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Journal and News Scan

Source: The Annals of Thoracic Surgery
Author(s): Tom C. Nguyen MD, Vinod H. Thourani MD, Alexander P. Nissen MD, Robert H. Habib PhD, Joseph A. Dearani MD, Allan Ropski MS

This is the largest analysis of COVID-19 related impact on adult cardiac surgery volume, trends, and outcomes. During the pandemic, cardiac surgery volume suffered dramatically, particularly in the Mid-Atlantic and New England regions during the first COVID-19 surge, with a concurrent increase in observed-to-expected 30-day mortality.

Source: The New England Journal of Medicine
Author(s): Peter Verhamme, B. Alexander Yi,Annelise Segers, Janeen Salter, Daniel Bloomfield, Harry R. Büller, Gary E. Raskob, Jeffrey I. Weitz

Interesting multi-center RCT that paves the way for potential paradigm shifts in antithrombotic modulation. The abcence of symptomatic pulmonary embolism warrants further investigation...

Source: Interactive CardioVascular and Thoracic Surgery
Author(s): Marcus Taylor, Glen P Martin, Udo Abah, Matthew Sperrin, Matthew Smith, Dilraj Bhullar, Michael Shackcloth, Steve Woolley, Doug West, Rajesh Shah, Stuart W Grant
This study used data from 6600 lung resections performed in the UK between 2012 and 2018 to develop a prediction model for 90-day mortality after lung resection.
Source: European Journal of Cardio-Thoracic Surgery
Author(s): Konstantinos Tsagakis, Anja Osswald, Alexander Weymann, Aydin Demircioglu, Bastian Schmack, Daniel Wendt, Heinz Jakob, Arjang Ruhparwar
This study focused on FET proximalization used in combination with four-sites perfusion and results show that these techniques when performed together have the potential to improve patient outcomes in terms of survival and major events.
Source: JAMA Surgery
Author(s): H Yang, H Liu, Y Chen, et al

Although the standard of care in the West for regionally advanced esophageal cancer entails induction therapy, this is routinely not the case in China. This randomized trial involving over 450 randomized participants to induction therapy (vinorelbine, cisplatin, 40 Gy RT) followed by resection vs resection alone. At a median f/u of 53.5 mos, trimodality therapy demonstrated overall (HR 0.74; CI 0.57-0.97) and disease free (HR 0.60; CI 0.45 to 0.80) survival advantages compared to surgery alone. This study may establish a new standard of care for management of resectable regionally advanced esophageal cancer in China.

Source: Interactive Cardiovascular and Thoracic Surgery
Author(s): Marcus-André Deutsch, Armin Zittermann, André Renner, René Schramm, Julia Götte, Jochen Börgermann, Henrik Fox, Sebastian V Rojas, Takayuki Gyoten, Michiel Morshuis, Andreas Koster, Nikolai Hulde, Dennis Hinse, Kavous Hakim-Meibodi, Jan F Gummert
This study examined data that suggested off-pump coronary artery bypass (OPCAB) may carry a higher risk of mortality in the long term than on-pump coronary artery bypass (ONCAB).
Source: European Journal of Cardio-Thoracic Surgery
Author(s): Marine Gaudry, Alizée Porto, Carine Guivier-Curien, Arnaud Blanchard, Laurence Bal, Noemie Resseguier, Virgile Omnes, Mariangela De Masi, Meghann Ejargue, Alexis Jacquier, Vlad Gariboldi, Valérie Deplano, Philippe Piquet
This study focused on the anatomical evolution of residual aortic dissection after type A repair. To improve long-term outcomes, early demographic and anatomic poor prognostic factors that were identified in this study should be considered for more aggressive treatment at an early phase.
Source: World Journal for Pediatric and Congenital Heart Surgery
Author(s): Dimitris Bertsimas, PhD, Daisy Zhuo, PhD, Jack Dunn, PhD, Jordan Levine, MΕng, Eugenio Zuccarelli, MBAn, MSc, Nikos Smyrnakis Nikos Smyrnakis, Zdzislaw Tobota, MD,  Bohdan Maruszewski, MD, PhD,  Jose Fragata, MD, PhD Jose Fragata, George E. Sarris ,  MD, PhD
In contrast to traditional risk assessment methods (logistic regression), which assume that risk factors interact linearly and additively, the non-linear machine learning methodology of Optimal Classification Trees provides superior power for predicting risks after congenital heart surgery, with the advantage over other machine learning methods of logical interpretability. This methodology also allows estimation of individual patient risk, based on aggregate database data, and may facilitate decision–making and quality improvements in congenital heart surgery.
Source: The Annals of Thoracic Surgery
Author(s): Taufiek Konrad Rajab, MD, and Max B. Mitchell, MD
Norwood palliation for hypoplastic left heart syndrome typically results in retrograde perfusion of the native aortic root. This may predispose to native aortic root thrombosis (NART).
Source: Interactive CardioVascular and Thoracic Surgery
Author(s): Alex Fourdrain, Olivier Georges, Sophie Lafitte, Jonathan Meynier, Pascal Berna
This article presents the assessment of long-term outcomes of patients treated by anatomical pulmonary resection with the video-assisted thoracoscopic surgery (VATS) approach, VATS requiring intraoperative conversion to thoracotomy, or an upfront open thoracotomy for lung cancer surgery. The study found that VATS is favored when possible.