This site is not optimized for Internet Explorer 8 (or older).
Please upgrade to a newer version of Internet Explorer or use an alternate browser such as Chrome or Firefox.
Journal and News Scan
How to manage solitary pulmonary nodules appearing after treatment of a prior malignancy remains a clinical challenge. The authors found that such patients most often had intrapulmonary metastases and less often had new lung cancers. Factors associated with new lung cancers included spiculated nodules, absence of nodal involvement with prior cancers, and prior cancers from other than head/neck and genitourinary sources.
The authors studied patients after resection of stage I non-small cell lung cancer. They found that nearly one-third had decreased muscle one year postoperatively, which was associated with poor performance status and decreased overall and cancer-specific survival.
Madariaga and colleagues retrospectively evaluated operative characteristics and outcomes in 86 patients who underwent resection of a posterior mediastinal tumor, with or without preoperative angiography. The nine patients who were selected for angiography had larger tumors that more often involved the neuroforamen than patients who were not selected. Blood loss, complication rate, and deaths related to tumor resection were comparable between patients who did and did not undergo angiography, and the authors did not find angiography itself to be associated with increased complications. They suggest that for properly selected patients, the ability to limit resection blood loss with embolization and to define spinal and tumor blood supply could outweigh the risk of angiography.
Kolb and colleagues describe their experience with tracheal replacement in a 12-year-old child with severe tracheal stenosis, for whom other available treatments had failed. The surgical team fashioned the new trachea from a myocutaneous latissimus dorsi free flap and chondrocartilage slings, using techniques that have been successfully performed in adults.
This is a retrospective review of 143 patients requiring reoperation after an initial AVR with a Freestyle® stentless bioprosthesis. Valve survival was 10.4 years for those with structural valve deterioration, but it was much less (4.1 years) if the initial procedure was for infective endocarditis. Operative mortality was <2%. This suggests a favourable result for reoperation.
A baby in Taiwan is the third-lightest to have undergone repair of a type A interrupted aortic arch and aortopulmonary window.
Did you know that April is Esophageal Cancer Awareness Month in the USA?
Drugs and Devices
Abiomed’s Impella CP heart pump received expanded premarket approval for its SmartAssist technology from the US Food and Drug Administration.
An experimental percutaneous catheter for cryoablation uses liquid nitrogen to reach very low temperatures.
Research, Trials, and Funding
Australian researchers provide more evidence that one should eat vegetables for healthy arteries.
Biostage, Inc has received funding to develop its Cellspan™ Esophageal Implant technology for pediatric patients with esophageal atresia.
Researchers from Canada find an increased risk of cardiovascular disease in women whose infants were born with congenital heart defects.
Researchers from around the USA have reported an approach for avoiding transcatheter aortic valve replacement-induced coronary obstruction, and their technique will be evaluated in a multicenter study.
Bhatnagar and colleagues randomized patients with malignant pleural effusion in order to test an outpatient approach to pleurodesis. All patients had indwelling pleural catheters placed for drainage, and they received a daily administration of either talc slurry or placebo through the catheter on an outpatient basis. Pleurodesis was evaluated after 35 days, with 30 of 69 patients (43%) in the talc group and 16 of 70 patients (23%) in the placebo group demonstrating successful pleurodesis.
The EJCTS and ICVTS are publishing a series of Statistical Primers to help clinicians perform and interpret research. In this article, Hickey and colleagues provide a practical introduction to repeated-measures analysis. The authors focus on linear mixed models, which are more amenable to real world data than other methods given their ability to handle mistimed or randomly missing longitudinal data. This primer on a more advanced statistical method could provide crucial information to increase the impact of your next manuscript.
Gosev and colleagues evaluated the baseline characteristics and outcomes in 156 patients from 12 centers who survived at least four years on left ventricular assist device (LVAD) support. Among this group of patients, mean survival was 7.1 years (95% CI 6.7 to 7.5 years). The average readmission rate was 1.1 ± 0.9 per patient-year, and the authors suggest that this low rate of complications could be responsible for the long survival seen in these patients.
70-year-old Arnold Schwarzenegger has undergone successful redo heart surgery at Ceders-Sinai Hospital, after an initial attempt to replace his pulmonic valve percutaneously. He famously underwent an attempted Ross Procedure in 1997, and the pulmonic valve left from that operation now required repeat surgery.
Apparently everything went well, and his first words were "I'm back!"