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Journal and News Scan

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Berger T, Chikvatia S, Siepe M, Kondov S, Meissl D, Gottardi R, Rylski B, Czerny M & Kreibich M
The authors examined the safety of combining aortic root replacement with frozen elephant trunk (FET) total arch replacement. Outcomes were similar between the FET alone and FET with aortic root replacement groups. Adding aortic root replacement was not associated with increased mortality and there was no difference in overall survival between the groups. Although concomitant root replacement lengthens the operation time, it does not appear to increase risk in an experienced centre with high volumes.
Source: The New England Journal of Medicine
Author(s): COAPT Investigators

This five-year follow-up of a large randomized controlled clinical trial on outcomes after transcatheter edge-to-edge repair of severe mitral regurgitation, as compared with outcomes after maximal doses of guideline-directed medical therapy alone, suggests superiority of the transcatheter 'Alfieri' (Mitra-clip) repair over BMT.

It will be interesting to juxtapose transcatheter to surgical repair, especially over a longer period. It's worth noting that more than one in ten recipients suffered device-related complications.

Source: Healio
Author(s): Regina Schaffer

A study found that patients who underwent a second TAVR procedure were no more likely to experience adverse outcomes than those who have only undergone one TAVR. Because TAVR patients are expanding into younger populations, the analysis of registry data is important in informing decision making among these patients, who are more likely to need a second TAVR in their lifetimes.

Source: The Annals of Thoracic Surgery
Author(s): Elizabeth H. Stephens, Joseph A. Dearani, Dawn E. Jaroszewski

Pectus excavatum is frequently associated with congenital heart disease that requires surgery. This comprehensive review of pectus excavatum in children and adults describes the morphology, pathophysiology, indications for repair, surgical strategies, and clinical outcomes.

Source: European Journal of Cardiothoracic Surgery
Author(s): Haidari TA, Nayahangan LJ, Bjerrum F, Hansen HJ, Konge L, Massard G, Novoa NM, Milton RS, Petersen RH et al.

Seventeen procedures were identified by a Delphi process as feasible for simulation-based training. The top five were video-assisted thoracoscopic surgery (VATS) lobectomy; VATS segmentectomy; VATS mediastinal lymph node dissection; diagnostic flexible bronchoscopy and robot-assisted thoracic port placement; and robot-assisted surgery docking and undocking. The authors concluded these procedures should be integrated in the thoracic surgery curriculum and should specifically be taught using simulation-based training.

Source: The Annals of Thoracic Surgery
Author(s): Bubse Na, Chang Hyun Kang, Kwon Joong Na, Samina Park, In Kyu Park, Young Tae Kim

In 737 patients who underwent esophagectomy at an experienced single center, strictures developed in 105 patients, or 14 percent, that required endoscopic dilation within a year. Risk factors for stricture included anastomotic leaks (hazard ratio [HR], 2.5), and anastomotic techniques other than triangular linear stapling with 60 mm staplers, which had a stricture rate of 3.2 percent (manual sewing: HR, 9.6; circular stapling: HR, 66.5; hybrid linear stapling: HR, 5.4). The authors conclude that a large anastomosis area with triangular linear stapling prevents strictures after esophagectomy.

Source: Cardiovascular Business
Author(s): Michael Walter

According to a presentation at the 103rd AATS Annual Meeting, Black cardiothoracic surgeons earn just 76–85 percent of the mean salary earned by white cardiothoracic surgeons. This number accompanies low diversity among the workforce. Presenters concluded that future studies are needed to understand the mechanisms of salary disparity and how to develop a more diverse workforce.

Source: Interdisciplinary CardioVascular and Thoracic Surgery
Author(s): Tanaka et al.

The authors sought differences in ninety-day postoperative mortality for patients treated with thoracotomy or video-assisted thoracic surgery (VATS) for descending necrotic mediastinitis (DNM). Sicker patients were more frequently treated with VATS. Although VATS patients had higher complication and reoperation rates, the risk-adjusted difference for ninety-day mortality was not statistically significantly different between thoracotomy and VATS.

Source: EurekAlert
Author(s): Mount Sinai Health System News Release

When compared to population-based models, a machine learning-based model improved prediction of mortality risk for cardiac surgery patients. The team used electronic health record data and machine learning methods to demonstrate how institutions can build their own mortality prediction models. The models were tested against STS population-based models for five different surgeries, and were found to have higher accuracy, precision, and recall for each of them.

Source: Cardiovascular Business
Author(s): Michael Walter

A lab focused on how artificial intelligence technology can improve the treatment of cardiovascular disease has tested the ability of ChatGPT to answer assessment questions from the American Board of Thoracic Surgery. ChatGPT-4 achieved an accuracy of 81.3 percent. The results prove that the AI model shows the ability to understand complex thoracic surgical clinical information, which the authors suggest could be developed into personalized learning platforms for trainees.