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Journal and News Scan

Source: The New England Journal of Medicine
Author(s): Joakim Nordanstig, M.D., Ph.D., Stefan James, M.D., Ph.D., Manne Andersson, M.D., Ph.D., Mattias Andersson, M.D., Peter Danielsson, M.D., Ph.D., Peter Gillgren, M.D., Ph.D., Martin Delle, M.D., Ph.D., Jan Engström, M.D., Torbjörn Fransson, M.D., Maher Hamoud, M.D., Ph.D., Anna Hilbertson, M.D., Patrik Johansson, M.D., Lars Karlsson, M.D., Ph.D., Björn Kragsterman, M.D., Ph.D., Hans Lindgren, M.D., Ph.D., Karin Ludwigs, M.D., Stefan Mellander, M.D., Ph.D., Niklas Nyman, M.D., Henrik Renlund, Ph.D., Birgitta Sigvant, M.D., Ph.D., Per Skoog, M.D., Ph.D., Joachim Starck, M.D., Gustaf Tegler, M.D., Ph.D., Asko Toivola, M.D., Maria Truedson, M.D., Carl-Magnus Wahlgren, M.D., Ph.D., Jonas Wallinder, M.D., Andreas Öjersjö, M.D., and Mårten Falkenberg, M.D., Ph.D.

An ad hoc interim analysis pursuant to previous publications raising concerns on Paclitaxel DCS in chronic critical and not-critical lower limb ischaemia. The short manuscript requires careful reading to form an individual opinion beyond the relatively simple arithmetics: slightly more deaths in the intervention group. The vasculopathic cohort had a 75% crude overall survival after only 2.5 years.

Source: Journal of Cardiac Surgery
Author(s): Fatima Osman, Noah Caplin, Mohamad Bashir

A brief and readable editorial on the United Kingdom prespective on the global impact of the pandemic to the delivery of cardiovascular care, attempting a semi-quantitative economic appraisal of the problem.

Source: The New England Journal Of Medicine
Author(s): Helio P. Guimarães, Renato D. Lopes, Pedro G.M. de Barros e Silva, Idelzuita L. Liporace, Roney O. Sampaio, Flávio Tarasoutchi, Conrado R. Hoffmann-Filho, Rodrigo de Lemos Soares Patriota, Tiago L.L. Diana Lamprea, Dalton B. ., Fernando A. Atik, Fabio S. Silveira, ., Fabio R. Farias, Diogo O. Barreto, Adail P. Almeida, Alexandre C. Zilli, João D. de Souza Neto, Margaret A. Cavalcante, Fernando A.M.S. Figueira, Flávia C.S. Kojima, Lucas Damiani, Renato H.N. Santos, Nanci Valeis, Viviane B. Campos, Jose F.K. Saraiva, Francisco H. Fonseca, Ibraim M. Pinto, Carlos C. Magalhães, Joao F.M. Ferreira, John H. Alexander, Ricardo Pavanello, Alexandre B. Cavalcanti, Otavio Berwanger, for the RIVER Trial Investigators

A large RCT with results somewhat supportive of considering a NOAC in the place of warfarin for post operative surgical patients. The study will be weighed against healthcare economical aspects. One question will arise:  Why,  if there was a subgroup ( the cohort had an average age below 60 years) eceiving lifelong warfarin or equivalent anticoagulation prior to surgery, they did not have a mechanical prosthesis?  It is of course possible that local financial constrains impede access to such devices, and bioprostheses were more affordable.  

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Hughes GC

A relatively recent, open-access, brief viewpoint on the utility of screening for thoracic aortic pathologies. Although the negative opinion expressed by the author may not be universally accepted, a debate fuelled by data and especially patient-centered cerebrospinal outcomes will certainly be of benefit; evem more so with the spreading of metrics for prediction of acute complications of aortic disease.

Source: Journal of Cardiothoracic and Vascular Anesthesia
Author(s): Jason Z. Qua, Lee-Wei Kaoa, Jennifer E. Smitha, Alexander Kuoa, Albert Xueb, Manoj H. Iyerc, Michael K. Essandohc, and Adam A. Dalia

This is a comprehensive review of current strategies for monitoring and protection of the brain during aortic arch surgery under hypothermic circulatory arrest. 

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Lucas Hoyos Mejía, Alejandra Romero Román, Mariana Gil Barturen, Maria del Mar Córdoba Pelaez, José Luis Campo-Cañaveral de la Cruz, José Manuel Naranjo, Silvana Crolwey Carrasco, Shin Tanaka, Alvaro Sánchez Calle, Andrés Varela de Ugarte, David Gómez de Antonio

Hoyos Mejia et al. present a single center report regarding the outcome of thoracic surgery during the COVID-19 pandemic. They recorded a significant reduction in thoracic surgical cases. They observed five cases of coronarvirus infection in 101 surgical patients within 14 days after surgery. Two of these patients needed inpatient treatment and none died due to the infection. They conclude that it is safe to perform selected surgical procedures during the pandemic if managed properly.

Source: The Annals of Thoracic Surgery
Author(s): E. Hope Weissler, MD, Soraya L. Voigt, MD, Vignesh Raman, MD, Oliver Jawitz, MD, Julie Doberne, MD, PhD, Jatin Anand, MD, Ryan Plichta, MD, Jeffrey G. Gaca, MD, Richard L. McCann, MD, and G. Chad Hughes, MD

This study evaluated preoperative cerebrospinal fluid drainage (CSFD) In patients undergoing isolated descending TEVAR with or without arch involvement (+/− arch TEVAR).

Source: Frontiers in Oncology
Author(s): Rilan Bai, Lingyu Li, Xiao Chen, Naifei Chen, Wei Song , Jiuwei Cui*

A scholarly and sober narrative review on , as the authors state,  a ' hot topic' that is already being debated in Multidisciplinary Meetings and Lung Cnacer Boards.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Philipp Angleitner, Aleksa Matic, Alexandra Kaider, Kamen Dimitrov, Sigrid Sandner, Dominik Wiedemann, Julia Riebandt, Thomas Schlöglhofer, Günther Laufer, Daniel Zimpfer

Philipp Angleitner et al. present a retrospective study regarding incidence and outcome of bloodstream infections in LVAD patients. The incidence of bloodstream infections is 32.1% within the first year. This event was associated with increased risk of death and stroke. Risk factors of bloodstream infections were identified as lower albumin and ECMO/IABP prior to LVAD implantation.

Source: The Annals of Thoracic Surgery
Author(s): Danielle O’Hara, BS, Allison McLarty, MD, Erick Sun, BA, Shinobu Itagaki, MS, MD, Henry Tannous, MD, Danny Chu, MD, Natalia Egorova, PhD, and Joanna Chikwe, MD

The authors used The Society of Thoracic Surgeons Database to evaluate cerebral perfusion strategies for type A aortic dissection.