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Journal and News Scan

Source: Annals of Surgery
Author(s): Brown LM, Thibault DP, Kosinski AS, Cooke DT, Onaitis MW, Gaissert HA, Romano PS

This examination of readmission rates is based on data from nearly 40,000 patients from the STS Database having undergone elective pulmonary lobectomy.   Readmission was driven by complications during the index operation, notably pulmonary embolism, empyema, pleural effusion, and pneumothorax.  Improved pleural space management may offer a means to mitigate readmission rates.

Source: Annals of Thoracic Surgery
Author(s): Subramanian MP, Sahrmann JM, Nickel KB, Olsen MA, Bottros M, Heiden B, Semenkovich TR, Meyers BF, Kozower BD, Patterson GA, Nava RG, Kreisel D, Puri V.

Over 30% of lung resection patients in the STS Database had prior exposure to opioid use.  They experienced longer length of postoperative stay, more frequent visits to the ED, and a higher incidence of readmission within 90 days.  Athough there is growing interest in standardized enhanced recovery pathways after lung resection, this challenging subset of patients appears to require unique targeted postoperative interventions.

Source: Annals of Surgical Oncology
Author(s): Pamela Milito, Jakub Chmelo, Lorna Dunn, Sivesh K. Kamarajah, Anantha Madhavan, Shajahan Wahed, Arul Immanuel, S. Michael Griffin, Alexander W. Phillips

Chyle leak remains a challenging postoperative complication to manage, and avoidance is always easier than mitigation.  The only predisposing factor identified in this study was low BMI.  Although ICU stay was longer in affected patients, operative mortality, hospital LOS, and survival were not negatively impacted by the presence of a leak. 

Source: Journal of Thoracic and Cardiovascular Surgery Techniques
Author(s): Abigail White, MD; Sabin J. Bozso, MD; Maral Ouzounian, MD, PhD; Michael W. A. Chu, MD; Michael C. Moon, MD; on behalf of Canadian Thoracic Aortic Collaborative

A good discussion on the concepts of:

1. aortic true lumen and false lumen behavior after repair of acute Type A aortic dissection
2. distal anastomotic new entry tear after hemiarch repair
3. impact of above on clinical outcomes
4. strategies on preventing distal anastomotic entry tear

The authors communicate that improved understanding of these hemodynamic conditions may serve to improve surgical technique, guide creation of novel devices toward new therapeutic targets, reduce surgical risk, and ultimately improve patient outcomes.

Source: Foldax news and events
Author(s): Foldax Inc

On May 25, 2021, Dr. David Heimansohn successfully performed the first surgical implantation of biopolymer Tria™ heart valve in a patient with mitral valve disease at Ascension St. Vincent Hospital, Indianapolis, IN. 

Foldax’s Tria valve is fabricated with a polymeric, silicone-rich polyurethane material intended to resist calcification, improve valve durability, and, most importantly, avoid the need for lifelong anticoagulation. 

Source: The Annals of Thoracic Surgery
Author(s): Christopher Ibarra, MD, Zachary Spigel, MD, MPH, Rija John, RN, MSN, Ziyad M. Binsalamah, MD, Iki Adachi, MD, Jeffrey S. Heinle, MD, Christopher A. Caldarone, MD, E. Dean McKenzie, MD, and Michiaki Imamura, MD, PhD
There are multiple techniques for the repair of supravalvular aortic stenosis (SVAS), but given the rarity of the lesion, analyses comparing the efficacy of each repair is limited.
Source: The Annals of Thoracic Surgery
Author(s): Anita Nguyen, MBBS, Hartzell V. Schaff, MD, Steve R. Ommen, MD, Bernard J. Gersh, MBChB, DPhil, Joseph A. Dearani, MD, Jeffrey B. Geske, MD, Brian D. Lahr, MS, Rick A. Nishimura, MD
Septal myectomy leads to excellent symptomatic relief in most patients, and more than 80% report subjective improvement in health status. Important predictors of worsening health included coronary artery disease and poor preoperative health status.
Source: The Annals of Thoracic Surgery
Author(s): William Z. Chancellor, MD, J. Hunter Mehaffey, MD, MSc, Raj P. Desai, MS, Jared Beller, MD, Rajesh Balkrishnan, PhD, Dustin M. Walters, MD, Linda W. Martin, MD, MPH
Chronic and prolonged opioid use were independently associated with reduced long-term, disease-specific survival after lung cancer resection. These findings provide epidemiologic support for a biological relationship between opioid use and lung cancer progression.
Source: The Annals of Thoracic Surgery
Author(s): Rachel L. Medbery, MD, Felix G. Fernandez, MD, MSc, Andrzej S. Kosinski, PhD, Betty C. Tong, MD, MHS, Anthony P. Furnary, MD, Liqi Feng, MS, Mark Onaitis, MD, Daniel Boffa, MD, Cameron D. Wright, MD, Patricia Cowper, PhD, Jeffrey P. Jacobs, MD, Joe B. Putnam, Jr, MD, and Robert H. Habib, PhD
The goal of this study was to determine underlying case mix factors that can contribute to a plethora of 90-day costs of lobectomy for early-stage lung cancer.
Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): G. Hossein Almassi, Robert B. Hawkins, Muath Bishawi, A. Laurie Shroyer, Brack Hattler, Jacquelyn A. Quin, Joseph F. Collins, Faisal G. Bakaeen, Ramin Ebrahimi, Frederick L. Grover, Todd H. Wagner, for theVeterans Affairs Randomized On/Off Bypass Follow-up Study (ROOBY-FS) Group

This month's update on the economical and general aspects of the ROOBY-FS trial. The conclusion (on no impact of de novo post-CABG AF on the incidence of stroke nor the 5 year expenditure ) challenges many hitherto perceptions on this frequent compication of coronary surgery.