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Journal and News Scan
A database analysis on 4212 patients found female sex to be associated with improved survival in patients with Stage I adenocarcinoma but not with other stages or with squamous carcinoma. The authors discuss the reasons for their findings.
A multicenter retrospective study on over 26000 patients compared off-pump and on-pump surgery for CABG. Off-pump surgery was associated with a lower perioperative incidence of stroke in patients with two or more cardiovascular risk factors especially with chronic renal failure.
See highlights as the meeting takes place, including the interview below with the EACTS President, Jose Luis Pomar.
This is an outstanding video on the surgical repair of the pulmonary arteries, which has been published in the MMCTS as a detailed techniques article.
This updated meta-analysis evaluated outcomes in 2687 pts from 8 randomized clinical trials assessing the utility of polyunsaturated fatty acids in preventing postoperative atrial fibrillation after cardiac surgery. Treatment reduced the incidence of a-fib overall by 16% to 25%. In patients undergoing isolated CABG the reduction was 34% (p=0.003).
This study reviewed single institutional data to develop a composite risk index for mortality after heart transplantation in patients with congenital heart disease. Results in 46 pts operated 1996-2011 were studied with the primary differentiation being single vs double ventricle morphology. Predictors of mortality were preoperative renal insufficiency and the combination of single ventricle morphology and dialysis.
This derivation and validation study involving 2300 patients who underwent resection for NSCLC explored predictors of local/regional recurrence. Recurrence-free survival was similar between the datasets. Predictors of recurrence were different between the datasets. The derivation dataset identified stage I adeno, stage I squamous/large cell, and stage II-IIIA as predictors. The validation dataset identified lymphovascular invasion and stage as predictors.
Management of a dilated ascending aorta at the time of AVR was investigated in patients undergoing AVR alone (362), AVR plus aortic wrapping (67), or AVR plus aortic replacement (70). Long-term outcomes including death and aortic expansion were similar among the 3 groups.
This is a lovely gem of an operation back from 1998 , by Donald Doty. Really nicely filmed.
The only bit I didn't get was where the surgeons was standing !! isn't he on the left side of the patient ?
Patients with prior coronary artery bypass graft surgery (CABG) who present with an acute coronary syndrome have a high risk for recurrent events. Whether intensive antiplatelet therapy with ticagrelor might be beneficial compared with clopidogrel is unknown. In this substudy of the PLATO trial, the authors studied the effects of randomized treatment dependent on history of CABG. Prior–CABG patients presenting with acute coronary syndrome are a high–risk cohort for death and recurrent cardiovascular events but have a lower risk for major bleeding. Similar to the results in no–prior–CABG patients, ticagrelor was associated with a reduction in ischemic events without an increase in major bleeding. Methods Patients participating in PLATO were classified according to whether they had undergone prior CABG. The trial's primary and secondary end points were compared using Cox proportional hazards regression. Results Of the 18,613 study patients, 1,133 (6.1%) had prior CABG. Prior-CABG patients had more high-risk characteristics at study entry and a 2-fold increase in clinical events during follow-up, but less major bleeding. The primary end point (composite of cardiovascular death, myocardial infarction, and stroke) was reduced to a similar extent by ticagrelor among patients with (19.6% vs 21.4%; adjusted hazard ratio [HR], 0.91 [0.67, 1.24]) and without (9.2% vs 11.0%; adjusted HR, 0.86 [0.77, 0.96]; Pinteraction = .73) prior CABG. Major bleeding was similar with ticagrelor versus clopidogrel among patients with (8.1% vs 8.7%; adjusted HR, 0.89 [0.55, 1.47]) and without (11.8% vs 11.4%; HR, 1.08 [0.98, 1.20]; Pinteraction = .46) prior CABG.