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Journal and News Scan

Source: The Annals of Thoracic Surgery
Author(s): Amalia Jonsson, Jose Binongo, Parth Patel, Yanan Wang, Vanessa Garner, Delki Mitchell-Cooks, Michael E. Halkos

In this single-center expert series of 1000 robotic-assisted left internal mammary artery harvest and off-pump anastomosis to the left anterior descending coronary artery through a 4 cm thoracotomy, 30 day mortality was 0.6 percent, stroke occurred in 5 patients (5 percent), and postoperative graft patency was 97.2 percent (491 of 505). The authors report that between 250 and 500 cases were required to acquire “mastery.”

Source: Endovascular Today
Author(s): Endovascular Today Authors

On April 21, Dr. Randy Moore at the University of Calgary in Canada performed the first implantation of Terumo's new hybrid graft, Thoracoflo, in North America for thoracoabdominal aortic aneurysm repair. Thoracoflo consists of a proximal stent graft for transabdominal retrograde delivery to the descending aorta and a distal six-branched abdominal device for open aortic repair.

Source: Stanford Scope Blog
Author(s): Erin Digitale

A researcher at Stanford has developed a method to visually identify the cardiac conduction system during surgery in order to avoid harm during cardiac surgery. To do this, antibodies are bound to surface markers on cardiac conduction cells and can be seen with infrared light. This is especially helpful for patients with congenital heart defects, as the anatomical landmarks that surgeons normally follow to avoid the cardiac conduction system may be different. The team hopes to launch a clinical trial in humans in a few years.

Source: TCTMD
Author(s): Shelley Wood

ROMA-Women is an offshoot of the original ROMA CABG trial designed to address the lack of women in surgical studies, and therefore the lack of guideline-directed surgical care for women patients. Women make up less than one third of participants in cardiac trials, yet they make up roughly half of annual cardiac deaths in the US annually. Researchers aim to alter this trend by creating a connected but separate trial for women to determine whether multiarterial grafts are better than single arterial grafts in CABG. 

Source: European Journal of Cardiothoracic Surgery
Author(s): Antonio Loforte, Gaik Nersesian, Daniel Lewin, Pia Lanmueller, Gregorio Gliozzi, Julia Stein, Giulio Giovanni Cavalli, Felix Schoenrath, Ivan Netuka, Daniel Zimpfer, Theo M M H de By, Jan Gummert, Volkmar Falk, Bart Meyns, Gloria Faerber, Davide Pacini, Evgenij Potapov

Mitral regurgitation (MR) is often seen in patients having a left ventricular assist device (LVAD) implanted. A comparison was done between LVAD patients from the EUROMACS registry with either none-to-mild or moderate-to-severe MR prior to implantation. Moderate-to-severe MR pre-LVAD was associated with better midterm survival and a lower incidence of major adverse events and complications.

Source: Journal of Clinical Oncology
Author(s): Peter G. Mikhael, Jeremy Wohlwend, Adam Yala, Ludvig Karstens, Justin Xiang, Angelo K. Takigami, Patrick P. Bourgouin, PuiYee Chan, Sofiane Mrah, Wael Amayri, Yu-Hsiang Juan, Cheng-Ta Yang, Yung-Liang Wan, Gigin Lin, Lecia V. Sequist, Florian J. Fintelmann, and Regina Barzilay

This study used lung cancer screening trial low dose CT scans to develop a model (Sybil) that predicts the likelihood of development of a lung cancer within the next year. The model was then tested using images from independent data sets totaling more than 27,000 patients. Areas under the receiver-operator curves were in the range of 0.85 to 0.95, indicating very good predictive value. The model may help individualize subsequent screening frequency or the need for diagnostic CT.

Source: Cardiovascular Business
Author(s): Michael Walter

Models created using artificial intelligence can now be used to help identify patients who may need a permanent pacemaker after transcatheter valve surgery. This relatively common complication of TAVR can now be more easily and accurately determined by the AI model, which uses characteristics like age, presence of right bundle branch block, and other factors associated with PPM implantation. Read the original study in the World Journal of Cardiology.

Source: European Heart Journal
Author(s): Jinlin Wu, Mohammad A Zafar, Yiwei Liu, Julia Fayanne Chen, Yupeng Li, Bulat A Ziganshin, Hesham Ellauzi, Sandip K Mukherjee, John A Rizzo, John A Elefteriades

By analyzing a cohort of patients with aortic aneurysms who were not undergoing surgery, this study aimed to determine the natural course of an aortic aneurysm. The patients’ ascending aortic aneurysms grew very slowly, and growth over 0.2 cm per year was rarely seen. The researchers concluded that aortic growth may not be a proper indicator for intervention, and that the criterial size for intervention should be changed from 5.5 cm to 5 cm.

Source: The Annals of Thoracic Surgery
Author(s): Alicia Bonanno, MD, Meredith Dixon, MPH, Jose Binongo, PhD, Seth D. Force, MD, Manu S. Sancheti, MD, Allan Pickens, MD, David A. Kooby, MD, Charles A. Staley, MD, Maria C. Russell, MD, Kenneth Cardona, MD, Mihir M. Shah, MD, Theresa W. Gillespie, PhD, MA, Felix Fernandez, MD, MSc, and Onkar Khullar, MD, MSc

This study aimed to measure the quality of life (QOL) as reported by patients after esophagectomy, a procedure which has a high rate of mortality. Researchers found that the one hundred and three patients in the study had declining QOL immediately following the procedure, which slowly rose back to baseline QOL in a one hundred day period, affirming important information for future esophagectomy patients.

Source: European Journal of Cardiothoracic Surgery
Author(s): Thomas Galetin, Christoph Eckermann, Jerome M Defosse, Olger Kraja, Alberto Lopez-Pastorini, Julika Merres, Aris Koryllos, Erich Stoelben

This single center, open RCT compared patients’ satisfaction with local (LA) or general anesthesia (GA) for video-assisted thoracoscopy. Fifty patients were allocated to GA and 57 to LA. Patient satisfaction did not differ significantly for anesthesiology care, general perioperative care, or recovery after surgery. Surgeons and anesthesiologists were both less satisfied with feasibility in the LA group. LA patients had significantly shorter hospital stays, averaging 3.9 vs. 6.0 days, with P < 0.01. The authors conclude that patients should be offered LA as an alternative to GA whenever medically appropriate and feasible.