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Journal and News Scan

Source: Journal of Cardiac Surgery
Author(s): Christopher Andrew Efthymiou, Rosalind Jane Mills, David John O'Regan
Recommendations for anticoagulation for patients after bioprosthetic AVR are in flux. Current algorithms are based on historical studies. This study summarizes a review of current literature on the topic.
Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): Puskas J, et al.
the Prospective Randomized On–X Anticoagulation Clinical Trial (PROACT) tests the safety of less aggressive anticoagulation than is recommended by ACC/AHA guidelines after implantation of an approved bileaflet mechanical valve. INR may be safely maintained between 1.5–2.0 after AVR with this approved bileaflet mechanical prosthesis. With low–dose aspirin, this resulted in significantly lower risk of bleeding, without significant increase in TE.
Source: New England Journal of Medicine
Author(s): Michael C. Reade and Simon Finfer
This review outlines causes of delirium and oversedation in ICU patients. Methods of managing these problems are outlined.
Source: Annals of Thoracic Surgery
Author(s): Aimee S. Parnell, Justine Shults, J. William Gaynor, Mary B. Leonard,Dingwei Dai, Chris Feudtner
The accuracy of the diagnosis in patients undergoing congenital heart surgery in a large administrative database was examined in over 14,000 patients aged 0 to 5. Patients admitted on day 1 of life and those undergoing ECMO had a much higher chance of being assigned non-cardiac diagnoses. Pts so misclassified had a substantially higher risk of mortality. This systematic misclassification may lead to inaccurate determination of case volumes and outcomes.
Source: Annals of Thoracic Surgery
Author(s): Sajjad Raza, Joseph F. Sabik, Stephen G. Ellis, Penny L. Houghtaling, Kerry C. Rodgers, Aleck Stockins, Bruce W. Lytle, Eugene H. Blackstone
Because the optimal management of CAD is unclear for many patients, the authors developed a decision support model for CABG and PCI with bare metal or drug eluting stents. Overall survival rates were similar for the different interventions. For PCI with drug eluting stents, optimal outcomes were observed for pts undergoing emergency revascularization for acute MI. Optimal outcomes for CABG were observed in pts with multivessel disease and with many comorbidities.
Source: Annals of Thoracic Surgery
Author(s): Hector Rodriguez Cetina Biefer, Simon H. Sündermann, Maximilian Y. Emmert, Frank Enseleit, Burkhardt Seifert, Frank Ruschitzka, Stephan Jacobs, Mario L. Lachat, Volkmar Falk, Markus J. Wilhelm
The authors report outcomes for recipients of heart transplants performed more than 20 years prior. Overall 20 year survival was 56%. Causes of mortality were similarly distributed among rejection, malignancy, infection, and allograft vasculopathy. Only 2 patients underwent retransplantation.
Source: Annals of Thoracic Surgery
Author(s): Raymond U. Osarogiagbon, Obiageli Ogbata, Xinhua Yu
The authors hypothesized that examination of more lymph nodes resulting from lung resection for NSCLC would result in fewer missed nodal metastases and be associated with better survival related to more accurate staging. Based on nearly 25,000 pts from SEER, they found the median number of nodes examined was only 6. Pts who had 18-21 nodes examined had a hazard ratio for mortality of 0.65.
Source: Journal of the American College of Cardiology
Author(s): Brett R. Anderson, Adam J. Ciarleglio, Denise A. Hayes, Jan M. Quaegebeur, Julie A. Vincent, Emile A. Bacha
In this article, the authors investigated the impact of the timing neonatal arterial switch operation on morbidity, mortality and costs. They included 140 patients with transposition of the great arteries and found a mortality and morbidity rate of 2% and 20%, as well as median hospital costs of $60,000. Their multivariable model showed that for every day beyond day 3 that the arterial switch was delayed, the risk of major morbidity increased with 47% and costs by 8%.
Source: The Peninsula Qatar
Author(s): The Peninsula Qatar
ISLAMABAD: Pakistan's former military ruler Pervez Musharraf wants to travel abroad for heart surgery requiring special equipment not available at home, legal sources said Friday quoting from a new medical report. Musharraf faces treason charges dating back to his 1999-2008 rule. But has not shown up for any hearings of a special tribunal due to security fears and lately a heart complaint. The 70-year-old former army chief has been in a military hospital since falling ill while travelling to the tribunal on January 2. An earlier diagnosis from the Armed Forces Institute of Cardiology, where Musharraf is being treated, said he was suffering coronary artery disease and his lawyers have suggested he should be treated abroad. The full report was not released but a legal source who has read it shared some of its contents with reporters. The source said that in the report, Musharraf said he needed "special equipment for his heart surgery which is only available abroad".
Source: EACTS
Author(s): Martin Czerny, Joseph Coselli, Bill Brinkman, and Martin Grabenwöger
This is a video from the EACTS/STS AORTIC SESSION Martin Czerny, Joseph Coselli, Bill Brinkman, and Martin Grabenwöger discuss the differences and common issues between the US and Europe in current practice in aortic surgery.