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Journal and News Scan
Chou et al. analyzed a nationwide ECMO register regarding patients with liver cirrhosis. They identified 233 patients, which represents 3.3% of all 7003 patients. These patients had a very high one-year mortality of more than 95%. Therefore, the authors conclude that ECMO should be used very carefully in patients with known liver cirrhosis.
An open-access large metanalysis on the utility and risks of antiplatelets after PCI. Of note, mortality was not a primary endpoint. The message is that long dual antiplatelet use is an exchange between avoidance of myocardial events and serious bleeding.
The novel oral anticoagulants may enter the arena soon..
The authors implemented a prospective longitudinal, residency-wide coronary anastomosis simulation curriculum providing each participant with a low-fidelity coronary anastomosis simulator, high-quality instruments, and faculty mentor. They demonstrate at 1 year of follow-up improve anastomosis times and technical skills. A great model for programs to adapt to enhance their institution's simulation curriculum.
In this article, the authors review the literature highlighting factors that increase a patient's risk in acute Type A aortic dissection repair and provides suggestions for risk stratification to guide timing of surgery in select patients.
In this article, the authors demonstrate a novel technique of antegrade cardioplegia decannulation using the Cor-Knot system with phenomenal video and description on their case series. This technique has great utility in cases where closing the cardioplegia cannulation site can be challenging in minimally invasive video-assisted cardiac surgery.
Del Forno et al. present a retrospective study of 77 patients with de-novo 50-70% coronary stenosis undergoing valvular surgery. In these patients, bypass grafting of these coronaries was intentionally omitted. Within their cohort they did not observe any perioperative mortality and there was only one acute coronary syndrome leading to PCI and the overall PCI rate at six years was only 8 +/- 3.9%. Therefore, it seems to be safe to not bypass such stenosis and leave it to later follow-up and ischemia diagnostics.
Patients with aneurysms 7 cm or greater demonstrated a higher probability of survival when treated immediately, compared to delayed repair, for patients under 80 years of age.
An interesting attempt to construct a decision tool for aortic aneurysms.
This original article retrospectively analyzes the outcome of 359 patients after TEVAR at seven centers. All patients were stratified regarding the modified arch landing nomenclatur (MALAN). The rate of proximal endograft failure was significantly lower in patients with favorable landing area (MALAN 2/III and 3/III). Regarding these results, the MALAN classification can be used to guide decisions in pre-TEVAR planning.
This is a comprehensive review on iatrogenic aortic dissection occurring intraoperatively,and within one month after cardiac surgery, covering the incidence, discovery, pathology, detection modalities, management, risk factors, and prevention of this rare but life-threatening complication.
In this article, Dr. Bethencourt outlines eight key strategies for successful robotic heart startups and how to initiate a new robotic program at one's institution.