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Journal and News Scan
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
Systolic and diastolic myocardial motion was determined using magnetic resonance tissue phase mapping (n=27). Cold ischemic time of the transplanted heart >155 min is associated with decreased myocardial velocities whereas longer postoperative time has a positive influence. The future aim is to develop a non-invasive method to diagnose transplant rejection.
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.
February 19, 2014
Submitted by: Joel Dunning
Aorto-oesophageal fistulation following thoracic endovascular aortic repair occurred in 36 of 2387 patients with a mean interval of 90 days according to the European Registry of Endovascular Aortic Repair Complications. Key symptoms included fever, haematemesis and shock. Aggressive therapy with radical oesophagectomy and aortic replacement achieved the best 1-year survival.
February 19, 2014
Submitted by: Joel Dunning
There is growing interest in reparative techniques that durably improve the mitral orifice while preserving the subvalvular apparatus. Many of these techniques are technically challenging and require complex resections with intricate chordal adjustments, which may have limited their global acceptance. In this report, a three-step technique is outlined that does not require significant resection or involve the use of neochords. This offers a potentially simplified approach to the repair of rheumatic mitral stenosis.
Two cases of acute bioprosthetic mitral valve thrombosis immediately after mitral valve replacement.
February 16, 2014
Submitted by: J. Rafael Sadaba
In this manuscript the authors present two cases of early thrombosis of biological prosthesis following mitral valve replacement. Both patients were on venous arterial extracorporeal membrane oxygenation (ECMO), which could be the factor responsible for this unusual event. The authors advocate the use of more aggressive anticoagulation on patients on ECMO and prosthetic cardiac valves.
February 16, 2014
Submitted by: J. Rafael Sadaba
This interesting study evaluates the hemodynamic effect of the residual ASD produced by the transeptal approach for MitraClip implantation. The new left to right shunt could contribute to the reduction in mitral regurgitation following MitraClip implantation
February 15, 2014
Submitted by: Mark Ferguson
Patients requiring readmission after cardiac surgery were compared to time-matched patients who did not require readmission to evaluate factors associated with this adverse event. Predictors of readmission included COPD, decreased EF, prolonged length of stay, and lower educational level. Failure to see a physician early after discharge increased the risk of readmission by 6-fold.
February 15, 2014
Submitted by: Mark Ferguson
Pts undergoing aortic root replacement who moderate MR preoperatively were evaluated for outcomes after mitral repair vs no repair. Mitral repair was associated with longer crossclamp times, and postoperative renal failure. Root replacement improved MR without mitral repair, but mitral repair further improved the degree of regurgitation. There was no difference in long-term survival.
February 15, 2014
Submitted by: Mark Ferguson
Pts surviving esophagectomy longer than 10 years were queried as to QOL. Alimentary comfort rating was 9 out of 10. 33% experienced diarrhea, dumping, or regurgitation. 15% had aspiration requiring hospital care. Mean weight loss was 26 lbs. Median GI QOL score was 2.9 out of 4.