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Journal and News Scan

Source: Multimedia manual of cardiothoracic surgery
Author(s): Patrick G. Chan, Awori J. Hayanga and Vinay Badhwar
There is growing interest in reparative techniques that durably improve the mitral orifice while preserving the subvalvular apparatus. Many of these techniques are technically challenging and require complex resections with intricate chordal adjustments, which may have limited their global acceptance. In this report, a three-step technique is outlined that does not require significant resection or involve the use of neochords. This offers a potentially simplified approach to the repair of rheumatic mitral stenosis.
Source: Circulation
Author(s): Kagiyama N, Okura H, Nezuo S, Kawamoto T, Murakami T, Hashimoto Y, Tanemoto K, Yoshida K.
In this manuscript the authors present two cases of early thrombosis of biological prosthesis following mitral valve replacement. Both patients were on venous arterial extracorporeal membrane oxygenation (ECMO), which could be the factor responsible for this unusual event. The authors advocate the use of more aggressive anticoagulation on patients on ECMO and prosthetic cardiac valves.
Source: American Journal of Cardiology
Author(s): Hoffmann R, Altiok E, Reith S, Brehmer K, Almalla M.
This interesting study evaluates the hemodynamic effect of the residual ASD produced by the transeptal approach for MitraClip implantation. The new left to right shunt could contribute to the reduction in mitral regurgitation following MitraClip implantation
Source: Journal of Clincal Oncology
Author(s): L Eng, J Su, X Qui, PR Palepu, H Hon, E Fadhel, L Harland, A La Delfa, S Habbous, A Kashigar, S Cuffe, FA Shepherd, NB Leighl, AF Pierre, P Selby, DP Goldstein, W Xu, G Liu
Over 700 lung cancer patients were surveyed at diagnosis and a mean of 54 months later regarding smoking status. 56% of those smoking at the time of diagnosis and stopped smoking 1 year later. Smoking cessation was adversely affected by second hand smoke exposure from housemates, spouses, and peers; these effects were cumulative.
Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): HS Maniar, JM Bell, MR Moon, BF Meyers, J Marsala, JS Lawton, RJ Damiano Jr
Patients requiring readmission after cardiac surgery were compared to time-matched patients who did not require readmission to evaluate factors associated with this adverse event. Predictors of readmission included COPD, decreased EF, prolonged length of stay, and lower educational level. Failure to see a physician early after discharge increased the risk of readmission by 6-fold.
Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): FH McCarthy, ND Desai, Z Fox, J George, P Moeller, P Vallabhajosyula, WY Szeto, JF Bavaria
Pts undergoing aortic root replacement who moderate MR preoperatively were evaluated for outcomes after mitral repair vs no repair. Mitral repair was associated with longer crossclamp times, and postoperative renal failure. Root replacement improved MR without mitral repair, but mitral repair further improved the degree of regurgitation. There was no difference in long-term survival.
Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): CL Greene, SR DeMeester, SG Worrell, DS Oh, JA Hagen, TR DeMeester
Pts surviving esophagectomy longer than 10 years were queried as to QOL. Alimentary comfort rating was 9 out of 10. 33% experienced diarrhea, dumping, or regurgitation. 15% had aspiration requiring hospital care. Mean weight loss was 26 lbs. Median GI QOL score was 2.9 out of 4.
Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): Z-S Ma, C-Y Yang, M-F Dong, S-M Wu, L-X Wang
The authors performed VSD closure in children using a 3-port technique and compared the outcomes to patients undergoing open repair. The MIS approach was associated with shorter ICU stay, shorter hospital stay, fewer blood transfusions, and less opioid use.
Source: Journal of Clinical Oncology
Author(s): V Oppedijk, A van der Gaast, JJB van Lanschot, P van Hagen, R van Os, CM van Rij, MJ van der Sangen, JC Beukema, H Rutten, PH Spruit, JG Reinders, DJ Richel, MI van Berge Henegouwen, MCCM Hulshof
The CROSS trials randomized pts with esophageal cancer or GEJ cancer to surgery vs induction chemoradiotherapy (CRT) followed by surgery. Prior studies reported a significant improvement in survival and freedom from recurrence associated with induction therapy. In this report, CRT reduced locoregional recurrence from 34% to 14% and reduced peritoneal carcinomatosis from 14% to 4%. Local recurrence within the RT field occurred in only 5% of patients.
Source: Eur J Cardiothorac Surg
Author(s): Di Giammarco G, Canosa C, Foschi M, Rabozzi R, Marinelli D, Masuyama S, Ibrahim BM, Ranalletta RA, Penco M, Di Mauro M
Di Giammarco and colleagues reported that intraoperative graft verification was significantly improved if a combination of transit-time flow measurement and epicardial echocardiography was used in comparison with transit-time flow measurement alone. The positive predictive value increased from 10% to almost 100% in an analysis of 678 grafts in 333 patients undergoing isolated CABG, reducing the rate of unnecessary graft revisions.

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