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Journal and News Scan

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Ourania Preventza, Jane L. Liao, Jacqueline K. Olive, Katherine Simpson, Andre C. Critsinelis, Matt D. Price, Marianne Galati, Lorraine D. Cornwell, Vicente Orozco-Sevilla, Shuab Omer, Ernesto Jimenez, Scott A. LeMaire, and Joseph S. Coselli

Dr Preventza and associates performed a meta-analysis of 3,154 patients who underwent frozen elephant trunk procedure to determine the incidence of neurologic complications. The incidences were 4.7% for spinal cord injury and 7.6% for stroke. Operative mortality was 8.8%.  Stent longer than 15 cm or coverage of T8 and beyond was assoicated with a higher incidence of spinal cord injury compared to stent length of 10 cm. 

Source: The Annals of Thoracic Surgery
Author(s): James M. Clark, Angelica S. Marrufo, Benjamin D. Kozower, Daniel J. Tancredi, Miriam Nuño, David T. Cooke, Brad H. Pollock, Patrick S. Romano, Lisa M. Brown

Compliance with American College of Chest Physicians guidelines for physiologic evaluation of lung resection patients was 50% or better for only half the physicians. The frequency of individualizing risk thresholds based on surgical approach increased according to the number of years in practice. Cardiothoracic surgeons more frequently referred all patients for cardiovascular risk assessment by a cardiologist than did thoracic surgeons (17.6% vs 2.4%).

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Gabriel Loor, Amit Parulekar, Michael Smith

A balanced  appraisal of last year's manuscript from the Lancet Group on a relatively novel portable Organ Care System for donor lungs. The analysis of the technical complications, especially organ damage from overenthusiastic revving of the pump, is particularly sobering.

Source: Journal of the American College of Cardiology
Author(s): Joanna Chikwe, Erick Sun, Edward L. Hannan, Shinobu Itagaki, Timothy Lee, David H. Adams, and Natalia N. Egorova

This article reviews real-life outcomes of 42,714 patients undergoing coronary bypass grafting from 2005 to 2012. After adjusting for the differences in the populations, the patients who received multiple arterial grafts had lower long-term mortality, myocardial infarction, and re-intervention rates than patients who received a single arterial graft. More telling, however, is the fact that only 15% of patients in the study group received more than one arterial graft.

Source: Circulation Research
Author(s): Jeong Hwan Kim, Zakaria Almuwaqqat, Muhammad Hammadah, Chang Liu, Yi-An Ko, Bruno Lima, Samaah Sullivan, Ayman Alkhoder, Rami Abdulbaki, Laura Ward, J. Douglas Bremner, David S. Sheps, Paolo Raggi, Yan V. Sun, Amit J. Shah, Viola Vaccarino, Arshed A. Quyyumi

Interesting clinicolaboratory experiment: Any translational value for the coronary surgeon and the cardiologist remains to be seen, especially regarding the  risk stratification and prioritization for urgent (inpatient) revascularisation. Also, the value of the observation for the cardiovascular anesthetist may be important with regards to induction of anesthesia for CABG.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Thomas K. Varghese Jr., John W. Entwistle III, John E. Mayer, Susan D. Moffatt-Bruce, Robert M. Sade, Robert M. Sade for the Cardiothoracic Ethics Forum

A must-read position paper.

Source: Interactive CardioVascular and Thoracic Surgery
Author(s): Etem Caliskan, Matthias Eberhard, Volkmar Falk, Hatem Alkadhi, Maximilian Y Emmert

The authors analyzed the effectiveness of left atrial appendage closure with AtriClip in 43 patients. In all patients, the absence of blood flow in the excluded appendage was confirmed. In 31 patients, no residual stump was observed. In only one patient, there was a significant (>10 mm) stump. In 11 patients, the residual stump was less than 10 mm. The authors concluded that the left atrial appendage closure with AtriClip is effective and the definition of clinical significant left atrial appendage stump should be further evaluated.

Source: The Annals of Thoracic Surgery
Author(s): Alexander A. Brescia, Jennifer F. Waljee, Hsou Mei Hu, Michael J. Englesbe, Chad M. Brummett, Pooja A. Lagisetty, Kiran H. Lagisetty

Persistent opioid use (>90 days postoperatively) in this Medicare database study identified modifiable factors, including prescription size and preoperative prescription refills, among other features, that could be targeted in order to reduce opioid dependency.

Source: AORTA
Author(s): Davide Carino, Mohammad A. Zafar, Mrinal Singh, Bulat A. Ziganshin, John A. Elefteriades

The authors review the growing suspicion that fluoroquinolone antibiotic (FQ) use may be related to the occurrence of thoracic aortic aneurysms and acute aortic dissection. The proposed mechanism is through an increase in matrix metalloproteinases (MMPs), which degrade collagen, a precursor to aortic injury. At least one international agency has recommended modifying the product package insert to warn users of this risk.

Source: The New England Journal of Medicine
Author(s): Christopher G. Schwarz, Walter K. Kremers, Terry M. Therneau, Richard R. Sharp, Jeffrey L. Gunter, Prashanthi Vemuri, Arvin Arani, Anthony J. Spychalla, Kejal Kantarci, David S. Knopman, Ronald C. Petersen, Clifford R. Jack, Jr.

Identification of Anonymous MRI Research Participants with Face-Recognition Software:  The authors demonstrated the ability to use facial recognition software to identify individuals undergoing head MR, highlighting the risk of loss of anonymity when seemingly de-identified data are available to others.