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Journal and News Scan

Source: Circulation
Author(s): Gabor Toth, MD; Bernard De Bruyne, MD, PhD; Filip Casselman, MD, PhD; Frederic De Vroey, MD; Stylianos Pyxaras, MD; Luigi Di Serafino, MD, PhD; Frank Van Praet, MD; Carlos Van Mieghem, MD, PhD; Bernard Stockman, MD; William Wijns, MD, PhD; Ivan Degrieck, MD; Emanuele Barbato, MD, PhD

This is a very interesting retropsective cohort study that looks at patients that either did or did not have an FFR preoperatively. 

FFR for intermediate stenoses reduced the number of grafts required and increased the number of patients suitable for OFF pump surgery with no difference in clinical outcome measures. 

Source: Transfusion
Author(s): PLASMACARD Study Group

This cohort study looks at the Administration of FFP in bleeding patients after cardiac surgery. it finds no difference in mortality in the FFP group and the no FFP group 

Source: Journal of Cardiac Surgery
Author(s): Timotheos G. Kelpis M.D.*, Vassilios A. Economopoulos M.D., Nikolaos E. Nikoloudakis M.D., Antonis A. Pitsis M.D.

71-year-old male who underwent successful minimally invasive transapical aortic valve implantation to treat severe aortic stenosis, with simultaneous pulmonary resection for the treatment of lung cancer. At five-year follow-up the patient remains free of symptoms (NYHA I) and recurrence.

Source: New England Journal of Medicine
Author(s): The Hokusai-VTE Investigators

This randomized, double-blind study assigned pts with acute VTE who were initially treated with heparin to endoxaban or warfarin.   The drugs were equivalent in preventing recurrent VTE, and endoxaban was associated with a lower risk of bleeding (p=0.004).  Pts who had RV dysfunction associated with PE had a substantially reduced risk of recurrent VTE with endoxaban.

Source: New England Journal of Medicine
Author(s): Frank Ruschitzka, William T. Abraham, Jagmeet P. Singh, Jeroen J. Bax, Jeffrey S. Borer, Josep Brugada, Kenneth Dickstein, Ian Ford, John Gorcsan, III, Daniel Gras, Henry Krum, Peter Sogaard, and Johannes Holzmeister for the EchoCRT Study Group

This randomized trial among 115 centers assigned patients with NYHA class III or IV heart failure, a short QRS duration, and LV dyssynchrony to device implantation with or without CRT.  The study was stopped prematurely by the DSMB for futility.  CRT was associated with increased deaths (p=0.02) and there was no difference in the primary outcome of death or hospitalization for worsening heart failure.

Source: The Annals of Cardiothoracic Surgery
Author(s): Edited by Roberto Di Bartolomeo

This issue on “Frozen Elephant Trunk” includes information on hybrid and endovascular surgical management of descending aorta and aortic arch pathologies. The issue includes a systematic review evaluating the current state of evidence on Frozen Elephant Trunks, long-term outcomes from international institutions, perspectives and opinions from leaders in the field, and operative video manuals for different hybrid prostheses.

Source: Annals of Thoracic Surgery
Author(s): Arman Kilic, Kristen Nelson, Janet Scheel, William Ravekes, Duke E. Cameron, Luca A. Vricella

Outcomes for small children (<10kg) bridged to heart transplant with VADs were compared to those who were not bridged. 2:1 propensity score matching was used to create comparison groups. Survival of 59 bridged pts was similar to that of 108 non-bridged pts, and most major complication rates were similar. Strokes occurred in 8.5% of bridged pts and 0.9% of non-bridged pts.

Source: Annals of Thoracic Surgery
Author(s): Anne-Mette C. Sauër, Hendrik M. Nathoe, Jeroen Hendrikse, Linda M. Peelen, Jakub Regieli, Dieuwke S. Veldhuijzen, Cor J. Kalkman, Diederick E. Grobbee, Pieter A. Doevendans, Diederik van Dijk, Octopus Study Group

This randomized study assigned patients with CAD to either PCI or OPCAB and assessed cognition 7.5 years later. The OPCAB group had better cognition at long-term follow-up in univariate analysis, but when adjusted for covariates, there was no significant difference in the cognition outcomes.

Source: Annals of Thoracic Surgery
Author(s): Feiran Lou, Inderpal Sarkaria, Catherine Pietanza, William Travis, Mee Sook Roh, Gabriel Sica, David Healy, Valerie Rusch, James Huang

This retrospective review of a large institutional database identified 337 patients who had undergone resection of a pulmonary carcinoid tumor and tracked recurrence and survival rates. 95% of recurrences were distant and only 24% were detected during routine follow-up. Only 3% of patients with typical carcinoid tumors suffered recurrence compared to 26% of those with atypical tumors. The authors suggest that routine follow up may not be indicated in patients with resected typical carcinoid tumors who have no risk factors.

Source: Annals of Thoracic Surgery

This study of 389 pts receiving a continuous flow LVAD evaluated the risk of thromoembolic (TE)complications associated with preop AF.   TE occured in 25% of pts; freedom from TE at 2 years was 46% in those with AF and 72% in those without AF (p<0.001).  AF did not affect late survival.