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Journal and News Scan

Source: European Journal of Cardio-Thoracic Surgery
Author(s): Takafumi Inoue, Yoshihiro Suematsu

Inoue and Suematsu report their experience using a minimally invasive approach to left atrial appendage resection. The procedure was performed in 87 patients using an endoscopic linear cutter device, without cardiopulmonary bypass or cardiac arrest. The authors found no change in cardiac function and no thrombus formation during patient follow-up three months after the operation.

Source: The Annals of Thoracic Surgery
Author(s): Edward Buratto, Brandon Khoo, Xin Tao Ye, Michael Daley, Christian P. Brizard, Yves d’Udekem, Igor E. Konstantinov

Buratto and colleagues retrospectively analyzed the outcomes of 68 patients with atrioventricular septal defects (AVSD) who underwent pulmonary artery banding between 1983 and 2016. Of these, 40 patients had balanced AVSD and 28 patients had unbalanced AVSD. Pulmonary arterial banding was not associated with a short-term increase in atrioventricular valve regurgitation for either group. Patients with unbalanced AVSD did not have a higher rate of atrioventricular valve reoperation than in previous series of patients without pulmonary artery banding. Patients with balanced AVSD did have a higher rate of valve reoperation than reported in previous series, though the authors speculate that the higher rate of reoperation might have been due to an increased severity of disease. The authors conclude that pulmonary artery banding can be used in patients with AVSD without affecting early survival or compromising atrioventricular valve function.

Source: News from around the web.
Author(s): Claire Vernon

Patient Care and General Interest

A 7-year-old girl who received a heart transplant as an infant is now competing in the Canadian Transplant Games, which are underway at the University of British Columbia in Vancouver, Canada.

The Lung Cancer Alliance held its National Advocacy Summit in the US capitol, working to increase awareness of the disease and support for research. Thoracic surgeons in the US also join the call for increased funding for lung cancer research.

A surgical team from Dubai, UAE, performs free heart surgery for children in Mumbai, India, as part of the Nabadat initiative of the Mohamed bin Rashid Charity and Humanitarian Establishment.

England’s National Health Service has approved routine funding for percutaneous left atrial appendage occlusion for patients with atrial fibrillation who cannot take blood thinning medication.


Drugs and Devices

The US Food and Drug Administration has approved the next-generation MitraClip® from Abbott. The device received the CE Mark earlier this year.


Research, Trials, and Funding

Working in pigs, researchers have demonstrated the feasibility of a micropacemaker, a leadless pacemaker that is percutaneously inserted into the pericardial space.

Source: Interactive Cardiovascular and Thoracic Surgery
Author(s): Grigorios Papageorgiou, Stuart W Grant, Johanna JM Takkenberg, Mostafa M Mokhles

Papageorgiou and colleagues discuss dealing with missing data, a common challenge in clinical research. Although the best approach is to minimize the amount of missing data through good study design and data collection protocols, missing data cannot always be avoided and they must be treated appropriately to maintain the validity of the statistical inferences from a study. The authors outline the different reasons that data may be missing and they discuss the methods for handling these types of missing data, including limitations of such methods. Finally, they provide an example using the scenario of a study of congenital heart disease patients receiving an aortic allograft.

Source: Annals of Cardiothoracic Surgery
Author(s): Giampiero Esposito, Antonio Pignatelli, Gaetano Contegiacomo, Giangiuseppe Cappabianca, Cesare Beghi, Carlo Lafranceschina, Fabio Tiecco, Francesco Bartolomucci, Matteo Miccoli, Massimiliano Conte

In this illustrated article, Esposito and colleagues outline the Lupiae technique for hybrid three-stage repair of mega aorta. The technique includes initial surgical replacement of the ascending aorta and proximal rerouting of the aortic arch vessels, followed by delayed surgical replacement of the infrarenal aorta with distal rerouting of the visceral and renal vessels, which then facilitates an endovascular approach for subsequent complete exclusion of the residual diseased aorta between the surgically shaped proximal and distal Dacron landing zone. The authors describe the outcomes for 27 patients treated with this approach, and they discuss tips for a safe and effective procedure.

Source: The Lancet
Author(s): The Lancet Editors

In an announcement entitled "Retraction—Tracheobronchial transplantation with a stem-cell-seeded bioartificial nanocomposite: a proof-of-concept study," the results of an investigation by the Karolinska Institute were shared with The Lancet, resulting in retraction of what had appeared to be an exciting new development in transplantation and airway reconstruction.  Hopefully this puts to rest this long and disturbing saga of scientific and ethical misconduct.

Source: News from around the web.
Author(s): Claire Vernon

Patient Care and General Interest

The Israeli nonprofit organization Save a Child’s Heart received the United Nations’ Population Award, in recognition of its work providing congenital cardiac surgery to children in developing countries.

Several hospitals in the UAE have added pulse CO-oximeters with technology that integrates with a patient’s electronic health record to improve screening for critical congenital heart defects.


Drugs and Devices

The US Food and Drug Administration has approved the Zephyr Endobronchial Valve from Pulmonx Corp to treat severe emphysema.


Research, Trials, and Funding

Researchers in Boston, USA, and Xi’an, China, find that nitric oxide administration during and after cardiopulmonary bypass might reduce postoperative kidney injury.

A team of medical anthropologists evaluated cooperation and conflict in the operating rooms of different surgical specialties, and they report their observations in the journal PNAS.

JenaValve Technology has launched a study of its JenaValve transcatheter aortic valve for the treatment of severe aortic regurgitation, which the company hopes will inform its anticipated application for CE mark approval in 2019.

Facilities voluntarily participating in the US Medicare’s Bundled Payments for Care Improvement programs for cardiac care are more likely to be large, high-resource centers, which may limit the generalizability of these models.

Source: Journal of Thoracic Oncology
Author(s): Ryota Nakamura, Yoshihisa Inage, Rika Tobita, Satoshi Yoneyama, Takeshi Numata, Kyoko Ota, Hidetoshi Yanai, Takeo Endo, Yukinori Inadome, Shingo Sakashita, Hiroaki Satoh, Kenji Yuzawa, Toru Terashima

This retrospective study of 328 patients undergoing resection for non-small cell lung cancer demonstrated that sarcopenia determined by psoas muscle mass on computed tomography was associated with increased postoperative complications and was an independent predictor of survival.

Source: Circulation Research
Author(s): Mariann Gyöngyösi, Paul M. Haller, Derek J. Blake, Enca Martin Rendon

A detailed and somewhat disheartening analysis of stem cell therapy for cardiac failure.

Source: World Journal for Pediatric and Congenital Heart Surgery
Author(s): Joseph A. Dearani

Joseph Dearani, Chair of the Department of Cardiovascular Surgery at the Mayo Clinic in Rochester, Minnesota, graciously shares a copy of the letter with which he welcomes cardiothoracic surgery residents as they embark on their rotation on his service. Dr Dearani’s letter describes the importance of professionalism, preparedness, responsibility, introspection, and honesty to both self and others. It would be equally appropriate as an essay defining the key elements of a successful and productive relationship between a trainee and mentor in any surgical subspecialty.