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Journal and News Scan
December 2, 2014
Submitted by: Mark Ferguson
This is an interesting historical vignette describing the discovery of transfer factor (TLCO, DLCO) and its subsequent importance in pulmonary physiology and cardiorthoracic risk assessment.
December 1, 2014
Submitted by: Joseph Basha
This is an excellent article on the feasibility of offering Veno Arterial ECMO in outlying community hospitals for Refractory Cardiogenic Shock (RCS). The Authors review a four year time period and describe assessing 104 patients of whom 87 were deemed eligible for V-A ECMO therapy. The authors conclude that providing V-A ECMO therapy in a community hospital environment for RCS is both feasible and resulted in an impressive mortality reduction of 30%. The Authors present points regarding the need for a constantly available dedicated staff, strong logistical support, and dedicated ICU beds. In addition, the authors discuss the probability of increased costs and resource utilization.
November 30, 2014
Submitted by: Joel Dunning
This is a stunning video of a myectomy and mitral anterior leaflet repair. It really shows the abilities of the robot very well indeed. Well done
November 30, 2014
Submitted by: Marcelo Jimenez
A reexamination of data from the National Lung Screening Trial (NLST) with nodules above the 4mm, has been shown that increasing the nodule size threshold for a positive screen, substantially reduces the false-positive CT screenings rate and increase slightly the lung cancer missed or delayed but without affecting the survival.
November 29, 2014
Submitted by: Tom C. Nguyen
Randomized multicenter trial comparing losartan versus atenolol in young patients with Marfan's syndrome with no significant difference in aortic root dilation between groups.
November 29, 2014
Submitted by: Tom C. Nguyen
141,905 isolated primary surgical aortic valve replacements (SAVR) were stratified by STS risk of mortality. SAVR outcomes were superior to those by the predicted risk models.
November 28, 2014
Submitted by: Mark Ferguson
Shanker Vedantam interviews Jason Hockenberry, an economist at Emory University, regarding recent research into patient behavior following PCI or CABG. CABG patients were more likely to quit smoking after intervention for CAD. This may be a result of the magnitude of the intervention, and has implications for improving smoking cessation programs.
November 27, 2014
Submitted by: Arie Blitz
Abrams and colleagues provide a comprehensive review of the topic of recirculation during VV ECMO. Specifically, the authors discuss the factors contributing to recirculation, how to calculate the extent of recirculation, and what interventions can be applied to correct the issue. Recirculation can be a significant challenge during VV ECMO, particularly in patients that have worse underlying pulmonary function. For ECMO programs, this article is a "must-have" to distribute to fellows, residents, and other health care providers managing these patients.
November 26, 2014
Submitted by: Arie Blitz
Goldberg and colleagues provide an excellent review on a complex topic: intramural hematomas. The article has several take-home messages: one must be very careful in how one defines IMH; its pathogenesis remains unclear; IMH tends to involve a more outer location of the aortic media than aortic dissections (AD) do; IMH is more likely to rupture externally than AD; risk factors for progression from IMH to AD include aortic diameter and aortic wall thickness; the liberal use of stent grafting for type B IMH is probably unwarranted. It remains to be proven whether IMH should be treated any differently from AD. Until then, except under unusual circumstances, the same treatment approach is likely warranted.
November 25, 2014
Submitted by: Joel Dunning
Simply fabulous !!
Well done Shanda Blackmon. We are all proud to be Cardiothoracic surgeon too !