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Journal and News Scan

Source: Annals of Thoracic Surgery
Author(s): Jeremie Reeb, Anne Olland, Julien Pottecher, Xavier Delabranche, Mickael Schaeffer, Stephane Renaud, Nicola Santelmo, Romain Kessler, Gilbert Massard, Pierre-Emmanuel Falcoz

The authors report the use of ECMO in 8 pts who suffered ARDS after pneumonectomy.  Predicted mortality was 80% prior to ECMO institution.  ECMO was weaned in 7 pts and overall hospital survival was 50%.  

Source: Annals of Thoracic Surgery
Author(s): Tyson A. Fricke, Anne Eva Bulstra, Benjamin R. Loyer, Robert G. Weintraub, Yves d'Udekem, Christian P. Brizard, Igor E. Konstantinov

31 pts who underwent arterial switch at a weight of 2.5 kg or less were evaluated for outcomes.  Surgery was performed at an average of 16 days of life.  Mortality was 2.8% for those weighing 2.0-2.5 kg, and was 50% for those under 2 kg.  At a mean follow-up of 13 years, 8% had required late reoperation.  There were no late deaths, and all pts were NYHA Class I at last follow-up.  

Source: Annals of Thoracic Surgery
Author(s): Daisuke Yoshioka, Hiroo Takayama, Paolo C. Colombo, Melana Yuzefpolskaya, Arthur R. Garan, Veli K. Topkara, Jiho Han, Paul Kurlansky, Yoshifumi Naka, Koji Takeda

Changes in end organ function were assessed in 59 pts having a continuous flow LVAD in place for more than 3 years.  Renal and hepatic function improved initially, but renal function deteriorated to preoperative levels during the follow-up period.

Source: Annals of Thoracic Surgery
Author(s): Kosaku Nishigawa, Toshihiro Fukui, Masataka Yamazaki, Shuichiro Takanashi

The authors describe a 10-year experience with extended arteriotomy for endarterectomy of a diffusely diseased LAD, using an internal mammary artery for reconstruction.  Perioperative mortality was 1.1% and postoperative MI occurred in 9%.  Survival at 5 years was 89% and freedom from acute cardiovascular events was 74%.

Source: New England Journal of Mendicine
Author(s): André Lamy, P.J. Devereaux, Dorairaj Prabhakaran, David P. Taggart, Shengshou Hu, Zbynek Straka, Leopoldo S. Piegas, Alvaro Avezum, Ahmet R. Akar, Fernando Lanas Zanetti, Anil R. Jain, Nicolas Noiseux, Chandrasekar Padmanabhan, Juan-Carlos Bahamondes, Richard J. Novick, Liang Tao, Pablo A. Olavegogeascoechea, Balram Airan, Toomas-Andres Sulling, Richard P. Whitlock, Yongning Ou, Peggy Gao, Shirley Pettit, and Salim Yusuf, for the CORONARY Investigators

This trial randomly assigned 4,752 patients from 19 countries to either on-pump or off-pump CABG with a mean follow-up of 4.8 years.  The authors report no difference in death, stroke, myocardial infarction, renal failure or repeat revascularization at 5 years between the two groups.

Source: The Royal College of Surgeons of Edinburgh
Author(s): Pala B. Rajesh

The webinar will be presented by one of the UK’s most senior general thoracic surgeons, Mr. Pala B. Rajesh, and will entail a one-hour interactive session on “everything you need to know” about the thymus. The session, aimed at trainees and surgeons alike, will be broadcast on March 6 at 2:00 p.m., Central Time (8:00 p.m., GMT), and will be repeated on March 7 at 2:30 a.m., Central Time (8:30 a.m., GMT). Visit https://www.rcsed.ac.uk/professional-support-development-resources/learning-resources/webinars to register.

Source: JACC Cardiovascular Interventions
Author(s): Alexander C. Egbe, Heidi M. Connolly, Patricia A. Pellikka, Hartzell V. Schaff, Richard Hanna, Joseph J. Maleszewski, Vuyisile T. Nkomo, Sorin V. Pislaru

In this manuscript, the authors describe their findings in an observational prospective study of 52 patients who had tentative diagnoses of bioprosthetic valve thrombosis (BPVT) of surgically implanted valves over a 3-year period. All patients underwent a trial of anticoagulation therapy with warfarin, and follow-up transthoracic or transesophageal echocardiography performed at least 4 weeks after the initiation of anticoagulation therapy. The authors found that an echocardiographic diagnostic score predicted the response to warfarin anticoagulation in BPVT with excellent accuracy, that warfarin significantly reduced prosthetic gradients in 83% of the patients; and that this diagnostic and therapeutic strategy was associated with minimal side effects and no mortality.

Source: The Annals of Thoracic Surgery
Author(s): Giuseppe Marulli, Andrea Dell’amore, Francesca Calabrese, Marco Schiavon, Niccolo Daddi, Giampiero Dolci, Franco Stella, and Federico Rea

Padova and Bologna groups present an interesting cohort of patients treated with cadaveric cryopreserved sternocondral allograft for reconstruction of the anterior chest wall. 

Source: Annals of Thoracic Surgery
Author(s): Hiroshi Kubota, MD Hiroshi Kubota, MD Hiroshi Kubota, Hidehito Endo, MD, Hikaru Ishii, MD, Hiroshi Tsuchiya, MD, Yu Takahashi, MD, Yusuke Inaba, MD, Mio Noma, MD, Akihiro Yoshimoto, MD, Satoshi Higuchi, MD, Hideyasu Kohshoh, MD, Seiichi Taniai, MD, Haruhisa Ishiguro, MD, Hideaki Yoshino, MD, Kenichi Sudo, MD

Coronary and/or CT angiograms were performed on 585 of 762 (94%) patients at varying intervals after CABG using the PAS-Port System proximal anastomotic device.  The authors retrospectively evaluated the SVG patency at a mean follow-up interval (between CABG and the diagnostic procedures) was 319 ± 624 days.  The patency rates of the SVG grafts performed with the device were 90% and 81% at 1 and 5 years, respectively, which compare very favorably with established SVG patency rates.

Source: JTCVS
Author(s): Héctor Cubero-Gallego, Mario Lorenzo,, María Heredia, Itziar Gómez, Eduardo Tamayo

These authors from Spain retrospectively analyzed a group of 805 patients undergoing isolated heart valve surgery in order to correlate levels of high-sensitivity troponin T (hs-cTnT) and CK-MB with whether a patient experienced a postoperative MI, as diagnosed by EKG and/or TTE.  

In all, 88 patients (10.9%) met the criteria for MI.  In comparing the non-MI to the MI patients, the authors found, by analyzing the Receiver Operating Characteristics (ROC), the following peak cut-off levels to distinguish whether a patient had a postop MI or not:

  • hs-cTnT:  >1057 pg/mL @ 16 hours
  • CK-MB:  >55 mg/dl @ 8 hours.

 

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