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Journal and News Scan

Source: Journal of Visualized Surgery
Author(s): Edited by Marcello Migliore, Alan Sihoe, and Diego Gonzalez-Rivas

Uniportal VATS and uniportal lobectomy have been developed over the last few years as valuable tools in modern thoracic surgery. This special issue of JOVS, with the aid of multimedia materials,  gives insights regarding the procedures performed with a uniportal technique.  The articles are also useful in order to understand the history, the difinitions, and the future possible applications of this revolutionary step for general thoracic surgery.

Source: Annals of Cardiothoracic Surgery
Author(s): Matthias Thielmann, Konstantinos Tsagakis, Mohamad El Gabry, Heinz Jakob, Daniel Wendt

Severe aortic regurgitation without calcification of the aortic annulus cannot be treated with transcatheter implantation of a balloon-expandable valve, however, self-expandable valves can be successfully anchored in the absence of annulus calcification. In this narrated video, Thielmann and colleagues present a case of transapical transcatheter aortic valve implantation in a 75-year-old man with pure aortic regurgitation grade II/III.

Source: News from around the web.
Author(s): Claire Vernon

Patient Care

Ambulances specially tailored to respond to cardiac emergencies will go into service in Goa, India, at the beginning of 2018.

The cardiac team at the University of the Free State in Bloemfontein, South Africa, has launched a research project focused on improving treatment of idiopathic dilating cardiomyopathy.

Getting into the Halloween spirit and showing off their gourd-slicing skills, surgeons competitively carved pumpkins in Phoenix, Arizona.


Drugs and Devices

Doctors at the General Hospital of Mexico in Mexico City have safely reused sterilized donated pacemakers for 33 patients who could not afford a new device.

The US Food and Drug Administration will now recognize good manufacturing practice inspections done by eight European Union drug regulators, the most recent move to strengthen regulatory collaboration between the US and EU.

Trastuzumab did not worsen cardiac function when added to chemotherapy for HER2-positive breast cancer.


Research, Trials, and Funding

Pediatric cardiac surgery patients receiving intermittent postsurgical dosing of morphine and midazolam show similar pain relief and shorter length of stay when compared to patients receiving continuous analgesics.

Neuromuscular blockade might not always be necessary during cardiac surgery, and researchers at the University of Chicago are seeking to determine if avoiding it reduces postsurgical pulmonary complications.

Ventricular assist devices might provide better survival than extracorporeal membrane oxygenation for children awaiting heart transplantation.

A randomized trial published in The Lancet finds that 230 patients with stable angina had similar symptom relief whether they received a percutaneous coronary intervention or a placebo procedure.

Source: The Annals of Thoracic Surgery
Author(s): Vasileios Kamperidis, Suzanne E. van Wijngaarden, Philippe J. van Rosendael, William KF Kong, Melissa Leung, Georgios Sianos, Nina Ajmone Marsan, Victoria Delgado, Jeroen J. Bax

Kamperidis and colleagues report that left ventricular (LV) functional recovery after mitral valve (MV) repair for severe secondary mitral regurgitation is associated with improved patient outcomes. Their retrospective analysis of 130 patient records found increased LV forward ejection fraction and LV forward stroke volume after MV annuloplasty, despite no observed change in LV ejection fraction. The authors found that LV forward stroke volume after repair independently associated with overall survival and survival without major adverse cardiac-related events by multivariable analysis.

Source: Annals of Thoracic Surgery
Author(s): Bryan M. Burt, Hyun-Sung Lee, Veronica Lenge De Rosen, Masatsugu Hamaji, Shawn S. Groth, Thomas M. Wheeler, David J. Sugarbaker

In this single institution study, the prognostic role of soluble mesothelin-related peptides (SMRP) was evaluated in patients with pleural mesothelioma.  Preoperative levels of SMRP were related to tumor volume and disease-free survival.  Percent change in postoperative SMRP was predictive of tumor recurrence. 

Source: The Annals of Thoracic Surgery
Author(s): Christopher W. Seder, Andrew T. Arndt, Lia Jordano, Sanjib Basu, Cristina L. Fhied, Selina Sayidine, Gary W. Chmielewski, Kelsey Gallo, Michael J. Liptay, Jeffrey A. Borgia

In this single institution study, the authors screened biorepository materials obtained from patients undergoing resection for early stage cancer.  They wished to identify serum markers related to early recurrence.   A 7-component panel was developed that had a negative predictive value of 83% and an accuracy of  78%.  The accuracy was 70%.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Han-Yu Deng, Zhi-Qiang Wang, Yun-Cang Wang, Gang Li, Jun Luo, Long-Qi Chen, Lun-Xu Liu, Qing-Hua Zhou, Yi-Dan Lin

Deng and colleagues analyzed the pattern of lymph node metastasis in a retrospective study including approximately 1200 patients with esophageal cancer. Patients with adenocarcinoma had a larger mean number of positive lymph nodes and a higher rate of lymph node metastasis than those with squamous cell carcinoma.

Source: Journal of Cardiothoracic Surgery
Author(s): Vipin Zamvar

A detailed review of the pericardial sinuses on the occasion of discovery of  a unilateral pericardial fold caudal to Marshall's ligament. The significance of the structure is discussed as an operating surgical note to ipsilateral pericardial traction/ elevation in beating heart surgery. It will be also relevant to procurement of intrathoracic organs for transplantation and cardiac surgery for structural disease and dysrhythmias.

Source: News from around the web.
Author(s): Claire Vernon

Patient Care

Emergency responders in Argentina use the WhatsApp messaging app to send ECG data to the hospital ahead of a patient’s arrival, and save about 50 minutes by skipping the emergency room on the way to the catheterization lab.

Next year, 150 rheumatic heart disease patients in Cape Town, South Africa, will receive a locally designed, inexpensive transcatheter heart valve as part of a clinical trial.

A cardiac contractility modulation device was implanted to treat heart failure for the first time in the Caribbean at Health City Cayman Islands in Grand Cayman.

A collaboration for training in minimally invasive thoracic surgery is one of many initiatives in a partnership between Addis Ababa University in Ethiopia and the University of Toronto in Canada, which has the goal of transforming health care in Ethiopia.


Drugs and Devices

The first patient has received the Intrepid™ transcatheter mitral valve from Medtronic as part of the APOLLO trial on transcatheter therapy for mitral valve regurgitation.

Artificial intelligence is at an interesting frontier, but how does an always-changing self-improving algorithm get regulatory approval?

Carmat announced that it has performed an artificial heart transplant in Kazakhstan, its first device implantation outside of France.

The US Food and Drug Administration has cleared the Confirm Rx™ Insertable Cardiac Monitor from Abbott, a device that monitors a patient’s heart rhythm and sends the information to their smartphone and their doctor.


Research, Trials, and Funding

A study published in the Lancet suggests that the heart might not be a morning person, at least in regards to surgery.

Researchers from Tel Aviv, Israel, found that both transcatheter and surgical aortic valve replacement were associated with better outcomes than conservative treatment for patients with normal flow-low gradient aortic stenosis.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Ahmet Kilic, Juan A. Crestanello

A measured succinct reflection on MagLev and older ventricular assist devices, on the occasion of a relevant 'expert opinion' paper on the topic.