Journal and News Scan

As interventional techniques continue to gain popularity in cardiothoracic surgery, familiarity and mastery of these techniques are increasingly important for trainees and early career surgeons. The authors discuss core endovascular concepts and clinical applications relevant to contemporary practice, including techniques for vascular access and management of associated complications, principles of angiography, endovascular tools such as catheters and guidewires, endovascular approaches for valve intervention (including aortic, mitral, and tricuspid valves), as well as aortic interventions (TEVAR). The authors also highlight the importance of integrating an endovascular curriculum into cardiothoracic training pathways. 

This multicenter randomized trial demonstrated that epicardial-endocardial hybrid ablation (HA) maintained superior effectiveness over endocardial catheter ablation (CA) for nonparoxysmal atrial fibrillation at 24 months (66.3 percent vs. 33.3 percent freedom from AF/atrial flutter/atrial tachycardia), with comparable safety rates and significantly fewer reinterventions after HA. 

This article provides a practical summary of the surgical indications from the 2023 European guidelines for the management of infective endocarditis (IE). IE remains a challenging condition with high morbidity and mortality despite advances in diagnosis and management. The 2023 European Society of Cardiology guidelines, endorsed by the European Association of Cardio-Thoracic Surgery, introduce significant updates, including several new recommendations regarding surgical intervention. This review synthesizes current evidence on the surgical management of IE, emphasizing indications, timing, and outcomes.  

The multidisciplinary Endocarditis Team approach is highlighted as a key factor in improving patient prognosis by optimizing diagnosis and treatment strategies. Advanced imaging techniques, such as positron emission tomography-computed tomography, have enhanced diagnostic accuracy, particularly for prosthetic valve endocarditis. Despite the clear survival benefits associated with surgery, only a minority of eligible patients undergo surgical treatment, underscoring the need for better patient selection and timely intervention. Furthermore, the worse prognosis is found in patients with indications for surgery who do not undergo surgical intervention. The updated IE guidelines provide detailed timing recommendations for surgery based on the clinical scenario, including new considerations for patients with stroke. Additionally, novel recommendations regarding partial oral antibiotic therapy following surgery have been introduced. Finally, important measures for the prevention of IE recurrence are discussed.  

In conclusion, timely surgical intervention, based on defined recommendations guided by multidisciplinary collaboration and enhanced diagnostic tools, is crucial in improving outcomes for IE patients. 

This cadaver-based study evaluated the variations in vascular perfusion territories of the descending thoracic aorta, including variations in the anatomy of the artery of Adamkiewicz. The authors found important variations in origin and location of the artery of Adamkiewicz and demonstrated its importance, along with the anterior spinal arteries in spinal cord perfusion. This was based on the differential dye staining of the anterior and posterior aspects of the spinal cord along its entire length. A pictorial representation of these differences is shown, as well as variations in the anatomy of the arterial supply itself.