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Journal and News Scan

Source: Journal of Vascular Surgery
Author(s): Joseph V. Lombardi, MD (SVS Co-Chair), G. Chad Hughes, MD (STS Co-Chair), Jehangir J. Appoo, MD,Joseph E. Bavaria, MD,Adam W. Beck, MD, Richard P. Cambria, MD,Kristofer Charlton-Ouw, MD,Mohammad H. Eslami, MD, Karen M. Kim, MD,Bradley G. Leshnower, MD,Thomas Maldonado, MD,T. Brett Reece, MD, Grace J. Wang, MD,

The SVS and STS produced a document that offers a framework of language, including definitions of nomenclature and a description for a new classification system, to allow for more detailed discussions and reporting of type B aortic dissections.

Source: The Journal of Thoracic and Cardiovascular Surgery
Author(s): Roberto Lorusso, Glenn Whitman, Milan Milojevic, Giuseppe Raffa, David M. McMullan, Udo Boeken, Jonathan Haft, Christian Bermudez, Ashish Shah, David A. D'Alessandro

A most comprehensive practice guideline, relevant not only to surgeons involved in VA ECMO, but also all cardiac and thoracic colleagues and perioperative clinicians.

The discussion on the need of modifying the antithrombotic modulation in recipients of post-cardiotomy ECMO (21) and the chapter on vascular complications (12.3) are particularly stimulating in terms of future research.

Source: JACC Imaging
Author(s): Gilbert H. L. Tang, MD, MSc, MBA

In the special April issue of JACC Imaging focusing on secondary mitral regurgitation (SMR), a number of articles on outcomes after transcatheter edge-to-edge repair (TEER) are reported. Specifically, the concept of proportionate vs disproportionate SMR was explored. Studies evaluated proportionality of SMR based on effective regurgitant orfice area (EROA) to left ventricular end-diastolic volume (LVEDV) and found a lower ratio (i.e., more proportionate SMR) had reduced benefit after TEER. Similarly, the ratio of regurgitant volume to LVEDV was found to impact survival with only medical therapy among those with high ratio, but benefit was observed after TEER. Yet, in MITRA-FR randomized trial, neither of these 2 parameters were predictive of outcomes after TEER vs optimal guideline-directed medical therapy (GDMT). Another concept looking total leaflet area to annular area ratio showed that a reduced ratio was associated with suboptimal MR reduction after TEER, likely due to inadequate coaptation reserve. In a study evaluating atrial SMR, a relatively new entity suggesting SMR due to left atrial enlargement and type 1 dysfunction, outcomes were poor except when surgery was performed. An important article on echo evaluation of MR was also presented, as well as CT evaluation of neo-LVOT on evaluation of anatomic feasibility of transcatheter mitral valve replacement (TMVR). Overall, this is a must-read issue from JACC Imaging if you want to learn the latest on research into SMR.

Source: The Annals of Thoracic Surgery
Author(s): Camille Yongue, MD, Diana C. Lopez, BS, Edward G. Soltesz, MD, MPH, Eric E. Roselli, MD, Faisal G. Bakaeen, MD, A. Marc Gillinov, MD, Go€sta B. Pettersson, MD, PhD, Marie E. Semple, MPH, Jeevanantham Rajeswaran, PhD, Michael Z. Tong, MD, MBA, Wael Jaber, MD, Eugene H. Blackstone, MD, Lars G. Svensson, MD, PhD, and Douglas R. Johnston, MD

This study, conducted at the Cleveland Clinic, investigated reports of failure of the Trifecta externally wrapped, bovine pericardial aortic valve prosthesis (Abbott Laboratories, Abbott Park, IL). Concerns were raised about the long-term Trifecta durability.

Source: The Annals of Thoracic Surgery
Author(s): DuyKhanh P Ceppa , John S Ikonomidis , Lava R Timsina, Natalie Boden, Lauren C Kane , Jessica S Donington

The Society of Thoracic Surgeons' most recent Practice Survey was executed in the fall of 2019, the results of which were discussed at their 2020 annual meeting. Women in Thoracic Surgery, in conjunction with STS, reviewed those results, with a focus on female respondents. Women remain a significantly small subset of the cardiothoracic workforce.

Source: The Annals of Thoracic Surgery
Author(s): Keiichi Hirose, MD, PhD, Akio Ikai, MD, PhD, Masaya Murata, MD, Hiroki Ito, MD, Hiroshi Koshiyama, MD, Motonari Ishidou, MD, Keisuke Ota, MD, Kentaro Watanabe, MD, Eiji Nakatani, PhD, and Kisaburo Sakamoto, MD
Patients who undergo eTCPC and ieTCPC appear to have excellent clinical outcomes, suggesting that ieTCPC may be a good option for TCPC cases with anatomical complexity.
Source: The Annals of Thoracic Surgery
Author(s): Amit Saha, MD, Douglas L. Jennings, PharmD, Yuming Ning, PhD, Paul Kurlansky, MD, Andrea N. Miltiades, MD, Jessica L. Spellman, MD, Joseph Sanchez, MD, Melana Yuzefpolskaya, MD, Paolo C. Colombo, MD, Hiroo Takayama, MD, PhD, Yoshifumi Naka, MD, PhD, and Koji Takeda, MD, PhD
This investigation studied the effectiveness of methylene blue (MB) for vasoplegia in LVAD recipients and found that clinical outcomes did not improve after LVAD implantation.
Source: The New England Journal of Medicine
Author(s): Fatima Rodriguez MD, MPH and Robert A Harrington MD

This review nicely summarizes the recommendations for antithrombotic therapy in the setting of acute coronary syndromes.  In a section relevant to cardiac surgeons, they suggest that patients who undergo CABG surgery in the setting of an acute coronary syndrome should be similarly treated with dual antiplatelet therapy.

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Silvia Mas-Peiro, Gloria Faerber, Dimitra Bon, Eva Herrmann, Timm Bauer, Sabine Bleiziffer, Raffi Bekeredjian, Andreas Böning, Christian Frerker, Andreas Beckmann, Helge Möllmann, Mariuca Vasa-Nicotera, Stephan Ensminger, Christian W Hamm, Friedhelm Beyersdorf, Stephan Fichtlscherer, Thomas Walther for the GARY-Executive Board
This analysis presents the impact of chronic kidney disease on patients undergoing TAVI or SAVR procedures.
Source: The Annals of Thoracic Surgery
Author(s): Erin M. Corsini, MD, MSc, Nicolas Zhou, DO, Mara B. Antonoff, MD, Reza J. Mehran, MD, David C. Rice, MD, Jack A. Roth, MD, Boris Sepesi, MD, Stephen G. Swisher, MD, Ara A. Vaporciyan, MD, Garrett L. Walsh, MD, and Wayne L. Hofstetter, MD
This study analyzes the medication Ketorolac when used for acute kidney injury or bleeding after surgery.