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Journal and News Scan

Source: New England Journal of Medicine
Author(s): Frank Ruschitzka, William T. Abraham, Jagmeet P. Singh, Jeroen J. Bax, Jeffrey S. Borer, Josep Brugada, Kenneth Dickstein, Ian Ford, John Gorcsan, III, Daniel Gras, Henry Krum, Peter Sogaard, and Johannes Holzmeister for the EchoCRT Study Group

This randomized trial among 115 centers assigned patients with NYHA class III or IV heart failure, a short QRS duration, and LV dyssynchrony to device implantation with or without CRT.  The study was stopped prematurely by the DSMB for futility.  CRT was associated with increased deaths (p=0.02) and there was no difference in the primary outcome of death or hospitalization for worsening heart failure.

Source: The Annals of Cardiothoracic Surgery
Author(s): Edited by Roberto Di Bartolomeo

This issue on “Frozen Elephant Trunk” includes information on hybrid and endovascular surgical management of descending aorta and aortic arch pathologies. The issue includes a systematic review evaluating the current state of evidence on Frozen Elephant Trunks, long-term outcomes from international institutions, perspectives and opinions from leaders in the field, and operative video manuals for different hybrid prostheses.

Source: Annals of Thoracic Surgery
Author(s): Arman Kilic, Kristen Nelson, Janet Scheel, William Ravekes, Duke E. Cameron, Luca A. Vricella

Outcomes for small children (<10kg) bridged to heart transplant with VADs were compared to those who were not bridged. 2:1 propensity score matching was used to create comparison groups. Survival of 59 bridged pts was similar to that of 108 non-bridged pts, and most major complication rates were similar. Strokes occurred in 8.5% of bridged pts and 0.9% of non-bridged pts.

Source: Annals of Thoracic Surgery
Author(s): Anne-Mette C. Sauër, Hendrik M. Nathoe, Jeroen Hendrikse, Linda M. Peelen, Jakub Regieli, Dieuwke S. Veldhuijzen, Cor J. Kalkman, Diederick E. Grobbee, Pieter A. Doevendans, Diederik van Dijk, Octopus Study Group

This randomized study assigned patients with CAD to either PCI or OPCAB and assessed cognition 7.5 years later. The OPCAB group had better cognition at long-term follow-up in univariate analysis, but when adjusted for covariates, there was no significant difference in the cognition outcomes.

Source: Annals of Thoracic Surgery
Author(s): Feiran Lou, Inderpal Sarkaria, Catherine Pietanza, William Travis, Mee Sook Roh, Gabriel Sica, David Healy, Valerie Rusch, James Huang

This retrospective review of a large institutional database identified 337 patients who had undergone resection of a pulmonary carcinoid tumor and tracked recurrence and survival rates. 95% of recurrences were distant and only 24% were detected during routine follow-up. Only 3% of patients with typical carcinoid tumors suffered recurrence compared to 26% of those with atypical tumors. The authors suggest that routine follow up may not be indicated in patients with resected typical carcinoid tumors who have no risk factors.

Source: Annals of Thoracic Surgery
Author(s): John M. Stulak, Salil Deo, John Schirger, Keith D. Aaronson, Soon J. Park, Lyle D. Joyce, Richard C. Daly, Francis D. Pagani

This study of 389 pts receiving a continuous flow LVAD evaluated the risk of thromoembolic (TE)complications associated with preop AF.   TE occured in 25% of pts; freedom from TE at 2 years was 46% in those with AF and 72% in those without AF (p<0.001).  AF did not affect late survival.


Source: Interactive Cardiovascular and Thoracic Surgery
Author(s): Hiroshi Iida, Toru Sunazawa, and Syunichi Kondo

The authors presented a novel concept of tricuspid annuloplasty for functional tricuspid regurgitation using an adjustable annuloplasty band. This method allowed authors to adjust the ring size on beating heart after weaning off the cardiopulmonary bypass.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Hermann Reichenspurner, Wolfgang Schillinger, Stephan Baldus, Jörg Hausleiter, Christian Butter, Ulrich Schäefer, Giovanni Pedrazzini, and Francesco Maisano

The MitraClip Therapy Economic and Clinical Outcomes Study Europe (ACCESS-EU) enroled 117 patients with degenerative mitral regurgitation (MR) considered ineligible for surgery. Mortalities at 30 days and 12 months were 6.0 and 17.1%, respectively. At 12 months, 74.6% (53 of 71) of patients in follow-up achieved significant reductions in MR and improved clinical outcomes. This complementary non-surgical intervention should be indicated by an inter-disciplinary team of cardiologists and cardiac surgeons.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Richard Warwick, Michael Shackcloth, Neeraj Mediratta, Richard Page, James McShane, Mathew Shaw, and Michael Poullis

A database analysis on 4212 patients found female sex to be associated with improved survival in patients with Stage I adenocarcinoma but not with other stages or with squamous carcinoma. The authors discuss the reasons for their findings.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Fernando Hornero, Elio Martín, Rafael Rodríguez, Manel Castellà, Carlos Porras, Bernat Romero, Luis Maroto, and Enrique Pérez de la Sota

A multicenter retrospective study on over 26000 patients compared off-pump and on-pump surgery for CABG. Off-pump surgery was associated with a lower perioperative incidence of stroke in patients with two or more cardiovascular risk factors especially with chronic renal failure.