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Journal and News Scan
A brief note on the feasibility (or not) of RCT on surgery for mitral fibroelastic prolapse.
Decaluwé and colleagues prospectively tested the capacity of preoperative staging by video-assisted mediastinoscopy (VAM) or VAM-lymphadenectomy (VAM-LA) to detect hidden mediastinal lymph node involvement in patients with non-small cell lung cancer (NSCLC). Of 105 patients with clinical N1 disease based on PET-CT imaging, one quarter eventually developed N2 disease. Patients underwent either VAM or VAM-LA, which were able to detect mediastinal node involvement with a sensitivity of 73% and accuracy of 93%. The authors suggest that VAM or VAM-LA could be a good staging approach for this group of patients.
In a prospective cross-sectional analysis of 37 adult patients palliated with a Fontan procedure, Buendía-Fuentes and colleagues assessed liver disease by three techniques: hepatic magnetic resonance imaging (MRI), acoustic radiation force impulse (ARFI) imaging, and hepatic ultrasound. They authors compared the prevalence of disease and the diagnostic conclusion between different techniques. They also evaluated the association between the diagnosis from noninvasive imaging and clinical variables such as liver disease biomarkers. Signs of liver disease were observed in most patients by both hepatic MRI and ARFI elastography, but not by ultrasound imaging. Increased liver stiffness did not identify specific disease patterns from MRI, supporting the need for multimodality imaging to characterize liver disease in Fontan patients.
A playful chocolate Labrador retriever puppy named Shamus is one lucky dog after having thoracic surgery to cure a fatal abnormality of blood vessels in his heart.
Not only did veterinarians at Hyannis Animal Hospital perform the surgery that saved the pup for free, veterinarian Kevin Smith studied up on the surgical procedure for two weeks and even enlisted the operating room assistance of a Cape Cod Hospital heart surgeon.
A CABG operation performed at the Uganda Heart Institute at Mulago National Referral Hospital was done by an all-Ugandan surgical team for the first time.
Software will help analyze emergency calls in Copenhagen, informing dispatchers when it detects nonverbal sounds that indicate cardiac arrest.
Drugs and Devices
Boston Scientific has entered into an acquisition option agreement with Millipede, Inc, a company that has developed a transcatheter mitral valve annuloplasty system.
The US Food and Drug Administration issued warning letters to 11 companies for illegal claims of their products’ abilities to treat opioid addiction and withdrawal. The letters were issued jointly with the Federal Trade Commission.
Research, Trials, and Funding
Data from the PARTNER II S3 trial showed no differences in survival or stroke between women and men undergoing TAVR, which the authors attribute partially to new-generation valves with more sizes and to better sizing techniques.
Taiwan’s Ministry of Health and Welfare says that the second stage of its Lung Cancer in Nonsmokers study shows that Taiwanese nonsmokers have twice the risk of lung cancer that heavy smokers in Europe and North American do.
A clear message (although no causation is proven) regarding an important patient-centered research question, going bravely against the tide.
Schneider and colleagues have narrated a video demonstrating their technique for valve-sparing root replacement in a patient with Marfan syndrome. In the accompanying article, the authors report the outcomes of 61 patients with Marfan syndrome who underwent either aortic valve reimplantation or root remodeling at their institution.
A large follow-up study comparing repair and replacement results and trends. Of particular interest to the UK and European readership is the page 113 discussion on the center of mitral excellence principle.
A well executed study on an important problem in cardiac surgery that merits careful reading, as no one-sentence conclusion can be adequately gleaned.
Miller and colleagues retrospectively compared anastomotic integrity with pleural amylase levels (PAL), measured daily from postoperative day 3-10 after an Ivor Lewis esophagectomy. Three of 45 patients had an anastomotic leak, each of which coincided with a large increase in their PAL. The authors conclude that measuring PALs is an accurate, safe, and inexpensive way to detect esophageal anastomotic leaks.