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Journal and News Scan

Source: The Society of Thoracic Surgeons
Author(s): Bartley P. Griffith, MD

In a brand new type of surgery, STS member Dr. Bartley P. Griffith and the University of Maryland Medicine team performed a successful transplant of a genetically modified pig heart into a fifty-seven-year-old man with terminal heart disease.

Source: NEJM Evidence
Author(s): Eric Lim, F.R.C.S., Tim J.P. Batchelor, F.R.C.S., Joel Dunning, F.R.C.S., Michael Shackcloth, F.R.C.S., Vladimir Anikin, F.R.C.S., Babu Naidu, F.C.R.S. (C-Th), Elizabeth Belcher, F.C.R.S. (C-Th), Mahmoud Loubani, F.R.C.S. (C-Th), Vipin Zamvar, F.R.C.S. (C-Th), Rosie A. Harris, M.Sc., Lucy Dabner, M.Sc., Holly E. McKeon, M.Res., Sangeetha Paramasivan, Ph.D., Alba Realpe, Ph.D., Daisy Elliott, Ph.D, Paulo De Sousa, P.G, Elizabeth A. Stokes, D.Phil, Sarah Wordsworth, Ph.D., Jane M. Blazeby, F.C.R.S., Chris A. Rogers, Ph.D.

Randomized evidence on the comparative outcomes of early-stage lung cancer resection by video-assisted thoracoscopic surgery (VATS) versus open resection is limited. Here was conducted a parallel-group multicenter randomized trial that recruited participants with known or suspected early-stage lung cancer and randomly assigned them to open or VATS resection of their lesions.

Source: Japanese Association for Coronary Artery Surgery
Author(s): Hitoshi Yokoyama MD, Yoshiki Sawa MD, Hirokuni Arai MD

The Japanese Society for Cardiovascular Surgery, Japanese Association for Thoracic Surgery, and Japanese Association for Coronary Artery Surgery recently issued a joint statement announcing that they disagree with recommendations in chapter 7.1 of the 2021 ACC/AHA/SCAI Guidelines published in December.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): S. Christopher Malaisrie, MD, Wilson Y. Szeto, MD, Monika Halas, MD, Leonard N. Girardi, MD, Joseph S. Coselli, MD, Thoralf M. Sundt III, MD, Edward P. Chen, MD, Michael P. Fischbein, MD, PhD, Thomas G. Gleason, MD, Yutaka Okita, MD, Maral Ouzounian, MD, PhD, Himanshu J. Patel, MD, Eric E. Roselli, MD, Malakh L. Shrestha, MD, PhD, Lars G. Svensson, MD, PhD, and Marc R. Moon, MD, the AATS Clinical Practice Standards Committee: Adult Cardiac Surgery

Acute type A aortic dissection remains a challenging emergency in cardiovascular surgery.The management of life-threatening complications has evolved to include endovascular options and complex aortic repair, but expeditious open replacement of the ascending aorta remains the preferred approach. This expert consensus offers recommendations based on current clinical evidence and expert opinions where all cardiac and aortic surgeons needed to be updated.

Notions like antimpulse management preoperatively in order to avoid aortic stress and stabilize the patient using opioid analgesia, thinking about a transfer to a (CAC) comprehensive aortic center after analyzing the recent evidence, focusing on clinical questions that are crucial for the decision making in all aspects, this excellent document gives answers based on the current literature.

Source: American Society for Artificial Internal Organs Journal
Author(s): Protecting the Right Ventricle Network (PRORVnet)

An editorial  with some interest for the cardiothoracic surgeon, in particular the awareness of changes in the right vantricle during ECMO support , mostly drawn from the recent Covid experiences, and with a useful paragraph on veno-pulmonary arterial ECMO, discussing the uncoupling of RV and PA. 

Source: The Annals of Thoracic Surgery
Author(s): Arnar B. Ingason, MD; Arnar Geirsson, MD, PhD; Tomas Gudbjartsson, MD, PhD; Jochen D. Muehlschlegel, MD; Martin I. Sigurdsson, MD, PhD

Recently, increased attention has been paid to the risk of chronic opioid use after surgery. In this nationwide cohort study, we examined the rate of new persistent opioid use after cardiac surgery by sternotomy.

Source: The Annals of Thoracic Surgery
Author(s): Tara Karamlou, MD, MSc; Jesse L. Hawke, PhD; Farhan Zafar, MD, MS; Mahendra Kafle, MS; James S. Tweddell, MD; Hani K. Najm, MD, MSc; James R. Frebis, MBA; Roosevelt G. Bryant III, MD

Socioeconomic and racial (SER) disparities among patients with congenital heart disease (CHD) can limit access to high-quality care. We characterized the national SER landscape and its relationship to early outcomes and identified interactions among determinants mitigating adverse outcome.

Source: European Journal of Vascular and Endovascular Surgery
Author(s): Marianne G. De Maeseneer ,, Stavros K. Kakkos , Thomas Aherne , Niels Baekgaard , Stephen Black , Lena Blomgren , Athanasios Giannoukas ,Manjit Gohel , Rick de Graaf Claudine Hamel-Desnos , Arkadiusz Jawien , Aleksandra Jaworucka-Kaczorowska , Christopher R. Lattimer Giovanni Mosti , Thomas Noppeney , Marie Josee van Rijn Gerry Stansby ESVS Guidelines Committee Philippe Kolh, Frederico Bastos Goncalves, Nabil Chakfé, Raphael Coscas, Gert J. de Borst, Nuno V. Dias, Robert J. Hinchliffe, Igor B. Koncar, Jes S. Lindholt, Santi Trimarchi, Riikka Tulamo, Christopher P. Twine, Frank Vermassen, Anders Wanhainen Document Reviewers , Martin Björck, Nicos Labropoulos, Fedor Lurie, Armando Mansilha, Isaac K. Nyamekye, Marta Ramirez Ortega, Jorge H. Ulloa, Tomasz Urbanek, Andre M. van Rij, Marc E. Vuylsteke

A scholarly update on the previous (2016) guidelines, with an interesting Chapter 9 Gaps in evidence and future perspectives. The guidelines have been extensively reviewed by European and other experts. The authors insist on the only advisory value of their conclusions. Understandably, there is no mention of venous ECMO.

Source: The Annals of Thoracic Surgery
Author(s): Tsuyoshi Yamabe, MD, Christian A. Pearsall, BS, Yanling Zhao, MPH, Paul A. Kurlansky, MD, Casidhe-Nicole R. Bethancourt, BS, Suzuka Nitta, BS, Isaac George, MD, Craig R. Smith, MD, and Hiroo Takayama, MD, PhD

This study looks to comprehensively characterize details of aortic and aortic valve reinterventions after aortic root replacement (ARR).

Source: University of Maryland Medical Center
Author(s): University of Maryland Medical Center

On January 10, 2021, the University of Maryland School of Medicine annnounced that Dr. Bartley P. Griffith and his team successfully transplanted a genetically modified pig heart in a 57-year-old man with end-stage heart failure, and the patient was doing well three days later. 

This historic xenotransplant operation may provide an important new option for patients with terminal heart disease in dire need of heart donor and a viable solution to the organ crisis.