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Journal and News Scan

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Thierry Bove, Kristof Vandekerckhove, Daniel Devos, Joseph Panzer, Katya De Groote, Hans De Wilde, Daniel De Wolf, Julie De Backer, Laurent Demulier, and Katrien François
According to a study on 22 patients after repair of tetralogy of Fallot, ejection fraction of the right ventricular sinus and the extent of akinesia of the right ventricular outflow tract predict exercise capacity better than global right ventricular function.
Source: European Journal of Cardio-Thoracic Surgery
Author(s): Hervé Dutau, Thomas Vandemoortele, Sophie Laroumagne, Carine Gomez, Véronique Boussaud, Arnaud Cavailles, Laurent Cellerin, Arlette Colchen, Tristan Degot, François Gonin, Christophe Hermant, Jacques Jougon, Romain Kessler, François Philit, Christophe Pison, Christel Saint Raymond, Delphine Wermert, Philippe Astoul, Pascal Thomas, Martine Reynaud-Gaubert, and Jean-Michel Vergnon
A new endoscopic standardized grading system for macroscopic central airway complications following lung transplantation is suggested by a group of French bronchoscopy experts. It considers macroscopic appearance, diameters and sutures of the bronchial anastomoses.
Source: Journal of the National Cancer Institute
Author(s): John P. Pierce, Ruth E. Patterson, Carolyn M. Senger, Shirley W. Flatt, Bette J. Caan, Loki Natarajan, Sarah J. Nechuta, Elizabeth M. Poole, Xiao-Ou Shu and Wendy Y. Chen
Using data from the 3 US cohorts in the After Breast Cancer Pooling Project (ABCPP) with information about duration and smoking exposure in 10000 breast cancer survivor, researchers analyzed the association between smoking and breast cancer survival. Exposition expressed in pack-year increase risks of recurrence and breast cancer mortality and all-cause mortality.
Source: Journal of cardiothoracic and vascular anesthesia
Author(s): Dixon, B.
In this single centre retrospective review, the authors in a multivariable analysis determined the surgeon was a predictor of blood loss after cardiac surgery. Despite much research, bleeding and blood use remains an issue after cardiac surgery. Each surgeon should examine their own techniques to minimise bleeding risk. IMA use and CPB time were other factors that were significant.
Source: Journal of the American College of Cardiology
Author(s): Shishehbor MH, Venkatachalam S, Sun Z, Rajeswaran J, Kapadia SR, Bajzer C, Gornik HL, Gray BH, Bartholomew JR, Clair DG, Sabik JF 3rd, Blackstone EH.
Significant carotid artery disease is not uncommon in patients undergoing open heart surgery (OHS). Whether to treat both conditions in a staged or combined procedure remains an unresolved matter. In this retrospective study, the authors compared outcomes in three groups of patients according to treatment strategies: staged carotid endarterectomy (CEA) followed by OHS (CEA-OHS), combined CEA-OHS (i.e. concomitant CEA and OHS under a single anesthesia), and staged carotid stenting (CAS) followed by OHS (CAS-OHS) No significant difference in the primary composit endpoint(all-cause death, stroke, and myocardial infarction) was found between staged CAS-OHS and combined CEA-OHS in the short term. However, beyond 12 months, the staged CAS-OHS option appears to be a better choice. Staged CEA-OHS has the highest risk during both early and late phases. These findings were consistent regardless of multiple adjustments using propensity score and propensity matching.
Source: Lancet
Author(s): A Gponfiotti, MO Jaus, D Barale, S Baiguera, S Comin, F Lavorini, G Fontana, O Sibila, G Rombola, P Jungebluth, P Macchiarini

This 5-year follow-up of the first tissue engineered airway using decellularized human trachea demonstrated that the graft became well vascularized, had normal ciliary function and mucous clearance, and maintained a normal diameter. no anti-donor antibodies developed. The graft replaced the left main bronchus that was affected by tracheomalacia. The proximal anastomosis developed stenosis requiring stenting.

Source: MedPage Today
Author(s): Todd Neale

The FDA approved the CoreValve TAVI device for use in the US. The approval was originally expected to occur in April 2014, but the panel decided that an independent review of data from the clinical study of extreme-risk patients in the CoreValve US Pivotal Trial was not needed at this time.

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): A Dardashti, P Ederoth, L Algotsson, B Bronden, H Bjursten

The authors studied over 5,700 pts undergoing CABG to assess the dynamics of changes in renal function and related such changes to mortality.  Perioperative renal dysfunction was associated with increased long-term mortality.  Recovery from renal dysfunction was associated with some improvement in long-term mortality risk.  Alternative methods of classifying renal dysfunction may be more useful than creatinine in assessing long-term risk.  

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): BE Lee, RJ Korst, E Kletsman, JR Rutledge

The authors compared outcomes for VATS lobectomy by experienced VATS surgeons to those for robotic lobectomies performed by the same surgeons who were learning robotic surgery.  69 pts were evenly divided between the approaches.  Other than longer time required for robotic upper lobectomy, there were no differences between the groups in OR time, LOS, nodal harvest, morbidity, or mortality. 

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): CE Mascio, EH Austin, JP Jacobs, ML Jacobs, AS Wallace, X He, SK Pasquali

The use of mechanical circulatory support (MCS) for pediatric patients undergoing heart surgery was analyzed.  Of over 96,000 operations, 2.4% were associated with MCS use.  MCS use was associated with younger patients, a greater number of preoperative risk factors, and certain operations (Norwood, complex biventricular repair).  Mortality associated with MCS was over 50%.  MCS rates differed substantially across participating institutions.

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