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Journal and News Scan
In this single site retrospective review, outcomes of repair of giant paraesophageal hiatal hernia were reviewed with respect to the effects of patient age. Patients aged 80 or greater had greater comorbidity at the time of surgery, more often had Type IV hernias, and underwent emergency intervention more often. The incidence of postoperative complications was higher in this group. Recurrence rates were similar between the older and younger groups.
The authors conducted a retrospective cohort study of 88 patients that received methylene blue (MB) for refractory vasoplegia following cardiopulmonary bypass. Administration of MB was associated with an 8 mmHg increase in mean arterial pressure, with the peak response occurring at 2 hours after completion of dose.
The purpose of this study was to evaluate differences in long-term survival without the influence of early mortality, and to identify factors associated with one-year conditional ten-year survival after heart transplantation across different age and diagnostic groups using the UNOS database.
Predictors of one-year conditional ten-year survival for infants were: recipient’s Caucasian race (odds ratio [OR]: 1.9, 95% confidence interval [CI]: 1.3-2.7) and donor–recipient weight ratio (OR: 0.8, 95% CI: 0.6-1); for children: Caucasian race (OR: 1.6, 95% CI: 1.2-2.1), retransplantation (OR: 0.4, 95% CI: 0.2-0.6), and transplantation after the year 2000 (OR: 1.5, 95% CI: 1.1-2.1); for adolescents: only Caucasian race (OR: 2.5, 95% CI: 1.9-2.3). In both congenital heart disease (CHD) and cardiomyopathy groups, adolescents had worse survival compared to infants and children. There was an era effect with improved survival after 2000. Male gender was a predictor of survival in cardiomyopathy group.
A surprisingly readable Australasian manuscript on risk prediction models for cardiac surgery. Interesting that the class of dyspnoea was not captured in 5.28% of the operated patients.
Following a charitable initiative launched in 2014 to impact one million underserved people by 2020, Edwards provides a current update on progress toward that goal. Dr. David Adams and other specialists comment on the magnitude and importance of the effort, and a request for proposals announces the beginning of the foundation's 2017 grant cycle.
He weighed merely 470 grams at birth and was just the size of a palm. He was born prematurely after 28 weeks (5.5 months). His eyes hadn't opened, lungs weren't developed, skin resembled parchment paper, too fragile and delicate to touch, and he had heart complications.
After 15 days of birth, he underwent a heart surgery and has now become the tiniest miracle baby to have undergone a PDA (patent ductus arteriosus) corrective operation.
An assessment of regional lung resection outcomes relative to compliance with NCCN resection guidelines was performed. Negative margins 94%, 91% anatomic, 51% hilar nodes sampled, 26% 3 mediastinal nodal stations sampled. On average, 17% of resections met all criteria, although the trend was upward over time. Survival was better for pts who met all four criteria.
Surgery for treatment of this aortopathy entailing aortic root replacement was assessed in this single institution retrospective study of 34 children. 90% had valve sparing surgery; there was no operative mortality. Reintervention is commonly needed, and frequent surveillance imaging is recommended.
Using data from the CoreValve US Expanding Use Study, outcomes for patients with end stage renal disease (ESRD) undergoing TAVR were evaluated using an endpoint of all-cause mortality or major stoke at 1 year. Mortality at 1 year was 30%, and the stroke incidence was 2.1%. New permanent pacemaker need was 27%. The 1-year mortality appears increased compared to patients without ESRD.
UNOS data for over 14,500 isolated heart transplant patients were analyzed to assess the relationship between donor distance from the transplantation center and recipient mortality at 30 days and 1 year. Ischemic time correlated with donor distance. Mortality was reduced for donor distances over 25 miles, and the reduction was highest for distances greater than 500 miles.