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Journal and News Scan

Source: The Annals of Thoracic Surgery
Author(s): Joseph V. Lombardi, G. Chad Hughes, Jehangir J. Appoo, Joseph E. Bavaria, Adam W. Beck, Richard P. Cambria, Kristofer Charlton-Ouw, Mohammad H. Eslami, Karen M. Kim, Bradley G. Leshnower, Thomas Maldonado, T. Brett Reece and Grace J. Wang

In this consensus statement, a new anatomic classfication system is proposed for thoracic aortic dissections.  The acuity of aortic dissection and complicated vs uncomplicated dissections are clearly defined.  Risk factors, presentations, management, and complications are expounded.  Follow-up criteria are also discussed with nomenclature for false lumen status, in addition to measurement criteria and definitions of aortic remodeling.  This expert consensus provides a comprehensive document that facilitates communcations and reporting of aortic dissection among the aortic community. 

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Sinan Sabit Kocabeyoglu, Umit Kervan, Dogan Emre Sert, Mehmet Karahan, Emre Aygun, Osman Fehmi Beyazal, Ertekin Utku Unal, Yesim Akin, Burcu Demirkan, Mustafa Pac

This study investigated the impact of preoperative levosimendan administration in patients undergoing LVAD implantation. The authors report on outcomes of patients who received preoperative optimization with levosimendan (n=58) versus patients optimized without a Calcium-sensitizer (n=27).

Although the patients’ characteristics have not been different at baseline, the end-organ function recovered to a greater extent within the levosimendan group. In this small group however, the mortality, as well as length of stay and ventilation, were not different within the two groups. The authors state that levosimendan administration prior to LVAD implantation is safe and well-tolerated.

Source: The Annals of Thoracic Surgery
Author(s): Amy G. Fiedler, Erik E. Lewis, and Joshua L. Hermsen

In this How-I-Teach-It tutorial, Dr Hermsen and associates from the the University of Wisconsin in Madison provide a step-by-step introduction to how they instituted their introductory CPB training course. 

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Yoshinori Handa, Yasuhiro Tsutani, Takahiro Mimae, Yoshihiro Miyata, Morihito Okada

Two groups of Clinical Stage IA lung cancer patients were retrospectively investigated. Ninety-nine patients underwent complex segmentectomy, and 94 patients underwent location-adjusted lobectomy. The results of these two different strategies were compared. Outcomes have been comparable regarding mortality, morbidity, overall survival, and recurrence-free survival rates.

 The authors concluded that complex segmentectomy can provide comparable outcomes in Stage IA lung cancer treatment.

Source: World Journal of Critical Care Medicine
Author(s): Massimo Capoccia and Marc O Maybauer

Capoccia and Maybauer performed a system review of 29 publications related to the use of ECMO in aortic surgery and aortic dissection. A total of 194 patients who had been treated with ECMO support were identified, with a survival rate of 39.7% (77/194). The authors conclude that the use of ECMO in major aortic surgery or dissection is justified, despite that there is no compelling evidence for or against the use of ECMO in this patient population. 

Source: YouTube
Author(s): Diego Gonzalez Rivas

Surely there can be no better example of how healthcare can break down all boundaries between people than this? 

While Trump and Iran ramp up tensions in the region, Diego Gonzalez Rivas makes good on his promise to go and do a materclass in Kurdistan in Iraq. What a fantastic example of putting people and patients ahead of politics! 

Diego, you should be put in charge of the United Nations. It looks like even in Iraq there are excellent surgeons and a need for the best surgery available for lung cancer. 

Source: World Journal for Pediatric and Congenital Heart Surgery
Author(s): Joseph A. Dearani

In this editorial, Dr Joseph Dearani, Chair of the Department of Cardiovascular Surgery at Mayo Clinic in Rochester, Minnesota, addresses the important and timely subject of outcomes measurement, and of transparency and public reporting of cardiac surgery outcomes.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Saadallah Tamer, Stefano Mastrobuoni, Michel van Dyck, Emiliano Navarra, Xavier Bollen, Alain Poncelet, Philippe Noirhomme, Parla Astarci, Gebrine El Khoury, Laurent de Kerchove

The aim of this study was to investigate the role of free margin length and geometric height in normal aortic valves and aortic dilatation. 

This study prospectively acquired these measurements within 132 patients, who were operated on for aortic insufficiency, aortic dilatation, endocarditis, or fibroelastoma. Patients with aortic dilatation and leaflet prolapse showed significantly larger free margin length and geometric height compared to patients with normal aortic valve function.

The authors concluded that these measurements provide a new point of view into the pathomorphology of the aortic valve and might support new aortic valve repair methods.

Source: CA: A Cancer Journal for Clinicians
Author(s): Rebecca L. Siegel MPH Kimberly D. Miller MPH Ahmedin Jemal DVM, PhD

Declines in US annual lung cancer mortality rates of 5% for men and 4% for women led improvements in overall cancer mortality rates in the latest update from the American Cancer Society. This is likely linked to efforts at decreasing tobacco use, improved screening, and newer systemic therapies.

Source: The Lancet
Author(s): Timo Mäkikallio, Niels R Holm, Mitchell Lindsay, Mark S Spence, Andrejs Erglis, Ian B A Menown, Thor Trovik, Markku Eskola, Hannu Romppanen, Thomas Kellerth, Jan Ravkilde, Lisette O Jensen, Gintaras Kalinauskas, Rikard B A Linder, Markku Pentikainen, Anders Hervold, Adrian Banning, Azfar Zaman, Jamen Cotton, Erlend Eriksen, Sulev Margus, Henrik T Sørensen, Per H Nielsen, Matti Niemelä, Kari Kervinen, Jens F Lassen, Michael Maeng, Keith Oldroyd, Geoff Berg, Simon J Walsh, Colm G Hanratty, Indulis Kumsars, Peteris Stradins, Terje K Steigen, Ole Fröbert, Alastair N J Graham, Petter C Endresen, Matthias Corbascio, Olli Kajander, Uday Trivedi, Juha Hartikainen, Vesa Anttila, David Hildick-Smith, Leif Thuesen, Evald H Christiansen, for the NOBLE study investigators

''CABG was significantly better than PCI (p=0·0066........''