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Journal and News Scan
Primary focal hyperhidrosis (PFH) may lead to psychosocial deficits. One of the minimally invasive treatment methods is endoscopic thoracic sympathectomy, an effective therapeutic option that the authors hypothesized might lead to decreased psychotropic medications usage. Li and colleagues looked at psychiatric symptomatology and medication usage in 106 patients with PFH, comparing this with 213 patients without PFH. Additionally, they evaluated medication usage, anxiety, and depression before and after surgical intervention in PFH patients, finding improvements following endoscopic thoracic sympathectomy.
Soquet and colleagues reviewed records from 289 pediatric patients who underwent 376 cavopulmonary connection (CPC) procedures to determine the incidence and associated complications of chylothorax following these procedures. The authors found that the incidence of postoperative chylothorax was high in these patients (19.7%), and they confirmed that chylothorax was indicative of a worse postoperative course. The presence of a systemic right ventricle was a risk factor for chylothorax (odds ratio 2.49).
Conzelmann and colleagues aimed to gain information about outcomes of transcatheter aortic valve replacement (TAVR) procedures in patients with coronary heights less than 7 mm. These procedures are not common, as one of the contraindications for TAVR is a low coronary height. Among more than 3,000 TAVR patients from the Karlsruhe registry, 86 had an average coronary height of 6.4 mm. Within 30 days, there were four cardiac deaths, three noncardiac deaths, and three coronary obstructions in this patient group. The authors concluded that coronary-related complications in TAVR with coronary heights less than 7 mm occurred infrequently, however they were serious when they occurred.
Patient Care and General Interest
An accident during a sword swallowing trick was bad news for the performer’s esophagus.
An imaging case study from Medscape walks through the echocardiography of a patient with rheumatic disease involving all four valves.
Disagreement between four different hospital ranking systems regarding cardiac surgery quality in the USA could cause confusion for patients trying to understand this publicly available data.
Research, Trials, and Funding
Researchers in the UK find unexpectedly high levels of cancer-associated mutations in normal esophageal tissue.
Researchers from Washington, DC, in the USA presented the prototype of their miniature pacemaker at the recent American Heart Association’s Annual Meeting, a device that they hope allows for less invasive placement of pacemaker leads on infants’ hearts.
An interesting randomized controlled trial asserting robustly that endoscopic harvesting of saphenous vein is: (1) better for leg dehiscence and (2) at least noninferior for MACE compared to the conventional open "full touch" method. Somewhat puzzling are the high mortalities and revascularization rates in both arms, across a median follow up less than three years. The requisite hour or more to harvest the vein(s) openly also seems a bit long for experienced operators, even if we include closure of the incision.
In this randomized controlled trial, Padmanabhan and colleagues focused on the ability of iron given intravenously to increase hemoglobin levels before elective cardiac surgery, comparing this with iron given orally. The study included 50 anemic patients who were scheduled for cardiac surgery. Ferritin levels increased significantly in patients with intravenous iron administration. Iron administration did not influence hemoglobin level, regardless of the method of administration.
Thornblade and colleagues endeavored to develop and validate a model that would predict the 2-year risk of recurrence in patients with completely resected node-negative non-small cell lung cancer (NSCLC). Improved recurrence prediction could direct selective use of adjuvant therapy and surveillance imaging in these patients. The authors’ models performed similar to chance, despite using clinical risk factors for recurrence and biomarkers associated with poor survival. They discuss potential reasons for the difficulty in predicting recurrence in this patient group.
In this paper, Dr Svensson covers his technique of leaflet repair during aortic root reimplantation. The core technical points are described as well as the long-term clinical outcomes. The author's experience has shown that for patients having leaflet repair, bracing the root with a reimplantation operation appears to reduce the risk of late regurgitation and reoperation.
A multidisciplinary team led by Bob Kiaii at the London Health Sciences Centre in Ontario, Canada, has reportedly completed the world's first robotic performance of a specific aortic valve replacement procedure in a patient with aortic stenosis.
The charity Tiny Tickers is launching a campaign with the goal of ensuring that all maternity wards across the United Kingdom have access to machines for detecting heart defects in newborns.
A woman with cystic fibrosis living in Holbrook, Massachusetts, USA, recently completed her first 5K race after receiving a double-lung transplant.
After reports of several patient injuries, the U.S. Food and Drug Administration has announced a Class I recall for a batch of warfarin test strips used with point-of-care or in-home devices to adjust warfarin dosing.
Research published in The Journal of Nuclear Medicine suggests that a new nuclear medicine tracer could improve the diagnosis and treatment of non-small cell lung cancer.
Interesting small randomized controlled trial that will definitely be widely discussed.