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Journal and News Scan

Source: The Annals of Thoracic Surgery
Author(s): Mariko Fukui, Kenji Suzuki,Takeshi Matsunaga, Shiaki Oh, Kazuya Takamochi

An interesting discussion in this manuscript of a case-control study of 666 subjects.

Source: JAMA
Author(s): Meredith S. Duncan, Matthew S. Freiberg, Robert A. Greevy Jr, Suman Kundu, Ramachandran S. Vasan, Hilary A. Tindle

It's never too late to quit.  Among heavy smokers, smoking cessation resulted in a significantly lower risk of cardiovascular disease within five years of quitting (hazard ratio 0.61), although their risk remained elevated compared to never smokers.

Source: Journal of Thoracic Oncology
Author(s): Hyun Woo Lee, Kwang-Nam Jin , Jung-Kyu Lee, Deog Kyeom Kim, Hee Soon Chung, Eun Young Heo, Seung Ho Choi

Interesting follow-up study of 208 pulmonary ground -glass opacities in 160 subjects, with a yield of three adenocardinomas.

Source: JAMA Network Open
Author(s): James W. Suliburk, Quentin M. Buck, Chris J. Pirko, Nader N. Massarweh, Neal R. Barshes, Hardeep Singh, Todd K. Rosengart

In a QI study of nearly 5,400 operations, 188 adverse events were recorded.  Of these, over 56% were associated with human error.  Of all human performance deficiencies, cognitive error accounted for over half.

Source: JAMA Internal Medicine
Author(s): James D. Douketis, Alex C. Spyropoulos, Joanne Duncan, Marc Carrier, Gregoire Le Gal, Alfonso J. Tafur, Thomas Vanassche, Peter Verhamme, Sudeep Shivakumar, Peter L. Gross, Agnes Y. Y. Lee, Erik Yeo, Susan Solymoss, Jeannine Kassis, Geneviève Le Templier, Stephen Kowalski, Mark Blostein, Vinay Shah, Elizabeth MacKay, Cynthia Wu, Nathan P. Clark, Shannon M. Bates, Frederick A. Spencer, Eleni Arnaoutoglou, Michiel Coppens, Donald M. Arnold, Joseph A. Caprini, Na Li, Karen A. Moffat, Summer Syed, Sam Schulman

A standardized perioperative management protocol for pts taking direct oral anticoagulants for atrial fibrillation entailed no bridging with other anticoagulants.  It resulted in low and acceptable rates of major bleeding (<2%) and stroke (<1%). 

Source: Infection Control and Hospital Epidemiology
Author(s): Lili Jiang, Allison McGeer, Shelly McNeil, Kevin Katz, Mark Loeb, Matthew P. Muller, Andrew Simor, Jeff Powis, Philipp Kohler, Julia M. Di Bella, Brenda L. Coleman for the Canadian Healthcare Worker Study Group

Ever wonder why your patients get respiratory infections postoperatively? Here's another risk factor. Almost 95% of hospital caregivers completed at least one shift while ill with an acute upper respiratory infection during flu season, despite hospital policies against such behavior. This was more common among physicians than among nurses.   

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): JTCVS

JTCVS just published a call for proposals of joining the Cardiac Surgery Intersociety Alliance (CSIA) as pilot sites. CSIA is jointly overseen by the AATS, EACTS, STS, the Asian Society for Cardiovascular and Thoracic Surgery, and the World Heart Federation. The mission of CSIA is to evaluate, endorse, and work with potential sites in low-income countries to increase access to sustainable heart surgery, with particular emphasis on rheumatic heart disease.

Source: US Food and Drug Administration
Author(s): FDA

The FDA-approved use of TAVR has now expanded to low-risk patients with severe aortic stenosis.  This includes both Edwards Lifesciences' Sapien 3 and Sapien 3 Ultra as well as Medtronic's  Evolut R and Evolut PRO.   

Source: The Annals of Thoracic Surgery
Author(s): Jennifer S. Nelson, Timothy M. Maul, Peter D. Wearden, Sara K. Pasquali, Jennifer C. Romano

Nelson and colleagues analyzed data from The Society of Thoracic Surgeons Congenital Heart Surgery Database on 3446 aortic valve replacement procedures performed between 2000 and 2016. The authors found that practice patterns varied widely, though autograft usage was higher at high-volume centers. Additionally, homografts were found to have higher rates of mortality and major complications than other valve types.

Source: JAMA Surgery
Author(s): J. Madison Hyer, Aslam Ejaz, Diamantis I. Tsilimigras, Anghela Z. Paredes, Rittal Mehta, Timothy M. Pawlik

Using a machine learning algorithm, resource utilization among more than 1 million Medicare patients undergoing one of 6 operations including CABG and lung resection was analyzed.  Super users comprised 4.8% of the cohort but consumed 31.7% of the resources.  Risk factors for super use included paraplegia/hemiplegia, weight loss, and CHF combined with chronic kidney disease.