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Journal and News Scan
March 29, 2014
Submitted by: Tom C. Nguyen
Consensus guidelines on performing PCI without on-site surgery backup. The document outlines best practices and requirements for centers performing PCI without on-site surgery and evaluates the role of PCI without on-site surgery within the context of the US healthcare system.
March 27, 2014
Submitted by: Joel Dunning
The authors analysed the influence of Haloperidol on post-cardiotomy delirium. The study on over 200 patients revealed that Haloperidol is not effective for reducing the duration of delirium.
March 27, 2014
Submitted by: Joel Dunning
The authors review 17 publications on the use of artificial chordae in mitral valve repair. Rates of mortality, morbidity, complications and reoperation are low. Correct determination of the length of the chordae presents still one of the most important problems.
March 27, 2014
Submitted by: Joel Dunning
A prospective multicentre study analysed 532 patients with a first surgical procedure for pulmonary metastases of colorectal carcinoma. Complications arose in 16%, reoperations were necessary in 1% and mortality was 0.4%. Major lung resection and respiratory and/or cardiovascular co-morbidity were identified as independent risk factors, whereas a video-assisted approach was protective.
March 27, 2014
Submitted by: Joel Dunning
A consensus statement on video-assisted thoracoscopic lobectomy for patients with non-small-cell lung cancer has been issued by 50 international experts.
March 27, 2014
Submitted by: Joel Dunning
Carcinoid heart disease is a major cause of morbidity and mortality in patients with metastatic neuroendocrine tumours (NETs). Although cases of carcinoid syndrome and severe carcinoid heart disease requiring urgent intervention are well described, many patients with significant carcinoid heart disease may have insidious symptoms or even be asymptomatic. As haemodynamically significant carcinoid heart disease may be clinically silent, specific and individualised considerations must be made as to the most appropriate clinical criteria and time point at which surgical valve replacement should be undertaken in patients with carcinoid heart disease.
March 27, 2014
Submitted by: Mark Ferguson
This 5-domain assessment tool was used to evaluate chest tube insertion performance by learners of various experience using mannequins and live patients. Inter-observer scoring consistency for a single performance was high, and test-retest scoring consistency was high. The instrument stratified scores appropriately by expected level of expertise. Scores were similar regardless of whether insertion was performed on a mannequin or a patient. The authors propose that this validated instrument can be used to assess competency in clinical training.
March 26, 2014
Submitted by: Mark Ferguson
This study summarizes 3 phases of clinical experience with a protocol for early extubation after CABG: standard practice, multidisciplinary protocol guidance, and multidisciplinary protocol guidance with expanded indications and bedside reminders. Early extubation (<6 hours) rates during the phases were 12%, 24%, and 38%. There were no differences in reintubation rates.
March 26, 2014
Submitted by: Mark Ferguson
The PROACT trial is evaluating the clinical utility and safety of less aggressive anticoagulation schemes after bileaflet AVR. This arm of the trial compared low dose (INR 1.5-2.0) to standard dose (INR 2.0-3.0)warfarin. At an average follow-up of nearly 4 years, the low dose group experienced significantly fewer bleeding complications but had similar rates of neurologic events and all-cause mortality.
March 26, 2014
Submitted by: Mark Ferguson
This study surveyed outcomes of sympathotomy for hyperhidrosis more than 1 year postoperatively. 77% reported clinically bothersome compensatory sweating, although the incidence decreased over time to 35% at 5 years and thereafter. Predictors of bothersome compensatory sweating included multiple sites of sweating and R2/R3 sympathotomy (rather than R4/R5).