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Journal and News Scan

Source: JACC: Heart Failure
Author(s): Farhan Zafar, MD, Chet R. Villa, MD, David L. Morales, MD, Elizabeth D. Blume, MD, David N. Rosenthal, MD, James K. Kirklin, MD, Angela Lorts, MD
The authors reviewed the retrospective INTERMACS database to assess whether outcomes after continuous-flow (CF) LVAD implantation varied with patient BSA.  A total of over 10,000 CF LVAD patients were included.  Of these, 231 (2%) had a BSA < 1.5 m².   Outcomes:  Survival was similar.  Postoepratively, smaller patients had a higher incidence of bleeding and driveline infection, but a lower incidence of RV failure and renal dysfunction.
Source: European Heart Journal Cardiovascular Imaging
Author(s): Ngo A, Hassager C, Thyregod HG, Søndergaard L, Olsen PS, Steinbrüchel D, Hansen PB, Kjærgaard J, Winther-Jensen M, Ihlemann N.
The authors report on an echocardiographic sub-study of the NOTION trial, a prospective randomized study which compared outcomes between 120 patients undergoing TAVI and 112 patients undergoing aortic valve replacement (AVR).  Although at 12 months of follow up, aortic valve area had increased significantly more in patients undergoing TAVI, left ventricular mass regression was more pronounced in those patients undergoing AVR. Also, whereas end diastolic volume (EDV) decreased in the AVR group, EDV increased in the TAVI group. Patients undergoing TAVI had more paravalvular leaks and need for pacemaker implantation. This could explain the differences in left ventricular mass and EDV in favour of AVR.
Source: Annals of Cardiothoracic Surgery
Author(s): Rakesh Suri, Randolph Chitwood, Matteo Pettinari, Kent Rehfeldt, Harold Burkhart, Didier Loulmet
Dr Rakesh Suri is the Guest Editor in this special issue of the Annals of Cardiothoracic Surgery exploring the emerging role of robotic instrumentation in cardiac surgery. With leading authors from the most experienced international institutions, we examine the current evidence, limitations, and future directions of this minimally invasive surgical technique. Contributors include Randolph Chitwood, Matteo Pettinari, Kent Rehfeldt, Harold Burkhart, Didier Loulmet and many more.
Source: Circulation Research
Author(s): Pouya Tahsili-Fahadan, Romergryko G. Geocadin
A review of particular interest for procurement (retrieval) of hearts after brain injury, especially subarachnoid bleeding, the commonest cause of death in DBD in our practice.  The authors discuss, amongst other things, the early stress micro-infarcts that may limit the performance of the donated heart, especally in female donors with sub arachnoid bleeding, and explain some common electrocardiographic changes ( especially the cerebral T ) that may puzzle the retrieval (procurement) team.  The essential catecholaminergic pathway for these changes is discussed in detail.  
Source: www.thoracicsurgery.co.uk
Author(s): Babu Naidu and the Birmingham Heartlands Hospital
Check out this very interesting website that has been set up to help patients who are looking for information on thoracic surgery prior to an operation.  It is really friendly and comprehensive and is a great resource for all patients who may want to find out more about their  operation. 
Source: Injury
Author(s): Fredric M. Pieracci, , , Sarah Majercik, Francis Ali-Osman, Darwin Ang, Andrew Doben, John G. Edwards, Bruce French, Mario Gasparri, Silvana Marasco, Christian Minshall, Babak Sarani, William Tisol, Don H. VanBoerum, Thomas W. White
These guidelines are intended to be a detailed, evidence-based resource for surgeons who practice SSRF. The goal of the author group was to both update and expand upon previous guidelines by focusing on SSRF specifically and incorporating the rapid increase in both literature and technology observed over the last five years.
Source: World Journal for Pediatric and Congenital Heart Surgery
Author(s): Anthony A. Sochet, MD, MSHS, Alexander M. Cartron, BS, Aoibhinn Nyhan, BS, Michael C. Spaeder, MD, Xiaoyan Song, PhD, Anna T. Brown, MD, and Darren Klugman, MD
A retrospective, matched cohort study to determine attributable hospital costs associated with surgical site infection after pediatric cardiothoracic surgery was performed. Of the 981 surgical cases within the study period, 12 with surgical site infection were identified. Compared to individually matched controls, children with surgical site infection had an associated increase in hospital costs of $136,950/case and hospital length of stay of 9.5 days/case. These data stress the importance of infection surveillance and prevention.
Source: Canadian Journal of Cardiology
Author(s): Nagpal AD, Singal RK, Arora RC, Lamarche Y
The authors of this review article offer an approach to the utilization of a contempory mechanical circulatory support devices.  They further provide insights of the key role that well-functioning interdisciplinary teams contribute to the success of a MCS program and future directions to consider as this field continues to rapidly evolve.
Source: Canadian Journal of Cardiology
Author(s): Beaubien-Souligny W, Bouchard J, Desjardins G, Lamarche Y, Liszkowski M, Robillard P, Denault A.
Appropriate perioperative fluid management is of increasing interest for the team caring for  the critically ill cardiac patient as fluid overload has been shown to have negative effects on organ function.  The Authors provide the reader with practical ultrasonographic techniques to examine patients for signs of extracardiac fluid overload and how to use this information to tailor management for the patient in a cardiac ICU.
Source: Canadian Journal of Cardiology
Author(s): Arora RC, Djaiani G, Rudolph JL
In this is review article the authors have proposed a "3-strike" model of risk that increases the likelihood of experiencing postoperative delirium in older adults undergoing cardiac surgery. The 3 strikes consists of a baseline vulnerability (such as frailty), the intraoperative surgical stressor and the postoperative hemodynamic perturbations (and other process of care factors) that can contribute to the occurance of postoperative delirium. Pratical tips on how cardiac team can begin to address this important issue are provided in this review.

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