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Journal and News Scan
This original article covers the topic of surgical ablation for atrial fibrillation (AF) during coronary artery bypass surgery (CABG). The presented data from the Polish national registry of cardiac surgery procedures includes more than 7800 patients with underlying AF undergoing CABG. Just above 4% of patients received concomitant surgical ablation and underwent a 1:3 propensity matching. The results showed no concerns regarding the safety of the procedure, but a significantly improved long-term survival of patients undergoing surgical ablation compared to CABG alone.
A timely article addressing common questions related to the COVID pandemic, particularly regarding preoperative decision-making for pediatric/congenital heart surgery.
Interesting metanalytic review on the effect of binary gender in mammals.
"We were all worried about the availability of ventilators but actually you've got to have enough people to run them." Consultant Cardiothoracic Surgeon, Joel Dunning, decided to do something about it by redeploying as an ICU Nurse for the NHS, setting a great example for all clinicians being asked to consider roles outside of the comfort zone. He discusses his decision and experience as a surgeon-turned-ICU nurse during the COVID-19 pandemic in this Medscape UK interview.
This manuscript by Yamanashi et al retrospectively looks into the outcome of patients with newly classified clinical T4 lung cancer. They report 93 patients who underwent surgical treatment during a 10-year study period. They identified several risk factors and conclude that “surgery should be considered if there is no suspicion of N2 disease and complete resection is technically feasible.”
Modolo et al. present a substudy from the EXCEL trail. They looked into the impact of the SYNTAX score II treatment recommendation for patients with left main disease. Patients who were randomized to PCI treatment against the SYNTAX II CABG recommendation had a four-fold higher mortality compared to patients who underwent CABG in conclusion with the syntax II recommendation.
A prepublication manuscript describing a balanced system for multidimensional decision making about timing of surgery in the COVID era.
The UNOS donor heart allocation system was revised in 2018, giving priority to patients on inpatient mechanical circulatory support (MCS). Patients admitted with heart failure-associated cardiogenic shock were tracked for the frequency of use of mechanical circulatory support before and after implementation of this change. In non-transplant centers, there was no change in the frequency of MCS. In transplant centers, use of MCS increased from 25% to 43%.
Guidance document for the triage of operations for thoracic malignancies produced by the Thoracic Outcomes Research Network. Their recommendations emphasize the importance of shared decision making, transparency and adherence to ethical principals.
Guidance document to assist in decision making and triage of congenital cardiac surgical patients during the COVID-19 pandemic. The article also includes guidance principles on the need and methods to preserve the workforce and emphasizes the need for regional collaboration, use of telecommunication technologies, and the evolving role of the congenital cardiac surgeon in the pandemic.