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Journal and News Scan

Source: Eur J Cardiothorac Surg
Author(s): Stephen Westaby, Kamran Baig, Ravi De Silva, Jonathan Unsworth-White, and John Pepper

Westaby and coworkers analyzed the demographic changes of cardiothoracic surgeons in the UK between 1999 and 2014. There was an increase in appointments from overseas and from other European countries which complemented a decrease of UK graduates entering the specialty. Only 5% are females. The authors attribute this to several public discussions in the last years that shed a negative light on cardiothoracic surgery and call to action to restore attractiveness of the specialty.

Source: Eur J Cardiothorac Surg
Author(s): José Sanz-Santos, Mireia Serra, Miguel Gallego, Concepción Montón, Borja Cosio, Jaume Sauleda, Alberto Fernández-Villar, Ricardo García-Luján, Eduardo de Miguel, Rosa Cordovilla, Gonzalo Varela, Enrique Cases, Felipe Andreo, and Eduard Monsó

False-negative results of endobronchial ultrasound-guided transbronchial needle aspiration in non-small-cell lung cancer staging were identified in 14% of 165 patients. Prevalence of false-negative results was low, when three satisfactory samples from mediastinal stations could be obtained and rose, when fewer adequate samples were available. Further, false-negative results were more frequent for left-sided tumors.
 

Source: Eur J Cardiothorac Surg
Author(s): David Prieto, Pedro Correia, Manuel Baptista, and Manuel J. Antunes

Transplantations of hearts from donors >50 years (n=26) were compared to 136 transplantations of hearts from younger donors. Hearts from older donors were preferably transplanted to older recipients, who had also longer waiting times. Short- and long-term survival of both groups was similar, however, there was a tendency to a higher frequency of cardiac allograft vasculopathy in the group that received older hearts.
 

Source: Eur J Cardiothorac Surg
Author(s): David Prieto, Pedro Correia, Manuel Baptista, and Manuel J. Antunes

Transplantations of hearts from donors >50 years (n=26) were compared to 136 transplantations of hearts from younger donors. Hearts from older donors were preferably transplanted to older recipients, who had also longer waiting times. Short- and long-term survival of both groups was similar, however, there was a tendency to a higher frequency of cardiac allograft vasculopathy in the group that received older hearts.
 

Source: Catheterization & Cardiovascular Interventions
Author(s): Charanjit S. Rihal, Srihari S. Naidu, Michael M. Givertz, Wilson Y. Szeto, James A. Burke, Navin K. Kapur, Morton Kern, Kirk N. Garratt, James A. Goldstein, Vivian Dimas, Thomas Tu and From the Society for Cardiovascular Angiography and Interventions (SCAI), Heart Failure Society of America (HFSA), Society for Thoracic Surgeons (STS), American Heart Association (AHA), and American College of Cardiology (ACC)

This concensus statement reviews the unique physiology, insertion techniques, and clinical indications for use of percutaneous mechanical circulatory support devices.  As the options for management of different etiologies of heart failure in adult and pediatric populations expand, understanding the advantages of specific devices is vital. 

Source: PLOS ONE
Author(s): Barbara J Drew, Patricia Harris, Jessica K Zegre-Hemsey, Tina Mammone, Daniel Schindler, Rebeca Salas-Boni, Yong Bai, Adelita Tinoco, Quan Ding, Xiao Hu

This thought provoking article by Drew et al., utilized state-of-the art monitoring technology to document the problem of "alarm fatigue" by recording an astounding number of alarm events; 2,558,760 unique alarms were triggered for 461 patients over a 31-day period.  They documented an audible alarm burden of 187/bed/day that is of great concern to patients and clinicians alike who must respond promptly to maintain safety, while confirming that 88.8% of these alarms were false.  The authors offer detailed documentation of this pervasive problem, cited repeatedly as one of the top 10 technological hazards of 2015, as well as offering realistic solutions that can be used to increase the reliability of current and future alarm systems.

Source: ASAIO Journal
Author(s): Broman, Marcus; Klarin, Bengt; Sandin, Karin; Carlsson, Ola; Wieslander, Anders; Sternby, Jan; Godaly, Gabriela

The authors describe a simplified method of providing regional citrate anticoagulation for Continuous Renal Replacement Therapy (CRRT) to patients. This simplified method could be beneficial for surgical patients needing renal replacement therapy where systemic anticoagulation is contraindicated and improve adoption of CRRT as a first choice therapeutic modality to treat acute renal failure in the post op surgical patient. The authors report only 5 patients and an intensly supervised, non randomized pilot study.

 

Source: Journal of Cardiac Surgery
Author(s): Andrea Perrotti, Paul Luporsi, Camille Durst, Dewi Vernerey, andSidney Chocron

The authors prospectively performed coronary angiograms in their patients undergoing isolated CABG who demonstrated a rising cardiac troponin I profile in the first 12 hours following heart surgery - despite being asymptomatic.  Among a total of 1693 patients from 2005-2011, 29 (1.7%) of patients had a rising CTnI.  Of these, 16 patients (55%) demonstrated significant abnormalities on the angiograms, including occlusions, stenoses, dissections, hematomas, and kinking.

 

Source: New England Journal of Medicine
Author(s): Gavin J. Murphy, F.R.C.S., Katie Pike, M.Sc., Chris A. Rogers, Ph.D., Sarah Wordsworth, Ph.D., Elizabeth A. Stokes, M.Sc., Gianni D. Angelini, F.R.C.S., and Barnaby C. Reeves, D.Phil. for the TITRe2 Investigators

This multicenter randomized trial examined restrictive versus liberal threshold in red-cell transfusion in patients after cardiac surgery.  The results were provocative, with more deaths in the restrictiv group compared to the liberal transfusion group.  Posoperative complications were also slightly higher in the restrictive group.  

Source: Annals of Thoracic Surgery
Author(s): Antonio G. Cabrera, Diane W. Chen, Ricardo H. Pignatelli, Muhammad S. Khan, Aamir Jeewa, Carlos M. Mery, E. Dean McKenzie, Charles D. Fraser

Repair of this congenital defect in 34 pts was associated with no early mortality and substantial improvement in LV function (EF, shortening fraction, LVEDD).  No postoperative circulatory support was required. 

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