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Journal and News Scan
This is a really nice summary article of the new oral antocoagulants which is freely available in full.
It describes the particular complications of the NOAC and cautions in renal failure and recommends safe stopping times before surgery
In this manuscript, the authors describe their findings after reviewing 27 young patients (between 7 and 30 years of age) who had undergone aortic valve replacement with two types of bovine pericardial biological prosthesis: Mitroflow® LXA (15 patients) and PERIMOUNT Magna® and Magna Ease® (12 patients) valves.
Life-threatening aortic bioprosthetic valve stenosis at 1.5 to 3 years after Mitroflow® LXA valve implantation occurred in 5 patients (33%). Freedom from valve failure at 3 years among those with a Mitroflow® LXA valve was 18%, and progression from less than mild to severe aortic stenosis was observed over a median of 6 months. No valve failures were noted in the observation period among 12 patients with a Magna® or Magna Ease® aortic bioprosthesis.
Based on their findings, the authors conclude that children and very young adults who have received a Mitroflow® LXA pericardial aortic bioprosthesis are at elevated risk for rapid prosthetic valve failure.
This systematic review and meta-analysis of individual patient data from 15 RCTs (2385 pts) assessed the utility of preoperative chemotherapy in patients with primarily stages Ib-IIIa NSCLC. Chemotherapy resulted in a 13% reduction in death (HR 0.87, p=0.007), and a 5% survival improvement at 5 years. Improvement was also evident for recurrence free survival and time to distant recurrence. There was no evidence for a difference in effects based on chemo regimens or patient characteristics.
For those of you anticipating the need to perform an emergency cricothyroidotomy outside of a medical setting, this article will guide you to the best pen to use for this purpose. [Spoiler alert: Baron retractable ballpoint and BIC soft feel jumbo]
A panel for the Centers for Medicare and Medicaid determined that annual low-dose CT screening for lung cancer carries too high a risk related to the potential benefits. They expressed concern about high false-positive rates, quality assurance, and gaps in evidence as to how the CT results would be used. Despite the fact that many professional groups have recommended screening, there is now concern that screening will not be approved for coverage at the vote scheduled for November 2014.
Dr. James Cox, DLV 2012 Faculty, gives his explanation of atrial fibrillation with an interesting imagery of a mouse on a yellow umbrella at Dallas-Leipzig Valve 2012.
Dr. Thomas Walther discusses the transapical TAVR Access technique at Dallas-Leipzig Valve 2012.
A Consensus Statement issued by the International Aortic Arch Surgery Study Group, on the standardization of clinical endpoints for aortic arch surgery. This guideline recommends a list important secondary outcomes that should be reported to enable comprehensive analysis of patient outcomes. It also defines the severity of various postoperative complications classified using a management-based grading system.
The new expert opinion paper by the ESC working on the optimal strategy for antiplateletet therapy in patients undergoing CABG
This article compares clinical adverse events after percutaneous intervention with drug‐eluting stents (DESs) and coronary artery bypass grafting (CABG) in patients with ESRD. Early mortality is lower with DESs compared with coronary artery bypass in patients with ESRD. Rate of reintervention is significantly higher in the DES cohort. At a mean pooled follow‐up of two years, both mortality and MACCE are comparable in both cohorts.