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Journal and News Scan
July 24, 2018
Submitted by: Claire Vernon
This video and article from Desai and colleagues demonstrates double transposition and single branched endovascular repair for total arch replacement in a 59-year-old man who presented with a 7 cm chronically dissected arch and distal aorta. The patient had previously undergone a DeBakey I dissection repair.
July 23, 2018
Submitted by: Claire Vernon
Ma and colleagues evaluated left ventricular diastolic function in 183 patients who had undergone isolated aortic valve replacement for severe aortic regurgitation. Echocardiographic data was used to evaluate the relationship between preoperative diastolic function and postoperative mortality and cardiac function. Serial echocardiographic data from a subgroup of 104 patients was used to further evaluate postoperative changes in diastolic function. The authors found that 43% of patients had an improved New York Heart Association functional class at long-term follow-up. Preoperative left ventricular end-diastolic volume index was the only predictor of reduced long-term diastolic functional recovery, emphasizing the importance of appropriately-timed surgical intervention.
July 20, 2018
Submitted by: Claire Vernon
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.
July 20, 2018
Submitted by: Claire Vernon
The authors report on their experience with three-demensional (3D) printed heart models in congenital cardiac surgery, having printed 20 3D models for preoperative simulation within the last three years. All operations were performed by a young consultant surgeon. The authors concluded that 3D printing helped them to understand the pathology and simulate the surgical approach.
July 17, 2018
Submitted by: Claire Vernon
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.
July 16, 2018
Submitted by: Claire Vernon
Inoue and Suematsu report their experience using a minimally invasive approach to left atrial appendage resection. The procedure was performed in 87 patients using an endoscopic linear cutter device, without cardiopulmonary bypass or cardiac arrest. The authors found no change in cardiac function and no thrombus formation during patient follow-up three months after the operation.
July 13, 2018
Submitted by: Claire Vernon
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.
July 13, 2018
Submitted by: Claire Vernon
Patient Care and General Interest
A 7-year-old girl who received a heart transplant as an infant is now competing in the Canadian Transplant Games, which are underway at the University of British Columbia in Vancouver, Canada.
The Lung Cancer Alliance held its National Advocacy Summit in the US capitol, working to increase awareness of the disease and support for research. Thoracic surgeons in the US also join the call for increased funding for lung cancer research.
A surgical team from Dubai, UAE, performs free heart surgery for children in Mumbai, India, as part of the Nabadat initiative of the Mohamed bin Rashid Charity and Humanitarian Establishment.
England’s National Health Service has approved routine funding for percutaneous left atrial appendage occlusion for patients with atrial fibrillation who cannot take blood thinning medication.
Drugs and Devices
The US Food and Drug Administration has approved the next-generation MitraClip® from Abbott. The device received the CE Mark earlier this year.
Research, Trials, and Funding
Working in pigs, researchers have demonstrated the feasibility of a micropacemaker, a leadless pacemaker that is percutaneously inserted into the pericardial space.
July 11, 2018
Submitted by: Claire Vernon
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.
July 9, 2018
Submitted by: Claire Vernon
In this illustrated article, Esposito and colleagues outline the Lupiae technique for hybrid three-stage repair of mega aorta. The technique includes initial surgical replacement of the ascending aorta and proximal rerouting of the aortic arch vessels, followed by delayed surgical replacement of the infrarenal aorta with distal rerouting of the visceral and renal vessels, which then facilitates an endovascular approach for subsequent complete exclusion of the residual diseased aorta between the surgically shaped proximal and distal Dacron landing zone. The authors describe the outcomes for 27 patients treated with this approach, and they discuss tips for a safe and effective procedure.