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Journal and News Scan
Advances in neuromonitoring and related screening by imaging constitute an expanding field of cardiovascular perioperative care, attracting the readership of interventional and conventional surgical providers. This pilot retrospective case series from two European hospitals provides some up to date insight to cerebral findings that are by and large 1: bi-spherical (and hence difficult to attribute to particle or gaseous embolization) and 2: anatomically related to the middle cerebral artery. It will be useful to discern , in this or a larger cohort of the 'Stroke from thoracic endovascular procedures' Registry, the theory and causation of the 'silent' (albeit including two TIA's and one possible paraplegic) bilateral lesions, and any association to current endovascular practice : a simple research idea would be to re-scan the subjects and obtain a robust neurocognitive follow-up by any of the relevant batteries ( sickness-impact-profile , Hopkins Verbal Learning Test, Rey Auditory Verbal Learning Test or other questionnaire ). The interval between TEVAR and imaging may have masked Transient Neurological Events. The exact anatomy, especially the variations of the Circe of Willis, may provide further opportunities for patient-centred research.
Ceylan et al. present a retrospective study regarding the prevention of viral transmission via chest tube in COVID-19 patients. Out of 542 hospitalized COVID-19 patients, 13 (3.8%) required chest tube insertion. In these patients, a two-bottle technique combined with a HEPA filter was used to prevent viral transmission. The incidence of bloodstream infections was 32.1% within the first year. This event was associated with increased risk of death and stroke. Risk factors of bloodstream infections were identified as lower albumin and ECMO/IABP prior to LVAD implantation.
This study analyzed the association of antibiotic resistance with morbidity and mortality for patients with empyema.
A large series of closure of atrial septal defects ( mostly secundum) in adult and some adolescent patients. There are token cases of other (moderate to severe) congenital cases included in this narrative. The Onans offer details on the evolution of their Da Vinci program in Istanbul.
An interesting retrospective study on the efficacy of the the US screening program for aortic aneurysmal disease in the abdomen. The discussion on the detective importance of clinical examination being complementary to sonography is pertinent. Additionally, we note the relevance of the paper to a recent call for relevant screening of the supradiaphragmatic proximal aorta: https://www.ctsnet.org/jans/commentary-lack-screening-makes-primary-prev....
This study investigates the need for follow-up and reoperation after the Ross procudure over 25 years.
Froede et al. present a new simplified technique to determine commissural orientation in bicuspid aortic valves using echocardiography. Their technique using a line between the center of the nonfused and fused sinuses led to reproducible results, whereas the use of the coaptation center led to misleading results.
Montgomery et al. report on untreated infectious aneurysms of native coronary artery and aortocoronary bypass grafts are associated with high mortality. Early diagnosis proves difficult given non-specific presenting symptoms, however once recognized, early intervention is essential to mitigate complications such as myocardial ischemia or pericardial tamponade. The successful surgical management of a patient who presented two months after diagnosis of Staphylococcus aureus bacteremia is described in this report.
A scholarly metanalytic review on training by surgical simulators. The authors submit that low-fidelity is acceptable, balancing affordable basic inanimate models against the higher cost (and ethics) of zootomy and cadaceric dissection.