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Journal and News Scan

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Asha Singh, Xiaojie Huang, Lu Dai, Daniel Wyler, Andrej Alfirevic, Eugene H. Blackstone, Gosta B. Pettersson, Andra E. Duncan

The authors prospectively analyzed right ventricular (RV) function in 109 patients undergoing a broad range of cardiac surgeries. RV function was assessed at several time points by evaluating TAPSE and 2D longitudinal RV strain to evaluate long axis RV function, and fractional area exchange to evaluate global RV function. After CPB and after chest closure, reduced RV function was demonstrated across all cardiac procedures. Thus, there is a significant failure to protect the RV during surgery.

If one accepts these findings, what modes of myocardial protection should be assessed or re-assessed to protect the RV? Why or why not?

Source: The New England Journal of Medicine
Author(s): Ann E. Woolley, Steve K. Singh, Hilary J. Goldberg, Hari R. Mallidi, Michael M. Givertz, Mandeep R. Mehra, Antonio Coppolino, Amanda E. Kusztos, Megan E. Johnson, Kaiwen Chen, Esther A. Haddad, John Fanikos, David P. Harrington, Phillip C. Camp, Lindsey R. Baden, for the DONATE HCV Trial Team

The authors of this single-center open-label pilot trial evaluated the intermediate-term outcomes of patients undergoing either heart (n=8) or lung (n=36) transplantation from donors that had evidence of active hepatitis C virus (HCV) infection. All patients underwent treatment of HCV antiviral treatment for 4 weeks after transplantation. The primary outcome measured was a composite of a sustained virologic response at 12 weeks after completion of antiviral therapy for HCV infection and graft survival 6 months after transplantation. Of the initial 35 patients who had completed 6 months of follow-up, all patients met the primary outcome. Thus, at intermediate term follow-up, HCV infection was prevented in 100% of patients.

Source: The Annals of Thoracic Surgery
Author(s): Roberta E. Redfern, Kevin Fleming, Rebekah L. March, Nathan Bobulski, Michael Kuehne, John T. Chen, Michael Moront

This single-center study retrospectively analyzed the impact of the implementation of thromboelastography (TEG) on all cardiac procedures performed during 2-year intervals prior to and after TEG implementation. A total of 367 and 310 patients were included in the analysis for the pre-TEG and post-TEG eras, respectively. The authors found that the implementation of TEG was associated with a significant reduction in blood product usage, reoperation, postoperative LOS, and 6-month mortality.

Source: The Annals of Thoracic Surgery
Author(s): Tyler Wallen, Andreas Habertheuer, Joseph E. Bavaria, G.Chad Hughes, Vinay Badhwar, Jeffrey P. Jacobs, Babatunde Yerokun, Dylan Thibault, Karianna Milewski, Nimesh Desai, Wilson Szeto, Lars Svensson, Prashanth Vallabhajosyula

The authors analyzed the STS database for elective aortic root replacement (with several important exclusions) to derive risk factors for mortality and morbidity. A total of 8,807 patients met inclusion criteria. Significant predictors for mortality that were discovered include atrial fibrillation, body surface area, chronic obstructive pulmonary disease, NYHA IV, diabetes, concomitant coronary artery bypass grafting, concomitant mitral valve surgery, and Bentall operation.

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

Patient Care and General Interest

Uruguay’s fight against tobacco and Phillip Morris was highlighted at the recent Annual Meeting of the American College of Cardiology, and one physician shares her thoughts.

The University of California Los Angeles has opened a new center, the Robert G. Kardashian Center for Esophageal Health, to focus on treatment, research, and education for esophageal disorders.


Drugs and Devices

Boston Scientific’s transcatheter Lotus Edge Aortic Valve System was cleared by the US Food and Drug Administration. The company launched the system recently in Europe and will launch it in the US soon.

Goggles that facilitated a mixed-reality view of 3D echocardiography were used for a percutaneous mitral valve intervention in Poland.


