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Journal and News Scan

Source: Journal of the National Cancer Institute
Author(s): John P. Pierce, Ruth E. Patterson, Carolyn M. Senger, Shirley W. Flatt, Bette J. Caan, Loki Natarajan, Sarah J. Nechuta, Elizabeth M. Poole, Xiao-Ou Shu and Wendy Y. Chen
Using data from the 3 US cohorts in the After Breast Cancer Pooling Project (ABCPP) with information about duration and smoking exposure in 10000 breast cancer survivor, researchers analyzed the association between smoking and breast cancer survival. Exposition expressed in pack-year increase risks of recurrence and breast cancer mortality and all-cause mortality.
Source: Journal of cardiothoracic and vascular anesthesia
Author(s): Dixon, B.
In this single centre retrospective review, the authors in a multivariable analysis determined the surgeon was a predictor of blood loss after cardiac surgery. Despite much research, bleeding and blood use remains an issue after cardiac surgery. Each surgeon should examine their own techniques to minimise bleeding risk. IMA use and CPB time were other factors that were significant.
Source: Interactive Cardiovascular and thoracic surgery
Author(s): Paul P. Urbanski, Witold Dinstak, Wilko Rents, Nicolas Heinz, and Anno Diegeler
The authors report on patients with a small aortic annulus who underwent aortic root replacement using self-assembled valve composite grafts with prosthesis larger than aortic annulus. This technique resulted in excellent haemodynamic and good neo-root durability at long-term follow-up.
Source: European Journal of Cardio-Thoracic Surgery
Author(s): Lars S. Bjerregaard, Katrine Jensen, Rene Horsleben Petersen, and Henrik Jessen Hansen
The authors removed chest tubes after video-assisted thoracic surgery (VATS) lobectomy with serous fluid production up to 500 ml/day in 622 patients. Of them, 17 (2,8%) needed reinterventions due to recurrent pleural effusion. There was no association to the postoperative day of tube removal.
Source: European Journal of Cardio-Thoracic Surgery
Author(s): Thierry Bove, Kristof Vandekerckhove, Daniel Devos, Joseph Panzer, Katya De Groote, Hans De Wilde, Daniel De Wolf, Julie De Backer, Laurent Demulier, and Katrien François
According to a study on 22 patients after repair of tetralogy of Fallot, ejection fraction of the right ventricular sinus and the extent of akinesia of the right ventricular outflow tract predict exercise capacity better than global right ventricular function.
Source: European Journal of Cardio-Thoracic Surgery
Author(s): Hervé Dutau, Thomas Vandemoortele, Sophie Laroumagne, Carine Gomez, Véronique Boussaud, Arnaud Cavailles, Laurent Cellerin, Arlette Colchen, Tristan Degot, François Gonin, Christophe Hermant, Jacques Jougon, Romain Kessler, François Philit, Christophe Pison, Christel Saint Raymond, Delphine Wermert, Philippe Astoul, Pascal Thomas, Martine Reynaud-Gaubert, and Jean-Michel Vergnon
A new endoscopic standardized grading system for macroscopic central airway complications following lung transplantation is suggested by a group of French bronchoscopy experts. It considers macroscopic appearance, diameters and sutures of the bronchial anastomoses.
Source: Journal of the American College of Cardiology
Author(s): Shishehbor MH, Venkatachalam S, Sun Z, Rajeswaran J, Kapadia SR, Bajzer C, Gornik HL, Gray BH, Bartholomew JR, Clair DG, Sabik JF 3rd, Blackstone EH.
Significant carotid artery disease is not uncommon in patients undergoing open heart surgery (OHS). Whether to treat both conditions in a staged or combined procedure remains an unresolved matter. In this retrospective study, the authors compared outcomes in three groups of patients according to treatment strategies: staged carotid endarterectomy (CEA) followed by OHS (CEA-OHS), combined CEA-OHS (i.e. concomitant CEA and OHS under a single anesthesia), and staged carotid stenting (CAS) followed by OHS (CAS-OHS) No significant difference in the primary composit endpoint(all-cause death, stroke, and myocardial infarction) was found between staged CAS-OHS and combined CEA-OHS in the short term. However, beyond 12 months, the staged CAS-OHS option appears to be a better choice. Staged CEA-OHS has the highest risk during both early and late phases. These findings were consistent regardless of multiple adjustments using propensity score and propensity matching.
Source: Lancet
Author(s): A Gponfiotti, MO Jaus, D Barale, S Baiguera, S Comin, F Lavorini, G Fontana, O Sibila, G Rombola, P Jungebluth, P Macchiarini

This 5-year follow-up of the first tissue engineered airway using decellularized human trachea demonstrated that the graft became well vascularized, had normal ciliary function and mucous clearance, and maintained a normal diameter. no anti-donor antibodies developed. The graft replaced the left main bronchus that was affected by tracheomalacia. The proximal anastomosis developed stenosis requiring stenting.

Source: MedPage Today
Author(s): Todd Neale

The FDA approved the CoreValve TAVI device for use in the US. The approval was originally expected to occur in April 2014, but the panel decided that an independent review of data from the clinical study of extreme-risk patients in the CoreValve US Pivotal Trial was not needed at this time.

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): A Dardashti, P Ederoth, L Algotsson, B Bronden, H Bjursten

The authors studied over 5,700 pts undergoing CABG to assess the dynamics of changes in renal function and related such changes to mortality.  Perioperative renal dysfunction was associated with increased long-term mortality.  Recovery from renal dysfunction was associated with some improvement in long-term mortality risk.  Alternative methods of classifying renal dysfunction may be more useful than creatinine in assessing long-term risk.