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Journal and News Scan

Source: JAMA Network Open
Author(s): James W. Suliburk, Quentin M. Buck, Chris J. Pirko, Nader N. Massarweh, Neal R. Barshes, Hardeep Singh, Todd K. Rosengart

In a QI study of nearly 5,400 operations, 188 adverse events were recorded.  Of these, over 56% were associated with human error.  Of all human performance deficiencies, cognitive error accounted for over half.

Source: JAMA Internal Medicine
Author(s): James D. Douketis, Alex C. Spyropoulos, Joanne Duncan, Marc Carrier, Gregoire Le Gal, Alfonso J. Tafur, Thomas Vanassche, Peter Verhamme, Sudeep Shivakumar, Peter L. Gross, Agnes Y. Y. Lee, Erik Yeo, Susan Solymoss, Jeannine Kassis, Geneviève Le Templier, Stephen Kowalski, Mark Blostein, Vinay Shah, Elizabeth MacKay, Cynthia Wu, Nathan P. Clark, Shannon M. Bates, Frederick A. Spencer, Eleni Arnaoutoglou, Michiel Coppens, Donald M. Arnold, Joseph A. Caprini, Na Li, Karen A. Moffat, Summer Syed, Sam Schulman

A standardized perioperative management protocol for pts taking direct oral anticoagulants for atrial fibrillation entailed no bridging with other anticoagulants.  It resulted in low and acceptable rates of major bleeding (<2%) and stroke (<1%). 

Source: Infection Control and Hospital Epidemiology
Author(s): Lili Jiang, Allison McGeer, Shelly McNeil, Kevin Katz, Mark Loeb, Matthew P. Muller, Andrew Simor, Jeff Powis, Philipp Kohler, Julia M. Di Bella, Brenda L. Coleman for the Canadian Healthcare Worker Study Group

Ever wonder why your patients get respiratory infections postoperatively? Here's another risk factor. Almost 95% of hospital caregivers completed at least one shift while ill with an acute upper respiratory infection during flu season, despite hospital policies against such behavior. This was more common among physicians than among nurses.   

Source: Journal of Thoracic and Cardiovascular Surgery
Author(s): JTCVS

JTCVS just published a call for proposals of joining the Cardiac Surgery Intersociety Alliance (CSIA) as pilot sites. CSIA is jointly overseen by the AATS, EACTS, STS, the Asian Society for Cardiovascular and Thoracic Surgery, and the World Heart Federation. The mission of CSIA is to evaluate, endorse, and work with potential sites in low-income countries to increase access to sustainable heart surgery, with particular emphasis on rheumatic heart disease.

Source: US Food and Drug Administration
Author(s): FDA

The FDA-approved use of TAVR has now expanded to low-risk patients with severe aortic stenosis.  This includes both Edwards Lifesciences' Sapien 3 and Sapien 3 Ultra as well as Medtronic's  Evolut R and Evolut PRO.   

Source: The Annals of Thoracic Surgery
Author(s): Jennifer S. Nelson, Timothy M. Maul, Peter D. Wearden, Sara K. Pasquali, Jennifer C. Romano

Nelson and colleagues analyzed data from The Society of Thoracic Surgeons Congenital Heart Surgery Database on 3446 aortic valve replacement procedures performed between 2000 and 2016. The authors found that practice patterns varied widely, though autograft usage was higher at high-volume centers. Additionally, homografts were found to have higher rates of mortality and major complications than other valve types.

Source: JAMA Surgery
Author(s): J. Madison Hyer, Aslam Ejaz, Diamantis I. Tsilimigras, Anghela Z. Paredes, Rittal Mehta, Timothy M. Pawlik

Using a machine learning algorithm, resource utilization among more than 1 million Medicare patients undergoing one of 6 operations including CABG and lung resection was analyzed.  Super users comprised 4.8% of the cohort but consumed 31.7% of the resources.  Risk factors for super use included paraplegia/hemiplegia, weight loss, and CHF combined with chronic kidney disease. 

Source: JAMA Surgery
Author(s): Kyle H. Sheetz, Karan R. Chhabra, Margaret E. Smith, Justin B. Dimick, Hari Nathan

Regionalization of care for complex problems remains an open question in most countries. This review demonstrated that, for high risk cancer operations in the US, the Leapfrog group's volume standards did not differentiate between surgical mortality outcomes for lung and esophageal cancer surgery. However, differences were evident comparing lowest and highest volume quintiles for operative mortality associated with these procedures. The percentage of hospitals meeting Leapfrog volume criteria increased for lung cancer surgery but recently decreased for esophageal cancer surgery; the latter finding is a reversal of an organic trend towards regionalization of esophageal cancer care over the prior decade and is of concern.

Source: University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories
Author(s): Henry D. Tazelaar

A comprehensive audio lecture from an academic pathologist on non-malignant pulmonary lesions.

Source: Circulation Research
Author(s): Kimon Stamatelopoulos, Georgios A Georgiopoulos, Fani Athanasouli, Panagiota-Efstathia Nikolaou, Marita Lykka, Maria Roussou, Maria Gavriatopoulou, Ageliki Laina, Georgia Trakada, Marietta Charakida, Dimitris Delialis, Ioannis Petropoulos, Constantinos Pamboukas, Efstathios Manios, Marina Karakitsou, Christos Papamichael, Aikaterini Gatsiou, Irene V Lambrinoudaki, Evangelos Terpos, Konstantinos Stellos, Ioanna Andreadou, Meletios A Dimopoulos, Efstathios Kastritis, Kimon Stamatelopoulos, Georgios A Georgiopoulos, Fani Athanasouli, Panagiota-Efstathia Nikolaou, Marita Lykka, Maria Roussou, Maria Gavriatopoulou, Ageliki Laina, Georgia Trakada, Marietta Charakida, Dimitris Delialis, Ioannis Petropoulos, Constantinos Pamboukas, Efstathios Manios, Marina Karakitsou, Christos Papamichael, Aikaterini Gatsiou, Irene V Lambrinoudaki, Evangelos Terpos, Konstantinos Stellos, Ioanna Andreadou, Meletios A Dimopoulos, Efstathios Kastritis

The translational value for cardiac transplantation of this prospective multi-centre clinical study of vasodilation in amyloidosis remains to be evaluated.

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