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Journal and News Scan
Following a charitable initiative launched in 2014 to impact one million underserved people by 2020, Edwards provides a current update on progress toward that goal. Dr. David Adams and other specialists comment on the magnitude and importance of the effort, and a request for proposals announces the beginning of the foundation's 2017 grant cycle.
He weighed merely 470 grams at birth and was just the size of a palm. He was born prematurely after 28 weeks (5.5 months). His eyes hadn't opened, lungs weren't developed, skin resembled parchment paper, too fragile and delicate to touch, and he had heart complications.
After 15 days of birth, he underwent a heart surgery and has now become the tiniest miracle baby to have undergone a PDA (patent ductus arteriosus) corrective operation.
An assessment of regional lung resection outcomes relative to compliance with NCCN resection guidelines was performed. Negative margins 94%, 91% anatomic, 51% hilar nodes sampled, 26% 3 mediastinal nodal stations sampled. On average, 17% of resections met all criteria, although the trend was upward over time. Survival was better for pts who met all four criteria.
Surgery for treatment of this aortopathy entailing aortic root replacement was assessed in this single institution retrospective study of 34 children. 90% had valve sparing surgery; there was no operative mortality. Reintervention is commonly needed, and frequent surveillance imaging is recommended.
Using data from the CoreValve US Expanding Use Study, outcomes for patients with end stage renal disease (ESRD) undergoing TAVR were evaluated using an endpoint of all-cause mortality or major stoke at 1 year. Mortality at 1 year was 30%, and the stroke incidence was 2.1%. New permanent pacemaker need was 27%. The 1-year mortality appears increased compared to patients without ESRD.
UNOS data for over 14,500 isolated heart transplant patients were analyzed to assess the relationship between donor distance from the transplantation center and recipient mortality at 30 days and 1 year. Ischemic time correlated with donor distance. Mortality was reduced for donor distances over 25 miles, and the reduction was highest for distances greater than 500 miles.
Bicuspid aortic valve (BAV) has been considered a relative contraindication for transcatheter aortic valve implantation (TAVI). Nevertheless, favourable results have been reported from registries and observational reports. In this manuscript, the authors present some useful technical considerations and tips-and-tricks for use during TAVI procedures in BAV.
A short and readable commentary on monoclonal antibodies and dyslipidaemias, particularly on FOURIER, SPIRE and ODYSSEY trials
With the 50th birthday of CABG, the New England Journal of Medicine published this nice article on the history and development of CABG.
I was moved by this editorial on global health matters in a daily British newspaper by an academic medical colleague, written in response to anticipated changes in the leadership of the World Health Organisation. It is perhaps time for us surgeons to augment our administrative participation in global healthcare.