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Journal and News Scan
July 6, 2017
Submitted by: Arie Blitz
The authors conducted a meta-analysis of 35 RCTs analyzing the use of IV Mg for the prevention or treatment of arrhythmias following cardiac surgery. The studies included had significant methodological heterogeneity.
Findings: Mg use was associated with a reduction in Afib as well as ventricular arrhythmias postop, with a RR of 0.69 (p=0.002) and 0.46 (p=.004), respectively.
July 5, 2017
Submitted by: Ruben Osnabrugge
In this excellent review article, the authors review the practice and evidence for fractional flow reserve (FFR) in patients undergoing CABG.
July 5, 2017
Submitted by: Claire Vernon
Talwar and colleagues randomized 100 pediatric patients receiving bidirectional superior cavopulmonary anastomosis to on-cardiopulmonary bypass (CPB) and off-CPB groups. Significantly lower anastomosis time, postoperative inotropic support, and ICU and hospital stay duration were observed in the off-CPB group. Although the study only addressed early outcomes, no short-term difference in neurocognitive measures was observed between groups.
June 30, 2017
Submitted by: Claire Vernon
Thornblade and colleagues report an increase in off-label esophageal stent usage to treat benign esophageal perforation between 2007 and 2014, with a concomitant decrease in surgical repair and no difference in surgical drainage. Despite increased use of stents, no significant changes in short-term outcomes were observed.
Does Surgical Ablation Energy Source Affect Long-Term Success of the Concomitant Cox Maze Procedure?
June 29, 2017
Submitted by: Claire Vernon
Ad and colleagues compared outcomes in patients receiving a Cox Maze (CM) procedure with cryothermal energy only or with cryothermal and bipolar radiofrequency, with 298 patients in each group. CM performed with either energy source proved safe and effective, with the authors evaluating perioperative outcomes, rhythm status, survival, and clinical events. Cryothermal ablation alone was associated with reduced perioperative stroke incidence and higher rates of sinus rhythm out to 60 months follow-up, findings that the authors highlight as important for future study.
June 28, 2017
Submitted by: Claire Vernon
The authors report on 38 patients who underwent bilateral lung transplantation for severe pulmonary hypertension with routine application of prophylactic postoperative veno-arterial extracorporeal membrane oxygenation (ECMO). These patients’ survival up to 5 years was not different from patients who received lung transplants for other causes, and cardiac parameters were improved 12 months after transplantation. In consequence, the authors recommend regular postoperative use of ECMO in this patient population.
June 27, 2017
Submitted by: Claire Vernon
Mehaffey and colleagues evaluated major adverse events in 118 cardiopulmonary bypass (CPB) patients who had received methylene blue (MB) within 72 hours of CPB. Although these patients had high incidence of comorbidities and postoperative complications, MB administration in the operating room was associated with reduced operative mortality rate and incidence of adverse events compared to MB administration in the intensive care unit.
June 27, 2017
Submitted by: Claire Vernon
Balsam and colleagues present two cases of Mycobacterium chimaera infection following implantation of left ventricular assist devices, likely linked to bioaerosols from heater-cooler units used during surgery. Both cases were milder than has been reported following valvular and aortic graft surgery, but long-term sterilization of the internal hardware is unlikely. The authors also discuss their local practice changes that aim to prevent future cases.
June 26, 2017
Submitted by: Claire Vernon
Patient Care
A cardiac surgeon in Mumbai, India, is raising money to fund bypass surgeries, angioplasties, and angiographies for people who cannot afford them.
A boy in Hong Kong receives heart transplant after 282 days on a mechanical pump.
TAVI is now an option for patients in Saskatchewan, Canada, and the first transcatheter pulmonary valve replacement in West Virginia, USA, is performed at WVU.
Doctors in Al Ain, UAE, call for more facilities to offer cardiac surgery.
Drugs and Devices
The US FDA used data from the STS/ACC Transcatheter Valve Therapy Registry to expand the approved use of a Edwards Lifesciences’ Sapien 3 TAVR to valve-in-valve procedures. The US FDA also cleared FlowGlide Technology, the latest generation of technology for chest drainage after CT surgery from company ClearFlow, Inc.
MedReleaf Corp. in Canada is now the first ICH-GMP certified medical cannabis producer.
Stryker Corporation is expanding into surgical imaging technologies with its purchase of Novadaq Technologies.
Research Trials and Funding
Tilray will support a Phase II trial on the efficacy of vaporized cannabis in COPD at McGill University in Montreal, Canada.
June 26, 2017
Submitted by: Claire Vernon
The authors analyzed long-term recurrent aortic regurgitation (AR) in 249 patients with aortic insufficiency and reimplantation procedure. Of the cusp repair techniques evaluated in the analysis, only free margin reinforcement and patch repair influenced valve durability, the former positively and the latter negatively. Proportional hazard analysis also identified preoperative cusp prolapse as a significant risk factor for recurrent AR.