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Journal and News Scan

Source: The Annals of Thoracic Surgery
Author(s): Bogdan Kindzelski, MD, MS Stephanie L. Mick, MD Amar Krishnaswamy, MD Samir R. Kapadia, MD Tamer Attia, MD, PhD Kevin Hodges, MD Shirin Siddiqi, MD Ashley M. Lowry, MS Eugene H. Blackstone, MD Zoran Popovic, MD, PhD Lars G. Svensson, MD, PhD Shinya Unai, MD James J. Yun, MD, PhD

The most common approach for transcatheter aortic valve replacement (TAVR) is transfemoral access. Yet, a subset of patients require alternative access. This study shows the evolution and outcomes of alternative-access TAVR at Cleveland Clinic.

Source: The Annals of Thoracic Surgery
Author(s): Tamar B. Nobel, MD Smita Sihag, MD Xin Xing, BA Mahmoud Eljalby, BA Meier Hsu, MS Kay See Tan, PhD David B. Sewell, MA Manjit S. Bains, MD Yelena Janjigian, MD Abraham Wu, MD Geoffrey Ku, MD David R. Jones, MD Daniela Molena, MD

Over one-half of patients treated with esophagectomy for esophageal cancer have recurrence. Oligometastasis, a proposed intermediate state of isolated local or solid organ recurrence that occurs before widespread systemic disease, is a possible target for aggressive local intervention. This study look at presentation and prognosis among solid organ recurrence sites.

Source: The Annals of Thoracic Surgery
Author(s): Sean M. Stokes, MD, MS Nader N. Massarweh, MD, MPH John R. Stringham, MD Thomas K. Varghese Jr., MD, MS

The wroth of neoadjuvant treatment in conjunction with resection as multimodality therapy (MMT) for stage IIB non-small cell lung cancer is still controversial.

Source: Journal of Cardiothoracic and Vascular Anesthesia
Author(s): Michael A. Mazzeffi, Vidya K. Rao, Jeffrey Dodd-o, Jose Mauricio Del Rio, Antonio Hernandez, Mabel Chung, Amit Bardia, Rebecca M. Bauer, Joseph S. Meltzer, Sree Satyapriya, Raymond Rector, James G. Ramsay, and Jacob Gutsche

The Society of Cardiovascular Anesthesiologists created an expert consensus statement intended to help anesthesiologists manage adult patients receiving ECMO who are cared for in the operating room.  This two-part consensus document may serve as a helpful reference for cardiothoracic surgeons, intensivists and all who engaged in the care of ECMO patients.  The second part discusses intraoperative management and troubleshooting for common ECMO-related problems.

Source: Journal of Cardiothoracic and Vascular Anesthesia
Author(s): Michael A. Mazzeffi, Vidya K. Rao, Jeffrey Dodd-o, Jose Mauricio Del Rio, Antonio Hernandez, Mabel Chung, Amit Bardia, Rebecca M. Bauer, Joseph S. Meltzer, Sree Satyapriya, Raymond Rector, James G. Ramsay, and Jacob Gutsche

The Society of Cardiovascular Anesthesiologists created an expert consensus statement intended to help anesthesiologists manage adult patients receiving ECMO who are cared for in the operating room.  This two-part consensus document may serve as a helpful reference for cardiothoracic surgeons, intensivists and all who engaged in the care of ECMO patients. The first part is focused on the technical aspects of ECMO.

Source: The New England Journal of Medicine
Author(s): CTSN Investigators

Impressive  decrease of death (by approximaltely 40% !) in 2 years from a small RCT in elective structural heart surgery for degeneration. The assumption is  a benefit  by improvement in right ventricular dynamics

Source: The Annals of Thoracic Surgery
Author(s): Sri Harsha Patlolla, MBBS, Hartzell V. Schaff, MD, Kevin L. Greason, MD, Alberto Pochettino, MD, Richard C. Daly, MD, Robert L. Frye, MD, Rick A. Nishimura, MD, Joseph A. Dearani, MD

Out of 223 patients who had isolated TV procedures between 2001 and 2017, 60 (27%) underwent TV repair and 163 (73%) received TV replacement. Indication for surgery was functional tricuspid valve regurgitation in 64%, lead induced in 18%, and primary leaflet dysfunction in 18%. RV reverse remodeling was assessed by echocardiography at a median of 11.3 months (interquartile range [IQR] 5.9-13.5) post-dismissal.

Source: The Annals of Thoracic Surgery
Author(s): Magdi H.Yacoub MD, Ahmed Afif iFRCS MD, Hatem Hosny FRCS, Mohamed Nagy MS, Nairouz Shehata MS, Mazen Abou Gamrah MS, AmrEl Sawy MS, Walid Simry MD, Ahmed Mahgoub MD, Nadine Francis MS, Hussam El Nashar BS, Yuan-TsanTseng PhD, Soha Romeih MD PhD, Heba Aguib PhD

Preserving dynamism and recreating the sinuses in the Dacron graft are recongnized to be important for increasing the results of aortic valve-conserving operations. We describe a novel technique that preserves dynamism and recreates the sinotubular junction. 

Source: Annals of Cardiothoracic Surgery
Author(s): Ahmed Afifi, Hatem Hosny, Ahmed Mahgoub, Magdi Yacoub

The only procedure which guarantees long-term viability of the aortic valve substitute is the Ross operation. This translates into increased durability, survival, exercise capacity, quality of life, and minimal valve related complications. However, progressive autograft dilatation does provide some is concern. Particularly, when used as a freestanding root. The incidence and degree of dilatation varies considerably in different series and is dependent on the technique used as well as management during the peri-operative period and importantly patient-specific characteristics. Here we present a new method which aims at preventing long-term dilatation, using autologous tissue, while preserving geometry and dynamism of the aortic root.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Piroze M. Davierwala, Alexander Verevkin, Sophia Sgouropoulou, Elham Hasheminejad, Konstantin von Aspern,Martin Misfeld, Michael A. Borger

Interesting in its candour mini-series of partial arterial revascularisation by left thoracotomy. The perioperative graft failure is delt in some detail.

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