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Journal and News Scan
This month's update on the economical and general aspects of the ROOBY-FS trial. The conclusion (on no impact of de novo post-CABG AF on the incidence of stroke nor the 5 year expenditure ) challenges many hitherto perceptions on this frequent compication of coronary surgery.
An authoritative, scholarly but very readable review of the evolution of mechanical circulatory support of the left ventricle from the non-surgical standpoint.
A large RCT concluding that 'surgical occlusion of the left atrial appendage provides additional protection against stroke when added to anticoagulation.' A number of limitations are briefly discussed. Findings are interesting in that absolute absence of surgical complications has been declared.
The updated version of an expert viewpoint on resources for management of acute aortic syndrome in the United States is presented. The esteemed authors advance the position of positive volume–outcome relationship for surgery for acute De Bakey I and II (ATAAD). They provide a historical perspective in favor of specialization and they comment on data on transferring the victims of ATAAD to aortic centers. The primary outcome measure is that of operative mortality rather than stroke. The case made is also relevant to European and global trends, although the geography, telecommunication, transport and health systems vary considerably from country to country.