This site is not optimized for Internet Explorer 8 (or older).

Please upgrade to a newer version of Internet Explorer or use an alternate browser such as Chrome or Firefox.

Journal and News Scan

Source: World Journal for Pediatric and Congenital Heart Surgery
Author(s): J. Chancellor Fox, Horacio G. Carvajal, Fei Wan, Matthew W. Canter, Taylor C. Merritt, Pirooz Eghtesady

Transcatheter pulmonary valve replacement (tPVR) is a key therapy in RVOT pathologies but is associated with long term risks such as infective endocarditis (IE). In fact, some reports claim a higher IE risk compared to surgical pulmonary valve replacement. This paper investigates outcomes to different management strategies used to treat IE in patients who underwent tPVR. A total of 69 cases were identified with 98 admissions due to a readmission rate of 29 percent. During the initial admission, surgical rates were 22 percent. Surgical rates were 36 percent overall, as the likelihood of surgical intervention increased with each subsequent admission. Mortality rate in the overall and surgical cohort was 4.3 percent and 8 percent respectively.

Source: The European Journal of Cardio-Thoracic Surgery
Author(s): Giuseppe Cardillo, René Horsleben Petersen, Sara Ricciardi, Akshay Patel, Joshil V Lodhia, Michael R Gooseman, Alessandro Brunelli, Joel Dunning, Wentao Fang, Dominique Gossot, Peter B Licht, Eric Lim, Eric Dominique Roessner, Marco Scarci, Milan Milojevic

The European Association of Cardio-Thoracic Surgery and the European Society of Thoracic Surgeons has collaborated to produce a review on the management of pure ground-glass and part-solid pulmonary nodules. The increase in CT scanning for the detection of early stage lung cancer is giving rise to a higher proportion of lesions presenting on the ground-glass to part-solid spectrum. With surgical resection being the gold standard, there is a growing demand for guidelines pertaining to the surgical management of such nodules. The scope of these guidelines covers main areas of interest as follows: managing solitary or multiple pure ground-glass nodules and solitary part-solid nodules, identifying non-palpable lesions, the role of minimally invasive surgery, and the decision making behind sublobar versus lobar resection.

Source: The Journal of Heart and Lung Transplantation
Author(s): Dominic Emerson MD, Pedro Catarino MD, Reinaldo Rampolla MD, Joanna Chikwe MD, Dominick Megna MD

Lung transplantation remains the best option for patients with end-stage lung disease. Despite improving outcomes, the procedure confers significant morbidity risk. This paper presents a single right-sided lung transplant in a sixty-nine-year-old recipient utilizing the Da Vinci robotic system. The patient had a diagnosis of end-stage choleric obstructive pulmonary disease refractory to medical management and was oxygen dependent at baseline. The authors describe their perioperative planning, intraoperative details, and the course of the patient following transplantation and at the eighteen month follow up.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Sowmya Ramanan, Arun Gopalakrishnan, Soumya Sundaram, Ravi Prasad Varma, Deepak Gopakumar, Vinitha K Viswam, Rahul Satheesan, Sudip Dutta Baruah, Sabarinath Menon, Baiju S Dharan

The paper aimed to inform answers to questions of parents to those born with congenital defects necessitating arterial switch correction. Authors explored the quality of life in children undergoing the arterial switch operation beyond the early postoperative period. They investigated parental and socioeconomic factors that could influence quality of life. A total of 208 patients were enrolled in the study at a single tertiary cardiac center between 2012-2018. PedsQL 3.0 was used to calculate HRQOL. The immediate survival rate was 94.2 percent and most children (98.9 percent) started formal school in age-appropriate classes. Social factors were not significantly associated with quality-of-life parameters in this cohort.

Source: The Annals of Thoracic Surgery
Author(s): Axtell, Muniappan, et. Al.

A retrospective cohort analysis of The Society of Thoracic Surgeons General Thoracic Surgery Database of 128,723 patients—who underwent pulmonary resection for non-small cell lung cancer between 2009 and 2019—identified 1,873 (1.5 percent) with interstitial lung disease. Patients with interstitial lung disease were more likely to smoke (90 percent vs 85 percent, P < .001), have pulmonary hypertension (6 percent vs 1.7 percent, P < .001), diffusion capacity of the lung for carbon monoxide < 40 percent (11 percent vs 4 percent, P < .001), and underwent more sublobar resections (34 percent vs 23 percent, P < .001) compared with patients without interstitial lung disease. Patients with interstitial lung disease had increased postoperative mortality (5.1 percent vs 1.2 percent; odds ratio, 3.94; 95 percent CI, 3.09-5.01; P < .001) and composite morbidity and mortality (13.2 percent vs 7.4 percent, P < .001).

Source: Anaesthesia
Author(s): S. L. Harrison, K. J. Loughran, J. Trevis, P. Witharana, R. Maier, H. Hancock, M. Bardgett, A. Mathias, E. F. Akowuah

This qualitative study explores the views and experiences of patients and staff involved in prehabilitation of elective patients undergoing cardiac surgery. This was nested within a wider randomized controlled trial comparing elective cardiac surgery patients undergoing a six-week prehabilitation program against those assigned to usual care. This qualitative study highlights some interesting considerations when designing and implementing a prehabilitation program in this group of patients.

Source: The Annals of Thoracic Surgery
Author(s): Tirone E. David

This newly published review on aortic valve sparing operations includes history and development, technical modifications, contemporary outcomes, and future directions.

Source: TCTMD
Author(s): Shelley Wood

A new survey found that sexual misconduct across the surgical profession is widely experienced in the United Kingdom. Nearly 90 percent of women and 80 percent of men reported having personally witnessed sexual harassment. Nearly 29 percent of woman reported having been victims of assault in the workplace. Although only 1.9 percent of survey respondents identified as cardiothoracic surgeons, and a larger sample size is needed, this study is an important first step in identifying and working to solve a looming problem in the surgical profession.

Source: Journal of the American Heart Association
Author(s): Ana Barradas‐Pires, Pablo Merás, Andrew Constantine, Giulia Costola, Teresa Segura de la Cal, Isma Rafiq, Aleksander Kempny, Wei Li, Sonya V. Babu‐Narayan, J. Andreas Hoschtitzky, Michael A. Gatzoulis, Antonio Martinez Rubio and Konstantinos Dimopoulos

The optimal timing for AVR in young adults can be hard to predict with the lack of evidence-based guidelines. One third of a total of 172 patients recruited from a single tertiary cardiac center between 2005-2019 underwent surgery before meeting guideline indications, but they were more likely to normalize their LV postoperatively. The authors found that patients with increased LV end-systolic diameters and those who underwent previous cardiac surgery were less likely to reach LV normalization post AVR. Prosthetic valve related complications occurred in 20.3 percent of patients at an average 5.6 year follow up and freedom from further aortic reinterventions was 98 percent, 96.5 percent and 85.4 percent at one, five and ten years respectively.

Source: The American Journal of Cardiology
Author(s): Maria Comanici, Sunil K. Bhudia, Nandor Marczin, Shahzad G. Raja

Use of antiplatelet medication following coronary artery bypass grafting is common practice to reduce thrombotic events. However, antiplatelet resistance is of growing concern. The authors of this review conducted a systematic review and meta-analysis of eleven studies involving 3122 patients. The primary outcome measures were major adverse cardiovascular events and mortality. The authors report a 39 percent prevalence of antiplatelet resistance from the studies included.