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Journal and News Scan

Source: The New England Journal of Medicine
Author(s): Kristin Newby

An editorial related to a recent randomized controlled trial suggesting a striking benefit of anti-inflammatory secondary prevention after recent myocardial events.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Ibrahim Sultan, Valentino Bianco, Himanshu J. Patel, George J. Arnaoutakis, Marco Di Eusanio, Edward P. Chen, Bradley Leshnower, Thoralf M. Sundt, Udo Sechtem, Daniel G. Montgomery, Santi Trimarchi, Kim A. Eagle, and Thomas G. Gleason

The International Registry of Acute Aortic Dissection investigators analyzed the impact of cerebral malperfusion (CM) on the surgical outcomes of acute type A dissection in 2402 patients. The incidence of CM and neurologic deficit was 15.1% (362/2402). While patients with CM were less likely to present with chest pain and back pain, they had a significantly higher incidence of syncope, peripheral malperfusion, and shock and were more likely to have Debakey type I dissection and pericardial effusion on presentation. In-hospital mortality and the incidences of cerebrovascular accident and acute kidney injury were significantly higher in patients with CM. The authors conclude that surgeons may continue to offer lifesaving surgery for acute type A dissection to this critically ill cohort of patients with acceptable morbidity and mortality.

Source: Interactive CardioVascular and Thoracic Surgery
Author(s): Kentaro Amano, Yoshiyuki Takami, Hiroshi Ishikawa, Michiko Ishida, Masato Tochii, Kiyotoshi Akita, Yusuke Sakurai, Mika Noda, Yasushi Takagi

The authors investigated the influence of hypothermic circulatory arrest on renal function. This study includes 191 patients who underwent surgery for acute aortic dissection type A. Postoperative acute kidney injury was observed in 49 patients. Lower body ischemic time was one of the risk factors for postoperative kidney injury.

Source: The Annals of Thoracic Surgery
Author(s): Rahul Nayak, Susan B. Brogly, Katherine Lajkosz, M. Diane Lougheed, Dimitri Petsikas

The authors evaluated outcomes of empyema management in over 9,000 patients in Ontario, Canada, from 1996-2015. Mortality was higher for nonoperative management at all time points assessed up to one year.

Source: World Journal for Pediatric and Congenital Heart Surgery
Author(s): Robyn Lotto, Ian Jones, Sarah E. Seaton, Ram Dhannapuneni, Rafael Guerrero, Attilio Lotto

This study examines the way in which risk is perceived by parents of children undergoing congenital cardiac surgery. The findings demonstrate differences in the way mothers and fathers perceive risk, with mothers reporting statistically significantly higher scores than their partners. In particular, parents of children who experience postoperative complications presented a persistent rise in risk perception following discharge, emphasizing the need for flexible levels of support and information as parents navigate uncertainty.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Percy ED, Kaneko T, Aranki SF

Interesting succinct note on a major issue, noting a possible association between cardiopulmonary bypass and this common complication.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Neha J. Pagidipati, Renato D. Lopes

A useful narrative on pharmacology and metabolomics for surgeons caring for the diabetic population; the vast majority of the CTSNet membership.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Francois Dagenais

A succinct analysis of a challenging problem, with a discussion on the 'magic diameter' of 55 mm.

Source: The Annals of Thoracic Surgery
Author(s): Fei-Yi Wu, Abhijit Mondal, Pedro J. del Nido, Kimberlee Gauvreau, Sitaram M. Emani, Christopher W. Baird, Aditya K. Kaza

This single institution study of outcomes for the treatment of supravalvular aortic stenosis over a 20-year period identified risk factors for reintervention or reoperation: age <1 year, smaller aortic valve or aortic root, and concomitant right ventricular outflow tract repair.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Ilaria Chirichilli, Francesco Irace, Luca Weltert, Kazumasa Tsuda, Raffaele Scaffa, Andrea Salica, Nicola Galea, Ruggero De Paulis

Aortic annulus size and shape were analyzed in computed tomography angiography after a reimplantation procedure in patients with bicuspid and tricuspid aortic valves. Prior to surgery, elliptic shape was observed in tricuspid valves and more circular shape in bicuspid valves. After reimplantation, there was no difference between groups with similar roundness regardless of valve morphology. The authors concluded that annuloplasty plays an active role on the geometry of the aortic annulus.