Journal and News Scan

Following the withdrawal of Professor Taggart’s name from the author list of the EXCEL trial, the BBC in the UK have filmed a full exposé of some of the background to this decision. Secretary General of EACTS, Dominic Pagano, has stated that if the allegations are true, then perhaps support should be withdrawn for the current guidelines that PCI is equivalent to bypass grafting. 

It looks like the published results of this trial in The New England Journal of Medicine are unravelling and either this paper will need to be withdrawn and re-published, or extensive modifications must be made. Let us know what you think after reading this article.

Abe and associates reported the trends in the early outcomes of surgical repair for acute type A aortic dissection in 11,843 patients from the Japan Cardiovascular Surgery Database between 2008 and 2015. Operative mortality was 9.5% and 30-day mortality was 7.6%. The number of surgically treated cases increased by 45% during the interval. A signficant upward trend was found in patient age and the incidences of preoperative renal failure. Unadjusted operative mortality rate with arch replacement showed a significant downward trend (P = 0.01). Risk-adjusted mortality rate showed a downward trend both in ascending aortic or hemiarch and arch replacement, which did not reach statistical signficance.  

Succinct commentary on the challenge of vascular access in ECMO circuits on the occasion of a manuscript on a novel design of a multi-access adaptor.

Higher case volumes (>10 annually) were associated with  decreased mortality for surgical treatment of aortic dissection. This relationship was not evident for thoracic endovascular aortic repair.