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Journal and News Scan
The authors reviewed the role of mechanical thrombectomy in patients who develop strokes following cardiac surgery in their own center and from the literature. They conclude that mechanical thrombectomy is indicated for those patients who develop a stroke following cardiac surgery in whom systemic thrombolysis is contraindicated and when the thrombectomy can be performed within 6 hours of the onset of the stroke
This was a meta-analysis of 15 retrospective studies involving 7123 valve prostheses performed in patients with end-stage renal disease (ESRD). The results showed that bleeding complications were significantly higher with mechanical valves and that structural degeneration of tissue valves during the follow-up period was low. The authors concluded that in patients with ESRD, tissue valves should be the prosthesis of choice.
This study investigated the mechanical properties of ePTFE sutures used for artificial chordae during mitral valve repair. The study revealed that chordae greater than 3cm in length are associated with increased stiffness. This suggests that repairs, using minimally invasive OFF PUMP beating heart techniques, which anchor ePTFE neochordae to the ventricular apex, may have less durability than when anchored to the tips of the papillary muscles.
Using a Taiwanese national database, the authors evaluated long-term survival after VATS vs open lobectomy for lung cancer using propensity matching and multvariate analyses. Among 5,222 patients, 2,164 (41%) had a VATS approach. Propensity matching yielded 1848 patients in each group. 5-year survival was similar for the VATS and open groups (68.7% vs 65.5%). Surgical resection was not an independent predictor of survival.
The authors compared the results of annuloplasty with flexible and rigid rings in patients with tricuspid valve regurgitation. This is a propensity score-matched analysis with 98 pairs. They concluded that both rings are equally effective, however the rigid one causes a more complete right heart reverse remodelling.
The authors describe their experience with radical resection by either extrapleural pneumonectomy or extended pleurectomy–decortication (EPD) for management of pleural mesothelioma. They present pathologic findings, progression and outcome and discuss the results with caution.
The propensity-score analysis compares minimized extent of repair with root replacement (RR). Results for mortality are similar; however, RR seems to be associated with fewer interventions.
The paper summarizes the opinions of cardiac surgeons on data collection and presentation for quality assessment on surgeon-specific and institutional level. The analysis is based on a questionnaire which was handed out at the EACTS Annual Meeting in 2015.
Proposed definitions for the 8th edition of the AJCC Cancer Staging Manual are presented.
This randomized trial evaluated the efficacy of postoperative metoprolol or losartan in preventing atrial fibrillation in patients with elevated N-terminal pro-brain natriuretic peptide who were undergoing lung resection for cancer. Among candidates, 29% (320) of patients had elevated NT-proBNP and were randomized. Both metoprolol and losartan reduced afib incidence compared to controls (6%, 12%, 40%).