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Journal and News Scan
A retrospective study found that women continue to have a higher mortality and morbidity rate after CABG compared with men. This has historically been the case, as women are often referred to surgery later than men and have more cardiovascular risk factors. Researchers emphasize that since this trend has not changed, there needs to be greater action to increase the quality of care for women who require CABG surgery. Read the original study, published in JAMA Surgery.
This study aimed to determine risk factors that lead to hospital readmission after lobectomy. Researchers found that patients experiencing postoperative complications are at increased risk for readmission, while a shorter time between discharge and follow-up is associated with a decreased risk of readmission.
Neointimal hyperplasia may affect systemic-to-pulmonary shunt failure in this group of infants. The histopathology of removed shunts was analyzed. Neointimal hyperplasia and shunt stenosis were correlated and significantly greater in the group with early interventions and shunt revision. Smaller shunt sizes and lower aspirin dosage were associated with increased neointimal proliferation.
Transcatheter pulmonary valve replacement (TPVR) carries an increased risk of infective endocarditis. This study used data from the Pediatric Health Information System for the period 2010–2020. Ninety-eight hospital admissions for infective endocarditis were identified for sixty-eight patients. For index admissions, 78 percent were treated medically and 22 percent surgically. The need for surgical intervention increased with increasing need for readmission. Mortality was 4.3 percent overall. Concern was expressed that reliance on medical therapy may delay surgery, which in this cohort was more successful overall.
A new study found that patients who undergo TAVR with concomitant chronic total occlusion lesions are more likely to experience complications from the procedure, but they do not have a higher risk of mortality. The results suggest that if a patient is otherwise a candidate for TAVR, their CTO status should not exclude them from the surgery.
The first minimally invasive artificial heart transplant surgery in China was completed in a patient experiencing severe heart failure. By implanting the left ventricular assist device using only two small incisions, surgeons were able to increase the patient’s quality of life as he waits for a donor heart.
As part of this study, patients 75 years and older with acute type A aortic dissection from 2011 to 2020 were reviewed. The surgical outcomes of noncommunicating acute type A dissection in this group were favorable, with no significant difference in maintaining physical function at discharge. The medical group had a significantly higher overall aortic event rate than the surgical group.
Because of advances in the treatment of hepatitis C virus (HCV), an increasing number of HCV-positive donors have become eligible to donate for heart transplant. This study aimed to conclude just how large that increase has been and the resulting outcomes. Researchers found that HCV-positive heart transplants have increased one-hundred-fold in recent years and recipients of those hearts have had acceptable outcomes similar to recipients of HCV-negative organs.
At UCSF, which has one of the longest running organ transplant programs in the United States, an all-women team led by Dr. Amy Fiedler performed a heart transplant for the first time recently. According to the United Network for Organ Sharing, this may have also been the first all-women team in history to perform a heart transplant.
Sleeve lobectomy is preferred to pneumonectomy for centrally located lung tumors. To report on surgical outcomes of this procedure, The European Society of Thoracic Surgeons database was searched between 2007 and 2021. The conclusion was that sleeve lobectomies can be performed safely after neoadjuvant treatment, and VATS was shown to result in shorter stays and decreased morbidity.