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Journal and News Scan

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

Patient Care and General Interest

A father got a sternotomy scar tattoo in support of his son after the boy underwent surgery for supravalvular aortic stenosis.

In a Viewpoint paper in JAMA Surgery, the authors highlight the importance of training on Geneva conventions and humanitarian law for surgeons embarking on medical missions to conflict zones.

 

Drugs and Devices

The US Food and Drug Administration has cleared Mimics Enlight from Materialise, software that is intended to assist in planning complex transcatheter mitral valve replacement procedures.

 

Research, Trials, and Funding

Researchers from Vancouver, Canada, used gut bacteria to convert type A blood cells into type O.

Researchers from France find that spin in health news, defined as overstating the efficacy or safety of a treatment, positively influences people’s views of those treatments.

A restrictive approach to blood cell transfusions did not increase the risk of acute kidney injury in patients undergoing cardiac surgery on cardiopulmonary bypass, report researchers from London, Canada.

Source: US News & World Report: Health
Author(s): US News & World Report

US News & World Report published a list of 613 hospitals in Cardiology & Heart Surgery that see many challenging patients, including those needing heart transplants, those with cardiovascular disease, and other complex heart conditions. In order to be eligible for ranking, listed hospitals had to treat at least 1,391 such Medicare inpatients in 2014, 2015, and 2016. The 50 top-scoring hospitals are ranked, followed by high performing hospitals.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Andras P Durko, Stuart J Head, Philippe Pibaro,t Pavan Atluri, Vinayak Bapat, Duke E Cameron, Filip P A Casselman, Edward P Chen, Gry Dahle, Tjark Ebels, John A Elefteriades, Patrizio Lancellotti, Richard L Prager, Raphael Rosenhek, Alan Speir, Marco Stijnen, Giordano Tasca, Ajit Yoganathan, Thomas Walther, Ruggero De Paulis (Task Force Chairman), EACTS–STS–AATS Valve Labelling Task Force

This position paper written by the EACTS, STS, and AATS Valve Labeling Task Force focuses on problems around sizing and labeling of various prosthetic valves. The authors provide information on European and international regulations and use of standards in prosthetic heart valve labeling, characteristics of surgical prosthetic heart valve design, and their hemodynamic performance and thrombogenicity. This first paper from the task force reviews current practices and identifies where improvements are necessary.

Source: JAMA
Author(s): Chetan P. Huded, E. Murat Tuzcu, Amar Krishnaswamy, Stephanie L. Mick, Neal S. Kleiman, Lars G. Svensson, John Carroll, Vinod H. Thourani, Ajay J. Kirtane, Pratik Manandhar, Andrzej S. Kosinski, Sreekanth Vemulapalli, Samir R. Kapadia

This large review of over 100,000 patients undergoing transcatheter aortic valve replacement demonstrated a stroke rate of 2.3% within 30 days of the procedure, and no decrease in the rate between 2011 and 2015.

Source: Seminars in Thoracic and Cardiovascular Surgery
Author(s): Alice Le Huu, Susan Y. Green, Joseph S. Coselli

Thoracoabdominal aortic aneurysm (TAAA) repair began in Houston, Texas, with  pioneer surgeons such as Drs Michael E. DeBakey, Denton A. Cooley, and E. Stanley Crawford. Their early attempts to repair TAAA were complicated by risk of renal and spinal cord ischemia and difficulty in reattaching the branching vessels of the thoracoabdominal aorta. This article delves into this history and the work being done at the current forefront of TAAA repair.

Source: The Thoracic and Cardiovascular Surgeon
Author(s): Barbara Christine Weckler, Natalie Baldes, Joachim Schirren

To evaluate the benefit of multimodality treatment for patients with limited disease small-cell lung cancer, Weckler and colleagues retrospectively reviewed outcomes for 47 patients treated at their institution between 1999 and 2016. Patients had undergone primary tumor resection and systematic lymph node dissection combined with chemotherapy, chemoradiotherapy, or thoracic radiotherapy, and all patients were treated with curative intent. Overall median survival was 56 months, and R0 resection was the only significant prognostic factor for survival. The authors conclude that multimodality treatment was safe, and that R0 resection was achievable with a low risk of locoregional relapse.

Source: The Annals of Thoracic Surgery
Author(s): Jeremiah R. Brown, Heather Thiessen-Philbrook, Christine A. Goodrich, Andrew R. Bohm, Shama S. Alam, Steven G. Coca, Eric McArthur, Amit X. Garg, Chirag R. Parikh
Given that acute kidney injury (AKI) after cardiac surgery is a risk factor for readmission, Brown and colleagues sought to determine whether urinary biomarkers were better at predicting readmission within 30 days that duration of AKI during the index admission. Using data from patients enrolled in the Translational Research Investigating Biomarker Endpoints-AKI trial, preoperative and postoperative levels of interleukin-18, neutrophil gelatinase–associated lipocalin, kidney injury molecule-1, liver-fatty-acid-binding protein, cystatin C, microalbumin, creatinine, and albumin-to-creatinine ratio were compared with the total number of days that AKI was present during the initial hospitalization. AKI duration of 3 to 6 days was associated with 30-day readmission or death (adjusted odds ratio, 1.82%; 95% confidence interval, 1.08 - 3.05), while urinary biomarkers had no association with readmission and death.
Source: Heart, Lung and Circulation
Author(s): Edward Litton, Frances Bass, Cheryl Dickson, Graham Hillis, Deborah Inskip, Theresa Jacques, David McGiffin, Shay McGuiness, Jennene Miller, Rachael Parke, Hugh Playford, Chris Reid, Julian Smith, Noah Solman, Lavinia Tran, Elizabeth Yarad, Anthony Delaney, on behalf of the ANZICS Clinical Trials Group

An intresting pilot that was stopped due to underrecruitment. Commendable mortality in high-risk coronary artery bypass grafting.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Arnar Geirsson, Arnar Geirsson, Kayoko Shioda, Christian Olsson, Anders Ahlsson, Jarmo Gunn, Emma C. Hansson, Vibeke Hjortdal, Anders Jeppsson, Ari Mennander, Anders Wickbom, Igor Zindovic, Tomas Gudbjartsson

Food for thought from a retrospective non-randomized study on the Scandinavian experience with acute aortic dissection. The reader may find outcomes that will surpise them.

Source: JACC
Author(s): Katelyn M. Atkins, Bhupendra Rawal, Tafadzwa L. Chaunzwa, Nayan Lamba, Danielle S. Bitterman, Christopher L. Williams, David E. Kozono, Elizabeth H. Baldini, Aileen B. Chen, Paul L. Nguyen, Anthony V. D’Amico, Anju Nohria, Udo Hoffmann, Hugo J.W.L. Aerts, Raymond H. Mak

In this retrospective review of the effects of radiation dose to the heart on long-term outcomes, 748 patients with regionally advanced non–small cell lung cancer were studied.  An increasing cardiac radiotherapy dose was associated with an increased risk of MACE and all-cause mortality. This was observed primarily in patients without preexisting heart disease.

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