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Journal and News Scan
The authors analyzed what is the best management for tricuspid valve disease in adults. This is a retrospective study with 1,735 patients who received tricuspid valve repair and 806 patients who underwent replacement. Replacement was associated with increased late mortality. Tricuspid valve repair did not result in a higher risk of reoperation. The authors concluded that tricuspid valve repair should be preferred whenever feasible.
Variations in, and elevation of, serum glucose within 24 hours of isolated CABG were associated with a significantly increased risk of cardiovascular complications and mortality within 30 days.
Puzzling subgroup from the GALILEO trial, which appears in the same issue of the periodical as an article that discredits the use of rivaroxaban as thromboprevention strategy :
And yet, in this particular subgroup, a subclinical benefit on leaflet mobility is being suggested! It would appear that the GALILEO will be discussed at length and in detail in the months and years to come.
A growing number of patients consult online resources for medical information, not only to learn about their own health issues and therapeutic options, but also to evaluate the background and reputation of their physicians. In 2015, the Workforce on Media Relations and Communications of The Society of Thoracic Surgeons (STS) created a Patient Information Task Force for the purpose of overhauling its patient information website into a comprehensive, multimedia, bilingual online education resource (ctsurgerypatients.org) for cardiothoracic surgical patients and their families. The website was also designed to be used as a reference tool to which STS member surgeons could refer their patients. The methodology and structure of the website are described, as well as an evaluation of its success using survey results both from patients utilizing the website and STS members.
Many surgeons remain skeptical navigating the intersection of professionalism and social media presence. Utilizing CTSNet.org profiles in Canada and the United States, these authors hypothesized that thoracic surgeons who are active on Twitter have a higher research citation index (h-index) than their nonactive counterparts.
Sixty-five children who underwent biventricular repair were extubated early (immediately after chest closure in the operating room) or were extubated later on intensive care unit (ICU). The results of these two different strategies were compared. Early extubation resulted in better cardiac output, fewer pleural effusion, and shorter stay in the ICU and hospital. The authors concluded that early extubation is safe and feasible and has a beneficial effect on the postoperative course.
In this study from the Mayo Clinic, outcomes of bioprosthetic valves placed in the pulmonary position in adults with congenital heart disease were evaluated. Cumulative prosthetic valve dysfunction at 15 years was 48%, raising the question of the efficacy of using such valves in this position.
An editorial related to a recent randomized controlled trial suggesting a striking benefit of anti-inflammatory secondary prevention after recent myocardial events.
The International Registry of Acute Aortic Dissection investigators analyzed the impact of cerebral malperfusion (CM) on the surgical outcomes of acute type A dissection in 2402 patients. The incidence of CM and neurologic deficit was 15.1% (362/2402). While patients with CM were less likely to present with chest pain and back pain, they had a significantly higher incidence of syncope, peripheral malperfusion, and shock and were more likely to have Debakey type I dissection and pericardial effusion on presentation. In-hospital mortality and the incidences of cerebrovascular accident and acute kidney injury were significantly higher in patients with CM. The authors conclude that surgeons may continue to offer lifesaving surgery for acute type A dissection to this critically ill cohort of patients with acceptable morbidity and mortality.
The authors investigated the influence of hypothermic circulatory arrest on renal function. This study includes 191 patients who underwent surgery for acute aortic dissection type A. Postoperative acute kidney injury was observed in 49 patients. Lower body ischemic time was one of the risk factors for postoperative kidney injury.