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Journal and News Scan

Source: European Journal of Vascular and Endovascular Surgery
Author(s): GVG Writing Group for the Joint Guidelines of the Society for Vascular Surgery (SVS), European Society for Vascular Surgery (ESVS), and World Federation of Vascular Societies (WFVS)

An important and recent consensus update.

Source: Interactive Cardio-Vascular and Thoracic Surgery
Author(s): Jinlin Wu, Yan Huang, Juntao Qiu, Bilal Saeed, Cuntao Yu

In this systemic review and meta-analysis, the authors compared outcomes of valve-sparing root replacement vs. the Bentall procedure in patients with acute aortic dissection type A. Valve-sparing root replacement was associated with lower risk of early and late mortality compared with the Bentall procedure. However, there was an increased risk of reintervention after valve-sparing root replacement. The authors concluded that valve-sparing root replacement can be performed safely in experienced centers and should be performed especially in young active patients.

Source: World Journal for Pediatric and Congenital Heart Surgery
Author(s): Yue-Hin Loke, Jason Mandell, Russell R. Cross, Ileen Cronin, Paige Mass, Elias Balaras, Laura J. Olivieri

Abnormal pulmonary artery bending in the setting of the Lecompte maneuver may affect right ventricular afterload in the absence of stenosis. The authors identified novel measurements related to the curvature of the pulmonary artery branches, and found that they correlated with right ventricular systolic pressures, as measured by contributions of curvature in the pulmonary arteries.

Source: MassDevice Network
Author(s): Chris Newmarker

The Hugo system includes a tower, surgeon console, surgical end effectors, and robotic arm carts.

Key aspects of the Hugo system include:

  • Modularity — The arms and other parts of the system are modular — and they’re on wheels — allowing for flexibility when it comes to placement and swapping around parts of the system. A surgeon could complete a procedure with an arm, push it out of the way, and start a laparoscopic procedure still using the tower, for example. After the surgery, hospital staff could undrape the system and roll it into a second sterilized and prepped OR so that the surgeon could quickly start a new surgery after a break. Because the arms are modular, a hospital could split up the arms for use in different procedures at the same time.
  • Universal use — The tower and its visualization system, generator, processors and endoscope are meant to support both robot-assisted surgery and laparoscopic applications, and even open surgery. The endoscope, for example, is a standard length. The FT10 generator powering the robotic system is the same type of generator powering laparoscopic and open surgery devices.
  • Upgradeable — Medtronic designed the system so that health providers can swap in new systems, generators, etc. as they become available, without having to buy an entirely new system. The company also has a pipeline of software applications and features that it will continually roll out.
  • An open console — The surgical console design boasts an open architecture with foot pedals so that surgeons can still interact with the patient and OR staff during procedures. At the same time, three-dimensional, high-definition glasses provide an immersive situation.
  • Drawing on existing surgical tool expertise — Medtronic is taking advantage of the expertise, know-how, and IP from its existing surgical instrumentation portfolio, which makes sense because the system’s instruments could be a big revenue source for the company. Doctors consulting for the company said today that they also like that the surgical tools are familiar.
Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Kenji Suzuki, Kenji Suzukik Kenji Suzuki, Hisashi Saji, Keiju Aokage, Shun-ichi Watanabe, Morihito Okada, Junki Mizusawa, Ryu Nakajima, Masahiro Tsuboi, Shinichiro Nakamura, , Kenichi Nakamura, Tetsuya Mitsudomi, Hisao Asamura

Interesting to see the long term curative results of this randomized controlled trial.

Source: The Annals of Thoracic Surgery
Author(s): Hari Padmanabhan, Matthew J. Brookes, Alan M. Nevill, Heyman Luckraz

Patients undergoing elective or urgent cardiac surgery who were anemic at the time of surgery were compared to a matched population who were not anemic.  Anemia was associated with increased mortality during follow-up, but blood transfusion was not associated with mortality.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Alessandro Leone, Luca Di Marco, Giuditta Coppola, Ciro Amodio, Marianna Berardi, Carlo Mariani, Daniela Votano, Maria Letizia Bacchi Reggiani, Roberto Di Bartolomeo, Davide Pacini

Open distal anastomosis in the frozen elephant trunk operation is usually performed in aortic arch zone 2 or 3. The authors compared outcomes in patients who underwent zone 2 versus 3 open distal anastomosis. They found that proximallization of the anastomosis simplifies the arch replacement, reducing the visceral ischaemia time.

Source: JAMA Surgery
Author(s): Joseph G. Crompton, Peter D. Crompton, Polly Matzinger

The authors point out that randomized trials of incentive spirometry have failed to mitigate early postoperative fevers, traditionally attributed to atelectasis. They propose that an immune response triggered by injured cells is responsible for noninfectious postoperative fevers, and that this is a natural, self-limited process that requires no intervention.

Source: MedPage Today
Author(s): Clifford Robinson, Ian Ingram

Investigators reported, in abstract form, promising results of a single dose of radiotherapy, delivered with electorphysiologic guidance, for managing ventricular tachycardia. Seventy-eight percent of patients had a clinically important reduction in ventricular tachycardia episodes. 

Source: Annals of Oncology
Author(s): R de Vries, M Muller, V van der Noort, W S M E Theelen, R D Schouten, K Hummelink, S H Muller, M Wolf-Lansdorf, J W F Dagelet, K Monkhorst, A H Maitland-van der Zee, P Baas, P J Sterk, M M van den Heuvel

Immune checkpoint inhibitors have revolutionized treatment of non-small cell lung cancer. In this study, breath prophiles were collected from 143 patients and a single biomarker profile was created that detected responses to anti-PD-1 treatment with 89% accuracy.