing data, a common challenge in clinical research. Although the best approach is to minimize the amount of missing data through good study design and data collection protocols, missing data cannot always be avoided and they must be treated appropriately to maintain the validity of the statistical inferences from a study. The authors outline the different reasons that data may be missing and they discuss the methods for handling these types of missing data, including limitations of such methods. Finally, they provide an example using the scenario of a study of congenital heart disease patients receiving an aortic allograft.