Research, Trials, and Funding

Researchers from St. Louis, Missouri, USA, report on the impact of a 2017 change in US lung transplant policy that expanded the geographic boundaries for determining which patients get first priority for donor lungs.

Simulation training improves a team’s ability to manage operating room fires more than training that is exclusively didactic, say researchers from Illinois, USA.

Source: The Annals of Thoracic Surgery
Author(s): Won Kyoun Park, Jae Suk Baek, Bo Sang Kwon, Yu Mi Im, Ji Hye Lee, Eun Seok Choi, Chun Soo Park, Tae-Jin Yun

Park and colleagues sought to identify risk factors that could predict the need for systemic outflow relief operations (SORO) in newborn patients with transposed great arteries and either double-inlet left ventricle or tricuspid atresia. The authors evaluated data from 20 patients with double-inlet left ventricle and 10 patients with tricuspid atresia who underwent single-ventricle palliation between 2000 and 2018. Approximately 67% of patients underwent SORO, and arch obstruction and smaller systemic outflow tract area index at end-systolic phase were both predictive of a subsequent need for an SORO.

Source: Radiology: Cardiothoracic Imaging
Author(s): Radiological Society of North America

The Radiological Society of North America debuts its first issue of a focused publication dedicated to cardiothoracic imaging—Radiology: Cardiothoracic Imaging.

The editor is Suhny Abbara, MD, Professor of Radiology and Chief of Cardiothoracic Imaging Division at the University of Texas Southwestern Medical Center in Dallas.

The first issue features an editorial by Abbara and a host of original research involving aortic dissection with 4D flow magnetic resonance imaging, dual-energy cardiac computed tomography to shed light on myocardial late iodine enhancement and extracellular volume quantification, and tissue tracking versus feature tracking for strain measurement on cardiac MR images.

Radiology: Cardiothoracic Imaging is a bimonthly journal available exclusively online. The journal is now accepting manuscript submissions that cover all aspects of cardiac, vascular, and pulmonary imaging.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Yosuke Inoue, Hitoshi Matsuda, Atsushi Omura, Yoshimasa Seike, Kyokun Uehara, Hiroaki Sasaki, Junjiro Kobayashi

In 148 patients with type A aortic dissection who underwent emergency total arch replacement, 155 had a conventional elephant trunk procedure (CET, age 65 ± 12 years) and 33 had a frozen elephant trunk procedure (FET, 67 ± 11 years). Early mortality was similar in the two groups (8.7% with CET versus 6.1% with FET). The FET group showed advantages of false lumen thrombosis and aortic remodeling at early follow-up examinations.

Source: Centers for Disease Control and Prevention
Author(s): US National Center for Health Statistics

Five highlights in the CDC’s most recent Health, United States report, based on data from 1999 to 2017:

  1. Black patients were more than twice as likely as Asians or Pacific Islanders to die of heart disease in both 1999 and 2017.
  2. Non-Hispanic whites are the only demographic whose rate of cardiovascular disease declined over the 18-year period.
  3. Black adults aged 20 and up were by far the most likely group to have hypertension between 2015 and 2016.
  4. Hispanics and non-Hispanic blacks were most likely to have diabetes and be obese in 2015 and 2016.
  5. Total cholesterol levels were relatively similar among all demographics between 2015 and 2016.
Source: Journal of the American College of Cardiology
Author(s): Shuang Rong, Linda G. Snetselaar, Guifeng Xu, Yangbo Sun, Buyun Liu, Robert B. Wallace, Wei Bao

Rong and colleagues evaluated data from 6,550 adults aged 40 to 75 years participating in the National Health and Nutrition Examination Survey III 1988 to 1994 who had no history of cardiovascular disease or cancer and who were followed for an average of 18 years. They found that participants who never consumed breakfast had an 87% higher risk of cardiovascular disease-specific mortality than those who ate breakfast every day.