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Journal and News Scan
Kawamura et al. present a retrospective multicenter study of 84 patients who underwent concomitant CABG to aortic surgery and anastomosis of the 109 CABG graft anastomosed either to the native aorta or to the vascular prosthesis. The patency evaluated by CT angiography or coronary angiography was significantly worse for those grafts anastomosed to the vascular graft compared to the native aorta.
In this article, Drs Ceppa et al provide an ad hoc analysis of women in cardiothoracic surgery from the Society of Thoracic Surgeons 2019 workforce report.
In this article in the Journal of Thoracic and Cardiovascular Surgery, Drs Norton et al performed a single institution retrospective analysis of outcomes of 182 patients with acute type B aortic dissection who underwent fenestration/stenting for suspected malperfusion. They demonstrate the laudible outcomes in this patient population, with 0% new onset paraplegia and 7.7% in-hospital mortality in this high-risk patient population, where acute paralysis was a significant risk factor for late mortality. Overall, endovascular fenestration/stenting can be associated with acceptable short- and long-term outcomes.
In this article, Drs Malaisrie and Mehta discuss updates on the indications for TEVAR in type B aortic dissection with comparison of the guidelines from The Society of Thoracic Surgeons, Society of Vascular Surgery, American Heart Association, American College of Cardiology, the European Society of Cardiology, and the Japanese Circulation Society.
Wang et al. present a retrospective single-center study on 712 patients with acute type A dissection who underwent repair utilizing hypothermic circulatory arrest. Within their cohort, preoperative Cystatin-C level and mechanical ventilation times were independent risk factors for acute kidney injury after aortic surgery. Furthermore, acute kidney injury was associated with increased short-term mortality.
Kitamura et al. present a single-center study looking into the outcomes of patients with acute type A intramural hematoma. Within their Japanese collective, patients showing an aortic diameter ≤ 50 mm, no ulcer-like projection, and a pain score of ≤ 3/10 had to be operated on in only 17% of cases, and had a low hospital mortality of 4%. They conclude a watch-and-wait strategy to be reasonable in this very specific patient cohort.
An analysis, from the cardiology viewpoint, of the MI nomenclature issues around the external validity of the EXCEL trial that undermined the EACTS support of the relevant 2018 guidelines
This is an a comprehensive consensus document on post-cardiotomy extracorporeal life support (PC-ECLS) jointly released by the European Association for Cardio-Thoracic Surgery (EACTS), the Extracorporeal Life Support Organization (ELSO), the Society of Thoracic Surgeons (STS) and the American Association for Thoracic Surgery (AATS). This position statement is focused on the most relevant issues to optimize indications and applications, to suggest configurations of PC-ECLS, to avoid or manage complications and to improve outcomes.
An unprecedented position piece signed by all editors of the NEJM condemning US political leadership for their response to the pandemic.
At the first day of its 34th Annual Meeting, the European Association for Cardio-Thoracic Surgery (EACTS) released the "Current Options and Recommendations for the Use of Thoracic Endovascular Aortic Repair in Acute and Chronic Thoracic Aortic Disease. This is an expert consensus document jointly drafted by the European Society for Cardiology (ESC) Working Group of Cardiovascular Surgery, the ESC Working Group on Aorta and Peripheral Vascular Diseases, the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC and the European Association for Cardio-Thoracic Surgery (EACTS). It is intended to provide a synopsis of current evidence regarding the use of TEVAR in acute and chronic thoracic aortic disease, to share latest recommendations for a modified terminology and reporting standards, and to take a glimpse at the trends of future development.