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Journal and News Scan
Reddy and colleagues evaluated oral, esophageal, and gastric microbial flora in 55 patients who underwent successful esophagectomy for adenocarcinoma, squamous cell carcinoma, or benign disease. The authors did not observe significant patterns between microbiome diversity and tumor stage or histology. Patients who had anastomotic leak, however, showed a greater variance in the composition of preoperative oral flora versus intraoperative gastric flora than patients who did not (p = 0.015). The authors suggest that better understanding of the relationship between the microbiome and esophagectomy recovery could lead to new predictive or therapeutic approaches for esophageal anastomotic leak.
An interesting two-year report from the MOMENTUM 3 randomized controlled trial comparison of HeartMate 3 and II, the analysis performed by Abbott. Although stroke and reoperation were clearly lower with the latest technology, reflected in the lower LDH measurements, there was bafflingly no improvement in survival.
Carter Capps, a pitcher for professional baseball team the San Diego Padres, has made himself a necklace out of the rib surgeons removed during his thoracic outlet surgery.
A Connecticut, USA, man gets some experimental and synergistic help from a bacteriophage and antibiotic to treat a persistent infection in his aortic graft.
Drugs and Devices
The US Food and Drug Administration (FDA) has approved the world’s smallest mechanical heart valve for pediatric patients, a 15 mm Masters Series Heart Valve from Abbott.
Durvalumab from AstraZeneca has been approved by the US FDA for patients with unresectable stage III non-small cell lung cancer; this follows the publication of a randomized trial showing superiority of durvalumab over placebo following chemotherapy.
Research, Trials, and Funding
Researchers from Vancouver, Canada, presented their early experience with the Sapien M3, a transcatheter mitral valve replacement device that caught the attention of attendees at the recent Cardiovascular Research Technologies meeting.
The use of lung cancer treatment modalities varies by geographic region across the UK, according to research published in Thorax, and the researchers say this could be negatively affecting patient survival in regions with lower treatment rates.
In Indiana, USA, the first patient has been enrolled in the EVAS2 IDE Confirmatory Clinical Study of the Nellix EndoVascular Aneurysm Sealing System from Endologix.
Inci and colleagues reviewed prospectively collected data from 117 patients with end-stage emphysema undergoing lung transplantation. The authors found that short-term and long-term survival were equivalent in patients who did and did not undergo lung volume reduction surgery prior to their transplantation (107 versus 86 months, p = 0.6).
A handy view from the pediatric standpoint on an expanding indication for sequential pulmonary transplanation.
Physicians are at high risk for burnout, physical disability, and financial deprivation after investing time and money in obtaining their training. This article highlights how physicians can maintain their health and positive outlook to enable them to continue helping others.
A few months after its publication, the ORBITA trial results do not seem to have filtered adequately to cardiac multidisciplinary teams worldwide.
This brief synopsis of an article published in Cell describes how certain skin microorganisms interact beneficially with the host to accelerate wound healing.
The authors retrospectively reviewed their minimally invasive aortic valve replacement experience over a three-year period to assess the outcomes in patients undergoing conventional knot tying (n = 39) versus automated knot tying with the Cor-Knot device (n = 53). Aortic cross-clamp time was approximately 10 minutes shorter in the latter group. Postoperative mortality and morbidity were comparable, as was valve function at one year.
The STS/ACC TAVR Registry was analyzed to determine the effect of tricuspid regurgitation (TR) on outcomes after transcatheter aortic valve replacement (TAVR). The authors found that TR, of any severity, is quite common in TAVR patients (80%). The breakup of TR severity was as follows:
- Mild TR: 56%
- Moderate TR: 19%
- Severe TR: 5%
Findings: Along with higher predicted risk, increasing TR severity was associated with increased mortality and readmission.
Should the TR of a certain severity be addressed at the time of TAVR? How?