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Journal and News Scan

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Elizabeth L. Norton, MS, David M. Williams, MD, Karen M. Kim, MD, Minhaj S. Khaja, MD, MBA, Xiaoting Wu, PhD, Himanshu J. Patel, MD, G. Michael Deeb, MD, Bo Yang, MD, PhD

In this article in the Journal of Thoracic and Cardiovascular Surgery, Drs Norton et al performed a single institution retrospective analysis of outcomes of 182 patients with acute type B aortic dissection who underwent fenestration/stenting for suspected malperfusion. They demonstrate the laudible outcomes in this patient population, with 0% new onset paraplegia and 7.7% in-hospital mortality in this high-risk patient population, where acute paralysis was a significant risk factor for late mortality. Overall, endovascular fenestration/stenting can be associated with acceptable short- and long-term outcomes.

Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Author(s): S. Chris Malaisrie MD, Christopher K. Mehta, MD

In this article, Drs Malaisrie and Mehta discuss updates on the indications for TEVAR in type B aortic dissection with comparison of the guidelines from The Society of Thoracic Surgeons, Society of Vascular Surgery, American Heart Association, American College of Cardiology, the European Society of Cardiology, and the Japanese Circulation Society. 

Source: Interactive CardioVascular and Thoracic Surgery
Author(s): Zhigang Wang, Min Ge, Tao Chen, Cheng Chen, Qiuyan Zong

Wang et al. present a retrospective single-center study on 712 patients with acute type A dissection who underwent repair utilizing hypothermic circulatory arrest. Within their cohort, preoperative Cystatin-C level and mechanical ventilation times were independent risk factors for acute kidney injury after aortic surgery. Furthermore, acute kidney injury was associated with increased short-term mortality.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Tadashi Kitamura, Shinzo Torii, Takashi Miyamoto, Toshiaki Mishima, Hirotoki Ohkubo, Shunichiro Fujioka, Kazuki Yakuwa, Haruna Araki, Shin Kondo, Yoshimi Tamura, Yuki Tadokoro, Yoshihiko Onishi, Kagami Miyaji

Kitamura et al. present a single-center study looking into the outcomes of patients with acute type A intramural hematoma. Within their Japanese collective, patients showing an aortic diameter ≤ 50 mm, no ulcer-like projection, and a pain score of ≤ 3/10 had to be operated on in only 17% of cases, and had a low hospital mortality of 4%. They conclude a watch-and-wait strategy to be reasonable in this very specific patient cohort.

Source: Journal of the American College of Cardiology
Author(s): John Gregson, Gregg W. Stone, Ori Ben-Yehuda, Björn Redfors, David E. Kandzari, Marie-Claude Morice, Martin B. Leon, Ioanna Kosmidou, Nicholas J. Lembo, W. Morris Brown iii, Dimitri Karmpaliotis, Adrian P. Banning, Jose Pomar, Manel Sabaté, Charles A. Simonton, Ovidiu Dressler, Arie Pieter Kappetein, Joseph F. Sabik iii, Patrick W. Serruys and Stuart J. Pocock

An analysis, from the cardiology viewpoint, of the MI nomenclature issues around the external validity of the EXCEL trial that undermined the EACTS support of the relevant 2018 guidelines

Source: The Annals of Thoracic Surgery
Author(s): Roberto Lorusso, Glenn Whitman, Milan Milojevic, Giuseppe Raffa, David M. McMullan, Udo Boeken, Jonathan Haft, Christian A. Bermudez, Ashish S. Shah, and David A. D’Alessandro

This is an a comprehensive consensus document on post-cardiotomy extracorporeal life support (PC-ECLS) jointly released by the European Association for Cardio-Thoracic Surgery (EACTS), the Extracorporeal Life Support Organization (ELSO), the Society of Thoracic Surgeons (STS) and the American Association for Thoracic Surgery (AATS). This position statement is focused on the most relevant issues to optimize indications and applications, to suggest configurations of PC-ECLS, to avoid or manage complications and to improve outcomes.

Source: New England Journal of Medicine
Author(s): The Editors, NEJM

An unprecedented position piece signed by all editors of the NEJM condemning US political leadership for their response to the pandemic.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Martin Czerny, Davide Pacini, Victor Aboyans, Nawwar Al-Attar, Holger Eggebrecht, Arturo Evangelista, Martin Grabenwöger, Eugenio Stabile, Maciej Kolowca, Mario Lescan, Antonio Micari, Claudio Muneretto, Christoph Nienaber, Ruggero de Paulis, Konstantinos Tsagakis, and Bartosz Rylski Reviewers: Alan C Braverman, Luca Di Marco, Kim Eagle, Volkmar Falk, Roman Gottardi and one anonymous

At the first day of its 34th Annual Meeting, the European Association for Cardio-Thoracic Surgery (EACTS) released the "Current Options and Recommendations for the Use of Thoracic Endovascular Aortic Repair in Acute and Chronic Thoracic Aortic Disease.  This is an expert consensus document  jointly drafted by the European Society for Cardiology (ESC) Working Group of Cardiovascular Surgery, the ESC Working Group on Aorta and Peripheral Vascular Diseases, the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC and the European Association for Cardio-Thoracic Surgery (EACTS).  It is intended to provide a synopsis of current evidence regarding the use of TEVAR in acute and chronic thoracic aortic disease, to share latest recommendations for a modified terminology and reporting standards, and to take a glimpse at the trends of future development.

Source: World Journal for Pediatric and Congenital Heart Surgery
Author(s): Emily Levy, Jennifer Blumenthal, Kathleen Chiotos, Elizabeth H Stephens , Joseph A Dearani

The authors provide a succint summary of FAQs in pediatric cardiac surgery. 

Source: Heart
Author(s): Jianhua Wu, Mamas A Mamas, Mohamed O Mohamed, Chun Shing Kwok, Chris Roebuck, Ben Humberstone, Tom Denwood, Thomas Luescher, Mark A de Belder, John E Deanfield, Chris P Gale

The authors are concerned about the 'deaths at home' having the greatest contribution to the excess of acute cardiovascular deaths in that period of the recent epidemic, AND LOCKDOWN in England and Wales. They advance the position that fear of the virus stopped patients from seeking potentially life-saving hospital treatment for cardiovascular conditions.