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Journal and News Scan

Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Author(s): Kunihiko Yoshino, MD, Kohei Abe, MD, Koyu Suzuki, MD, Rihito Tamaki, MD, Atusyuki Mituishi, MD, Manabu Yamasaki, MD, Hiroyasu Misumi, MD

In this article, the authors present a novel no-touch saphenous vein harvesting technique with preservation of the perivascular tissue with use of the harvester (MAQUET Getinge Group, Getinge AB, Göteborg, Sweden).

Source: European Journal of Cardio-Thoracic Surgery
Author(s): An-Hsun Chou, Victor Chien-Chia Wu, Dong-Yi Chen, Kuo-Chun Hung, Shang-Hung Chang, Pao-Hsien Chu, Shao-Wei Chen

Chou et al. analyzed a nationwide ECMO register regarding patients with liver cirrhosis. They identified 233 patients, which represents 3.3% of all 7003 patients. These patients had a very high one-year mortality of more than 95%. Therefore, the authors conclude that ECMO should be used very carefully in patients with known liver cirrhosis.

Source: Circulation
Author(s): Safi U. Khan, Maninder Singh, Shahul Valavoor, Muhammad U. Khan, Ahmad N. Lone, Muhammad Zia Khan, Muhammad Shahzeb Khan, Preethi Mani, Samir R. Kapadia, Erin D. Michos, Gregg W. Stone, Ankur Kalra, and Deepak L. Bhatt

An open-access large metanalysis on the utility and risks of antiplatelets after PCI. Of note, mortality was not a primary endpoint. The message is that long dual antiplatelet use is an exchange between avoidance of myocardial events and serious bleeding.

The novel oral anticoagulants may enter the arena soon..

Source: The Annals of Thoracic Surgery
Author(s): Jatin Anand, MD, Julie Doberne, MD, PhD, Charles M. Wojnarski, MD, MS, Peter K. Smith, MD, Brittany A. Zwischenberger, MD.

The authors implemented a prospective longitudinal, residency-wide coronary anastomosis simulation curriculum providing each participant with a low-fidelity coronary anastomosis simulator, high-quality instruments, and faculty mentor. They demonstrate at 1 year of follow-up improve anastomosis times and technical skills. A great model for programs to adapt to enhance their institution's simulation curriculum. 

Source: The Annals of Thoracic Surgery
Author(s): Ashraf A. Sabe, MD, Edward Percy, MD, Tsuyoshi Kaneko, MD, Ryan P. Plichta, MD, G. Chad Hughes, MD

In this article, the authors review the literature highlighting factors that increase a patient's risk in acute Type A aortic dissection repair and provides suggestions for risk stratification to guide timing of surgery in select patients.

Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Author(s): Aristotelis Panos, MD, Kyriakos Mpellos, MD, Sylvio Vlad, MD, Patrick O. Myers, MD

In this article, the authors demonstrate a novel technique of antegrade cardioplegia decannulation using the Cor-Knot system with phenomenal video and description on their case series. This technique has great utility in cases where closing the cardioplegia cannulation site can be challenging in minimally invasive video-assisted cardiac surgery.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Benedetto Del Forno, Guido Ascione, Elisabetta Lapenna, Cinzia Trumello, Stefania Ruggeri, Igor Belluschi, Alessandro Verzini, Giuseppe Iaci, David Ferrara, Davide Schiavi, Roberta Meneghin, Alessandro Castiglioni, Ottavio Alfieri, Michele De Bonis

Del Forno et al. present a retrospective study of 77 patients with de-novo 50-70% coronary stenosis undergoing valvular surgery. In these patients, bypass grafting of these coronaries was intentionally omitted. Within their cohort they did not observe any perioperative mortality and there was only one acute coronary syndrome leading to PCI and the overall PCI rate at six years was only 8 +/- 3.9%. Therefore, it seems to be safe to not bypass such stenosis and leave it to later follow-up and ischemia diagnostics.

Source: Journal of Vascular Surgery
Author(s): Brandon McGuinness, Michael Troncone, Lyndon P. James, Steve Bisch, Vikram Iyer

Patients with aneurysms 7 cm or greater demonstrated a higher probability of survival when treated immediately, compared to delayed repair, for patients under 80 years of age.

An interesting attempt to construct a decision tool for aortic aneurysms.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Massimiliano M Marrocco-Trischitta, Hector W de Beaufort, Gabriele Piffaretti, Stefano Bonardelli, Mauro Gargiulo, Michele Antonello, Joost A van Herwaarden, Sara Boveri, Raffaello Bellosta, Santi Trimarchi on behalf of the MALAN Collaborators

This original article retrospectively analyzes the outcome of 359 patients after TEVAR at seven centers. All patients were stratified regarding the modified arch landing nomenclatur (MALAN). The rate of proximal endograft failure was significantly lower in patients with favorable landing area (MALAN 2/III and 3/III). Regarding these results, the MALAN classification can be used to guide decisions in pre-TEVAR planning.

Source: Journal of Cardiothoracic and Vascular Anesthesia
Author(s): Harish Ram, Sanjay Dwarakanath, Ashley E. Green, Johannes Steyn, and Eugene A. Hessel

This is a comprehensive review on iatrogenic aortic dissection occurring intraoperatively,and within one month after cardiac surgery, covering the incidence, discovery, pathology, detection modalities, management, risk factors, and prevention of this rare but life-threatening complication.