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Journal and News Scan

Source: The Annals of Thoracic Surgery
Author(s): Victor Dayan, Gerardo Soca, Leandro Cura, Carlos A. Mestres
In this meta-analysis, the authors set out to investigate whether MV repair or replacement was better for patients with ischemic mitral regurgitation. Combining 12 eligible studies, they found that MV repair is associated with lower operative mortality, but higher recurrence of regurgitation. There were no differences in survival, functional measures and NYHA class.
Source: Journal of Thoracic Oncology
Author(s): Bovolato, Pietro; Casadio, Caterina; Billè, Andrea; Ardissone, Francesco; Santambrogio, Luigi; Ratto, Giovanni Battista; Garofalo, Giuseppe; Bedini, Amedeo Vittorio; Garassino, Marina; Porcu, Luca; Torri, Valter; Pastorino, Ugo
A group of 1365 pts from 6 institutions was retrospectively reviewed for outcomes after palliative treatment, chemotherapy alone, pleurectomy/decortication (P/D), or extrapleural pneumonectomy (EPP). Multivariable analysis identified age <70, epithelial histology, and chemotherapy as independent predictors of improved survival. In patients with all 3 favorable characteristics, median survival with or without P/D or EPP was similar.
Source: Journal of Thoracic Oncology
Author(s): Smith, Cardinale B.; Kale, Minal; Mhango, Grace; Neugut, Alfred I.; Hershman, Dawn L.; Mandeli, John P.; Wisnivesky, Juan P.
Using SEER data the authors compared open to VATS segmental resection in a population of pts >65 years old. Propensity score matching was used to adjust for baseline differences between the groups. VATS pts had lower complication rates, fewer ICU admissions, and shorter length of hospital stay. Outcomes did not appear to be surgeon-specific. Survival was similar between the groups.
Source: Journal of Thoracic Oncology
Author(s): Evison, Matthew; Crosbie, Philip A. J.; Martin, Julie; Bishop, Paul; Doran, Helen; Joseph, Leena; Chaturvedi, Anshuman; Barber, Philip V.; Booton, Richard
This study evaluated safety and efficacy of EBUS-TBNA in a population of pts 70 or older and compared their results to those of younger patients. Tolerance was better in the older group, and complication rates were similar. Overall accuracy was higher in the older group, possibly related to differences in the underlying diagnoses.
Source: Journal of Thoracic Oncology
Author(s): Jeantieu, Morgana; Gaillat, Françoise; Antonini, François; Azoulay, Elie; Martin, Claude; Thomas, Pascal; Leone, Marc
The authors hypothesized that major lung surgery may predispose patients to post-traumatic stress disorder (PTSD). 47 pts were evaluated prospectively. 50% were identified as having an elevated PTSD risk score 3 months posteroperatively. Predictors included excess preoperative anxiety and increased acute postoperative pain.
Source: European Journal of Cardio-Thoracic Surgery
Author(s): Daniela Föll, Michael Markl, Marius Menza, Asad Usman, Tobias Wengenmayer, Anna Lena Anjarwalla, Christoph Bode, James Carr, and Bernd Jung
Systolic and diastolic myocardial motion was determined using magnetic resonance tissue phase mapping (n=27). Cold ischemic time of the transplanted heart >155 min is associated with decreased myocardial velocities whereas longer postoperative time has a positive influence. The future aim is to develop a non-invasive method to diagnose transplant rejection.
Source: European Journal of Cardio-Thoracic Surgery
Author(s): Simona Celi and Sergio Berti
Computational models based on data from computed tomography show that maximal wall shear stress is associated with the maximal diameter in large aortic aneurysms whereas eccentricity of the bulge is more important in small aneurysms.
Source: European Journal of Cardio-Thoracic Surgery
Author(s): Martin Czerny, Holger Eggebrecht, Gottfried Sodeck, Ernst Weigang, Ugolino Livi, Fabio Verzini, Jürg Schmidli, Roberto Chiesa, Germano Melissano, Andrea Kahlberg, Philippe Amabile, Wolfgang Harringer, Michael Horacek, Raimund Erbel, Kay-Hyun Park, Friedhelm Beyersdorf, Bartosz Rylski, Philipp Blanke, Ludovic Canaud, Ali Khoynezhad, Lars Lonn, Hervè Rousseau, Santi Trimarchi, Jan Brunkwall, Michael Gawenda, Zhihui Dong, Weiguo Fu, Ingrid Schuster, and Michael Grimm
Aorto-oesophageal fistulation following thoracic endovascular aortic repair occurred in 36 of 2387 patients with a mean interval of 90 days according to the European Registry of Endovascular Aortic Repair Complications. Key symptoms included fever, haematemesis and shock. Aggressive therapy with radical oesophagectomy and aortic replacement achieved the best 1-year survival.
Source: Multimedia manual of cardiothoracic surgery
Author(s): Patrick G. Chan, Awori J. Hayanga and Vinay Badhwar
There is growing interest in reparative techniques that durably improve the mitral orifice while preserving the subvalvular apparatus. Many of these techniques are technically challenging and require complex resections with intricate chordal adjustments, which may have limited their global acceptance. In this report, a three-step technique is outlined that does not require significant resection or involve the use of neochords. This offers a potentially simplified approach to the repair of rheumatic mitral stenosis.
Source: Circulation
Author(s): Kagiyama N, Okura H, Nezuo S, Kawamoto T, Murakami T, Hashimoto Y, Tanemoto K, Yoshida K.
In this manuscript the authors present two cases of early thrombosis of biological prosthesis following mitral valve replacement. Both patients were on venous arterial extracorporeal membrane oxygenation (ECMO), which could be the factor responsible for this unusual event. The authors advocate the use of more aggressive anticoagulation on patients on ECMO and prosthetic cardiac valves.

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