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Journal and News Scan
July 15, 2015
Submitted by: Arie Blitz
The University of Pennsylvania group, in a porcine model of ischemic mitral regurgitation (IMR), compared echocardiographic surface coaptation in two groups of pigs: Those undergoing MV repair with a flat semirigid annuloplasty ring vs. with a saddle-shaped rigid annuloplasty ring. The group found that the latter ring led to significantly improved leaflet coaptation compared to the former.
July 14, 2015
Submitted by: Mark Ferguson
This important consensus statement on definitions of postoperative complications after esophagectomy was developed by an international group of surgical experts. It should serve as a template for data collection and reporting for clinical reports and trials.
July 14, 2015
Submitted by: Mark Ferguson
This small randomized trial evaluated the potential benefits of ghrelin, an anti-inflammatory agent, in reducing the SIRS response after esophagectomy. The ghrelin group had a reduced SIRS duration, lower CRP levels, and lower IL-6 levels compared to controls. Pulmonary complications were reduced in the ghrelin group, but other complication incidences were similar.
July 14, 2015
Submitted by: Mark Ferguson
This meta-analysis evaluated results from 6 studies totalling 868 patients randomized to local control (radiotherapy vs surgery) after induction therapy for NSCLC with N2 disease. Four studies evaluated induction chemotherapy, the other 2 evaluated induction chemoradiotherapy. Differences in outcomes were not significant, but there was a strong trend favoring surgery as part of multimodality therapy for NSCLC with N2 disease.
July 9, 2015
Submitted by: CTSNet Staff
The authors report on aortic arch surgery after previous type A dissection repair in 55 patients. The results with 5% perioperative deaths and 7% permanent stroke are satisfactory in this challenging patient’s group.
July 9, 2015
Submitted by: CTSNet Staff
The 600 Finnish patients who were analyzed, underwent repair of tetralogy of Fallot at the age of <15 years between 1962 and 2007. The long-term prognosis improved considerably over time. The data indicate an increased risk of death in patients who had undergone a primary palliative procedure. Further, the need of a transannular patch was associated with a higher risk of reoperation, but had no impact on late survival.
July 9, 2015
Submitted by: CTSNet Staff
A two-center prospective study on 229 patients with pulmonary lobectomy for lung cancer was conducted. Large postoperative pleural effusion (>400 ml/day) could be predicted by an aggregate score which includes age >70 years, lower lobectomy and presence of COPD.
July 9, 2015
Submitted by: CTSNet Staff
Approximately 5400 patients who underwent lobectomy for non-small-cell lung cancer were analyzed. Post-discharge mortality (PDM) within 90 days came up to 1.9%. Patient-dependent risk factors were identified by multivariate logistic and Cox regression analyses. The authors consider PDM an under-reported phenomenon and suggest measures to improve it.
July 9, 2015
Submitted by: Arie Blitz
Twenty-five cardiac surgery trainees underwent randomization to learn TEE interpretation by either of two approaches: traditional teaching during cardiac surgery vs. simulation-based teaching via the Heartworks simulator. Pre- and post-testing revealed comparable improvements in both groups, but with a trend towards better learning in the simulation group.
July 6, 2015
Submitted by: Arie Blitz
This is a provocative study questioning the current practice of using blood pressure targets perioperatively to ensure adequate perfusion. Plasma levels of a brain-specific injury biomarker (GFAP) were measured in 121 patients undergoing cardiac surgery. The cerebral oximetry index, which correlates changes in mean arterial pressure (MAP) and regional cerebral oxygen saturation, was used to define individualized optimal MAPs. A comparison was made correlating the degree of cerebral injury as measured by GFAP levels and either conventional MAP targets or oximetry-based targets defining hypotension. The incidence of hypotension varied from 22-37% by conventional definitions, but the incidence was much higher at 54% when using the cerebral oximetry index. Whereas oximetry-derived hypotension correlated with GFAP levels on POD 1, conventional hypotension did not.