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Journal and News Scan

Source: JACC Cardiovascular Interventions
Author(s): Fassa AA, Himbert D, Brochet E, Depoix JP, Cheong AP, Alkhoder S, Nataf P, Vahanian A.

Interesting images of one of the very few reports on transeptal mitral valve implantation, in this case with a SAPIEN XT valve. The valve was implanted in a 72-year old female patient with previous aortic valve replacement and tricuspid valve annuloplasty. She had symptomatic mitral stenosis with severe calcification of the mitral annulus.

Source: Annals of Surgery
Author(s): Haugen AS, Søfteland E, Almeland SK, Sevdalis N, Vonen B, Eide GE, Nortvedt MW, Harthug S.

Stepped wedged cluster randomized control trial from the World Health Organization comparing outcomes in those who received a Checklist.  Implementation of the WHO Surgical Safey Checklist decreased morbidty and hospital length of stay.

Source: Journal of the American College of Cardiology
Author(s): Darryl Abrams; Alain Combes; Daniel Brodie

In this extensive review, the authors focus on extracorproreal membrane oxygenation (ECMO), both for cardiac and respiratory failure. They describe the explosive increase in ECMO use, the expanding indications, and the need for more evidence-based use. Moreover, they review the cannulation strategies, current indications and potential future applications.

Source: International Journal of Cardiology
Author(s): Stabile E, Pucciarelli A, Cota L, Sorropago G, Tesorio T, Salemme L, Popusoi G, Ambrosini V, Cioppa A, Agrusta M, Catapano D, Moscariello C, Trimarco B, Esposito G, Rubino P.

Traditionally, patients undergoing TAVI are treated with dual antiplatelet therapy (DAPT). This strategy in not based on strong evidence.  In this paper, the authors describe their findings in a randomized trial comparing outcomes (morbidity and mortality) in two groups of patients undergoing TAVI, one treated with aspirin only (ASA group) and another treated with aspirin and clopidogrel or ticlopidine (DAPT group). There were no significant differences in “all cause” and “cardiovascular” mortality at six months or in the VARC (Valve Academic Research Consortium) combined safety endpoints at 30 days. Nevertheless, at 30 days, vascular complications were significantly more frequent in the in the DAPT group. Based on their data, the authors suggest that, in patients undergoing TAVI, vascular complications may be reduced by the adoption of an antiplatelet therapy based only on aspirin.

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): S Wang, Y Tachimori, H IGaki, H Nakazato, T Kishino

Pts undergoing salvage esophagectomy after definitive chemoradiotherapy were evaluated for perdictors of survival.  5-year survival was 30%, which was related to tumor recurrence rather than residual tumor, complete resection, N status, M status, and dissection of more than 15 nodes.  Additional neck dissection was not found to provide additional benefit.

Source: Journal of Clinical Oncology
Author(s): AG Sacher, LW Le, NB Leighl

This study evaluated over 200 RTCs of systemic therapy for NSCLC.  There has been a steady increase in the number of trials reporting outcomes for progression-free survival.  Over 50% of trials now report a positive outcome without meeting the primary endpoint of the trial.  Although the sample size of the trials is increasing, the magnitude of reported survival gain is decreasing (now 2.5 mos).

Source: St. Jude Medical
Author(s): St. Jude Medical

The PORTICO trial has opened to evaluate the Portico Transcatheter Aortic Valve System.  This prospective multicenter trial involving up to 40 sites will randomize pts to Portico vs another TAVR valve in the US. 

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): S Taghavi, SN Jayarajan, E Komaroff, AA Mangi

The influence of continuous flow LVAD devices on heart transplant was examined using UNOS data, comparing outcomes of cfLVAD to pulsatile flow LVAD (pfLVAD) and no LVAD pts.   cfLVAD pts spent longer time on the waitlist and were status IA for longer than either of the other groups.  Waitlist survival was better for the cfLVAD pts.  Post-transplant survival was similar among the 3 groups. 

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): H Gutermann, M Pettinari, C Van Kerrebroek, M Vander Laenen, K Engelen, T Fret, RA Dion

The authors present results of surgery in 12 pts for hypertrophic cardiomyopathy extending to the papillary muscles.  Repair was performed through a detached anterior mitral leaflet, which was subsequently repaired.  The intraventricular end-diastolic gradient was decreased by 80% postop, and mitral regurgitation that was present preop was eliminated.  One patient died, the others were in NYHA class I or II postop. 

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): A Della Corte and others for the International Bicuspid Aortic Valve Consotium (BAVCon) Investigators

This expert review identifies knowledge gaps with regards to valvulopathy and aortopathy associated with bicuspid valves and proposes strategies for improving knowledge.