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Journal and News Scan

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Alberto Rodríguez-Fuster, José Belda-Sanchis, Rafael Aguiló, Raul Embun, Sergio Mojal, Sergi Call, Laureano Molins, Juan José Rivas de Andrés, and on behalf of GECMP-CCR-SEPAR

A prospective multicentre study analysed 532 patients with a first surgical procedure for pulmonary metastases of colorectal carcinoma. Complications arose in 16%, reoperations were necessary in 1% and mortality was 0.4%. Major lung resection and respiratory and/or cardiovascular co-morbidity were identified as independent risk factors, whereas a video-assisted approach was protective.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Tristan D. Yan, Christopher Cao, Thomas A. D'Amico, Todd L. Demmy, Jianxing He, Henrik Hansen, Scott J. Swanson, William S. Walker, and on behalf of the International VATS Lobectomy Consensus Group

A consensus statement on video-assisted thoracoscopic lobectomy for patients with non-small-cell lung cancer has been issued by 50 international experts.

Source: International Journal of Cardiology
Author(s): R Dobson et al

Carcinoid heart disease is a major cause of morbidity and mortality in patients with metastatic neuroendocrine tumours (NETs). Although cases of carcinoid syndrome and severe carcinoid heart disease requiring urgent intervention are well described, many patients with significant carcinoid heart disease may have insidious symptoms or even be asymptomatic. As haemodynamically significant carcinoid heart disease may be clinically silent, specific and individualised considerations must be made as to the most appropriate clinical criteria and time point at which surgical valve replacement should be undertaken in patients with carcinoid heart disease.

Source: Thorax
Author(s): MR Salamonsen, F Bashirzadeh, AJ Ritchie, HE Ward, DIK Fielding
This 5-domain assessment tool was used to evaluate chest tube insertion performance by learners of various experience using mannequins and live patients. Inter-observer scoring consistency for a single performance was high, and test-retest scoring consistency was high. The instrument stratified scores appropriately by expected level of expertise. Scores were similar regardless of whether insertion was performed on a mannequin or a patient. The authors propose that this validated instrument can be used to assess competency in clinical training.
Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): ZW Fitch, O Debesa, R Ohkuma, D Duquaine, J Steppan, EB Schneider, GJR Whitman
This study summarizes 3 phases of clinical experience with a protocol for early extubation after CABG: standard practice, multidisciplinary protocol guidance, and multidisciplinary protocol guidance with expanded indications and bedside reminders. Early extubation (<6 hours) rates during the phases were 12%, 24%, and 38%. There were no differences in reintubation rates.
Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): J Puskas, M Gerdisch, D Nichols, R Quinn, C Anderson, B Rhenman, L Fermin, M McGrath, B Kong, C Hughes, G Sethi, M Wait, T Martin, A Graeve
The PROACT trial is evaluating the clinical utility and safety of less aggressive anticoagulation schemes after bileaflet AVR. This arm of the trial compared low dose (INR 1.5-2.0) to standard dose (INR 2.0-3.0)warfarin. At an average follow-up of nearly 4 years, the low dose group experienced significantly fewer bleeding complications but had similar rates of neurologic events and all-cause mortality.
Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): AS Bryant, RJ Cerfolio
This study surveyed outcomes of sympathotomy for hyperhidrosis more than 1 year postoperatively. 77% reported clinically bothersome compensatory sweating, although the incidence decreased over time to 35% at 5 years and thereafter. Predictors of bothersome compensatory sweating included multiple sites of sweating and R2/R3 sympathotomy (rather than R4/R5).
Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): K Bedeir, M Reardon, B Ramlawi
This comprehensive review discusses evolving strategies for managing infective endocarditis and the mechanisms for how the most common and life-threatening complications occur.
Source: MedPage Today
Author(s): C Phend

On March 20, 2014, a panel of the FDA gave unanimous approval for use of an ex-vivo perfusion system for improving the quality of explanted lungs prior to transplantation.  If this recommendation is followed by the FDA, such devices could be used clinically under IRB protocols.

Source: Journal of the American College of Cardiology
Author(s): Lindman BR, Pibarot P, Arnold SV, Suri RM, McAndrew TC, Maniar HS, Zajarias A, Kodali S, Kirtane AJ, Thourani VH, Tuzcu EM, Svensson LG, Waksman R, Smith CR, Leon MB
In this manuscript, the authors compare outcomes among patients from the PARTNER trial with diabetes who underwent surgical or transcatheter treatment. Among these patients with diabetes, 6-month and 1-year all cause mortality was lower in the transcatheter group compared with the surgical group. At 2 years this survival benefit was lost. Stroke rates were similar between surgical and transcatheter treated patients at 30 days and 1 year.