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Journal and News Scan
Data from the PARTNER trials were assessed regarding post-procedural prosthetic valve endocarditis (PVE) after transcatheter aortic valve replacement and surgical aortic valve replacement. The timing and rates of PVE were similar between the groups, and they had a similar high mortality.
In this randomized trial, percutaneous coronary intervention and CABG had equivalent outcomes for the composite of death, stroke, or myocardial infarction at five years for patients with left main disease of low or intermediate anatomical complexity.
Gudala and associates performed a literature review of 108 patients who sustained left ventricular rupture following mitral valve replacement. The incidence in pooled data was 0.72%. The authors expounded on the mechanisms, classification, repair techniques, and treatment outcomes of this dreadful complication. In addtion, they added a subcategory, type IV, and proposed an alternative surgical classification. This is a thorough and comprehensive review that would be helpful to all cardiac surgeons.
Participation in a post-discharge rehabilitation program after valve surgery was associated with a 34% relative decrease in hospitalization during the first year and a 61% relative decrease in mortality at one year.
A batch of staplers manufactured in July-August 2019 and distributed during August-September 2019 has been recalled. Seven serious injuries and one death are reported to have been associated with failure of this device.
In this multicenter study, the authors report on outcomes in 156 patients who underwent surgery for anomalous aortic origin of the coronary arteries. Unroofing and reimplantation were the most common procedures. There was no perioperative mortality. The authors concluded that surgery for anomalous aortic origin of the coronary arteries is safe and effective and most patients can return to normal life.
Commonly, a jejunostomy is placed during esophagectomy. In this report including 188 patients, the impact of jejunostomy on outcomes after esophagectomy was examined. Jejunostomy lead frequently (7%) to jejunostomy-related complications and did not reduce the risk of postoperative weight loss. The authors concluded that the routine use of intraoperative jejunostomy appears to be an unnecessary step.
Dr Preventza and associates performed a meta-analysis of 3,154 patients who underwent frozen elephant trunk procedure to determine the incidence of neurologic complications. The incidences were 4.7% for spinal cord injury and 7.6% for stroke. Operative mortality was 8.8%. Stent longer than 15 cm or coverage of T8 and beyond was assoicated with a higher incidence of spinal cord injury compared to stent length of 10 cm.
Compliance with American College of Chest Physicians guidelines for physiologic evaluation of lung resection patients was 50% or better for only half the physicians. The frequency of individualizing risk thresholds based on surgical approach increased according to the number of years in practice. Cardiothoracic surgeons more frequently referred all patients for cardiovascular risk assessment by a cardiologist than did thoracic surgeons (17.6% vs 2.4%).
A balanced appraisal of last year's manuscript from the Lancet Group on a relatively novel portable Organ Care System for donor lungs. The analysis of the technical complications, especially organ damage from overenthusiastic revving of the pump, is particularly sobering.