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Journal and News Scan

Source: The New England Journal of Medicine
Author(s): Shamir R. Mehta, David A. Wood, Robert F. Storey, Roxana Mehran, Kevin R. Bainey, Helen Nguyen, Brandi Meeks, Giuseppe Di Pasquale, Jose López-Sendón, David P. Faxon, Laura Mauri, Sunil V. Rao, Laurent Feldman, P. Gabriel Steg, Álvaro Avezum, Tej Sheth, Natalia Pinilla-Echeverri, Raul Moreno, Gianluca Campo, Benjamin Wrigley, Sasko Kedev, Andrew Sutton, Richard Oliver, Josep Rodés-Cabau, Goran Stanković, Robert Welsh, Shahar Lavi, Warren J. Cantor, Jia Wang, Juliet Nakamya, Shrikant I. Bangdiwala, and John A. Cairns, for the COMPLETE Trial Steering Committee and Investigators

Quite interesting to see that the incidence of revascularisation after multivessel PCA (the additional element on the second co-primary outcome) appears to have occured in more than 1% of the patients within three years...

Source: Journal of the American College of Cardiology
Author(s): Mohammed Qintar, Karin H. Humphries, Julie E. Park, Suzanne V. Arnold, Yuanyuan Tang, Phillip Jones, Adam C. Salisbury, Faraz Kureshi, Michael E. Farkouh, Valentin Fuster, David J. Cohen and John A. Spertus

Using data from the FREEDOM (Future Revascularizaiton Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease) trial, the authors developed an 8 variable model that predicts individual risk of major acute cardiovascular events in diabetic patients with multivessel disease. Percutaneous coronary intervention (PCI) never outperformed CABG; the latter was superior to PCI in 54% of patients overall and in 100% of those who smoked. 

Source: Brazilian Journal of Cardiovascular Surgery
Author(s): Andrzej Loesch, Bruno Botelho Pinheiro, Michael Richard Dashwood

This review offers data suggesting that intermediate-term outcomes for saphenous vein grafting are similar to those for radial artery grafts used for CABG.

Source: CA: A Cancer Journal for Clinicians
Author(s): Kathryn H. Schmitz, Anna M. Campbell, Martijn M. Stuiver, Bernardine M. Pinto, Anna L. Schwartz, G. Stephen Morris, Jennifer A. Ligibel, Andrea Cheville, Daniel A. Galvão, Catherine M. Alfano, Alpa V. Patel, Trisha Hue, Lynn H. Gerber, Robert Sallis, Niraj J. Gusani, Nicole L. Stout, Leighton Chan, Fiona Flowers, Colleen Doyle, Susan Helmrich, William Bain, Jonas Sokolof, Kerri M. Winters‐Stone, Kristin L. Campbell, Charles E. Matthews

A coalition of international organizations dealing with cancer and sports medicine have updated recommendations, stating that exercise may help prevent cancer and can improve survival in patients with cancer. Methods of implementation are discussed.

Source: NEJM
Author(s): Stuart J. Spechler, John G. Hunter, Karen M. Jones, Robert Lee, Brian R. Smith, Hiroshi Mashimo, Vivian M. Sanchez, Kerry B. Dunbar, Thai H. Pham, Uma K. Murthy, Taewan Kim, Christian S. Jackson, Jason M. Wallen, Erik C. von Rosenvinge, Jonathan P. Pearl, Loren Laine, Anthony W. Kim, Andrew M. Kaz, Roger P. Tatum, Ziad F. Gellad, Sandhya Lagoo-Deenadayalan, Joel H. Rubenstein, Amir A. Ghaferi, Wai-Kit Lo, Ronald S. Fernando, Bobby S. Chan, Shirley C. Paski, Dawn Provenzale, Donald O. Castell, David Lieberman, Rhonda F. Souza, William D. Chey, Stuart R. Warren, Anne Davis-Karim, Shelby D. Melton, Robert M. Genta, Tracey Serpi, Kousick Biswas, and Grant D. Huang

Patients with proton-pump inhibitor refractory heartburn have a multitude of underlying causes. In this randomized trial of patients with refractory heartburn, only 21% had symptoms related to gastroesophageal reflux disease. Treatments included fundoplication vs omeprazole and baclofen vs omeprazole. Success at one year was higher in the surgery group than either of the medical therapy groups (67% vs 28% vs 12%).

Source: JACC
Author(s): Kuan Ken Lee, Amy V. Ferry, Atul Anand, Fiona E. Strachan, Andrew R. Chapman, Dorien M. Kimenai, Steven J.R. Meex, Colin Berry, Iain Findlay, Alan Reid, Anne Cruickshank, Alasdair Gray, Paul O. Collinson, Fred S. Apple, David A. McAllister, Donogh Maguire, Keith A.A. Fox, David E. Newby, Chris Tuck, Catriona Keerie, Christopher J. Weir, Anoop S.V. Shah, Nicholas L. Mills and on behalf of the High-STEACS Investigators

Using gender specific thresholds for abnormalities in cardiac troponin I, the rate of injury among women increased by 42%. This did not translate into improved management of women, who remained about half as likely to undergo revascularization, receive dual antiplatet therapy, or undergo other interventions.  

Source: Journal of Cardiothoracic and Vascular Anesthesia
Author(s): Meenal Rana, Hakeem Yusuff, Vasileios Zochios

A narrative review offering an intensivists' viewpoint  on specific cardiovascular sequela of double-lumen anaesthesia for pulmonary resections (and by extension, implantation of donor lungs) and other cardiothoracic and vascular operations.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Philip J. McCall, Alex Arthur, Adam Glass, David S. Corcoran, Alan Kirk, Alistair Macfie, John Payne, Martin Johnson, John Kinsella, Benjamin G. Shelle

An extremely interesting  research question abutting cardiac physiology, and a manuscript that may generate future additional clinical research.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Siva Raja, Sudish C. Murthy, Andrew Tang, Hafiz Umair Siddiqui, Malav P. Parikh, Usman Ahmad, Scott Gabbard, Prashanthi Thota, Monica N. Ray, Neha Wadhwa, Madhu R. Sanaka

Interesting sizeable series, and a commentary that follows, on what is effectively a thoracic example of Natural Orifice Transluminal Endoscopic Surgery (NOTES).

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Sebron Harrison, Tiany Sun, Mohamed K Kamel, Corbin Cleary, Brendon M Stiles, Nasser K Altorki, Art Sedrakyan

These incredible findings are the result of an analysis of the New York State Department of Health Statewide Planning and Research Cooperative database. They represent over 99,000 major lung resections from 1995 to 2014. Surgeons performing more than 30 lobectomies per year have a mortality of 1% and surgeons performing less than 12 per year have a mortality of 2.8%. But the most surprising fact is that the low-volume surgeons performed 90% of the lobectomies. Do you agree with the results of this very large study and if you do, what do you think should happen about this?