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Journal and News Scan
Can we increase the rate and consistency of organ donation from donors experiencing out-of-hospital arrest? What are the challenges and opportunities associated with procurement from this population? The International Liaison Committee on Resuscitation released a scientific statement defining a protocol for organ donation after cardiac arrest, designed for applicability to all health systems. Read the full statement from Circulation journal ahead of print.
Recently, NICE released guidance from the British regulatory body limiting the Ozaki operation to research until further review, which is scheduled in three calendar years. The overarching concern appears to be the durability of the autoprosthesis. NICE guidelines have the strongest influence in healthcare in the United Kingdom and often abroad.
The first domino transplant procedure performed on infants was successfully completed recently in New York City. One patient needed a heart transplant because of cardiomyopathy and was able to donate a heart valve to another infant, who was only born with one.
This study reported long term outcomes of over three thousand single ventricle patients in the United Kingdom, with a median of 7.6 years. The most significant predictor of long-term survival was single ventricle subtype, with the worst outcomes observed among patients with hypoplastic left heart syndrome or unbalanced AVSD. Other negative outcome predictors were low weight at time of first procedure and acquired comorbidities. Although center volume was not a major predictor of long-term outcomes in this study, it is important to note that congenital care in the UK is highly centralized; thus, no low volume centers were captured in this study.
This article provides a systematic review of the choice of conduits for coronary artery bypass grafting and has been endorsed by both the STS and EACTS. The review reports on a variety of factors related to specific conduits, from patency and clinical outcomes to harvesting and target vessel selection.
In a research letter on a small pilot genomic study of sampling coronary atheroma, the authors offer a brief explanation on how their technique can be applied to detect stability of coronary plaque.
Because of the potential risk of early structural valve deterioration, the FDA has sent notice about Abbott’s decision to stop selling and distributing Trifecta aortic surgical heart valves in the United States. The FDA recommends that healthcare providers be aware of the risk of SVD with Trifecta valves, discuss risk with patients, and monitor patients who have undergone implantation with Trifecta valves.Because of the potential risk of early structural valve deterioration, the FDA has sent notice about Abbott’s decision to stop selling and distributing Trifecta aortic surgical heart valves in the United States. The FDA recommends that healthcare providers be aware of the risk of SVD with Trifecta valves, discuss risk with patients, and monitor patients who have undergone implantation with Trifecta valves.
This report describes a new Society of Thoracic Surgeons mortality risk model for adults with congenital heart disease undergoing cardiac operations that are not included in existing risk models. A risk model was developed using forty-seven congenital variables in 192,196 patients operated on between 2011 and 2019. The risk model was more accurate at predicting operative mortality in adult patients undergoing congenital cardiac surgery (C statistic, 0.815) than the existing Society of Thoracic Surgeons adult risk model without congenital variables (C statistic, 0.79). This will support an online risk calculator for adult patients undergoing congenital cardiac surgery.
Authors representing the American Association for Thoracic Surgery and The Society of Thoracic Surgeons published a rebuttal to the Chronic Coronary Disease Guidelines. The authors explain their stance on the revised guidelines, stating their belief that the new recommendations on revascularization are flawed adaptations of the 2021 guidelines. The rebuttal points out contradicting evidence, missing information, selection biases, and more within the revised guidelines.
For more on the societies’ reaction to the new guidelines, read this article from tctMD.
Alberta’s first minimally invasive direct coronary artery bypass (MIDCAB) surgery was performed at one of the few sites in Canada offering the procedure. The procedure is less invasive than traditional bypass surgery and provides patients with a faster recovery time. Since the first procedure, the multidisciplinary team at the center have performed ten more, a big step for Canadian cardiac surgical care.