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Journal and News Scan
Blood of septic or healthy pigs was used in a 12-h ECMO mock loop experiment. No higher activation of coagulation or inflammatory response or increased problems with the oxygenator was found with septic compared to control blood.
Christophe Chautems and colleagues shed light on the challenges, strategies and current developments in the field of magnetically driven medical microrobots for intracorporeal use.
The authors report here on the results of the Italian CHEETAH study, a randomized, double-blind, placebo-controlled trial examining whether adding the unique inotrope levosimendan—in low doses—improves 30-day mortality after cardiac surgery in patients with perioperative LV dysfunction. The trial was halted after the first 506 patients were enrolled because of the futility of continuing the trial. There were no significant differences between the levosimendan group and the placebo group in 30-day survival, as well as for any of the measured postoperative secondary outcomes. (Levosimendan is currently not FDA approved for use in the U.S.)
Evidence for the benefit of sleeve lobectomy over pneumonectomy for lung cancer is limited. This 10 year retrospective nationwide study compared propensity score matched sleeve resection and pneumonectomy patients (794 in each group). Postoperative outcomes and long-term disease-free survival were superior in the sleeve resection patients when matched patients were evaluated, but this advantage did not hold when treatment weighting was considered.
The authors describe use of a stented jugular vein graft in the mitral position in infants at a median of 8.5 months and 5.6 Kg. Hemodynamics improved substantially, with no important MR or paravalvular leak. The ratio of the narrowest subaortic dimension in systole to the actual mitral valve dimension <0.5 was associated with LV outflow tract obstruction.
The authors sought to enhance the landing zone in management of retrograde Type A aortic dissection by inducing thrombosis of the false lumen as a first stage followed by TEVAR. Management was successful in all 9 pts in whom it was attempted.
Using MR scans and computational fluid dynamics, the authors sought to evaluate differences in flow, shear stress, and oscillatory shear stress in normal individuals and patients with 1 of 4 different categories of aortic valvular disease. The flow patterns were patient and category specific, and may provide the ability to determine interventions on an individualized basis.
The authors randomized 68 patients undergoing CABG to three treatment groups:
- ASA 81 mg QD
- ASA 325 mg QD
- ASA 162 mg BID
On the 4th day following CABG, the authors measured serum thromboxane B2 (TXB2) as an inverse surrogate for ASA effect. The order of TXB2 levels were as follows: 162 mg BID << 81 mg BID ≈ 81 mg QD. Thus, the optimal regimen, according to this small study, would be ASA 162 mg BID.
Three quarters of a century in caring for patients with congenital heart disease are summarized well in this brief viewpoint article, with the big data issue discussed.
According to BBC Tyne & Wear, a patient died after surgeons inserted a heart valve upside down causing irreversible damage to her heart. The procedure was performed at the Freeman Hospital in Newcastle upon Tyne. NHS Foundation Trust has admitted the error, and the family has begun legal action.