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Journal and News Scan
Video and a readable digest of a talk in a Harvard meeting, especially interesting in its scepticism on prevention.
The authors compared mechanically expanded TAVR to self-expanding TAVR in a randomized non-inferiority trial. Major adverse events occurred in 20% and 17% of patients, respectively (safety measure). The one-year rates of mortality, stroke, or paravalvular leak for the valves were 15.4% and 25.5%, respectively (effectiveness measure). Mechanically expanded valves are not inferior to self-expanding valves and broaden the options available for high risk patients.
A sobering editorial, read last May at the AATS, that discusses at length the ethics of ventricular assist as a super expensive therapy seen from the principle of fairness.
A dense but short and readable editorial arguing for the complexity of risk stratification of aortic pathology.
Incredible story about how American Heart Association President Dr John Warner suffered a cardiac arrest after his presidential address and was subsequently saved by two bystanders. This story emphasizes the fortune of being in the right place at the right time, but more importantly, the public value of knowing CPR.
The Nationwide Inpatient Sample was evaluated to assess tricupsid valve surgery. Isolated and concurrent tricuspid surgery outcomes are analyzed. The authors conclude that "surgical treatment of TR remains underused and is associated with high operative morbidity and mortality, prolonged hospitalizations, and considerable cost."
Using a simulated out-of-hospital cardiac arrest scenario, the authors compared the time from an emergency call to resource deployment and arrival for drone-delivered automatic external defibrillator (AED) and ground vehicle-based emergency medical services (EMS). Mean time to dispatch was 3 sec for the drone and 3 min for EMS. Over a median flight distance of 3.2 km, mean time to arrival was 5:21 min for the drone vs 22:00 min for EMS.
Sure, we all receive emergency calls that potentially could interrupt an operation. This surgeon, however, was taking a Spanish language proficiency test on his cell phone while performing varicose vein surgery on an awake patient. Common sense appears to have failed in this case.
The Task Force for the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) copublished the 2017 guidelines for the management of valvular disease in the European Heart Journal and in the European Journal of Cardio-Thoracic Surgery. In this comprehensive paper, there are many new and strong classes of recommendations since the previous 2012 guidelines.
This review article explores the association between postoperative mediastinal blood and atrial fibrillation.