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Journal and News Scan

Source: JAMA Surgery
Author(s): H Yang, H Liu, Y Chen, et al

Although the standard of care in the West for regionally advanced esophageal cancer entails induction therapy, this is routinely not the case in China. This randomized trial involving over 450 randomized participants to induction therapy (vinorelbine, cisplatin, 40 Gy RT) followed by resection vs resection alone. At a median f/u of 53.5 mos, trimodality therapy demonstrated overall (HR 0.74; CI 0.57-0.97) and disease free (HR 0.60; CI 0.45 to 0.80) survival advantages compared to surgery alone. This study may establish a new standard of care for management of resectable regionally advanced esophageal cancer in China.

Source: Interactive Cardiovascular and Thoracic Surgery
Author(s): Marcus-André Deutsch, Armin Zittermann, André Renner, René Schramm, Julia Götte, Jochen Börgermann, Henrik Fox, Sebastian V Rojas, Takayuki Gyoten, Michiel Morshuis, Andreas Koster, Nikolai Hulde, Dennis Hinse, Kavous Hakim-Meibodi, Jan F Gummert
This study examined data that suggested off-pump coronary artery bypass (OPCAB) may carry a higher risk of mortality in the long term than on-pump coronary artery bypass (ONCAB).
Source: European Journal of Cardio-Thoracic Surgery
Author(s): Marine Gaudry, Alizée Porto, Carine Guivier-Curien, Arnaud Blanchard, Laurence Bal, Noemie Resseguier, Virgile Omnes, Mariangela De Masi, Meghann Ejargue, Alexis Jacquier, Vlad Gariboldi, Valérie Deplano, Philippe Piquet
This study focused on the anatomical evolution of residual aortic dissection after type A repair. To improve long-term outcomes, early demographic and anatomic poor prognostic factors that were identified in this study should be considered for more aggressive treatment at an early phase.
Source: World Journal for Pediatric and Congenital Heart Surgery
Author(s): Dimitris Bertsimas, PhD, Daisy Zhuo, PhD, Jack Dunn, PhD, Jordan Levine, MΕng, Eugenio Zuccarelli, MBAn, MSc, Nikos Smyrnakis Nikos Smyrnakis, Zdzislaw Tobota, MD,  Bohdan Maruszewski, MD, PhD,  Jose Fragata, MD, PhD Jose Fragata, George E. Sarris ,  MD, PhD
In contrast to traditional risk assessment methods (logistic regression), which assume that risk factors interact linearly and additively, the non-linear machine learning methodology of Optimal Classification Trees provides superior power for predicting risks after congenital heart surgery, with the advantage over other machine learning methods of logical interpretability. This methodology also allows estimation of individual patient risk, based on aggregate database data, and may facilitate decision–making and quality improvements in congenital heart surgery.
Source: The Annals of Thoracic Surgery
Author(s): Taufiek Konrad Rajab, MD, and Max B. Mitchell, MD
Norwood palliation for hypoplastic left heart syndrome typically results in retrograde perfusion of the native aortic root. This may predispose to native aortic root thrombosis (NART).
Source: Interactive CardioVascular and Thoracic Surgery
Author(s): Alex Fourdrain, Olivier Georges, Sophie Lafitte, Jonathan Meynier, Pascal Berna
This article presents the assessment of long-term outcomes of patients treated by anatomical pulmonary resection with the video-assisted thoracoscopic surgery (VATS) approach, VATS requiring intraoperative conversion to thoracotomy, or an upfront open thoracotomy for lung cancer surgery. The study found that VATS is favored when possible.
Source: The Annals of Thoracic Surgery
Author(s): Hector I. Michelena, Alessandro Della Corte, Arturo Evangelista, Joseph J. Maleszewski, William D. Edwards, Mary J. Roman, Richard B. Devereux, Borja Fernández, Federico M. Asch, Alex J. Barker, Lilia M. Sierra-Galan, Laurent De Kerchove, Susan M. Fernandes, Paul W.M. Fedak, Evaldas Girdauskas, Victoria Delgado, Suhny Abbara, Emmanuel Lansac, Siddharth K. Prakash, Malenka M. Bissell, Bogdan A. Popescu, Michael D. Hope, Marta Sitges, Vinod H. Thourani, Phillippe Pibarot, Krishnaswamy Chandrasekaran, Patrizio Lancellotti, Michael A. Borger, John K. Forrest, John Webb, Dianna M. Milewicz, Raj Makkar, Martin B. Leon, Stephen P. Sanders, Michael Markl, Victor A. Ferrari, William C. Roberts, Jae-Kwan Song, Philipp Blanke, Charles S. White, Samuel Siu, Lars G. Svensson, Alan C. Braverman, Joseph Bavaria, Thoralf M. Sundt, Gebrine El Khoury, Ruggero De Paulis, Maurice Enriquez-Sarano, Jeroen J. Bax, Catherine M. Otto, Hans-Joachim Schäfers

On July 22, The Annals of Thoracic Surgery published this consensus statement on nomenclature and classification of the congenital bicuspid aortic valve (BAV) and Its aortopathy.  

This consensus statement divides BAV into 3 types:  1) Cusp-fused type (right-left, right-non and left-non-coronary cusp fusion ); 2) Two-sinus type (latero-lateral and antero-posterior ); and 3) Partial-fusion (forme fruste) type.

BAV-associated aortopathy are categorized into 3 types: 1) Ascending type; 2) Root type; and 3) Extended type.

Source: Annals of Surgery
Author(s): Dias RD, Zenati MA, Conboy HM, Clarke LA, Osterweil LJ, Avrunin GS, Yule SJ.

This study assessed cognitive involved in cardiac surgical procedures from the perspective of three different specialty groups: surgeons, anesthesiologists, and perfusionists.  The 137 unique processes that were identified were classified as: decision points, critical communications, pitfalls, and strategies.  Understanding these processes and the different perspectives each team member brings to the operation may help improve patient safety and outcomes.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Jonas Pausch, Tatiana Sequeira Gross, Lisa Müller, Maria von Stumm, Benjamin Kloth, Hermann Reichenspurner, Evaldas Girdauskas

This study analyzes the relocation of both papillary muscles to correct FMR in both ICM and DCM. The results demonstrate very satisfactory in-hospital and 1-year outcomes.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Harleen K. Sandhu, MD, MPH, Alexander P. Nissen, MD, Harith Mushtaq, MD, Charles C. Miller III, PhD, Hazim J. Safi, MD, FACS, Anthony L. Estrera, MD, FACS, Kristofer M. Charlton-Ouw, MD, FACS

In this article, Dr. Sandhu et al. review their 22-year experience in managing patients with thoracic aortic graft infection. They demonstrate that this infection is highly morbid and requires prompt antimicrobial coverage, debridement, graft replacement, and vascularized graft coverage to prevent morbidity and mortality. 

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