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Journal and News Scan
May 11, 2023
Submitted by: Cameron Lind
This single institution study retrospectively reviewed the outcome of pediatric Ebstein’s anomaly surgical correction. Of the 188 patients with a median (IQR) age of three years (1.6–5.6), 108 had cone reconstruction. Nearly 30 percent of patients required a bidirectional cavopulmonary shunt. Another 12 percent developed recurrent moderate to severe tricuspid regurgitation (TR). There was a lower incidence of recurrent TR in the group undergoing cone reconstruction. The age group of patients did not appear to affect the incidence of recurrent TR, reoperation, or death.
May 11, 2023
Submitted by: Jo Chikwe
Between 2011 and 2020, 14,704 isolated tricuspid operations were reported in The Society of Thoracic Surgeons Adult Cardiac Surgery Database, and 6,507 cases were identified after excluding emergencies, endocarditis, stenosis, and prior heart transplants. Operative mortality was 7.3 percent, and 1.7 percent in elective patients without heart failure, organ dysfunction, or prior surgery. Heart failure (odds ratio [OR] 1.6), higher Model For End-Stage Liver Disease score, tricuspid replacement (OR 1.56), and annual center volume < 5 cases per year (OR 1.37) were associated with worse operative mortality, suggesting early referral to higher volume centers may improve outcomes.
May 8, 2023
Submitted by: Emily Farkas
This article presents a tier-based framework with proposed benchmarks for the development of quality pediatric and congenital heart disease care in resource-limited settings. This was achieved by identifying the most common barriers to care and using a literature review method to determine the most effective solutions.
May 4, 2023
Submitted by: Cameron Lind
A team of surgeons at National Heart Hospital in Lusaka, Zambia collaborated with a team from the University of Michigan to complete the first total aortic arch replacement in the country. Despite the patient’s 8 cm aortic dissection, the procedure was uneventful with no complications. This was part of an ongoing effort to strengthen Zambia’s cardiac care teams and resources.
May 4, 2023
Submitted by: Cameron Lind
A systematic review of prognostic factors for five-year survival after pulmonary metastasectomy (PM) from colorectal cancer (CRC) identified 11 of 77 preoperative factors as having statistically significant positive effects. These included a solitary metastasis < 2 cm. The disease free interval at twenty-four months did not affect five-year survival. These findings consolidate the evidence and support clinical practice and future research design.
April 28, 2023
Submitted by: Edward Savage
This double-blind, randomized study compared albumin to Ringer's acetate for volume resuscitation. The results showed that the group that was perioperatively administered albumin had a greater blood loss and higher UDBP compared to those who were administered Ringer’s acetate.
April 28, 2023
Submitted by: Cameron Lind
The first ever heart transplant with a still-beating heart from a donor who had undergone cardiac death was performed recently at Stanford Medicine. This method allows for less cardiac injury and a lower chance of morbidity for the recipient. The new method expands the donor pool for the more that 3,500 people in the US who are awaiting a heart transplant. Read the original report.
April 28, 2023
Submitted by: Cameron Lind
Recent studies have found that SAVR after TAVR has a significantly high mortality rate. Because of this, surgeons should try to avoid redo procedures in TAVR patients by considering how different risk factors will contribute to outcomes. Some researchers argue that while the database that supplied this research is large, it lacks granularity. Mid- and long-term research on the performance of redo TAVR is needed to come to a conclusion.
April 28, 2023
Submitted by: Aristotle Protopapas
This study compared vein bypass with best endovascular treatment for chronic limb-threatening ischemia. The twice-quoted phrase of the RCT manuscript: “Participants were excluded if they had ischemic pain or tissue loss considered not to be primarily due to atherosclerotic peripheral artery disease” needs further clarification. Major amputation or death occurred in 63 percent of patients in the vein bypass group and 53 percent of patients in the best endovascular treatment group. Researchers concluded that for this group, a revascularization procedure to restore limb perfusion should be considered.
April 28, 2023
Submitted by: Jo Chikwe
In this single-center expert series of 1000 robotic-assisted left internal mammary artery harvest and off-pump anastomosis to the left anterior descending coronary artery through a 4 cm thoracotomy, 30 day mortality was 0.6 percent, stroke occurred in 5 patients (5 percent), and postoperative graft patency was 97.2 percent (491 of 505). The authors report that between 250 and 500 cases were required to acquire “mastery.”