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Journal and News Scan

Source: Circulation Journal
Author(s): Hitoshi Ogino, Osamu Iida, Koichi Akutsu, Yoshiro Chiba, Hiromitsu Hayashi, Hatsue Ishibashi-Ueda, Shuichiro Kaji, Masaaki Kato, Kimihiro Komori, Hitoshi Matsuda, Kenji Minatoya, Hiroko Morisaki, Takao Ohki, Yoshikatsu Saiki, Kunihiro Shigematsu, Norihiko Shiiya, Hideyuki Shimizu, Nobuyoshi Azuma, Hirooki Higami, Shigeo Ichihashi, Toru Iwahashi, Kentaro Kamiya, Takahiro Katsumata, Nobuyoshi Kawaharada, Yoshihisa Kinoshita, Takuya Matsumoto, Shinji Miyamoto, Takayuki Morisaki, Tetsuro Morota, Kiyonori Nanto, Toshiya Nishibe, Kenji Okada, Kazumasa Orihashi, Junichi Tazaki, Masanao Toma, Takuro Tsukube, Keiji Uchida, Tatsuo Ueda, Akihiko Usui, Kazuo Yamanaka, Haruo Yamauchi, Kunihiro Yoshioka, Takeshi Kimura, Tetsuro Miyata, Yutaka Okita, Minoru Ono, Yuichi Ueda, on behalf of the Japanese Circulation Society, the Japanese Society for Cardiovascular Surgery, the Japanese Association for Thoracic Surgery and the Japanese Society for Vascular Surgery Joint Working Group

This is the newly published latest version of Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection developed by the Japanese Circulation Society, Japanese Society for Cardiovascular Surgery, Japanese Association for Thoracic Surgery, and Japanese Society for Vascular Surgery. Compared to the 2022 ACC/AHA Guidelines on Aortic Disease, the Japanese document discusses the following topics in more detail, along with 86 figures and 1,943 references, which may warrant careful study. Topics included definition, pathogenesis, and epidemiology; pathology; symptoms, examinations, and diagnosis; selection of treatment; treatment for aortic aneurysm; treatment for aortic dissection, issues associated with aortic surgery, other aortic diseases; rehabilitation; and various issues of medical treatment for aortic diseases.

Source: Circulation Research
Author(s): Konstantinos Theofilatos, Stefan Stojkovic, Maria Hasman, Sander W. van der Laan, Ferheen Baig, Javier Barallobre-Barreiro, Lukas Schmidt, Siqi Yin, Xiaoke Yin, Sean Burnap, Bhawana Singh, Jude Popham, Olesya Harkot, Stephanie Kampf, Maja Carina Nackenhorst, Andreas Strassl, Christian Loewe, Svitlana Demyanets, Christoph Neumayer, Martin Bilban, Christian Hengstenberg, Kurt Huber, Gerard Pasterkamp, Johann Wojta, Manuel Mayr

This is an open access genomic study of carotid atheroma in Viennese patients with a useful extensive discussion on potential translational value of the signature of calcification, juxtaposed to sonographic diagnostics and in the quest to manage the risk of rupture of carotid atheromatous plaque. The article also has gravitas in the light of the updated ESVS guidelines in carotid disease. 

Source: Journal of the American College of Cardiology
Author(s): David Couto-Mallón, Luis Almenar-Bonet, Eduardo Barge-Caballero, Francisco José Hernández-Pérez, Juan Carlos López-Azor García, María Jesús Valero-Masa, María Ángeles Castel-Lavilla, Sonia Mirabet-Pérez, Iris Paula Garrido-Bravo, Carles Díez-López, Amador López-Granados, Rebeca Manrique-Antón, Carmen Neri Fernández-Pombo, Javier Muñiz, and Maria Generosa Crespo-Leiro

The authors reported the prognostic impact of donor transmitted coronary artery disease in heart transplantation in their retrospective multicenter cohort study. They found that TCAD was not associated with reduced survival. However, TCAD patients showed increased risk of cardiovascular death.The authors reported the prognostic impact of donor transmitted coronary artery disease in heart transplantation in their retrospective multicenter cohort study. They found that TCAD was not associated with reduced survival. However, TCAD patients showed increased risk of cardiovascular death.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Ren J, Royse C, Tian DH, Gupta A, and Royse A

Survival of diabetics after single or multiple coronary artery bypass grafting was compared in a national database over twenty years with 69,224 patients. End points were long-term all-cause mortality and thirty-day clinical outcomes. 17,474 nondiabetic and 10,989 diabetic matched pairs were generated. At a median of 5.9 years after grafting, mortality was statistically significantly lower after multiple arterial grafting in both diabetic and nondiabetic cohorts. The incidence of myocardial infarction was significantly higher in single rather than multiple grafting for both cohorts. Multiple arterial grafting was associated with improved survival for both diabetic and nondiabetic patients.

