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Journal and News Scan

Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Author(s): Daniel M. Bethencourt, MD

In this article, Dr. Bethencourt outlines eight key strategies for successful robotic heart startups and how to initiate a new robotic program at one's institution. 

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Jennifer Chung, MD, MSC, Thais Coutinho, MD, Michael W.A. Chu, MD, MEd, Maral Ouzounian, MD, PhD

This succinct article reviews the contemporary literature regarding sex differences in thoracic aortic disease including the epidemiology, biology, natural history, surgical management and outcomes. Furthermore, the authors propose explanations for the observed differences and puts out a call to action to close the gender gap in sex differences in thoracic aortic disease. 

Source: The Annals of Thoracic Surgery
Author(s): Giuseppe Santarpino, MD, Paolo Berretta, MD, Utz Kappert, MD, PhD, Kevin Teoh, MD, Carmelo Mignosa, MD, Bart Meuris, MD, PhD, Emmanuel Villa, MD, PhD, Alberto Albertini, MD, Thierry P. Carrel, MD, PhD, Martin Misfeld, MD, PhD, Gianluca Martinelli, MD, Kevin Phan, MD, Antonio Miceli, MD, PhD, Thierry Folliguet, MD, PhD, Malak Shrestha, MD, Marco Solinas, MD, Martin Andreas, MD, PhD, Carlo Savini, MD, PhD, Tristan Yan, MD, PhD, Theodor Fischlein, MD, Marco Di Eusanio, MD, PhD

The present study reports on the multicenter cohort of patients from the Sutureless and Rapid-Deployment Aortic Valve Replacement International Registry who underwent minimally invasive reoperative aortic valve replacement with a sutureless or rapid-deployment prosthesis. This study demonstrates the safety and feasiblitity of minimally invasive reoperative aortic valve replacement with a sutureless or rapid-deployment prosthesis. 

Source: The Annals of Thoracic Surgery
Author(s): Ronald D. Baxter, MD, James I. Fann, MD, J. Michael DiMaio, MD, Kevin Lobdell, MD

The present article is a digital health primer for cardiothoracic surgeons that reviews the role of data integration, processing, modelling, monitoring, and more on the future of cardiothoracic surgery.

Source: Annals of Thoracic Surgery
Author(s): Anita Nguyen, MBBS MS; Hartzell V. Schaff, MD; Arman Arghami, MD; Gabor Bagameri, MD; M. Sertac Cicek, MD; Juan A. Crestanello, MD; Richard C. Daly, MD; Kevin L. Greason, MD; Alberto Pochettino, MD; Phillip G. Rowse, MD; John M. Stulak, MD; Brian D. Lahr, MS; Joseph A. Dearani, MD

The authors created 612 matched pairs of patients with a history of hematologic malignancy and controls. They compared operative details, early postoperative complications, and late survival.

Patients with prior diagnosis of malignancy had lower hemoglobin levels and were at greater risk of receiving postoperative blood transfusions (47.4% vs. 35.6%, P<0.0001).
Reoperations for postoperative bleeding (4.7% vs. 3.3%, P=0.253) and stroke (1.3% vs. 1.3%, P>0.999) were similar. Thirty-day mortality in patients with hematologic malignancy was 3.3%, and 1.5% in matched controls (P=0.061).
Overall survival among patients with cancer was reduced (P<.0001).

The authors concluded that while late survival is reduced in patients with hematologic malignancies, early outcomes are generally similar to matched controls. As such, these patients should be offered surgery. 

Source: The Annals of Thoracic Surgery
Author(s): Fausto Biancari., MD, PhD; Antti Valtola, MD; Tatu Juvonen, MD, PhD; Annastiina Husso, MD, PhD; Sebastian Dahlbacka, MD, PhD; Teemu Laakso, MD; Maina P. Jalava, MD; Tuomas Tauriainen, MD, PhD; Tuomas Ahvenvaara, MD; Eeva-Maija Kinnunen, MD, PhD; Matti Niemelä, MD, PhD; Timo Mäkikallio, MD, PhD; Markku Eskola, MD, PhD; Marko P.O. Virtanen, MD; Pasi Maaranen, MD; Stefano Rosato, MSc; Vesa Anttila, MD, PhD; Antti Vento, MD, PhD; Juhani Airaksinen, MD, PhD; Peter Raivio, MD, PhD

The authors comducted a comparative analysis of the Trifecta and Perimount Magna Ease bioprosthetic valves, using data from a national Finnish database between 2008 and 2017.

They included 2216 patients, with a mean follow-up 3.8±2.1 years. 851 patients received the Trifecta valve and 1365 received the Perimount Magna Ease bioprosthesis. The rates of late mortality and prosthetic valve endocarditis were comparable in the study cohorts. At 7-year, the Trifecta cohort had significantly higher risk of repeat aortic valve replacement for structural valve failure (3.3% vs. 0%), repeat aortic valve replacement for any cause (3.6% vs. 0.4%) and repeat aortic valve replacement and/or prosthetic valve endocarditis (4.1% vs. 0.9%) compared to the Perimount Magna Ease cohort.
Among 772 propensity score matched pairs, at 7-year, the Trifecta cohort had a higher risk of repeat aortic valve replacement for structural valve failure (5.7% vs. 0%).

The authors report that the Trifecta aortic bioprosthesis is associated with a higher occurrence of repeat aortic valve replacement for structural valve failure compared to the Perimount Magna Ease bioprosthesis.

Source: Circulation Research
Author(s): Laura A Bienvenu, Ana Maluenda, James D McFadyen, Amy Kate Searle, Eefang Yu, Carolyn Haller, Elliot L Chaikof, Karlheinz Peter, Xiaowei Wang

A review that may affect pharma strategy in the immediate future.

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): Niv Ad, Jessica G Y Luc, Tom C Nguyen, COVID-19 North American Cardiac Surgery Survey Working Group

The present study demonstrates the impact of COVID-19 on North American cardiac surgery institutions as well as helps associate region and COVID-19 burden with the impact on cardiac surgery volumes and case mix.

Source: The Annals of Thoracic Surgery
Author(s): Takashi Miura, Kikuko Obase, Tsuneo Ariyoshi, Ichiro Matsumaru, Shogo Yokose, Shun Nakaji, Yuichi Tasaki, MD, Takashi Shimada, Junya Miyamoto, Kiyoyuki Eishi

This single-institution study of 83 patients investigated mitral valve repair for infective endocarditis based on the location of the lesion. 

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Josephina Haunschild, Konstantin von Aspern, Zara Khachatryan, Edoardo Bianchi, Till Friedheim, Sabine Wipper, Constantin J Trepte, Susann Ossmann, Michael A Borger, Christian D Etz

Haunschild et al. investigated the effect of cerebrospinal fluid pressure elevation on spinal cord perfusion in a large animal model. They could measure spinal cord perfusion by NIRS and microsphere injections. The spinal perfusion was significantly diminished during elevated cerebrospinal fluid pressure. Furthermore, rapid withdrawal of cerebrospinal fluid was associated with hyperperfusion, which might lead to aggravated ischemia-reperfusion injury and should therefore be avoided.

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