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Journal and News Scan
The accuracy of the diagnosis in patients undergoing congenital heart surgery in a large administrative database was examined in over 14,000 patients aged 0 to 5. Patients admitted on day 1 of life and those undergoing ECMO had a much higher chance of being assigned non-cardiac diagnoses. Pts so misclassified had a substantially higher risk of mortality. This systematic misclassification may lead to inaccurate determination of case volumes and outcomes.
Because the optimal management of CAD is unclear for many patients, the authors developed a decision support model for CABG and PCI with bare metal or drug eluting stents. Overall survival rates were similar for the different interventions. For PCI with drug eluting stents, optimal outcomes were observed for pts undergoing emergency revascularization for acute MI. Optimal outcomes for CABG were observed in pts with multivessel disease and with many comorbidities.
The authors report outcomes for recipients of heart transplants performed more than 20 years prior. Overall 20 year survival was 56%. Causes of mortality were similarly distributed among rejection, malignancy, infection, and allograft vasculopathy. Only 2 patients underwent retransplantation.
The authors hypothesized that examination of more lymph nodes resulting from lung resection for NSCLC would result in fewer missed nodal metastases and be associated with better survival related to more accurate staging. Based on nearly 25,000 pts from SEER, they found the median number of nodes examined was only 6. Pts who had 18-21 nodes examined had a hazard ratio for mortality of 0.65.
February 5, 2014
Submitted by: Ruben Osnabrugge
In this article, the authors investigated the impact of the timing neonatal arterial switch operation on morbidity, mortality and costs. They included 140 patients with transposition of the great arteries and found a mortality and morbidity rate of 2% and 20%, as well as median hospital costs of $60,000. Their multivariable model showed that for every day beyond day 3 that the arterial switch was delayed, the risk of major morbidity increased with 47% and costs by 8%.
The worst case of heartburn ever: Norwegian doctors accidentally set fire to patient undergoing cardiac surgery Victim wakes up during the operation after suffering third-degree burns Surgeons ignited alcoholic disinfectant while using an electrical scalpel
ISLAMABAD: Pakistan's former military ruler Pervez Musharraf wants to travel abroad for heart surgery requiring special equipment not available at home, legal sources said Friday quoting from a new medical report. Musharraf faces treason charges dating back to his 1999-2008 rule. But has not shown up for any hearings of a special tribunal due to security fears and lately a heart complaint. The 70-year-old former army chief has been in a military hospital since falling ill while travelling to the tribunal on January 2. An earlier diagnosis from the Armed Forces Institute of Cardiology, where Musharraf is being treated, said he was suffering coronary artery disease and his lawyers have suggested he should be treated abroad. The full report was not released but a legal source who has read it shared some of its contents with reporters. The source said that in the report, Musharraf said he needed "special equipment for his heart surgery which is only available abroad".
This is a video from the EACTS/STS AORTIC SESSION Martin Czerny, Joseph Coselli, Bill Brinkman, and Martin Grabenwöger discuss the differences and common issues between the US and Europe in current practice in aortic surgery.
The most common type of mesothelioma is malignant pleural mesothelioma, a nearly invariably lethal tumour of the pleura. Very seldom diagnosed prior to the advent of widespread asbestos mining in the early to mid twentieth century, this disease has sharply risen in incidence over the last five decades (1). The worldwide consumption of asbestos has peaked in the 1980s consequent to the call for an asbestos ban in several developed countries. However, in recent years the use of this carcinogenic mineral and its products seems to get an unprecedented popularity in Eastern Europe, Asia and South America (2). The tragic consequences of increased asbestos use in these parts of the world are that many more mesothelioma cases will be diagnosed in the future and that a major carcinogenic legacy is left behind for next generations. Asbestos has also been characterized as a time-bomb due to the long latency between first asbestos exposure and occurrence of disease (3). The purpose of these guidelines is clear. They are providing a set of concise evidence-based recommendations for the diagnosis, treatment and care of patients with malignant pleural mesothelioma. Although they were written to be used in an Australian context they will lend themselves also to be translated in health care settings outside of Australia. The team who voluntarily invested a significant amount of time in this project considered it a privilege to focus on better diagnostics, better treatment and care for those unfortunate victims of a hideous man-made disease called malignant pleural mesothelioma.
January 23, 2014
The authors report on patients with a small aortic annulus who underwent aortic root replacement using self-assembled valve composite grafts with prosthesis larger than aortic annulus. This technique resulted in excellent haemodynamic and good neo-root durability at long-term follow-up.