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Journal and News Scan

Source: US Food and Drug Administration
Author(s): US Food and Drug Administration

A batch of staplers manufactured in July-August 2019 and distributed during August-September 2019 has been recalled. Seven serious injuries and one death are reported to have been associated with failure of this device.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Massimo A Padalino, Nicola Franchetti, Mark Hazekamp, Vladimir Sojak, Thierry Carrel, Alessandro Frigiola, Mauro Lo Rito, Jurgen Horer, Regine Roussin, Julie Cleuziou, Bart Meyns, Jose Fragata, Helena Telles, Anastasios C Polimenakos, Katrien Francois, Altin Veshti, Jukka Salminen, Alvaro Gonzalez Rocafort, Matej Nosal, Luca Vedovelli, Alvise Guariento, Vladimiro L Vida, George E Sarris, Giovanna Boccuzzo, Giovanni Stellin

In this multicenter study, the authors report on outcomes in 156 patients who underwent surgery for anomalous aortic origin of the coronary arteries. Unroofing and reimplantation were the most common procedures. There was no perioperative mortality. The authors concluded that surgery for anomalous aortic origin of the coronary arteries is safe and effective and most patients can return to normal life.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Tiuri E Kroese, Leonidas Tapias, Jacqueline K Olive, Lena E Trager, Christopher R Morse

Commonly, a jejunostomy is placed during esophagectomy. In this report including 188 patients, the impact of jejunostomy on outcomes after esophagectomy was examined. Jejunostomy lead frequently (7%) to jejunostomy-related complications and did not reduce the risk of postoperative weight loss. The authors concluded that the routine use of intraoperative jejunostomy appears to be an unnecessary step.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Ourania Preventza, Jane L. Liao, Jacqueline K. Olive, Katherine Simpson, Andre C. Critsinelis, Matt D. Price, Marianne Galati, Lorraine D. Cornwell, Vicente Orozco-Sevilla, Shuab Omer, Ernesto Jimenez, Scott A. LeMaire, and Joseph S. Coselli

Dr Preventza and associates performed a meta-analysis of 3,154 patients who underwent frozen elephant trunk procedure to determine the incidence of neurologic complications. The incidences were 4.7% for spinal cord injury and 7.6% for stroke. Operative mortality was 8.8%.  Stent longer than 15 cm or coverage of T8 and beyond was assoicated with a higher incidence of spinal cord injury compared to stent length of 10 cm. 

Source: The Annals of Thoracic Surgery
Author(s): James M. Clark, Angelica S. Marrufo, Benjamin D. Kozower, Daniel J. Tancredi, Miriam Nuño, David T. Cooke, Brad H. Pollock, Patrick S. Romano, Lisa M. Brown

Compliance with American College of Chest Physicians guidelines for physiologic evaluation of lung resection patients was 50% or better for only half the physicians. The frequency of individualizing risk thresholds based on surgical approach increased according to the number of years in practice. Cardiothoracic surgeons more frequently referred all patients for cardiovascular risk assessment by a cardiologist than did thoracic surgeons (17.6% vs 2.4%).

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Gabriel Loor, Amit Parulekar, Michael Smith

A balanced  appraisal of last year's manuscript from the Lancet Group on a relatively novel portable Organ Care System for donor lungs. The analysis of the technical complications, especially organ damage from overenthusiastic revving of the pump, is particularly sobering.

Source: Journal of the American College of Cardiology
Author(s): Joanna Chikwe, Erick Sun, Edward L. Hannan, Shinobu Itagaki, Timothy Lee, David H. Adams, and Natalia N. Egorova

This article reviews real-life outcomes of 42,714 patients undergoing coronary bypass grafting from 2005 to 2012. After adjusting for the differences in the populations, the patients who received multiple arterial grafts had lower long-term mortality, myocardial infarction, and re-intervention rates than patients who received a single arterial graft. More telling, however, is the fact that only 15% of patients in the study group received more than one arterial graft.

Source: Circulation Research
Author(s): Jeong Hwan Kim, Zakaria Almuwaqqat, Muhammad Hammadah, Chang Liu, Yi-An Ko, Bruno Lima, Samaah Sullivan, Ayman Alkhoder, Rami Abdulbaki, Laura Ward, J. Douglas Bremner, David S. Sheps, Paolo Raggi, Yan V. Sun, Amit J. Shah, Viola Vaccarino, Arshed A. Quyyumi

Interesting clinicolaboratory experiment: Any translational value for the coronary surgeon and the cardiologist remains to be seen, especially regarding the  risk stratification and prioritization for urgent (inpatient) revascularisation. Also, the value of the observation for the cardiovascular anesthetist may be important with regards to induction of anesthesia for CABG.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Thomas K. Varghese Jr., John W. Entwistle III, John E. Mayer, Susan D. Moffatt-Bruce, Robert M. Sade, Robert M. Sade for the Cardiothoracic Ethics Forum

A must-read position paper.

Source: Interactive CardioVascular and Thoracic Surgery
Author(s): Etem Caliskan, Matthias Eberhard, Volkmar Falk, Hatem Alkadhi, Maximilian Y Emmert

The authors analyzed the effectiveness of left atrial appendage closure with AtriClip in 43 patients. In all patients, the absence of blood flow in the excluded appendage was confirmed. In 31 patients, no residual stump was observed. In only one patient, there was a significant (>10 mm) stump. In 11 patients, the residual stump was less than 10 mm. The authors concluded that the left atrial appendage closure with AtriClip is effective and the definition of clinical significant left atrial appendage stump should be further evaluated.