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Journal and News Scan

Source: Journal of Thoracic and Cardiovascular Diseases
Author(s): Masaya Sugimoto, Hirofumi Saiki, Akiko Tamai, Mitsuru Seki, Ryo Inuzuka, Satoshi Masutani, Hideaki Senzaki
The authors measured serum amino-terminal procollagen III (PIII) as a marker of myocardial fibrogenesis in patients undergoing the Fontan procedure for single ventricle circulation and in controls.  Patients with single venticle circulation had elevated PIII levels compared to controls.  Staged Fontan elements successively reduced PIII levels.   The levels of volume load and cyanosis were related to PIII levels.  Persisently elevated PIII levels were related to venticular stiffening.  PIII may be a useful marker of disease state and could indicate a therpeutic target.
Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): Rakesh M. Suri, Joseph A. Dearani, Tomislav Mihaljevic, W. Randolph Chitwood Jr., Douglas A. Murphy, Alfredo Trento, Hoda Javadikasgari, Harold M. Burkhart, Wiley L. Nifong, Richard C. Daly, A. Marc Gillinov
This article summarizes the current status of robotic approaches to mitral valve repair.  The technique is suitable to all types of degenerative mitral valve disease, and the outcomes are similar to those for open repair. 
Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): Mark Rodefeld
The author summarizes the challenges but tremendous potential of mechanical circulatory support for infants and children undergoing heart surgery.
Source: Journal of Cardiac Surgery
Author(s): Niv Ad, Sari D. Holmes, Linda Halpin, R.N., Deborah J. Shuman, Casey E. Miller, Deborah Lamont
This article examined the impact of gait speed, as a marker of frailty, on surgical outcomes in a group of 167 cardiac patients aged 65 years or older. The authors concluded that there was no relation between gait speed and outcome. 
Source: New York Times
Author(s): CHARLES ORNSTEIN
A hospital has agreed to pay a $2.2 million penalty for permitting the video-taping of two patients who did not consent to the filming. U.S. Federal regulators have also used the opportunity to clarify stipulations governing the filming of patients.   
Source: J Thorac Cardiovasc Surg
Author(s): Paparella D, Di Mauro M, Bitton Worms K, Bolotin G, Russo C, Trunfio S, Scrofani R, Antona C, Actis Dato G, Casabona R, Colli A, Gerosa G, Renzulli A, Serraino F, Scrascia G, Zaccaria S, De Bonis M, Taramasso M, Delgado L, Tritto F, Marmo J, Parolari A, Myaseodova V, Villa E, Troise G, Nicolini F, Gherli T, Whitlock R, Conte M, Barili F, Gelsomino S, Lorusso R, Sciatti E, Marinelli D, Di Giammarco G, Calafiore AM, Sheikh A, Alfonso JJ, Glauber M, Miceli A; GIROC Investigators.
In a large multi-center, propensity-matched study, Paparella et al found that antiplatelet therapy as opposed to oral anticoagulation therapy initiated after mitral valve repair as antithrombotic prophylaxis caused significantly less major bleeding, which also caused mortality to be less by a 5-fold than with anticoagulation therapy. 
Source: The New England Journal of Medicine
Author(s): Guyton RA, Smith LA
An editorial discussion of the impressive 10-year benefits of CABG for ischemic cardiomyopathy as found in the STICH trial.
Source: Annals of Thoracic Surgery
Author(s): Marco Ranucci, MD, Valeria Pistuddi, Ekaterina Baryshnikova, PhD (Biol), Dionisio Colella, MD, Paolo Bianchi, MD
These authors analyzed retrospectively the effect of postoperative fibrinogen level on bleeding after heart surgery in their database of 2,800 patients.   They found that serum fibrinogen levels lower than 220 mg/dl more than doubled the risk of postoperative bleeding.   Is it time to standardize the measurement of postop fibrinogen in cardiac surgery?
Source: Annals of Thoracic Surgery
Author(s): Francesca Fiorentino, John Stickley, Dan Dorobantu, Ragini Pandey, Gianni Angelini, David Barron, Serban Stoica
Results of an audit of the National Congenital Heart Disease database were evaluted to determine characteristics of patients undergoing reoperation within 30 days of their primary procedure.  Among over 18,000 patients, 3.5% had early reoperations.  The reoperations were most commonly arterial shunt, PA band, and VSD procedures.  60 day mortality was 5-fold higher than among patients who did not have an early reoperation. 
Source: Annals of Thoracic Surgery
Author(s): Meyeon Park, Michael G. Shlipak, Heather Thiessen-Philbrook, Amit X. Garg, Jay L. Koyner, Steven G. Coca, Chirag R. Parikh, for the Translational Research Investigating Biomarker Endpoints in Acute Kidney Injury (TRIBE-AKI) Consortium
The association of acute kidney injury (AKI) with adverse outcomes after cardiac surgery is well known.  This study compared the association of AKI and the elevation of cystatin C, another filtration marker, with long-term survival after cardiac surgery.  30% of patients experienced an abnormal increase in creatinine postop compared to 15% who had an abnormal rise in cystatin C.  A rise in  cystatin C was better predictive of decreased long-term survival than was creatinine.

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