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Journal and News Scan
The incidence of coronary artery disease among patients with severe aortic stenosis and candidates for TAVI ranges from 40 to 75%. In the absence of randomized trials, the management of these patients remains to be established. In this paper, the authors offer a good overview of the subject and propose an algorithm for treatment.
This article looks at the availability of cardiac surgery in africa using a survey to calculate the availability of surgeons around this continent and also looks at the models of care employed.
A great use for google glasses is demonstrated here. The glasses can be used to film the operative field and communicate with others online in real time.
Thus real time expert opinions from around the world would potentially be possible with their use. They are used here for the first time.
Two-patch, single-patch, and modified single-patch repairs are accepted techniques for repair of complete atrioventricular (AV) canal defects. We propose a novel, alternative technique: the central patch technique.
The central patch technique is applicable to all forms of complete AV canal defect. Subjectively, it offers technical advantages compared to standard techniques and may result in a shorter learning curve for junior congenital heart surgeons. Results are preliminary but are consistent with standard techniques.
this is a video and article decribing the technique for bullectomy and pleural abrasion using the original drain as a port and 2 3mm ports.
The cause of ischemic stroke remains elusive in up to 20-40% of cases. In patients with cryptogenic stroke, 8.9% of patients with long term monitoring using an insertable cardiac monitor were found to an episode of atrial fibrillation, which may have implications in therapy.
In this study the authors use data from 1432 patients included in the German TAVI registry to identify variables which predict poor outcome in patients left with more than mild aortic regurgitation (AR) following TAVI. The Medtronic Core Valve prosthesis had been used in the great majority of the procedures. 1-year follow up data was available in 92% of the patients. Of these patients, 201 (15.2%) were found to have significant AR. Using Cox regression analysis, only more than mild pre-existing mitral regurgitation and pulmonary hypertension were identified as independent predictors of 1-year mortality .
Although lung cancer is common in the elderly population, little information specific to this population is available to inform healthcare practitioners. The EORTC, in collaboration with the International Society of Geriatric Oncology, released a concensus statement in 2010 on this topic. Since then a number of related studies have been published. The current publication is an update on the 2010 statement that includes new recommendations for treatment, data on patient preferences, and concepts regarding geriatric assessment.
In this study presented by Dr. Joshua A. Roth recently at the ASCO meeting, they used a model to forecast the 5-year results of implementation of a screening program (as suggest the NLST, age older than 55 with at least 30 pack-years of smoking history) in comparison to no screening program. They modeled various scenarios involving faster and slower diffusion of the program. The number of lung cancer detected at the localize stage will raise from 15% to 32% with 54900 of new lung cancer diagnoses, but the cost of this advantage will exceed 9.3 $ billion.
Predictors of resectability on preoperative CT were evaluated in 133 pts undergoing resection for thymoma over a 13 year period in a single institution. 60% of pts were Masaoka stage I or II. 17% of pts had an incomplete resection. On multivariate analysis, pleural nodularity and the degree of abutment of adjacent vessels predicted incomplete resection.