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Journal and News Scan

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Eva Sames-Dolzer, Lale Hakami, Michaela Innerhuber, Gerald Tulzer, and Rudolf Mair


The single-centre study analyses 257 Norwood procedures. Patients older than 20 days were at higher risk for early postoperative mortality, postoperative pulmonary hypertensive and impaired cardiac function. 

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Francesco Onorati, Fausto Biancari, Marisa De Feo, Giovanni Mariscalco, Antonio Messina, Giuseppe Santarpino, Francesco Santini, Cesare Beghi, Giannantonio Nappi, Giovanni Troise, Theodor Fischlein, Giancarlo Passerone, Juni Heikkinen, and Giuseppe Faggian for RECORD (REdo Cardiac Operation Research Database) initiative


Results from the European REdo Cardiac Operation Research Database (RECORD) indicate that outcome of redo aortic valve replacement is influenced by baseline risk factors and perioperative complications. Hospital mortality was seen in 5.1% of 711 evaluated cases.

Source: Thoracic Surgery News
Author(s): Patrice Wendling

The incidence of bacterial endocarditis has significantly increased in the UK and this coincides with a 90% reduction of antibiotic prophylaxis for dental work according to the 2008 NICE guidance which recommended against its use. 

This video from the AHA describes the study and implications for the future. 

Source: Journal of Cardiac Surgery
Author(s): Tomasz Plonek

17 manuscripts were included in the final analysis and postoperative data of 722 patients were studied. The mean age of patients was 58 years and mean follow-up was 62 months. Hospital mortality was 1.5% (11 deaths). During the follow-up late aortic related mortality was noted in two patients (0.3%), there were 12 (1.7%) cases of significant redilatation of the ascending aorta, and 13 (1.8%) patients had to have their ascending aorta reoperated. All of the aortic complications were noted in patients who either did not have their external wrapping sutured to the aorta or who underwent concomitant aortoplasty.

The results of the metaanalysis suggest that external aortic wrapping may be considered as a safe operative technique. In patients with a moderately dilated aorta it offers good mid-term and long-term outcome compared to replacement of the ascending aorta.


Source: Journal of Cardiac Surgery
Author(s): Diana Reser M.D., Mathias van Hemelrijck, Jovana Pavicevic M.D., Anna Platzmann M.D., Etem Caliskan M.D. , Volkmar Falk M.D. and Stephan Jacobs M.D.

This article shows that MIMVS is a safe approach with low morbidity and mortality that allows a high and durable repair rate with low reoperation rates and favorable short-term event-free survival

Source: Annals of Thoracic Surgery
Author(s): Colleen G. Koch, Edmunds Z. Reineks, Anne S. Tang, Eric D. Hixson, Shannon Phillips, Joseph F. Sabik III, J. Michael Henderson, Eugene H. Blackstone

The CCF group conducted a study of their phlebotomy practices during a 6-month period in 2012.  Phlebotomy volumes on each patient were estimated and calculated.  Surprisingly, the group found that, on average, cardiac surgery patients lose ~10% of their blood volume due to postoperative phlebotomy alone.  Clearly, further efforts are indicated to minimize such blood loss.  These efforts will include using smaller volume tubes, assessing the necessity of some of the blood tests, and developing a suitable means of minimizing discard volumes when blood is drawn from a patient line.

Source: MedPage Today
Author(s): Crystal Phend

The FDA recently approved the fourth new oral anticoagulant, Savaysa for use in non-valvular afib, DVT, and PE.  It is another factor Xa inhibitor.  Use in non-valvular afib requires renal function assessment prior to prescribing, as the drug is renally excreted.  Paradoxically, efficacy may be reduced in patients with better-than-normal renal function.

Source: Annals of Surgery
Author(s): Watson, David I.; Thompson, Sarah K.; Devitt, Peter G.; Smith, Lorelle; Woods, Simon D.; Aly, Ahmad; Gan, Susan; Game, Philip A.; Jamieson, Glyn G.

This study investigated repair methods for large hiatal hernias randomized to suture only vs absorbable mesh vs nonabsorbable mesh.  The design was randomized, double blind.  At 12 mos the recurrence rate was 21%, with no difference among the groups.  Postoperative symptoms were different among the groups, but these differences were judged to be of small clinical importance. 

Source: Annals of Thoracic Surgery
Author(s): Talha Shaikh, Karen Ruth, Walter J. Scott, Barbara A. Burtness, Steven J. Cohen, Andre A. Konski, Harry S. Cooper, Igor Astsaturov, Joshua E. Meyer

The authors retrospectively analyzed pathologic response rates and their relation to the interval between completion of induction therapy and esophagectomy for esophageal cancer in 88 patients.  Complete response rates increased from 12.5% to 40.9% among quartiles as the interval increased from <45 days to >63 days.  There was no increase in morbidity associated with longer intervals to surgery.

Source: Annals of Thoracic Surgery
Author(s): Maria Restrepo, Elaine Tang, Christopher M. Haggerty, Reza H. Khiabani, Lucia Mirabella, James Bethel, Anne Marie Valente, Kevin K. Whitehead, Doff B. McElhinney, Mark A. Fogel, Ajit P. Yoganathan

Patients who underwent a Fontan procedure for single ventricle physiology were evaluated with serial cardiac MR over time to identify changes in vessel characteristics and their relationship to flow.  Although vessel diameter increased over time, normalized diameters decreased.  This was not associated with changes in flow, but hemodynamic efficiency declined over time.