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Journal and News Scan
More than minimally manipulated (MMM) allograft heart valves should be classified as high risk devices, requiring premarket approval including safety and efficacy studies, according to an FDA panel.
This multicenter observational study evaluated midterm outcomes after use of the lung volume reduction endobronchial coil for severe emphysema in 60 pts. The 30-day complication rate was moderate. At 12 mos, the St. George's Respiratory Questionnaire decreased by 11.1 points, 6 min walk distance increased by 51.4 m, FEV1 increased by 0.11 L, and residual volume decreased by 0.71 L.
Lung cancer cases 2000-2013 in the UK Health Improvement Network were evaluated for factors associated with early death (within 90 days of diagnosis) vs later death. Risk factors for early death included male sex, older age, current smoking, social deprivation, and rural location. Those experiencing early death saw their primary care physicians more frequently prior to diagnosis, possibly representing missed opportunities to make an earlier diagnosis.
This is a fabulous paper comparing VATS versus open lobectomy. The 5 year survival is the same, the hospital stay is 2 days less and the in hospital mortality is slightly lower
In a cohort of 11,922 diabetic patients undergoing CABG, the authors compare single versus bilateral internal thoracic artery grafting (BITA), complete versus incomplete revascularization, and on versus off-pump CABG. The authors conclude that BITA with complete revascularization maximizes long-term survival.
This is an amazing Ted.com video on Tal Golesworthy who designed his own aortic root
In this article authors describe their technique to manage complex mitral reoperations using a minimally invasive approach, moderate hypothermia and avoiding aortic cross-clamping. Minimally invasive procedures with an unclamped aorta have the potential to combine the benefits of less invasive access and continuous myocardial perfusion. The advantage of a right mini-thoracotomy is the avoidance of sternal re-entry and limited dissection of adhesions, reducing the risk of cardiac structures or patent graft injury.
This study demonstrates the basic concepts and technique of robotic mitral valve replacement for valve pathologies that are not suitable for repair. Among this group of patients, robotic surgery is still feasible with some technical differences from a standard robotic mitral valve repair procedure.
This paper presents an update on diagnostic and prognostic biomarkers in malignant pleural mesothelioma considering also recent molecular biologic achievements as microRNA and genomic sequencing.
This prospective observational study compares patients with coronary artery bypass grafting on aspirin and ticagrelor (n = 173) or on aspirin and clopidogrel (n = 232). Major bleeding complications occurred in 14.5% with ticagrelor and 13.8% with clopidogrel (p=0.89).
No significant differences were observed, too, when the drugs were discontinued ≥5 or 2-4 days before surgery. A strong tendency to more bleeding complications in the ticagrelor group was found, however, when the drugs were given until 0–1 day before surgery.