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Journal and News Scan
Sleeve lobectomy is preferred to pneumonectomy for centrally located lung tumors. To report on surgical outcomes of this procedure, The European Society of Thoracic Surgeons database was searched between 2007 and 2021. The conclusion was that sleeve lobectomies can be performed safely after neoadjuvant treatment, and VATS was shown to result in shorter stays and decreased morbidity.
This guideline on acute mechanical circulatory support covers medical and surgical treatment of cardiogenic and pulmonary shock, management of patients supported with temporary mechanical circulatory support devices, complications, special populations, as well as palliative care, social and ethical dilemmas. Because of the association between cardiogenic and pulmonary shock and morbidity, this guideline was critically needed.
The Society of Thoracic Surgeons published its newly developed short-term risk calculator of operative and thirty day risk specific to isolated mitral valve repair for primary mitral regurgitation and degenerative mitral etiology.
The calculation is based on more than preoperative variables. It takes into account age, height, weight, sex, race, Hispanic, smoker, diabetes, chronic lung disease, beta blocker, adenosine diphosphate receptor inhibitor (within 5 days), steroids, hypertension, home oxygen, cerebrovascular disease, dialysis, liver disease, IV drug abuse, alcohol (>1 drink/week), immunosuppression, hematocrit, WBC count, platelet count, creatinine (mg/dl), ejection fraction (%), cardiac reoperation, chronic heart failure, surgical priority, preoperative atrial fibrillation, tricuspid insufficiency, and predominant mitral lesion.
A retrospective analysis of early experience with a new approach to totally endoscopic aortic valve replacement in 266 patients showed satisfactory results, with acceptable morbidity and low mortality rates.
To understand the shift toward nonsurgical management of esophageal cancer, researchers set out to determine the long-term quality of life (QOL) after esophagectomy. This study found that, in esophagectomy patients surviving more than three years, QOL did not differ significantly from the normative population reference values.
Since the recent increase of TAVR to treat aortic valve disease, multidisciplinary heart teams consisting of surgeons, cardiologists, and other allied professionals have become a necessary component in a successful surgery. Both surgeons and cardiologists who have worked on a TAVR case with a multidisciplinary heart team praise the ability to tailor each patient’s treatment to their unique situation. This article also outlines each component of a successful heart team.
The rate of serious complications in transcatheter aortic valve implantation (TAVI) has decreased markedly in recent years, going from 5.5 percent in 2012 to 2 percent in 2019. However, the total number of adverse events remains around 500, with about 100 requiring conversion to sternotomy, because of increased use of the procedure. The article reviews various complications and concludes that interdisciplinary TAVI heart team should be prepared and aware of possible rescue strategies.
The rising incidence of infective endocarditis (IE) along with the de-escalation of antibiotic prophylaxis and the complexity of surgical treatment makes IE treatment a challenge. In this study, researchers reviewed all patients who underwent cardiac surgery for IE at one institution with a focus on causative organisms and infective foci. They concluded that current risk-benefit evaluations need to be revisited.
Since reexploration after cardiac surgery, most often for bleeding, is used as a metric to assess surgical performance, surgeons may delay returning to the operating room in favor of attempting nonoperative management. This single-institution retrospective review aimed to investigate the impact of the timing of reexploration on morbidity and mortality. The study concluded that implications from using reexploration as a performance metric may lead to unnecessary delay and patient harm.
Since time to surgery for lung cancer is not well established, researchers aimed to assess whether time to surgery from diagnosis correlates with outcomes like unplanned return to care, mortality, and disease recurrence. The study found that patients with time to surgery within four weeks experienced lower rates of recurrence, which may be shorter than previously reported.