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Journal and News Scan

Source: The Society of Thoracic Surgeons
Author(s): The Society of Thoracic Surgeons

The Society of Thoracic Surgeons published its newly developed short-term risk calculator of operative and thirty day risk specific to isolated mitral valve repair for primary mitral regurgitation and degenerative mitral etiology.

The calculation is based on more than preoperative variables. It takes into account age, height, weight, sex, race, Hispanic, smoker, diabetes, chronic lung disease, beta blocker, adenosine diphosphate receptor inhibitor (within 5 days), steroids, hypertension, home oxygen, cerebrovascular disease, dialysis, liver disease, IV drug abuse, alcohol (>1 drink/week), immunosuppression, hematocrit, WBC count, platelet count, creatinine (mg/dl), ejection fraction (%), cardiac reoperation, chronic heart failure, surgical priority, preoperative atrial fibrillation, tricuspid insufficiency, and predominant mitral lesion.

 

Source: European Journal of Cardiothoracic Surgery
Author(s): Alaaddin Yilmaz, Silke Van Genechten, Jade Claessens, Loren Packlé, Jos Maessen, Abdullah Kaya

A retrospective analysis of early experience with a new approach to totally endoscopic aortic valve replacement in 266 patients showed satisfactory results, with acceptable morbidity and low mortality rates.

Source: The Annals of Thoracic Surgery
Author(s): Amit Katz, MD, Yehonatan Nevo, MD, Jose Luis Ramírez García Luna, MD, PhD, Sonia Anchouche, DEC, James Tankel, MD, Natasha Caminsky, MDCM, MSc, Carmen Mueller, MD, MEd, Jonathan Spicer, MD, PhD, Jonathan Cools-Lartigue, MD, PhD, Lorenzo Ferri, MD, PhD

To understand the shift toward nonsurgical management of esophageal cancer, researchers set out to determine the long-term quality of life (QOL) after esophagectomy. This study found that, in esophagectomy patients surviving more than three years, QOL did not differ significantly from the normative population reference values.

Source: Cardiovascular Business
Author(s): Dave Fornell

Since the recent increase of TAVR to treat aortic valve disease, multidisciplinary heart teams consisting of surgeons, cardiologists, and other allied professionals have become a necessary component in a successful surgery. Both surgeons and cardiologists who have worked on a TAVR case with a multidisciplinary heart team praise the ability to tailor each patient’s treatment to their unique situation. This article also outlines each component of a successful heart team.

Source: The Thoracic and Cardiovascular Surgeon
Author(s): Lars Conzelmann, Philipp Grotherr, Lu Dapeng , Alexander Würth, Julian Widder, Claudius Jacobshagen, Uwe Mehlhorn

The rate of serious complications in transcatheter aortic valve implantation (TAVI) has decreased markedly in recent years, going from 5.5 percent in 2012 to 2 percent in 2019. However, the total number of adverse events remains around 500, with about 100 requiring conversion to sternotomy, because of increased use of the procedure. The article reviews various complications and concludes that interdisciplinary TAVI heart team should be prepared and aware of possible rescue strategies.

Source: The Thoracic and Cardiovascular Surgeon
Author(s): Shekhar Saha, Anna Dudakova, Bernhard C. Danner, Ingo Kutschka, Marco H. Schulze, Heidi Niehaus

The rising incidence of infective endocarditis (IE) along with the de-escalation of antibiotic prophylaxis and the complexity of surgical treatment makes IE treatment a challenge. In this study, researchers reviewed all patients who underwent cardiac surgery for IE at one institution with a focus on causative organisms and infective foci. They concluded that current risk-benefit evaluations need to be revisited.

Source: The Annals of Thoracic Surgery
Author(s): Benjamin L. Shou, BS, Pathik Aravind, MBBS, Chin Siang Ong, MBBS, PhD, Diane Alejo, BA, Joseph K. Canner, MHS, Eric W. Etchill, MD, MPH, Joseph DiNatale, MS, Rochelle Prokupets, BS, Tina Esfandiary, BS, Jennifer S. Lawton, MD, Stefano Schena, MD, PhD

Since reexploration after cardiac surgery, most often for bleeding, is used as a metric to assess surgical performance, surgeons may delay returning to the operating room in favor of attempting nonoperative management. This single-institution retrospective review aimed to investigate the impact of the timing of reexploration on morbidity and mortality. The study concluded that implications from using reexploration as a performance metric may lead to unnecessary delay and patient harm.

Source: World Journal of Surgery
Author(s): Kian C. Banks, Jennifer R. Dusendang, Julie A. Schmittdiel, Diana S. Hsu, Simon K. Ashiku, Ashish R. Patel, Lori C. Sakoda, Jeffrey B. Velotta

Since time to surgery for lung cancer is not well established, researchers aimed to assess whether time to surgery from diagnosis correlates with outcomes like unplanned return to care, mortality, and disease recurrence. The study found that patients with time to surgery within four weeks experienced lower rates of recurrence, which may be shorter than previously reported.

Source: TCTMD
Author(s): Yael L. Maxwell

A new study comparing Society of Thoracic Surgeons data with that in the ISCHEMIA trial once again has surgeons calling for a reevluation of the most recent revascularization guidelines. CTSNet treasurer Joseph Sabik, who presented the findings from the STS database, does not believe that using the ISCHEMIA data to downgrade the recommendation for surgery was warranted. The debate continues as new data is continuously released.

Source: Healio
Author(s): Erik Swain, Richard Smith

A model of mortality risk for adults with congenital heart disease undergoing cardiac surgery was presented at the annual meeting of the Society of Thoracic Surgeons. The model was developed to gain insight on one of the fastest growing groups in need of cardiac surgery, as the risks of surgery on adults with congenital heart disease were not previously as well understood. The model had excellent performance in the trial group and will continue to be used for its predictive ability.

You can view the original study here.

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