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Journal and News Scan
March 2, 2014
Submitted by: Mark Ferguson
The utility of dental extraction for infection prior to planned cardiac surgery is unkown. The authors evaluated the risk of dental extraction in a group of 205 patients for whom elective cardiac surgery was planned. 8% experienced major morbidity after dental extraction, 3% died prior to cardiac surgery, and 3% died following cardiac surgery.
March 2, 2014
Submitted by: J. Rafael Sadaba
In this manuscript the authors report on 6 patients who underwent implantation of a MitraClip device for failing surgical mitral valve repair. All the procedures were successful with the use of a simple clip. MitraClip appears to be a good alternative in this setting.
March 2, 2014
Submitted by: Mark Ferguson
LVI is thought to be an adverse prognostic indicator of survival in patients with NSCLC. This review quantified the relationship of LVI and survival. The unadjusted effect of LVI for recurrence-free survival was HR=3.63 and for overall survival was HR=2.38. After adjustment for covarates, these HRs were 2.52 and 1.81, both highly significant.
February 28, 2014
Submitted by: Stuart Head
Yates and coauthors evaluated the implementation of Heart Team discussions for patients with complex coronary artery disease, and determined whether the 2010 ESC/EACTS guideline recommendations changed clinical practice in this regards. Unfortunately, Heart Team discussions were infrequent pre- and post-guideline publication (9% vs 17%).
February 28, 2014
Submitted by: Ruben Osnabrugge
In this meta-analysis, the authors set out to investigate whether MV repair or replacement was better for patients with ischemic mitral regurgitation. Combining 12 eligible studies, they found that MV repair is associated with lower operative mortality, but higher recurrence of regurgitation. There were no differences in survival, functional measures and NYHA class.
February 24, 2014
Submitted by: Mark Ferguson
A group of 1365 pts from 6 institutions was retrospectively reviewed for outcomes after palliative treatment, chemotherapy alone, pleurectomy/decortication (P/D), or extrapleural pneumonectomy (EPP). Multivariable analysis identified age <70, epithelial histology, and chemotherapy as independent predictors of improved survival. In patients with all 3 favorable characteristics, median survival with or without P/D or EPP was similar.
February 24, 2014
Submitted by: Mark Ferguson
Using SEER data the authors compared open to VATS segmental resection in a population of pts >65 years old. Propensity score matching was used to adjust for baseline differences between the groups. VATS pts had lower complication rates, fewer ICU admissions, and shorter length of hospital stay. Outcomes did not appear to be surgeon-specific. Survival was similar between the groups.
February 24, 2014
Submitted by: Mark Ferguson
This study evaluated safety and efficacy of EBUS-TBNA in a population of pts 70 or older and compared their results to those of younger patients. Tolerance was better in the older group, and complication rates were similar. Overall accuracy was higher in the older group, possibly related to differences in the underlying diagnoses.
February 24, 2014
Submitted by: Mark Ferguson
The authors hypothesized that major lung surgery may predispose patients to post-traumatic stress disorder (PTSD). 47 pts were evaluated prospectively. 50% were identified as having an elevated PTSD risk score 3 months posteroperatively. Predictors included excess preoperative anxiety and increased acute postoperative pain.
February 19, 2014
Submitted by: Joel Dunning
Computational models based on data from computed tomography show that maximal wall shear stress is associated with the maximal diameter in large aortic aneurysms whereas eccentricity of the bulge is more important in small aneurysms.