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Journal and News Scan

Source: The New England Journal of Medicine
Author(s): William F. Fearon, M.D., Frederik M. Zimmermann, M.D., Bernard De Bruyne, M.D., Ph.D., Zsolt Piroth, M.D., Ph.D., Albert H.M. van Straten, M.D., Ph.D., Laszlo Szekely, M.D., Giedrius Davidavičius, M.D., Ph.D., Gintaras Kalinauskas, M.D., Ph.D., Samer Mansour, M.D., Rajesh Kharbanda, Ph.D., Nikolaos Östlund-Papadogeorgos, M.D., Adel Aminian, M.D., Keith G. Oldroyd, M.D., Nawwar Al-Attar, M.D., Ph.D., Nikola Jagic, M.D., Ph.D., Jan-Henk E. Dambrink, M.D., Ph.D., Petr Kala, M.D., Ph.D., Oskar Angerås, M.D., Ph.D., Philip MacCarthy, Ph.D., F.R.C.P., Olaf Wendler, M.D., Ph.D., Filip Casselman, M.D., Ph.D., Nils Witt, M.D., Ph.D., Kreton Mavromatis, M.D., Steven E.S. Miner, M.D., Jaydeep Sarma, Ph.D., F.R.C.P., Thomas Engstrøm, Ph.D., D.M.Sci., Evald H. Christiansen, M.D., Ph.D., Pim A.L. Tonino, M.D., Ph.D., Michael J. Reardon, M.D., Di Lu, M.S., Victoria Y. Ding, M.S., Yuhei Kobayashi, M.D., Mark A. Hlatky, M.D., Kenneth W. Mahaffey, M.D., Manisha Desai, Ph.D., Y. Joseph Woo, M.D., Alan C. Yeung, M.D., and Nico H.J. Pijls, M.D., Ph.D. for the FAME 3 Investigators

Patients with three-vessel coronary artery disease have been known to have better outcomes with coronary-artery bypass grafting (CABG) than patients with percutaneous coronary intervention (PCI). However, studies in which PCI is guided by measurement of fractional flow reserve (FFR) have been lacking.

In this multicenter, international, noninferiority trial, patients with three-vessel coronary artery disease were randomly assigned to undergo CABG or FFR-guided PCI with current-generation zotarolimus-eluting stents. The primary end point was the occurrence within 1 year of a major adverse cardiac or cerebrovascular event, defined as death from any cause, myocardial infarction, stroke, or repeat revascularization.

Source: The New England Journal of Medicine
Author(s): Andres Schanzer, Gustavo S. Oderich

An extremely useful and free-access update on a major vascular entity. The 'Areas of Uncertainty'  is a particularly useful chapter, discussing the available technology and its current supra-renal limitations and the emerging solutions.

Source: Journal of the American College of Cardiology
Author(s): Kevin R. An, Charlesde Mestral, Derrick Y. Tam, Feng Qiu, Maral Ouzounian, Thomas F. Lindsay, Harindra C. Wijeysundera, and Jennifer C.-Y. Chung

In this large series, Dr. Chung and associates performed a study on  completeness of guideline-directed imaging surveillance (GDIS) and its association with long-term outcomes.  In 888 patients with acute type A dissection who survived surgical repair, 14% received GDIS throughout a median follow-up of 5.2 years, and GDIS was available in 3.4% at 6 years.  Intriguingly, greater adherence to GDIS was associated with mortality (hazard ratio: 1.08; 95% confidence interval: 1.05-1.11) and reintervention (hazard ratio: 1.04; 95% confidence interval: 1.01-1.07).  

Source: The Annals of Thoracic Surgery
Author(s): Thilo P.K. Fleck, MD, Rafael Ayala, MD, Johannes Kroll, MD, Matthias Siepe, MD, David Schibilsky, MD, Christoph Benk, PhD, Sven Maier, MSc, Katja Reineker, MD, René Hoehn, MD, Frank Humburger, MD, Friedhelm Beyersdorf, MD, Brigitte Stiller, MD

Pediatric heart transplant (HTx) recipients with congenital heart defects need complex concomitant surgical procedures with the risk of prolonging the allograft’s ischemic time. Ex vivo allograft perfusion with the Organ Care System (OCS; Transmedics, Andover, MA) may improve survival of these challenging patients.

Source: The Annals of Thoracic Surgery
Author(s): Megan T. Quintana, MD, Michael Mazzeffi, MD, MPH, Samuel M. Galvagno, DO, PhD, Danny Herrera, BS, Gregory P. Boyajian, BS, Nicole M. Hays, BS, David Kaczorowski, MD, Ronson J. Madathil, MD, Raymond P. Rector, CCP, LP, Ali Tabatabai, MD, Daniel Herr, MD, Joseph Rabin, MD

Healthcare-associated infections (HAIs) in critically ill patients are a public health issue. Extracorporeal membrane oxygenation (ECMO) has been increasingly used for patients with severe cardiac or respiratory failure, but it may increase HAI risk. This study's goal was to characterize HAIs in ECMO patients at an ECMO referral center.

 

 

Source: World Journal for Pediatric and Congenital Heart Surgery
Author(s): Peter P. Roeleveld, MD, PhD, Nicolaas A. Blom, MD, PhD, Mark G. Hazekamp, MD, PhD

This is a commentary on the article, "Residual Lesions and ECMO: Seek and You Shall Find Ways to Narrow the ECMO Gap"

Source: World Journal for Pediatric and Congenital Heart Surgery.
Author(s): , Igor A. Kornilov, MD, PhD, Yuriy Y. Kulyabin, MD, PhD, Alexey V. Zubritskiy, MD, PhD, Dmitry N. Ponomarev, MD, PhD, Nataliya R. Nichay, MD, PhD, Ivan S. Murashov, MD, Alexander V. Bogachev-Prokophiev, MD, PhD

This study aims to assess the impact of diagnostic procedures in identifying residual lesions during extracorporeal membrane oxygenation (ECMO) on survival after pediatric cardiac surgery.

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): Nienaber CA, Yuan X

A brief focused commentary on a recent medium size Japanese series of succesful surgery for Acute Aortic Syndrome. The limitations of the series presented in well- written Uchida manuscript( and already to the last AATS Meeting) are being explored, and the commentators' allusion to the need for randomised trial is evident. The FET techniques should probably be considered for the extended arch reconstruction arm of such a trial. 

Source: The New England Journal of Medicine
Author(s): EMPEROR-Preserved Trial Investigators

A large randomised double-blinded trial reporting a considerable benefit ( 0.79 HR with very small p and supporting confidence intervals) of the Boehringer SGLPT-2 inhibitor regardless of presence of formal diagnosis of diabetes. If corroborated by further research and thence included on guidelines  , the findings may alter the standard of pharmacological care of our surgical patients, namely coronopaths and vasculopaths .  

Source: The Annals of Thoracic Surgery
Author(s): Uma M. Sachdeva, MD, PhD, Andrea L. Axtell, MD, MPH, Tiuri E. Kroese, MD, David C. Chang, PhD, MPH, Christopher R. Morse, MD

 

There is an increasingneed to understand how obesity effect treatment due to its  prevalence  and known association with esophageal cancer. 

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