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Journal and News Scan
71-year-old male who underwent successful minimally invasive transapical aortic valve implantation to treat severe aortic stenosis, with simultaneous pulmonary resection for the treatment of lung cancer. At five-year follow-up the patient remains free of symptoms (NYHA I) and recurrence.
This randomized, double-blind study assigned pts with acute VTE who were initially treated with heparin to endoxaban or warfarin. The drugs were equivalent in preventing recurrent VTE, and endoxaban was associated with a lower risk of bleeding (p=0.004). Pts who had RV dysfunction associated with PE had a substantially reduced risk of recurrent VTE with endoxaban.
This randomized trial among 115 centers assigned patients with NYHA class III or IV heart failure, a short QRS duration, and LV dyssynchrony to device implantation with or without CRT. The study was stopped prematurely by the DSMB for futility. CRT was associated with increased deaths (p=0.02) and there was no difference in the primary outcome of death or hospitalization for worsening heart failure.
This issue on “Frozen Elephant Trunk” includes information on hybrid and endovascular surgical management of descending aorta and aortic arch pathologies. The issue includes a systematic review evaluating the current state of evidence on Frozen Elephant Trunks, long-term outcomes from international institutions, perspectives and opinions from leaders in the field, and operative video manuals for different hybrid prostheses.
Outcomes for small children (<10kg) bridged to heart transplant with VADs were compared to those who were not bridged. 2:1 propensity score matching was used to create comparison groups. Survival of 59 bridged pts was similar to that of 108 non-bridged pts, and most major complication rates were similar. Strokes occurred in 8.5% of bridged pts and 0.9% of non-bridged pts.
This randomized study assigned patients with CAD to either PCI or OPCAB and assessed cognition 7.5 years later. The OPCAB group had better cognition at long-term follow-up in univariate analysis, but when adjusted for covariates, there was no significant difference in the cognition outcomes.
This retrospective review of a large institutional database identified 337 patients who had undergone resection of a pulmonary carcinoid tumor and tracked recurrence and survival rates. 95% of recurrences were distant and only 24% were detected during routine follow-up. Only 3% of patients with typical carcinoid tumors suffered recurrence compared to 26% of those with atypical tumors. The authors suggest that routine follow up may not be indicated in patients with resected typical carcinoid tumors who have no risk factors.
This study of 389 pts receiving a continuous flow LVAD evaluated the risk of thromoembolic (TE)complications associated with preop AF. TE occured in 25% of pts; freedom from TE at 2 years was 46% in those with AF and 72% in those without AF (p<0.001). AF did not affect late survival.
The authors presented a novel concept of tricuspid annuloplasty for functional tricuspid regurgitation using an adjustable annuloplasty band. This method allowed authors to adjust the ring size on beating heart after weaning off the cardiopulmonary bypass.
The MitraClip Therapy Economic and Clinical Outcomes Study Europe (ACCESS-EU) enroled 117 patients with degenerative mitral regurgitation (MR) considered ineligible for surgery. Mortalities at 30 days and 12 months were 6.0 and 17.1%, respectively. At 12 months, 74.6% (53 of 71) of patients in follow-up achieved significant reductions in MR and improved clinical outcomes. This complementary non-surgical intervention should be indicated by an inter-disciplinary team of cardiologists and cardiac surgeons.