Source: Structural Heart
Author(s): Saad M Hasan et. Al.

While much research is ongoing regarding the safety of transcatheter aortic valve replacement (TAVR) compared to surgical aortic valve replacement (SAVR) after prior coronary artery bypass (CABG), there is limited data on morbidity outcomes and discharge locations among these two procedures. This article looked into a single center experience over fifteen years and found shorter length of stay, less new-onset atrial fibrillation, and more discharges home in the TAVR group compared to the SAVR group, with an overall improved morbidity profile.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Mateo Marin-Cuartas, Suzanne de Waha, Stefanie Naumann, Salil V Deo, Jagdip Kang, Thilo Noack, Alexandro Hoyer, David Holzhey, Sergey Leontyev, Diyar Saeed, Martin Misfeld, Massimiliano Meineri, Joerg Ender, Mohamed Abdel-Wahab, Steffen Desch, Holger Thiele, Michael A Borger, Philipp Kiefer

During some transcatheter aortic valve implant (TAVI) procedures, complications require conversion to emergency open heart surgery (E-OHS). This study evaluated early and midterm outcomes in a large center over fifteen years. Patients were grouped by surgical risk and the study time was divided into three five-year periods. In the entire study period, 1.1 percent of TAVI patients (74/6903) required E-OHS. The rate of E-OHS decreased over the three periods, from 3.5 percent to 0.4 percent. However, the proportion of patients from the study with low or intermediate risk increased considerably, from 1 percent to 26 percent. In-hospital mortality was 62 percent in high-risk and 12.5 percent in low and intermediate-risk patients. One-year survival was 31.8 percent in high-risk and 87.5 percent in low/intermediate risk patients.

Source: JTCVS Open
Author(s): Ashiq Abdul Khader, Aina Pons, Abigail Palmares, Sarah Booth, Chiara Proli, Paulo De Sousa, Eric Lim

This study reports outcomes of protocolized management of chest drain removal on-table for patients undergoing wedge resections and minor thoracic procedures. Chest drains were removed at the end of the operation if air leak was < 20 ml/min. Between 2016 and 2021, 107 patients underwent on-table chest drain removal with a 0.9 percent reintervention rate. Safe on-table chest drain removal using digital drainage in select cases challenges the need for routine drain insertion in thoracic surgery.

Source: JAMA Cardiology
Author(s): Jeremy P. Brown, Kevin Wing, Clémence Leyrat, Stephen J. Evans, Kathryn E. Mansfield, Angel Y. S. Wong, Liam Smeeth, Nicholas W. Galwey, Ian J. Douglas

The risk of dissection associated with fluoroquinolone use has gained wide acceptance, but recent data indicate there’s more to the story. Pasternak and colleagues report a Swedish, multicenter, propensity-matched study of one million treatment episodes examining the relationship between fluoroquinolone use and aneurysm or dissection. Interestingly, after adjustment for confounders, the absolute risk of aneurysm or dissection associated with fluoroquinolone use was smaller than previously reported, risk was found to be driven by aneurysm rather than dissection, and greatest risk was identified in the first ten days during treatment. 

Source: The Annals of Thoracic Surgery Short Reports
Author(s): Jacob N. Schroder, Sharon L. McCartney, Piet Jansen, Ryan Plichta, Jason N. Katz, David M. Smadja, Krish C. Dewan, Carmelo A. Milano

The authors present the first autoregulated total artificial heart implant in the United States. The Aeson total artificial heart provides biventricular support with improvements in hemocompatibility and autoregulation in response to higher filling pressures, when compared to previous generations. The authors present the case of a patient who was successfully bridged to transplant using this improved total artificial heart implant.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Sinha S, Dong T, Dimagli A, Vohra HA, Holmes C, Benedetto U, Angelini GD

This study compared in-hospital mortality risk prediction after cardiac surgery using the EuroSCORE II system with results generated by several machine-learning techniques. The dataset contained 227,087 adult patients, among whom there were 6,258 deaths (2.76 percent). Machine learning techniques showed some statistical improvements over EuroSCORE II, but the clinical impact of this was modest. The addition of other risk factors in future studies may result in further improvements.